Accepted for/Published in: JMIR Dermatology
Date Submitted: Mar 8, 2023
Open Peer Review Period: Mar 8, 2023 - May 3, 2023
Date Accepted: Jun 20, 2023
Date Submitted to PubMed: Aug 26, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Distinguishing Gender Identity from Biological Sex in Dermatologic Healthcare: Methods, Harms, and Paths Forward
ABSTRACT
Gender identity and biological sex are important, distinct variables in dermatology research. However, these are often conflated or poorly demarcated. Our analysis highlights the need for agreement on assessing gender identity and biological sex in dermatology research to address their complexity and importance fairly. We first analyzed current methodologies. Despite calls for transparency and reproducibility, assessment of gender identity and biological sex differences varied widely between sources. We then analyzed the impact of gender identity and biological sex on skincare, disease prevalence, and symptoms. We found disparities in skin disease rates and skin care practices between males and females. Next, we discussed the disparity in literature representation between males and females. Recognition and response to female underrepresentation in literature are growing, but underrepresentation of transgender and non-binary patients persists. Lastly, we discussed provider communication about gender identity. Giving physicians better communication skills can prevent confusing sex and gender and ensure respectful patient interactions. Healthcare researchers need more thorough guidance regarding gender and sex assessments. This often ignored distinction reduces respect for patients and weakens the accuracy of study outcomes. Given the marked differences between male and female skin, this issue is particularly relevant to dermatology research.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.