Department of Sociology and Institute for Health, Health Care Policy and Aging Research, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
Soc Sci Med. 2012 Jun;74(11):1817-24. doi: 10.1016/j.socscimed.2011.05.033. Epub 2011 Jun 15.
Extensive medical, public health, and social science research have focused on cataloguing male-female differences in human health. Unfortunately, much of this research unscientifically and unquestionably attributes these differences to biological causes--as exemplified in the Institute of Medicine's conclusion that "every cell has a sex." In this manuscript we theorize the entanglement of sex and gender in human health research and articulate good practice guidelines for assessing the role of biological processes--along with social and biosocial processes--in the production of non-reproductive health differences between and among men and women. There are two basic tenets underlying this project. The first is that sex itself is not a biological mechanism and the second is that "sex" and "gender" are entangled, and analyses should proceed by assuming that measures of sex are not pristine, but include effects of gender. Building from these tenets--and using cardiovascular disease as a consistent example--we articulate a process that scientists and researchers can use to seriously and systematically assess the role of biology and social environment in the production of health among men and women. We hope that this intervention will be one further step toward understanding the complexity and nuance of health outcomes, and that this increased knowledge can be used to improve human health.
大量的医学、公共卫生和社会科学研究都集中在描述人类健康中的男女差异上。不幸的是，许多此类研究都不科学且不加质疑地将这些差异归因于生物学原因，正如美国医学研究所的结论所举例说明的那样，“每个细胞都有性别”。在本文中，我们从理论上探讨了性和性别在人类健康研究中的交织，并阐明了评估生物学过程（以及社会和生物社会过程）在男女之间产生非生殖健康差异中的作用的良好实践指南。该项目有两个基本前提。第一个前提是，性本身不是生物学机制，第二个前提是“性”和“性别”是交织在一起的，分析应该假设性的衡量标准不是原始的，而是包括性别的影响。基于这些前提——并以心血管疾病为例——我们阐明了一个科学家和研究人员可以用来认真和系统地评估生物学和社会环境在男性和女性健康中的作用的过程。我们希望这一干预措施将是进一步理解健康结果的复杂性和细微差别的一步，并且可以利用这些新知识来改善人类健康。
