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Open research questions in Sex and Gender in Healthcare

31 unresolved questions extracted from the limitations and future-work sections of 1,169 Sex and Gender in Healthcare papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Despite the growing acceptance of the more domestic modern responsibility between husbands and wives, married female physicians with children spend 8.5 hours more per week on parenting and household duties. This correlates to their shorter work week, which is seven hours less than those of married male physicians with children.19 It is difficult for women to weave the traditional household and parenting duties expected of them into the hectic schedule of a medical professional. In a study that interviewed university hospital department chairs in various medical specialties, a large majority (78%) agreed that the demands of the household were a barrier to the advancement of women in medicine.16,21 Also worthy of note is that female physicians with children have lower employability and slower career development as compared to their male counterparts.24 Female physicians face challenges with their academic work due to a lack of flexible work policies to support their work-life balance.25 Cultural norms within academia also play a role. Women often bear disproportionate service and teaching loads, leaving less time for research—the very work that propels academic recognition.26 also Solution: Judicious use of resources, flexible work schedule and family support In a study by Schueller-Weidekamm and Kautzky- Willer on the creation of career development for women physicians who are mothers and working in leadership positions, they discovered that these female physicians advised that judicious use of resources like time, money, scope of decisionmaking, and mentorship and networking are the most important factors for achieving work-life balance.27 Similarly, Treister-Goltzman and Peleg suggested and aforementioned advocated for special factors like flexible work schedules and expanded support for childcare for women in academic medicine. Also, they noticed that female physicians with good spousal support do better in academic environments than people who do not.28 factors the Some institutions alleviate this burden by offering faculty reduction in duties, extension of their probationary period, or part-time employment to those female physicians who are struggling to balance their personal responsibilities at home with professional responsibilities at work.25 Reason: Hostile work environments and sexual harassment female Women are at a high risk of harassment, especially sexual, and this poses a danger to their career advancement. A study that assessed the challenges and obstacles encountered by junior physicians in Jeddah, Saudi Arabia, showed that 52% of female residents experienced gender discrimination mostly by their supervisors and 40% were regularly harassed. About 53% of those who agreed to be interviewed were suffering from severe depression, resulting in reconsidering their career in medicine.

    The Silent Pandemic: The Under-representation of Women in Academic Medicine and Publications—Reasons and Solutions · 2026 · DOI

  • The historical exclusion of females from clinical research continues to limit our understanding of immune aging and its biological variability. In response to thalidomide-related pregnancy tragedies, the US Food and Drug Administration issued its 1977 guideline “General Considerations for the Clinical Evaluation of Drugs”, which unintentionally created a male-biased research standard (Box 2), obscuring how processes such as immune aging differ by sex or age, or by the interaction of these two factors [134–137]. As a result, key aspects of female immune aging, such as menopausal transition, remain poorly characterized, hindering progress towards personalized medicine. PLOS Biology | https://doi.org/10.1371/journal.pbio.3003763 May 11, 2026 12 / 20 Box 2. The 1977 FDA recommendation and its impact on the health of females. In the late 1950s and early 1960s, the use of thalidomide for pregnant females caused thousands of infants worldwide to be born with severe limb deformities and led to countless deaths. The United States avoided the worst of this tragedy due to the US Food and Drug Administration’s (FDA) insistence on rigorous scientific evidence before drug approval. The Kefauver–Harris Amendments, passed by Congress in 1962, gave the FDA the power to demand evidence of a drug’s effectiveness and to mandate that unexpected adverse events be reported. Despite these reforms, additional events throughout the 1960s and 1970s, such as complications associated with high dose estrogen contraceptives, and the discovery that prenatal exposure to diethylstilbestrol increased the risk of clear cell vaginal adenocarcinoma, renewed concerns about drug safety and reproductive toxicity. In response to these tragedies, the FDA issued the 1977 guidance “General Considerations for the Clinical Evaluation of Drugs”, which recommended excluding females of childbearing potential from Phase 1 and early Phase 2 clinical trials, except in life-threatening conditions [135,137]. The term ‘childbearing potential’ was generally interpreted to include nearly all premenopausal females, regardless of abstinence or contraceptive use [135,137,139]. Although intended to protect females and potential fetuses from harm, the policy had unintended consequences. By systematically excluding females from early-stage clinical research, it delayed understanding of sex-specific drug metabolism, efficacy, and toxicity. This oversight contributed to decades of male-biased dosing standards and a higher incidence of adverse drug reactions in females. The 1977 policy thus represents a pivotal moment in regulatory history, one that underscores the necessity of balanced inclusion, transparency, and sex-aware study design to achieve equitable and effective medical care. Federal policies since then have increasingly emphasized the ethical and scientific necessity of including women in clinical research.

