The future of sex and gender in research.

Our understanding of sex and gender evolves. We asked scientists about their work and the future of sex and gender research. They discuss, among other things, interdisciplinary collaboration, moving beyond binary conceptualizations, accounting for intersecting factors, reproductive strategies, expanding research on sex-related differences, and sex's dynamic nature.

Shirin Heidari.

Dr. Shirin Heidari is the lead author of the Sex and Gender Equity in Research (SAGER) guidelines. In this interview with Dr. Isabel Goldman at Cell, she discusses her research, GENDRO, the SAGER guidelines and importance of considering sex- and gender-related variables in research, and her work on sexual and reproductive health in forced displacement.

Rigorous science demands support of transgender scientists.

To build a just, equitable, and diverse academy, scientists and institutions must address systemic barriers that sex and gender minorities face. This Commentary summarizes (1) critical context informing the contemporary oppression of transgender people, (2) how this shapes extant research on sex and gender, and (3) actions to build an inclusive and rigorous academy for all.

Is gender primacy universal?

Emerging evidence suggests that gender is a defining feature of personhood. Studies show that gender is the primary social category individuals use to perceive humanness and the social category most strongly related to seeing someone-or something-as human. However, the universality of gender's primacy in social perception and its precedence over other social categories like race and age have been debated. We examined the primacy of gender perception in the Mayangna community of Nicaragua, a population with minimal exposure to Western influences, to test whether the primacy of gender categorization in humanization is more likely to be a culturally specific construct or a cross-cultural and potentially universal phenomenon. Consistent with findings from North American populations [A. E. Martin, M. F. Mason, J. Pers. Soc. Psychol. 123, 292-315 (2022)], the Mayangna ascribed gender to nonhuman objects more strongly than any other social category-including age, race, sexual orientation, disability, and religion-and gender was the only social category that uniquely predicted perceived humanness (i.e., the extent to which a nonhuman entity was seen as "human"). This pattern persisted even in the most isolated subgroup of the sample, who had no exposure to Western culture or media. The present results thus suggest that gender's primacy in social cognition is a widely generalizable, and potentially universal, phenomenon.

The gender agency gap in fiction writing (1850 to 2010).

Works of fiction play a crucial role in the production of cultural stereotypes. Concerning gender, a widely held presumption is that many such works ascribe agency to men and passivity to women. However, large-scale diachronic analyses of this notion have been lacking. This paper provides an assessment of agency attributions in 87,531 fiction works written between 1850 and 2010. It introduces a syntax-based approach for extracting networks of character interactions. Agency is then formalized as a dyadic property: Does a character primarily serve as an agent acting upon the other character or as recipient acted upon by the other character? Findings indicate that female characters are more likely to be passive in cross-gender relationships than their male counterparts. This difference, the gender agency gap, has declined since the 19th century but persists into the 21st. Male authors are especially likely to attribute less agency to female characters. Moreover, certain kinds of actions, especially physical and villainous ones, have more pronounced gender disparities.

The need for an intersectionality framework in precision medicine research.

Precision medicine research has seen growing efforts to increase participation of communities that have been historically underrepresented in biomedical research. Marginalized racial and ethnic communities have received particular attention, toward the goal of improving the generalizability of scientific knowledge and promoting health equity. Against this backdrop, research has highlighted three key issues that could impede the promise of precision medicine research: issues surrounding (dis)trust and representation, challenges in translational efforts to improve health outcomes, and the need for responsive community engagement. Existing efforts to address these challenges have predominantly centered on single-dimensional demographic criteria such as race, ethnicity, or sex, while overlooking how these and additional variables, such as disability, gender identity, and socioeconomic factors, can confound and jointly impact research participation. We argue that increasing cohort diversity and the responsiveness of precision medicine research studies to community needs requires an approach that transcends conventional boundaries and embraces a more nuanced, multi-layered, and intersectional framework for data collection, analyses, and implementation. We draw attention to gaps in existing work, highlight how overlapping layers of marginalization might shape and substantiate one another and affect the precision-medicine research cycle, and put forth strategies to facilitate equitable advantages from precision-medicine research to diverse participants and internally heterogeneous communities.

Psychosocial Functioning in Transgender Youth after 2 Years of Hormones.

