Fuentes Artiles Rubén, Gebhard Caroline E, Gebhard Catherine
Department of Cardiology, Bern University Hospital Inselspital, University of Bern, Bern, Switzerland.
Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland.
Eur J Clin Invest. 2025 Oct;55(10):e70089. doi: 10.1111/eci.70089. Epub 2025 Jun 12.
Sex and gender are fundamental determinants of health, influencing disease risk, diagnosis, treatment, and outcomes across medical disciplines. While sex refers to biological characteristics, gender encompasses sociocultural dimensions, including behaviours and identities.
The field of gender medicine has evolved significantly from its roots in the women's health movement of the 1960s and 1970s, which initially sought to address reproductive rights and the systematic exclusion of women from clinical research. Over time, the focus has expanded to recognize sex- and gender-based differences in all populations, including men and gender-diverse individuals. Despite progress, persistent challenges remain. Many clinical guidelines inadequately incorporate sex and gender considerations, and women continue to be underrepresented in clinical trials, resulting in suboptimal efficacy and a higher incidence of adverse effects in women. Recent initiatives, including government-funded research programs, specialized gender medicine professorships and regulatory measures promoting equitable clinical trial participation, represent positive steps forward. However, a systematic, interdisciplinary approach is required to fully integrate gender-sensitive medicine into research, education and clinical practice. This narrative review explores the historical development of gender medicine, current advancements and remaining challenges. We highlight the need for improved research methodologies, policy changes and targeted interventions to ensure equitable healthcare. A structured action plan emphasizing regulatory support, education, industry involvement and public awareness is essential to accelerate the field's integration.
Recognising and addressing sex- and gender-sensitive health differences will lead to more personalised and effective medical care, ultimately improving health outcomes for all individuals.
性别是健康的基本决定因素，影响着各个医学学科的疾病风险、诊断、治疗及预后。性别（sex）指生物学特征，而社会性别（gender）涵盖社会文化层面，包括行为和身份认同。
社会性别医学领域已从20世纪60年代和70年代的妇女健康运动发展而来，该运动最初旨在解决生殖权利问题以及女性在临床研究中的系统性被排斥问题。随着时间的推移，关注点已扩大到认识所有人群（包括男性和性别多样化个体）中基于性别的差异。尽管取得了进展，但持续存在的挑战依然存在。许多临床指南未充分纳入性别因素考量，女性在临床试验中的代表性仍然不足，导致疗效欠佳且女性不良反应发生率更高。最近的举措，包括政府资助的研究项目、专门的社会性别医学教授职位以及促进公平参与临床试验的监管措施，都是积极的进步。然而，需要一种系统的、跨学科的方法，将对性别敏感的医学全面融入研究、教育和临床实践。本叙述性综述探讨了社会性别医学的历史发展、当前进展及尚存的挑战。我们强调需要改进研究方法、政策变革和针对性干预措施，以确保医疗公平。强调监管支持、教育、行业参与和公众意识的结构化行动计划对于加速该领域的整合至关重要。
认识并应对性别敏感的健康差异将带来更个性化、更有效的医疗护理，最终改善所有人的健康结局。
