Getting down to basics

The project team, led by Dr Ineke Klinge of the University of Maastricht in The Netherlands, analysed the factors which facilitated or inhibited the incorporation of the gender dimension into basic, preclinical and clinical research in selected EU-funded life sciences projects and at leading European research institutes. They also commissioned international experts on sex, gender and health to write review articles on the relevant methodological, practical, ethical and financial issues as well as the impacts of sex and gender on a number of diseases and conditions. The articles appeared in a special edition of the journal Gender Medicine (Vol. 4, Suppl. B, Dec. 2007).

Based on their analyses, the GenderBasic scientists produced a set of recommendations to help scientists, funding agencies, the pharmaceutical industry, governments and other stakeholders ensure that sex and gender differences are given the attention they deserve.

When factoring in gender can save lives

The review articles commissioned by the project highlight the extent to which disease susceptibility differs between the sexes. For example, before puberty, asthma is more common in boys than in girls. In adulthood however, it is more common in women. The scientists speculate that a combination of hormonal changes and genetic susceptibility could contribute to the change in prevalence during adolescence.

Among other things, the paper calls for more studies in animals investigating the observed differences between males and females and their susceptibility to hormonal and environmental factors in relation to lung development. It also underlines the importance of studying differences in response to treatments.

Another article reveals how the absence of gender balance in research can also have negative consequences for men. The paper is about osteoporosis and fracture risk research. Sex hormones play an important role in bone development, and differences in the levels of these hormones mean that men have structurally stronger bones and so experience fewer fractures than women.

Currently, much of our understanding of osteoporosis and fracture risk is based on research on women, and most of the drugs used to treat osteoporosis were only tested on women. In contrast, detailed data on men is lacking.

Osteoporosis and fracture risk are underdiagnosed in women, but the problem is even greater in men. This problem is compounded by the fact that because women have more frequent screening opportunities than men, their problems are usually picked up at an earlier stage.

For both examples, studying the impact of gender role behaviour in relation to disease development and management was emphasised. The study of the interaction of sex and gender from a life-course perspective was firmly put on the research agenda.

Closing the gap – recommendations for gendered innovations in research

If the research community is to tackle this serious problem, action is needed on a number of fronts. Among other things, the project partners recommend that research studies and clinical trials should include both men and women as subjects, and if this is not the case, researchers should explain why one sex has been left out. Furthermore, results should be disaggregated by sex.

This consideration of the impact of sex on health outcomes should also be considered by those carrying out research on animals or on tissue samples taken from humans.

Research funding agencies are called on to promote research that links biomedical and social dimensions, including gender dimensions. The editorial boards of journals are encouraged to request that papers present data disaggregated by sex and explain sex and gender differences adequately.

Meanwhile, the GenderBasic researchers are still driving forward their aim of integrating sex and gender into research. They are particularly keen to turn their results into a training module, aimed at the research community, on the sex and gender aspects of biomedical and public health research.

‘I really think that for life sciences and health research, it is integral to view the sexes as different from the molecular to the social level,’ comments Dr Klinge. ‘Gender experts have a lot of expertise to offer concerning the influence of gender in biomedical and public health research and this was very well acknowledged in the project. I think one of our major strategies is to convince people to see that addressing sex and gender aspects is not necessarily feminist but a question of quality of research.’