How to integrate sex and gender into research
The following tools are available to help researchers:
- Distinguish between and define sex and gender in health research;
- Identify sex and gender differences in the mechanism, disease or treatment under study;
- Identify methods for integrating sex and gender variables in health research contexts; and
- Assess a research protocol or publication based on the integration or omission of sex and/or gender.
Definitions
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Sex
Sex refers to a set of biological attributes in humans and animals. It is primarily associated with physical and physiological features including chromosomes, gene expression, hormone levels and function, and reproductive/sexual anatomy. Sex is usually categorized as female or male but there is variation in the biological attributes that comprise sex and how those attributes are expressed. Download Sex and Gender Infographic.
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Gender
Gender refers to the socially constructed roles, behaviours, expressions and identities of girls, women, boys, men, and gender diverse people. It influences how people perceive themselves and each other, how they act and interact, and the distribution of power and resources in society. Gender is usually conceptualized as a binary (girl/woman and boy/man) yet there is considerable diversity in how individuals and groups understand, experience, and express it. Download Sex and Gender Infographic.
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Sex- and Gender-Based Analysis (SGBA)
Sex- and Gender-Based Analysis (SGBA) is an approach that systematically examines sex-based (biological) and gender-based (socio-cultural) differences between men, women, boys, girls and gender-diverse people. The purpose of SGBA is to promote rigorous science that considers sex and gender and therefore has the potential to expand our understanding of health determinants for all people. SGBA is meant to be applied within the context of a diversity framework that considers the ways in which determinants such as ethnicity, socioeconomic status, disability, sexual orientation, migration status, age and geography interact with sex and/or gender to contribute to exposures to various risk factors, disease courses and outcomes. Applying SGBA brings these considerations into focus and can help formulate health research, policies and programs that are relevant to the diversity of the Canadian population.
Below are some guidelines, tools and resources to help researchers and reviewers better account for sex and gender in health research. CIHR expects that all research applicants will integrate sex and gender into their research designs, methods and analyses and interpretation and/or dissemination of findings when appropriate.
Whether you are an applicant or a peer reviewer, we encourage you to familiarize yourself with the training resources available to help you perform your important work. A series of FAQs will be available soon.
Applicants
All Applicants
To continue to support applicants' efforts to learn more about how and why to consider sex and gender in their research, the following tools are available:
- What is Gender? What is Sex?
- Online training modules:
- Sex and Gender in Biomedical Research
- Sex and Gender in Primary Data Collection with Human Participants
- Sex and Gender in the Analysis of Secondary Data from Human Participants
- Video: Assessing Sex and Gender in Peer Review
- Video: Learning about Sex and Gender
- Video: Shaping science for a healthier world
- Webinar: Accounting for Sex and Gender in Research with Cells or Animals
- Webcast: The X Factor: Accounting for Sex in Biomedical Research
- Why Do We Need an Institute of Gender and Health?
- Key considerations for the appropriate integration of sex and gender in research
- Better science with sex and gender: Facilitating the use of a sex and gender-based analysis in health research
- How to study the impact of sex and gender in medical research: a review of resources
- Sex and Gender Equity in Research (SAGER) Guidelines (European Association of Science Editors)
- ARRIVE (Animal Research: Reporting of In Vivo Experiments) Guidelines (NCR3)
- Reviewer Guidance to Evaluate Sex as a Biological Variable (U.S. National Institutes of Health)
- Strategies and methods to study sex differences in cardiovascular structure and function: a guide for basic scientists
- Other learning resources
- Sex and Gender Champions
- Considerations for Inclusion of Women in Clinical Trials and Analysis of Sex Differences(Health Canada)
- Sex, Gender and Knowledge Translation
- Rising to the Challenge: Sex- and gender-based analysis for health planning, policy and research in Canada
- The Ethical Imperative of Sex and Gender Considerations in Health Research
- Sex/Gender-Responsive Assessment Scale for Health Research
Biomedical
Guidance documents
- Studying both sexes: a guiding principle for biomedicine (U.S. National Institutes of Health)
- ARRIVE (Animal Research: Reporting of In Vivo Experiments) Guidelines [ PDF (36 KB) - external link ] (NCR3)
- Rigor and Reproducibility in Grant Applications (U.S. National Institutes of Health)
- Considering sex as a biological variable in preclinical research (U.S. National Institutes of Health)
- Sexing 101 (sexing rats and mice) (American Fancy Rat & Mouse Association)
- GISTeR Cell Database
Key articles and reports
- Female mice liberated for inclusion in neuroscience and biomedical research
- Female rats are not more variable than male rats: a meta-analysis of neuroscience studies
- Perspective: Equality need not be painful
- Sex bias in neuroscience and biomedical research
- SeXX matters in immunity
- Do you know the sex of your cells? Table of the most commonly used cell lines appearing in AJP-Cell Physiology
- Sex Matters for Mechanism
- The role of sex in the genomics of human complex traits
Clinical
Guidance documents
- Reporting Sex, Gender, or Both in Clinical Research?
