Better science with sex and gender: Facilitating the use of a sex and gender-based analysis in health research

Springer Science and Business Media LLC - Tập 8 - Trang 1-11 - 2009
Joy L Johnson1, Lorraine Greaves2, Robin Repta1
1NEXUS, School of Nursing, University of British Columbia, Canada
2British Columbia Centre of Excellence for Women's Health, Canada

Tóm tắt

Much work has been done to promote sex and gender-based analyses in health research and to think critically about the influence of sex and gender on health behaviours and outcomes. However, despite this increased attention on sex and gender, there remain obstacles to effectively applying and measuring these concepts in health research. Some health researchers continue to ignore the concepts of sex and gender or incorrectly conflate their meanings. We report on a primer that was developed by the authors to help researchers understand and use the concepts of sex and gender in their work. We provide detailed definitions of sex and gender, discuss a sex and gender-based analysis (SGBA), and suggest three approaches for incorporating sex and gender in health research at various stages of the research process. We discuss our knowledge translation process and share some of the challenges we faced in disseminating our primer with key stakeholders. In conclusion, we stress the need for continued attention to sex and gender in health research.

Tài liệu tham khảo

Bird CE, Rieker PP: Gender matters: An integrated model for understanding men's and women's health. Soc Sci Med. 1999, 48 (6): 745-755. 10.1016/S0277-9536(98)00402-X. Courtenay W: Constructions of masculinity and their influence on men's being: A theory of gender and health. Social Science & Medicine. 2001, 50 (10): 1385-1401. 10.1016/S0277-9536(99)00390-1. Holdcroft A: Integrating the dimensions of sex and gender into basic life sciences research: Methodologic and ethical issues. Gender Medicine. 2007, 4 (Suppl B): S64-S74. 10.1016/S1550-8579(07)80048-9. Macintyre S, Hunt K, Sweeting H: Gender differences in health: Are things really as simple as they seem?. Social Science & Medicine. 1996, 42 (4): 617-624. 10.1016/0277-9536(95)00335-5. Ordovas JM: Gender, a significant factor in the cross talk between genes, environment, and health. Gender Medicine. 2007, 4 (Suppl B): S111-S122. 10.1016/S1550-8579(07)80052-0. Vlassoff C, Garcia Moreno G: Placing gender at the centre of health programming: Challenges and limitations. Social Science & Medicine. 2002, 54: 1713-1723. 10.1016/S0277-9536(01)00339-2. Doyal L: Sex, gender and health: The need for a new approach. BMJ. 2001, 323: 1061-1063. 10.1136/bmj.323.7320.1061. Prins MH, Smits KM, Smits LJ: Methodologic ramifications of paying attention to sex and gender differences in clinical research. Gender Medicine. 2007, 4 (Suppl B): S106-S110. 10.1016/S1550-8579(07)80051-9. Krieger N: Genders, sexes, and health: What are the connections – and why does it matter?. International Journal of Epidemiology. 2003, 32 (4): 652-657. 10.1093/ije/dyg156. Lawrence K, Rieder A: Methodologic and ethical ramifications of sex gender differences in public health research. Gender Medicine. 2007, 4 (Suppl B): S96-SS104. 10.1016/S1550-8579(07)80050-7. Prins MH, Smits KM, Smits LJ: Methodologic ramifications of paying attention to sex and gender differences in clinical research. Gender Medicine. 2007, 4 (Suppl B): S106-S110. 10.1016/S1550-8579(07)80051-9. Johnson JL, Greaves L, Repta R: Better Science with Sex and Gender: A Primer for Health Research. 2007, Vancouver: Women's Health Research Network Phillips SP: Defining and measuring gender: A social determinant of health whose time has come. International Journal for Equity in Health. 2005, 4: 11-15. 10.1186/1475-9276-4-11. Phillips SP: Measuring the health effects of gender. Journal of Epidemiology and Community Health. 2008, 62: 368-371. 10.1136/jech.2007.062158. World Health Organization: Gender Analysis in Health: A Review of Selected Tools. Geneva, Switzerland. Institute of Medicine (U.S.), Wizemann TM, Pardue M, (Eds): Exploring the Biological Contributions to Human Health: Does Sex Matter?. 2001, Washington, DC: National Academy Press Greaves L, Hankivsky O, Amaratunga C, Ballem P, Chow D, De Koninck M: CIHR 2000: Sex, Gender and Women's Health. 1999, Vancouver: British Columbia Centre of Excellence in Women's Health Aulakh AK, Anand SS: Sex and gender subgroup analyses of randomized trials: The need to proceed with caution. Women's Health Issues. 2007, 17 (6): 342-350. 10.1016/j.whi.2007.04.002. Gesensway D: Reasons for sex-specific and gender-specific study of health topics. Annals of Internal Medicine. 2001, 135 (10): 935-938. Butler J: Gender trouble: Feminism and the Subversion of Identity. 1999, London: Routledge Halberstam J: Female Masculinity. 1998, Duke University Press Health Canada: Exploring Concepts of Gender and Health. 2003, Ottawa: Women's Health Bureau Fausto-Sterling A: The bare bones of sex: Part 1 – sex and gender. Signs: Journal of Women in Culture and Society. 2005, 30 (2): 1491-1527. 10.1086/424932. Ettorre E: Revisioning women and drug use: Gender sensitivity, embodiment and reducing harm. International Journal of Drug Policy. 2004, 15 (5–6): 327-335. 10.1016/j.drugpo.2004.06.009. Doyal L: Gender equity in health: Debates and dilemmas. Social Science & Medicine. 2001, 51: 931-939. 10.1016/S0277-9536(00)00072-1. Knaak S: On the reconceptualizing of gender: Implications for research. Sociological Inquiry. 2004, 74 (3): 302-317. 10.1111/j.1475-682X.2004.00093.x. Fausto-Sterling A: Sexing the Body: Gender Politics and the Construction of Sexuality. 2000, New York: Basic Books Reddy G: With Respect to Sex: Negotiating Hijra Identity in South India. 2005, Chicago: University of Chicago Press Schofield T, Connell RW, Walker L, Wood JF, Butland DL: Understanding men's health and illness: a gender-relations approach to policy, research, and practice. J Am Coll Health. 2000, 48 (6): 247-256. Bottorff JL, Kalaw C, Johnson JL, Stewart M, Greaves L, Carey J: Couple dynamics during women's tobacco reduction in pregnancy and postpartum. Nicotine and Tobacco Research. 2006, 8 (4): 499-509. 10.1080/14622200600789551. DiFranza JR, Celebucki CC, Mowery PD: Measuring statewide merchant compliance with tobacco minimum age laws: the Massachusetts experience. American Journal of Public Health. 2001, 91 (7): 1124-1125. 10.2105/AJPH.91.7.1124. Landrine H, Klonoff EA, Alcaraz R: Asking age and identification may decrease minors' access to tobacco. Preventive Medicine. 1996, 25 (3): 301-306. 10.1006/pmed.1996.0060. Moore RS, Lee JP, Atin TMJ, Martin SE: Tobacco free workplace policies and low socioeconomic status female bartenders in San Francisco. Journal of Epidemiology and Community Health. 2008, 60 (Suppl II): ii51-ii56. Attanapola CT: Changing gender roles and health impacts among female workers in export-processing industries in Sri Lanka. Social Science & Medicine. 2004, 58: 3201-2312. 10.1016/j.socscimed.2003.08.022. Choudhury KK, Hanifi MA, Rasheed S, Bhuiya A: Gender inequality and severe malnutrition among children in a remote rural area of Bangladesh. Journal of Health, Population, and Nutrition. 2000, 18 (3): 123-130. Ene-Obong HN, Enugu GI, Uwaegbute AC: Determinants of health and nutritional status of rural Nigerian women. Journal of Health, Population, and Nutrition. 2001, 19 (4): 320-330. Lorber J, Farrell SA: The Social Construction of Gender. 1991, Newbury Park, California: Sage Publications Edwards DA, Wetzel K, Wyner DR: Intercollegiate soccer: Saliva and testosterone are elevated during competition, and testosterone is related to status and social connectedness with teammates. Physiology & Behavior. 2006, 87 (1): 135-143. 10.1016/j.physbeh.2005.09.007. Eichler M: Feminist methodology. Current Sociology. 1997, 45 (2): 9-36. 10.1177/001139297045002003. Burns N, Grove SK: The practice of nursing research: Conduct, critique and utilization. 2001, Philadelphia: W.B. Saunders, 4 O'Brien R, Hunt K, Hart G: 'It's cavemen stuff, but that is to a certain extent how guys still operate': Men's accounts of masculinity and help-seeking. Social Science & Medicine. 2005, 61: 503-516. 10.1016/j.socscimed.2004.12.008. Bem SL: Bem Sex Role Inventory: Professional Manual. 1981, Palo Alto, California: Consulting Psychologists Press Eisler RM, Skidmore JR, Ward CH: Masculine gender-role stress: Predictor of anger, anxiety, and health-risk behaviors. J Pers Assess. 1988, 52 (1): 133-141. 10.1207/s15327752jpa5201_12. World Health Organization, Centre for Health Development: Report of the Consulative Meeting to Finalize a Gender-Sensitive Core Set of Leading Health Indicators. 2005 Greaves L, Johnson J, Bottorff J, Kirkland S, Jategaonkar N, McGowan M: What are the effects of tobacco policies on vulnerable populations? A better practices review. Canadian Journal of Public Health. 2006, 97 (4): 310-315. Diez-Roux AV: Multilevel analysis in public health research. Annu Rev Public Health. 2000, 21 (1): 171-192. 10.1146/annurev.publhealth.21.1.171. Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map?. J Contin Educ Health Prof. 2006, 26 (1): 13-24. 10.1002/chp.47. Armstrong R, Waters E, Roberts H, Oliver S, Popay J: The role and theoretical evolution of knowledge translation and exchange in public health. J Public Health (Oxf). 2006, 28 (4): 384-389. 10.1093/pubmed/fdl072. Shultz SJ, Schmitz RJ, Nguyen AD: Research retreat IV: ACL injuries-the gender bias: April 3–5, 2008 Greensboro, NC. J Athl Train. 2008, 43 (5): 530-531. Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, Badley EM: Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med. 2000, 342 (14): 1016-1022. 10.1056/NEJM200004063421405. Tosi LL, Boyan BD, Boskey AL: Does sex matter in musculoskeletal health? The influence of sex and gender on musculoskeletal health. J Bone Joint Surg Am. 2005, 87 (7): 1631-1647. 10.2106/JBJS.E.00218. Harmon KG, Ireland ML: Gender differences in noncontact anterior cruciate ligament injuries. Clinics in Sports Medicine. 2000, 19 (2): 287-302. 10.1016/S0278-5919(05)70204-0. Greene KA: Gender-specific design in total knee arthroplasty. The Journal of Arthroplasty. 2007, 22 (7, Supplement 1): 27-31. 10.1016/j.arth.2007.05.019. Pizzari T, McBurney H, Taylor N, Feller J: Adherence to anterior cruciate ligament rehabilitation: A qualitative analysis. Journal of Sport Rehabilitation. 11 (2): 89-13. Slauterbeck JR, Fuzie SF, Smith MP, Clark RJ, Xu K, Starch DW, Hardy DM: The menstrual cycle, sex hormones, and anterior cruciate ligament injury. J Athl Train. 2002, 37 (3): 275-278. Shultz SJ, Sander TC, Kirk SE, Perrin DH: Sex differences in knee joint laxity change across the female menstrual cycle. J Sports Med Phys Fitness. 2005, 45 (4): 594-603. Borkhoff CM, Hawker GA, Kreder HJ, Glazier RH, Mahomed NN, Wright JG: The effect of patients' sex on physicians' recommendations for total knee arthroplasty. CMAJ. 2008, 178 (6): 681-687.