BACKGROUND: Limited prospective outcome data exist regarding transgender and nonbinary youth receiving gender-affirming hormones (GAH; testosterone or estradiol). METHODS: We characterized the longitudinal course of psychosocial functioning during the 2 years after GAH initiation in a prospective cohort of transgender and nonbinary youth in the United States. Participants were enrolled in a four-site prospective, observational study of physical and psychosocial outcomes. Participants completed the Transgender Congruence Scale, the Beck Depression Inventory-II, the Revised Children's Manifest Anxiety Scale (Second Edition), and the Positive Affect and Life Satisfaction measures from the NIH (National Institutes of Health) Toolbox Emotion Battery at baseline and at 6, 12, 18, and 24 months after GAH initiation. We used latent growth curve modeling to examine individual trajectories of appearance congruence, depression, anxiety, positive affect, and life satisfaction over a period of 2 years. We also examined how initial levels of and rates of change in appearance congruence correlated with those of each psychosocial outcome. RESULTS: A total of 315 transgender and nonbinary participants 12 to 20 years of age (mean [±SD], 16±1.9) were enrolled in the study. A total of 190 participants (60.3%) were transmasculine (i.e., persons designated female at birth who identify along the masculine spectrum), 185 (58.7%) were non-Latinx or non-Latine White, and 25 (7.9%) had received previous pubertal suppression treatment. During the study period, appearance congruence, positive affect, and life satisfaction increased, and depression and anxiety symptoms decreased. Increases in appearance congruence were associated with concurrent increases in positive affect and life satisfaction and decreases in depression and anxiety symptoms. The most common adverse event was suicidal ideation (in 11 participants [3.5%]); death by suicide occurred in 2 participants. CONCLUSIONS: In this 2-year study involving transgender and nonbinary youth, GAH improved appearance congruence and psychosocial functioning. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.).

Persistence of gender biases in Europe.

Prior work suggests that modern gender bias might have historical roots but has not been able to demonstrate long-term persistence of this bias due to a lack of historical data. We follow archaeological research and employ skeletal records of women's and men's health from 139 archaeological sites in Europe dating back, on average, to about 1200 AD to construct a site-level indicator of historical bias in favor of one gender over the other using dental linear enamel hypoplasias. This historical measure of gender bias significantly predicts contemporary gender attitudes, despite the monumental socioeconomic and political changes that have taken place since. We also show that this persistence is most likely due to the intergenerational transmission of gender norms, which can be disrupted by significant population replacement. Our results demonstrate the resilience of gender norms and highlight the importance of cultural legacies in sustaining and perpetuating gender (in)equality today.

Discordance in chromosomal and self-reported sex in the UK Biobank: Implications for transgender- and intersex-inclusive data collection.

There is growing need to distinguish between sex and gender. While sex is assigned at birth, gender is socially constructed and may not correspond to one's assigned sex. However, in most research studies, sex or gender is assessed in isolation or the terms are used interchangeably, which has implications for research accuracy and inclusivity. We used data from the UK Biobank to quantify the prevalence of disagreement between chromosomal and self-reported sex and identify potential reasons for discordance. Among approximately 200 individuals with sex discordance, 71% of discordances were potentially explained by the presence of intersex traits or transgender identity. The findings indicate that when describing sex- and/or gender-specific differences in health, researchers may be limited in their ability to draw conclusions regarding specific sex and/or gender health information.

Update in Adult Transgender Medicine.

Transgender people often face barriers in health care due to lack of access to care, lack of knowledgeable healthcare professionals, discrimination, and gaps in medical and mental health research. Existing research on transgender health has focused heavily on mental health, HIV/AIDS, sexually transmitted diseases/infections, and substance abuse. Gender-affirming hormone therapy and/or surgery allows for some alignment of biology and gender identity. Gender-affirming care may offer quality-of-life benefits, which may outweigh modest concerns related to exogenous hormone therapy. The Endocrine Society treatment guidelines were revised in 2017, and this article reviews recent data that might inform a future guideline revision. Future longitudinal research is needed to close the gap in knowledge in the field of transgender medicine.

Gender-Affirming Care of Transgender and Gender-Diverse Youth: Current Concepts.

Increasing numbers of transgender and gender-diverse (TGD) youth, from early puberty through late adolescence, are seeking medical services to bring their physical sex characteristics into alignment with their gender identity-their inner sense of self as male or female or elsewhere on the gender spectrum. Numerous studies, primarily of short- and medium-term duration (up to 6 years), demonstrate the clearly beneficial-even lifesaving-mental health impact of gender-affirming medical care in TGD youth. However, there are significant gaps in knowledge and challenges to such care. Long-term safety and efficacy studies are needed to optimize medical care for TGD youth.

Biological sex is binary, even though there is a rainbow of sex roles: Denying biological sex is anthropocentric and promotes species chauvinism: Denying biological sex is anthropocentric and promotes species chauvinism.