- Considerations and guidance in designing equity-relevant clinical trials
- When is a randomised controlled trial health equity relevant? Development and validation of a conceptual framework
- Gender Sensitive Aspects of 21st Century Health Care (for health care professionals and the public) (Gender in coronary artery disease in Europe) (GenCAD)
- Considerations for Inclusion of Women in Clinical Trials and Analysis of Sex Differences (Health Canada)
Key articles and reports
- Essential metrics for assessing sex & gender integration in health research proposals involving human participants
- Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review
- Sex and gender considerations in Canadian clinical practice guidelines: a systematic review
- Sex and gender influence on pharmacological response: an overview
- Sex Versus Gender-Related Characteristics: Which Predicts Outcome After Acute Coronary Syndrome in the Young?
- Older men with dementia are at greater risk than women of serious events after initiating antipsychotic therapy
- Gender role affects experimental pain responses: A systematic review with meta-analysis
- Sex differences in pain: A brief review of clinical and experimental findings
Health Systems and Services
Guidance documents
- Measuring gender when you don't have a gender measure: constructing a gender index using survey data
- Essential metrics for assessing sex & gender integration in health research proposals involving human participants
- Gender Sensitive Aspects of 21st Century Health Care (for health care professionals and the public) (Gender in coronary artery disease in Europe) (GenCAD)
Key articles and reports
- How to do (or not to do)…gender analysis in health systems research
- Why sex and gender matter in implementation research
- Rising to the Challenge: Sex- and gender-based analysis for health planning, policy and research in Canada
- How can gender equality be addressed through health systems? [ PDF (327 KB) - external link ]
- Ten arguments for why gender should be a central focus for universal health coverage advocates
- Does a change in health research funding policy related to the integration of sex and gender have an impact?
Population Health
Guidance documents
- Measuring gender when you don't have a gender measure: constructing a gender index using survey data
- Essential metrics for assessing sex & gender integration in health research proposals involving human participants
- Development and Evaluation of ‘Briefing Notes’ as a Novel Knowledge Translation Tool to Aid the Implementation of Sex/Gender Analysis in Systematic Reviews: A Pilot Study
- Gender Sensitive Aspects of 21st Century Health Care (for health care professionals and the public) (Gender in coronary artery disease in Europe) (GenCAD)
Key articles and reports
- Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity
- Why sex and gender matter in implementation research
- A new method for estimating race/ethnicity and associated disparities where administrative records lack self-reported race/ethnicity
- Sex Versus Gender-Related Characteristics: Which Predicts Outcome After Acute Coronary Syndrome in the Young?
Peer reviewers
To continue to support peer reviewers efforts, CIHR has developed a framework for thinking through whether gender and/or sex are appropriately integrated into CIHR applicants' proposed research designs. These tools are available on our website:
- Online training modules:
- Course 1: Sex and Gender Considerations in Biomedical Research
- Course 2: Sex and Gender in Primary Data Collection with Human Participants
- Course 3: Sex and Gender in the Analysis of Secondary Data from Human Participants
- Other Resources:
- Key considerations for the appropriate integration of sex and gender in research (CIHR College of Reviewers)
- Video: Assessing Sex and Gender in Peer Review
- Sex and Gender Champions
- Learning for participants in Peer Review
- Reviewer Guidance to Evaluate Sex as a Biological Variable [ PDF (228 KB) - external link ] (U.S. National Institutes of Health)
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