Addressing sex and gender bias in health: now is the time

Sex and gender affect health in countless ways – from the conditions people develop, the symptoms they experience, the treatment they receive, to their overall outcomes. Sometimes these differences disadvantage men, but more often they disadvantage women, as well as people with variations of sex characteristics (intersex), trans people, and gender diverse people, causing a sex and gender health gap.

Recognising the sex and gender health gap

Health isn’t one-size-fits-all. Sex and gender gaps in health research and care exist because, for too long, cisgender men have been treated as the ‘standard’ in medicine. This standard is the result of a system that has made sex and gender differences invisible by not paying attention to them and by simplifying research for convenience rather than accuracy.

With research primarily conducted on male cells, male mice and male humans, and clinical care guidelines developed based on male symptoms and responses to treatment, a sex and gender health gap persists that disadvantages people who do not fit this so-called ‘standard’. This disadvantage permeates all aspects of health and care, often resulting in delays to diagnosis and treatment, and inappropriate prescribing and dosing of medicines.

Closing the sex and gender health gap holds the potential to benefit health outcomes, systems, economies and, ultimately, to achieve equity – with more of us living longer, healthier lives.

We are working to promote lifelong health for all

At The George Institute for Global Health, we are working towards clear answers and solutions to the sex and gender health gap with the aim of promoting lifelong health no matter a person’s sex or gender.

We know that health is not sex or gender-neutral. But by understanding the causes of the disparities through our research and collaborations, we can support healthcare services, pharmaceutical companies, educational institutions, and governments to develop more targeted, cost-effective, and safer interventions. We also want researchers to build sex and gender considerations into their work, for research funders to reflect this as a requirement in their policies, and for medical and allied health students and professionals to be educated on the issue.

How we are addressing the problem

By collaborating with research funders, academics, journal publishers, health policymakers, healthcare professionals, community groups and individuals with lived experience across the world we are filling evidence gaps and creating lasting impact. We are:

• Improving the integration of sex and gender considerations in biomedical, health and care research in the United Kingdom through the Medical Science Sex and Gender Equity (MESSAGE) project. This is crucial because if research does not include women, intersex and gender diverse people, and disaggregate data accordingly, conclusions may miss the real story, risking compromised quality of care and increasing costs due to inappropriate resource allocation.
• Conducting sex-specific analyses to better understand the differences in how women and men present with, are diagnosed, managed and treated for diseases, focusing in particular on heart disease, stroke, dementia and diabetes. To date, discoveries include findings that well-known risk factors, such as smoking and diseases like diabetes, modify risk of non-communicable diseases differently in women and men. Insights from this work will inform sex-specific changes to treatment for better health outcomes.
• Addressing gaps in the collection, analysis and reporting of sex and gender in health and medical research in Australia, including under-representation of women in clinical trials, such as those for stroke. Sex and gender equity in medical research and healthcare provision is only achieved through representation across the ecosystem. From the funding and reporting of research that recognises – and seeks to respond to – evidence gaps in differences and similarities between women and men, through to representation of women and other underserved populations in clinical trials and health research, and at the highest editorial levels of academic journals.
• Bringing together the best minds in Australia to address the effects of sex and gender on health outcomes through the first national Centre for Sex and Gender Equity in Health and Medicine. The initiative launched in March 2024 as an outcome of our three-year research project with the Australian Human Rights Institute at UNSW Sydney. New partner Deakin University has joined and we have strong support from collaborative partners the Victorian Department of Health and the Association of Australian Medical Research Institutes, with the New South Wales Department of Health sponsoring the launch symposium. Meanwhile, in the United Kingdom, our Women’s Health Network of Excellence based at Imperial College London connects colleagues interested in women’s health and sex- and gender-based health equity.

Our sex and gender initiatives are a core component of The George Institute’s Women’s Health Programme which addresses women’s lifelong health. For over 20 years we have worked to better understand the unique health experiences of women and other disadvantaged population groups.

Factoring in sex and gender considerations is not only sound science but also results in improved health for everyone, particularly that of women, and intersex and gender-diverse people. Be a part of this fairer, healthier future.