Health research: Giving greater consideration to gender diversity

Gender diversity is still understudied in health research. This is shown by a recent survey conducted by researchers at the Institute for Public Health and Nursing Research at the University of Bremen. A distinction into the categories "male" and "female" is common, but does not reflect the complexity of the biological and social dimensions of gender.

How is gender diversity incorporated in health research? This question was investigated by a team led by health scientists Sophie Horstmann and Gabriele Bolte from the Institute for Public Health and Nursing Research at the University of Bremen. "Gender is a frequently used variable in health research, but it is usually limited to a simple distinction between 'male' and 'female,'" explains Professor Gabriele Bolte of the University of Bremen.

This contradicts the current state of research in the natural and social sciences, which documents a wide range of variation for the physiological and anatomical as well as the psychosocial manifestations of gender. "For the development of gender-appropriate health services, there is currently a great need for a more differentiated coverage in health research—namely, to take into account the diversity within the groups of 'women,' 'men,' and other gender identities," emphasizes the professor.

Now published: Overview of the current state of research

The publication stemming from the research project, which appeared in the International Journal for Environmental Research and Public Health, shows the results of a review that aimed to map the current state of research with regard to incorporating gender diversity in quantitative health research. One finding is that an instrument based on gendered role expectations developed by American students in the 1970s is still most commonly used in surveys.

"We were pleased to see that the development and use of instruments that capture variability in gender have increased in recent years. One example is to not only provide the two answer boxes 'male' and 'female,' but to ask both the gender assigned at birth and the current own gender identity," says Sophie Horstmann, who works as a research assistant in the research project at the Institute for Public Health and Nursing Research. "However, the need for further development is also apparent at this point. In particular, little attention has been paid to capturing different dimensions of biological sex, whether at the level of chromosomes, internal sex organs, or hormones."

About the project

The Federal Ministry of Health has been funding the DIVERGesTOOL project (Toolbox for operationalizing gender diversity in research on health care, health promotion, and prevention) since May 2020. In this interdisciplinary research project led by Professor Gabriele Bolte, the Department of Social Epidemiology of the Institute of Public Health and Nursing Research at the University of Bremen is working closely with areas of gender studies at Humboldt University in Berlin and gender medicine at Radboud University in Nijmegen.

Large cohort studies in Germany are contributing: Participatory development of a toolbox

The project aims to develop a toolbox to assist researchers in adequately including gender and its wide variation in health care, health promotion, and prevention research. The results of the review will be used directly in the development process of the toolbox. The DIVERGesTOOL project is characterized by its participatory approach: several large cohort studies in health research in Germany have been involved in the project from the outset.