Exploring the Biological Contributions to Human Health Does Sex Matter? (2001) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-12
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Investigators are now positioned to take this work 1The committee defines sex as the classification of living things, generally as male or female according to their reproductive organs and functions assigned by the chromosomal complement, and gender as a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation. Gender is shaped by environment and experience.
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Specifically, they asked that the following issues be addressed: · the knowledge base on and research priorities for animal and cellular models that could be used to determine when sex and gender differences exist and when they are relevant to biological functioning at the cellular, developmental, organ, organismal, and behavioral levels; · current and potential barriers to the conduct of valid and productive research on sex and gender differences and their determinants, including ethical, financial, sociological, and scientific factors; and · strategies that can be used to overcome such barriers and promote the acceptance of this research by the scientific community and the general public. The committee was not charged with the task of preparing a definitive text on all known differences and similarities between the sexes but, rather, was charged with considering factors and traits that characterize and differentiate males and females across the life span and that underlie sex differences in health (including genetic, biochemical, physiological, physical, and behavioral elements)
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OVERARCHING CONCLUSIONS Three common, recurring messages emerged as the committee addressed its primary task (reviewing and evaluating the current state of knowledge about sex differences in health and illness and scientific evidence related to sex differences in health and illness) and as it met with scientific experts across diverse disciplines.
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Until the question of sex, however, is routinely asked and the results positive or negative are routinely reported, many opportunities to obtain a better understanding of the pathogenesis of disease and to advance human health will surely be missed. FINDINGS AND RECOMMENDATIONS Every Cell Has a Sex The biological differences between the sexes have long been recognized at the biochemical and cellular levels.
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RECOMMENDATION 2: Study sex differences from womb to tomb. The committee recommends that researchers and those who fund research focus on the following areas: · inclusion of sex as a variable in basic research designs, · expansion of studies to reveal the mechanisms of intrauterine effects, and · encouragement of studies at different stages of the life span to determine how sex differences influence health, illness, and longevity.
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To better understand the influences and roles of factors that may lead to sex differences, the committee makes the following recommendations: RECOMMENDATION 4: Investigate natural variations. · Examine genetic variability, disorders of sex differentiation, reproductive status, and environmental influences to better understand human health.
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Conducting studies that account for sex differences might require innovative designs, methods, and model systems, all of which might require additional resources. Studies relying on biological materials would benefit from a determination and disclosure of the sex of origin of the material, and clinical researchers should attempt to identify the endocrine status of research subjects.
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To clarify usage and bring some consistency to the literature, the committee recommends the following: · In the study of human subjects, the term sex should be used as a classification, generally as male or female, according to the reproductive organs and functions that derive from the chromosomal complement. · In the study of human subjects, the term gender should be used to refer to a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation.
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Opportunities for interdisciplinary collaboration to enhance the understanding of sex differences, however, have not been fully realized. The committee recommends the continued development of interdisciplinary research programs and strategies for more effective communication and cooperation to achieve the following goals: · synergy between and among basic scientists, epidemiologists, social scientists, and clinical researchers; · enhanced collaboration across medical specialties; and · better translational or bench-to-bedside research and interlevel integration of data (cellular, to animal, to human)
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SUMMARY Despite the progress made in focusing on women's health research and including women in clinical trials, such research will have limited value unless the underlying implications that is, the actual differences between males and females that make such research so critical are systematically studied and elucidated. Such research can enhance the basis for interpreting the results of separate studies with males and females, helping to clarify findings of no essential sex differences and suggesting mechanisms to be pursued when sex differences are found.
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. The committee members brought expertise from a broad array of disciplines in basic and applied biomedical research, including behavioral science, cellular biology, clinical research, developmental psychology, developmental and reproductive biology, epidemiology, genetics, health sciences policy, immunology, molecular biology, neuroscience, pathology, pharmacology, physiology' women~s health' arid zoology.
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