    The problem with one-size-fits-all medicine: Biological sex and the aging immune system · 2026 · DOI

  • Madhumita Premkumar1 · Rakesh Kocchar2,3 · Usha Dutta3 © Indian Society of Gastroenterology 2026 This issue, dedicated to Women and Gastroenterology and released in March 2026 to commemorate International Women’s Day, seeks to highlight the intersection between gender and gastrointestinal (GI) as well as liver health. Sev- eral GI and hepatological disorders are either more preva- lent in women or present unique diagnostic and therapeutic challenges in this population. At the same time, women physicians in gastroenterology encounter distinctive profes- sional barriers that shape both their careers and the evolving landscape of the speciality. By examining gastroenterology through a gender lens, this issue brings together clinical sci- ence, lived experience and system-level reflection to offer meaningful insights for our readers.

    Gastroenterology through a gender lens: Clinical and professional perspectives · 2026 · DOI

  • Thus, it remains unclear how LGBTQ people of color internalize and navigate multiple cultural, institutional, and societal stressors, and, furthermore, how these sources of stress may affect health and well-being.

    Integrating the Neurobiology of Minority Stress with an Intersectionality Framework for LGBTQ-Latinx Populations · 2018 · DOI

  • The 1993 National Institutes of Health (NIH) Revitalization Act set a new standard, requiring investigators to consider the inclusion of women and analyze outcomes by gender, yet compliance with these standards in depression research has not been examined systematically.

    Inclusion of Women and Gender-Specific Analyses in Randomized Clinical Trials of Treatments for Depression · 2010 · DOI

  • Diseases including glioblastoma, cirrhosis, idiopathic pulmonary fibrosis, and schizophrenia emerged as critically understudied in females despite affecting both sexes comparably.

    Large-scale automated detection reveals pervasive sex imbalance in biomedical research · 2026 · DOI

  • Although available data remain limited, understanding these interconnections is essential for optimizing therapeutic strategies, improving cardiovascular health, and fostering more inclusive clinical practices for the transgender community.

    Vascular Health and Gender-Affirming Hormone Therapy: The Immune System in Motion · 2026 · DOI

  • This review also discusses factors that limit current research, contributing to inconsistent findings and persistent gaps in understanding the cardiovascular and immunologic effects of gender-affirming hormone therapy, along with directions for future studies.

    Vascular Health and Gender-Affirming Hormone Therapy: The Immune System in Motion · 2026 · DOI

  • A growing body of research identifies structural sexism as a driver of population health, but it remains unknown if structural sexism is linked to preventive care use and, if so, whether the relationship differs for women and men.

    Structural Sexism and Preventive Health Care Use in the United States · 2023 · DOI

  • This article examines the concept of sex as a biological “fact” in Western science from the eighteenth century to the present and, in particular, how the binary definition of sex has been maintained despite empirical flaws and contradictory data.

    No Way Out of the Binary: A Critical History of the Scientific Production of Sex · 2017 · DOI

  • We focus on a number of conceptual and methodological issues surrounding sex-disaggregated administrative data, and we conclude that sex disaggregation alone is insufficient.

    Sex Is Not Enough: The Need for Gender-Based Analysis in Health Research · 2011 · DOI

  • Further investigation into questions around the causal machinery of sex determination is warranted in the social science literature, as well as in that of biology and medicine.

    Exploring the Causal Machinery behind Sex Ratios at Birth: Does Hepatitis B Play a Role? · 2010 · DOI

  • Men and women in national surveys from four countries, the United States, Canada, Great Britain, and Norway, give mutually inconsistent reports of numbers of opposite-gender sexual partners.

    Discrepancies between men and women in reporting number of sexual partners: A summary from four countries · 1992 · DOI

  • Super- parasitism tinlike genotypes together andI causes at least parrtial (outbreeding; there- l'ore, since males are scarcer, they are under more intense selection for competition ability.

    Extraordinary Sex Ratios · 1967 · DOI

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31 open questions have been extracted from the limitations and future-work passages of 1,169 Sex and Gender in Healthcare papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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