Biomedical and social scientists are increasingly calling the biological sex into question, arguing that sex is a graded spectrum rather than a binary trait. Leading science journals have been adopting this relativist view, thereby opposing fundamental biological facts. While we fully endorse efforts to create a more inclusive environment for gender-diverse people, this does not require denying biological sex. On the contrary, the rejection of biological sex seems to be based on a lack of knowledge about evolution and it champions species chauvinism, inasmuch as it imposes human identity notions on millions of other species. We argue that the biological definition of the sexes remains central to recognising the diversity of life. Humans with their unique combination of biological sex and gender are different from non-human animals and plants in this respect. Denying the concept of biological sex, for whatever cause, ultimately erodes scientific progress and may open the flood gates to "alternative truths."

Competitiveness among Nandi female husbands.

In the Nandi society in Kenya, custom establishes that a woman's "house property" can only be transmitted to male heirs. As not every woman gives birth to a male heir, the Nandi solution to sustain the family lineage is for the heirless woman to become the "female husband" to a younger woman by undergoing an "inversion" ceremony to "change" into a man. This biological female, now socially a man, becomes a "husband" and a "father" to the younger woman's children, whose sons become the heirs of her property. Using this unique separation of biological sex and social roles holding constant the same society, I conduct competitiveness experiments. Similar to Western cultures, I find that Nandi men choose to compete at roughly twice the rate as Nandi women. Importantly, however, female husbands compete at the same rate as males, and thus around twice as often as females. These findings are robust to controlling for several risk aversion, selection, and behavioral factors. The results provide support for the argument that social norms, family roles, and endogenous preference formation are crucially linked to differences in competitiveness between men and women.

The intergenerational sources of the U-turn in gender segregation.

In the early 1970s, the balkanization of the US labor market into "men's occupations" and "women's occupations" began to unravel, as women entered the professions and other male-typed sectors in record numbers. This decline in gender segregation continued on for several decades but then suddenly stalled at the turn of the century and shows no signs of resuming. Although the stall is itself undisputed, its sources remain unclear. Using nearly a half-century of data from the General Social Survey, we show that a resurgence in segregation-inducing forms of intergenerational transmission stands behind the recent stall. Far from serving as impartial conduits, fathers are now disproportionately conveying male-typed occupations to their sons, whereas mothers are effectively gender-neutral in their transmission outcomes. This segregative turn among fathers accounts for 47% of the stall in the gender segregation trend (between 2000 and 2018), while the earlier integrative turn among fathers accounts for 34% of the initial downturn in segregation (between 1972 and 1999). It follows that a U-turn in intergenerational processes lies behind the U-turn in gender segregation.

Chronic frames of social inequality: How mainstream media frame race, gender, and wealth inequality.

How social inequality is described­as advantage or disadvantage­critically shapes individuals' responses to it [e.g., B. S. Lowery, R. M. Chow, J. R. Crosby, J. Exp. Soc. Psychol. 45, 375­378, 2009]. As such, it is important to document how people, in fact, choose to describe inequality. In a corpus of 18,349 newspaper articles (study 1), in 764 hand-coded news media publications (study 2), and in a preregistered experiment of 566 lay participants (study 3), we document the presence of chronic frames of race, gender, and wealth inequality. Specifically, race and gender inequalities are more likely to be framed as subordinate groups' disadvantages than as dominant groups' advantages, and wealth inequality is more likely to be described with no frame (followed by dominant group advantage, then subordinate group disadvantage). Supplemental lexicon-based text analyses in studies 1 and 2, survey results in study 3, and a preregistered experiment (study 4; N = 578) provide evidence that the differences in chronic frames are related to the perceived legitimacy of the inequality, with race and gender inequalities perceived as less legitimate than wealth inequality. The presence of such chronic frames and their association with perceived legitimacy may be mechanisms underlying the systematic inattention to White individuals' and men's advantages, and the disadvantages of the working class.

Gender-diverse teams produce more novel and higher-impact scientific ideas.

Science's changing demographics raise new questions about research team diversity and research outcomes. We study mixed-gender research teams, examining 6.6 million papers published across the medical sciences since 2000 and establishing several core findings. First, the fraction of publications by mixed-gender teams has grown rapidly, yet mixed-gender teams continue to be underrepresented compared to the expectations of a null model. Second, despite their underrepresentation, the publications of mixed-gender teams are substantially more novel and impactful than the publications of same-gender teams of equivalent size. Third, the greater the gender balance on a team, the better the team scores on these performance measures. Fourth, these patterns generalize across medical subfields. Finally, the novelty and impact advantages seen with mixed-gender teams persist when considering numerous controls and potential related features, including fixed effects for the individual researchers, team structures, and network positioning, suggesting that a team's gender balance is an underrecognized yet powerful correlate of novel and impactful scientific discoveries.