Sex Versus Gender; Which One Should Be Used Where in Medical Scientific Writing?
Recently, while I was trying to submit a couple of articles in some high rank and prestigious journals, I faced a new but essential caution in the “information/guidelines for authors” parts of journals’ websites recommending to use the appropriate terms of “sex” and “gender” when necessary and not interchangeably. So, I intended to study a little about this matter and clarify the notion for myself and even for you if you are interested. Besides, I suggest reading this article if you don’t want to get your papers rejected by meticulous journals.
The first journal that poked me to learn about this concept was the great THE Lancet group of journals. In the “Information for Authors” parts of one of its journals (as you know this journal consists of about twenty titles of journals) that should be thoroughly studied and considered before submission (if you want to increase your chance of acceptance), in a paragraph, the journal encourages all the authors of all types of articles to use the correct word of sex (when reporting biological factors) and gender (when reporting identity, psychological, or cultural factors. Even the journal recommends the separate reporting of sex and gender variables and the method of determining each when reporting the demographics of participants. This way of reporting data could make pooling data for subgroups between different studies much easier, in articles like meta-analyses.
If we want to discuss this notion with more details, I want to refer to an editorial paper published by the “BMJ Global Health” in 2018 and revealed new editorial policies on the correct use of words sex and gender. Authors of this paper said that “sex” is a biological variable that defines human and any other creature as male and female (or intersex) based on their reproductive organs and genitalia, derived from their chromosomes. (XX for women, and XY for men in most of the people) Therefore this term should only be used when the authors want to talk about sex-related biological or physiological differences. On the other hand, “gender” is a socially originated term that refers to the roles, behaviors, and activities a specified society, condition, and time allocates to people.
Despite the sex that is easy to recognize by phenotype or genotype (for example, by a karyotype testing), there is no specific method of measuring gender, and it can even change on a continuum during the time. Also, knowing about gender identity (how a person perceives and presents about his/her gender), gender norms (the implied rules in societies that affect individual attitudes and behaviors), and gender relations (the power relations between different gender identities) can help to cope with this variable.
After understanding differences between sex and gender and appropriate use of each term in its place, the matter of equity of research on these two different concepts had led to a guideline of Sex and Gender Equity in Research (SAGER), and many journals mandate sticking to SAGER guidelines in the past few years. All these guidelines are prepared and installed to fight the sex and gender inequity in medical research and other fields of research since we know women and the female gender is less investigated in medical research, and many studies lack sex-based and gender-based analyses and interpretations.
In this essay, I explained the differences between terms sex and gender, and how the correct use of each word can help scientific society and policymakers think more clearly about sexual and gender-related variations. Also, I added four used references in the text if you are interested in reading more about this topic.
