Integrating A Sex And Gender Lens

Much of modern medicine is based on research conducted predominantly on male bodies, leading to significant and sometimes deadly consequences due to this research gap. Some consider it a public health crisis. Sex and gender influence the manifestation, pathophysiology, and clinical outcomes of many diseases, yet research remains insufficient and is still catching up after decades of underrepresentation in clinical trials. In the United States, it wasn't until June 10, 1993, with the passing of the NIH Revitalization Act, that the inclusion of women in clinical research became mandatory. The repercussions of this historical exclusion are still evident 30 years later.

The leading causes of disease in women—such as cardiovascular disease, cancer, and mental health disorders—have distinct sex- and gender-specific risk factors that are less understood than those that affect the sexes equally. For instance, women with acute myocaridal infarction (AMI) have higher 30-day mortality rates than men and are less likely to receive timely perfusion therapy, coronary angiography for non-STEMI, dual antiplatelet therapy, and secondary prevention therapies, all of which are guideline-recommended. Furthermore, diagnosed significantly later than men for numerous diseases, as shown in a Danish population-wide analysis. Women also experience nearly twice as many adverse drug reactions (ADRs) as men, attributable to sex differences in pharmacokinetics. These examples highlight the pervasive lack of data on women's health, resulting in critical gaps in our understanding that affect research, product design, investment decisions, and pipeline priorities, ultimately threatening women's health outcomes globally.