Being a woman or a man – what we call biological sex in science – is of key importance in Medicine. We cannot ignore that the morbidity and prevalence of the disease, risk factors, age of onset, and clinical symptoms often differ between women and men.

Sex refers to biological and genetic characteristics. Gender includes roles and relationships linked to sociocultural rules.

Association of sex and gender with health

Being a man or a woman makes a difference, not only from a social, economic and cultural perspective, but also from a health perspective. Recent research has shown the association of sex and gender with health.

Until very recently, medicine has been characterized by a strong androcentric connotation, and for a long time clinical trials have been carried out mainly in male patients. Generating, consequently, results that were simply extrapolated to women.

To give you an idea, women were only a third of the patients included in clinical trials conducted between 2002 and 2007 to evaluate cardiovascular therapies. Since then, the number of women recruited has not changed substantially over time.

sex and gender in health

Personalized medicine and genomic medicine that considers the association of sex and gender with each element of the disease process constitute a young paradigm of clinical practice. Just a decade ago, in 2010, the prestigious scientific journal Nature published an editorial with the title “Putting gender on the agenda”. A phrase that summarizes old and new problems. The editors of Nature concluded that “medicine as it is currently applied to women is less evidence-based than that applied to men”.

“Being a man or being a woman” from a health point of view

Today we know that biomarkers of disease and prognosis could be different between men and women, and should be used selectively according to sex and gender.

In this scenario, omics sciences have become a powerful tool to identify sex-specific disease markers. They include potential benefits in terms of health, social and psychological well-being for each individual, as well as profitability and greater efficiency for health systems.

The characteristics underlying sex and gender involve both internal and exogenous factors that change over the life course. Biological sex and sociocultural gender represent an important source of diversity among patients, sex and gender differences can be observed in key areas such as:

  • Genetics and genomics
  • The hormonal environment
  • Immune function
  • The neurocognitive aging process
  • Cardiovascular health
  • The therapeutic response
  • The individual’s own interaction with health systems

Without a doubt, “being a man or being a woman” is key from a health point of view. It is no longer possible to avoid the “biological sex and gender approach” when addressing our patients’ problems.

Personalized medicine and genomic medicine

Research in medicine must be oriented towards a model that understands how sex and gender influence health throughout life.

Prioritizing the role of sex and gender in biomedical research, innovation and clinical practice is crucial. Above all, in terms of efficient prevention, identification of clinical signs, definition of prognosis and optimization of therapy.

We have to face the evidence that biological, genetic, genomic, cultural and environmental factors mutually interact to define sex differences. At the same time, they help establish possible gender disparities.

Therefore, personalized medicine and genomic medicine, from the perspective of sex and gender, are an inevitable and essential step in patient-centered care, and an essential development to achieve the health care that the 21st century requires.