Sex and Gender in Biomedical Research : The Concepts of Sex and Gender
Imprecise use of the terms "sex" and "gender" has serious implications for future biomedical research, clinical practice, and treatment. Without a clear distinction between sex and gender, the nature of related health outcomes and differences in health status will be inadequately understood and addressed.
To prevent confusion and to promote the highest degree of accuracy in the development and application of science and medicine, a clear understanding and consistent usage of the terms "sex" and "gender" are essential. However, describing and explaining sex differences in health status, as well as in the pathogenesis, natural history, and treatment of conditions and diseases, is challenging. For example, should differences in rates of heart disease, participation in research, adherence to treatment, or access to specialty services be attributed to sex or to gender?
A similar challenge was made to the notions of biologically determined racial characteristics attributed to African Americans and others, which allegedly accounted for differences in affect, intelligence, and economic status.
A dominant belief of the late 19th and early 20th centuries held that the differences between men and women were biologically determined and that women's constitutions were more biologically driven than those of men. Challenging this belief, an important distinction between sex and gender emerged in the mid-20th century. Feminist (and other) scholars3 distinguished between:
