Sex and gender also interact to shape the ways we engineer and design objects, buildings, cities, and infrastructures. Recognizing how gender shapes sex and how sex influences culture is critical to designing quality research. Sex and gender also intersect in important ways with a variety of other social factors, including age, socioeconomic status, ethnicity, geographical location, etc. (see Analyzing Factors Intersecting with Sex and Gender).
"Sex" and "gender" are distinguished for analytical purposes (see Sex and Gender are Distinct Terms). In reality, sex and gender interact (mutually shape one another) to form individual bodies, cognitive abilities, and disease patterns, etc. (Nowatzki & Grant, 2011; Fausto-Sterling, 2012; Springer et al., 2011). Pain, for example, has biological aspects (sex differences in pain signaling) and also cultural aspects (gender differences in how men or women report pain, and how men or women physicians treat pain in men or women (Lepold et al., 2014). How men and women report pain differently may suggest a sex difference in how a device functions, for example, but these differences in reported pain may not necessarily be related to the medical device itself (U.S. FDA).
Example 1: How Sex and Gender interact when Exploring Markets for Assistive Technologies for the Elderly
- Analyzing sex (physical needs) and analyzing gender (social needs) of the elderly, and analyzing how these needs combine in individual women and men helps researchers design the most effective and marketable assistive technologies. For examples, see Exploring Markets for Assistive Technologies for the Elderly.
Example 2: How Sex and Gender Interact throughout the Life Course
- Complex interdependency of sex and gender throughout the human life cycle (Regitz-Zagrosek, 2012). If we take health status, for example, sex influences health by modifying behavior. At the same time, gender behaviors can modify biological factors. Although women and men are fundamentally alike, differences of sex and gender can interact to produce differing health outcomes (see Heart Disease in Women; Nutrigenomics; Osteoporosis Research in Men).
Example 3: How Sex and Gender Interact in Animal Research
- Animal research includes the interaction between sex (biological characteristics, such as genes, hormones, age, reproductive phase, strain, etc.) and gender (cultural or environmental process, such as caging practices, attitudes and behaviors of researchers, room temperature, diet, etc.). The double-ended arrows represent interactions between sex and gender. Environmental processes may impact male and female animals differently, such as caging practices or differential handling (which may include gender assumptions and practices on the part of researchers). Investigators should not identify an effect as dependent on sex (or a biological trait) when, in fact, it depends on an environmental condition (see Animal Research 2).
Example 4: How Sex, Gender, and other Factors Interact in Nutrigenomics
- Both sex- and gender-related factors determine an individual's functional capacity across the the course of his or her life. Because sex and gender interact it is difficult to identify the respective influences of each factor independently. For a discussion, see Nutrigenomics.
Example 5: How Sex, Gender, and other Factors Interact in Brain Development
Sex (genes, chromosomes, hormones, etc.) converges with gender (parental stimuli, media, education, etc.) across an individual's life to influence brain development. Factors intersecting with sex and gender, such as socio-economic status, geographic location, the influence of language and religion, etc., further influence brain development. This image is suggestive of the many factors that converge in brain development. Our placement of factors is not specific to developmental periods; development will differ by individual, geographic location, environment, etc. We welcome comments and improvements on this image.
Fausto-Sterling, A. (2012). Sex/Gender: Biology in a Social World. New York: Routledge.
Leopold, S., Beadling, L., Dobbs, M., Gebhardt, M., Lotke, P., Manner, P., Rimnac, C., & Wongworawat, M. (2014). Editorial: Fairness to All: Gender and Sex in Scientific Reporting. Clin Orthop Relat Res, 472, 391-392.
Notwatski, N. & Grant, K. (2011). Sex is not Enough: The Need for Gender Based Analysis in Health Research. Health Care for Women International, 32 (4), 263-277.
Regitz-Zagrosek, V. (2012). Sex and Gender Differences in Health. European Molecular Biology Organization Reports, 13 (7), 596-603.
Springer, K., Stellman, J., & Jordan-Young, R. (2012). Beyond a Category of Differences: A Theoretical Frame and Good Practice Guidelines for Researching Sex/Gender in Human Health. Social Science & Medicine, 74, 1817-1824.
U.S. Food and Drug Administration (2014), Evaluation of Sex-Specific Data in Medical device Clinical Studies. Washington, D.C.