- "Sex and gender can’t be an afterthought when designing a study."
– J. Bowen
When designing a study, the first thing we should be considering is sex and gender differences. Then you need a framework to consider whether there are perceived societal differences, biological differences, cultural differences, or information-related differences from a KT standpoint that need to be considered. But one thing is certain - if you don’t collect that data, you can’t do anything with it. Sex and gender can’t be an afterthought, because otherwise at the end of the study there may not be enough of a sample to be able to determine anything. So sex and gender integration have to be planned from the outset and built into recruitment strategies.
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“It is abundantly clear that sex and gender
differences impact the research.”
– DAC Investigator
After working on clinical trials in both diabetes and heart disease, it is abundantly clear that sex and gender differences influence our research. It is widely recognized that women with heart disease and diabetes respond and are treated differently than males. Related work around gender-based differences has been done by others in the goal group along with others in the field. Although gender is not found to be applicable to all of the research studies, this area may warrant further investigation.
Key results have been found that relate to the study of sex differences in heart disease, including; that women are less likely to seek attention when they present with symptoms, that women experience atypical symptoms, and that women are treated less aggressively than men. There is a recurring trend around how we treat males and females in different ways, with the aggressiveness of treatments varying by sex.
- “It is important for the research community to realize
the importance of considering these [sex and gender differences]."
– M. Belanger
I think the online resources are helpful because one of them walked you through how to integrate the sex and gender lens into your grant applications. That was really helpful for us in preparing the grant, combined with Robin looking at the grant and getting feedback. That was great.
I don’t think there are any negative impacts of incorporating sex and gender. I think the challenge for many of us is learning how to do it well. We’re certainly continuing to learn how to do that and all of the support of the sex and gender group have been really valuable. The multiplicity of different resources that are available to help researchers integrate sex and gender differences is great, like having somebody look at the grant, participating in workshops and having a website that houses key resources. I think all those strategies are very effective We’re acutely aware of the importance of incorporating a sex and gender lens into research. The training reinforced not only why this is important but how we can include it. Even if we can’t provide the data to our researchers, we tell them to become familiar with CIHR’s guidelines on sex and gender and make sure that’s incorporated into their proposals. Being in the research world, the importance of using a sex and gender lens was always in the back of my head. I think the awareness really came when I went to the sex and gender goal group training sessions .
The diabetes studies always look at and publish on differences between sex and gender. I can tell you, for example, the rate of diabetes is greater in men than women. Sex and gender is certainly an area where more awareness could be raised. When people work on something together, it’s much more concrete.
- “The challenge
for many of us is learning how to incorporate [sex and gender] well.”
– J. Ploeg, M. Markle-Reid, R. Valaitis
I think the online resources are helpful because one of them walked you through how to integrate the sex and gender lens into your grant applications. That was really helpful for us in preparing the grant, combined with Robin looking at the grant and getting feedback. That was great.
I don’t think there are any negative impacts of incorporating sex and gender. I think the challenge for many of us is learning how to do it well. We’re certainly continuing to learn how to do that and all of the support of the sex and gender group have been really valuable. The multiplicity of different resources that are available to help researchers integrate sex and gender differences is great, like having somebody look at the grant, participating in workshops and having a website that houses key resources. I think all those strategies are very effective. -
“We’re acutely aware of the importance of
incorporating a sex and gender lens into research.”
– C. Pow
We’re acutely aware of the importance of incorporating a sex and gender lens into research. The training reinforced not only why this is important but how we can include it. Even if we can’t provide the data to our researchers, we tell them to become familiar with CIHR’s guidelines on sex and gender and make sure that’s incorporated into their proposals.
– M. Greiver
The diabetes studies always look at and publish on differences between sex and gender. I can tell you, for example, the rate of diabetes is greater in men than women.
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“Just by proxy and participating in the annual
meetings, I got much more information than I ever had before with regards to
sex and gender.”
– A. Carpentier
The availability of individuals from the sex and gender goal group during our annual workshop meetings has really helped me to consider sex and gender in my research. I was not used to having frequent interactions with sex and gender experts. Just by proxy and participating in the annual meetings, I have received much more information than I ever had before with regards to sex and gender. I was able to also interact with the leaders of the goal group during DAC training sessions, which also helped me to become aware of the definition of gender versus sex and how to consider each in research. That helped me integrate a sex and gender lens into my own research and into different activities within Diabetes Action Canada. From what I’ve seen so far, the group is very available and responsive when we call upon them to help us.
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“The
reviewers need more education on the differences between sex and gender.”
– DAC Investigator
One of our challenges is that grant reviewers don’t always understand the difference between sex and gender. A lot of reviewers are mixing the terms and send comments like ‘this is sex, not gender’ when I’m exploring the social connotations of an issue, such as the role of the woman and how it is perceived, the role of a mother and her multiple roles, and how these may impact access to care or treatment amidst her multiple priorities. That is gender, not sex, but I get comments from the reviewers saying, ‘this is sex.’ I was interested in gender differences in referral patterns. Are women receiving fewer referrals for certain interventions? Not just because they are female but because, for example, other perceived biases like their symptoms aren’t as severe, or their healthcare seeking behaviour differs. The comments from reviewers were ‘that’s not gender, that’s sex.’ The reviewers need more education on the differences between sex and gender.
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“We’re prioritizing the integration of sex and gender
much more than we ever have in the past. We’ve changed.”
– M. Mahmud
In the beginning, we weren’t very conscious about sex and gender differences or how to incorporate these into our work. But now after some support and advice, we are more attuned to sex and gender in the same way that we’ve become more attuned to social determinants and other bio-psychosocial factors. That’s been part of our evolution. We’re prioritizing the integration of sex and gender much more than we ever have in the past. We’ve changed. Thinking about sex and gender has been relevant as we develop our protocols, look at our outcomes and conduct the analyses. It has also impacted the way that we describe the research to potential participants and later, the knowledge translation.
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“We have brought sex and gender to the medical
community, in particular, the community that has access to physicians through
the organization that trains them and ensures they have competency.”
–F. Légaré
I think because I am a woman, I was more sensitive to issues of sex and gender. But that has not always been the case. Five or so years ago, I would not have thought about these issues. I think that the sex and gender goal group has indirectly influenced my work by influencing my student and getting us to think about these differences more and more. This project, Matrices-F (mATrICES-F : ApplicaTIon des Connaissances axée sur le gEnre et le Sexe des personnes en contexte Francophone) is really the coming together of the French speaking medical association, which is geared to the development of continuing medical education programs in the province. We have brought sex and gender to the medical community, in particular the community that has access to physicians through the organization that trains them and ensures they have competency. And, it was quite difficult at the start.
