Gender-Related Variables for Health Research

Nielsen, M. W.; Stefanick, M. L.; Peragine, D.; Neilands, T. B.; Ioannidis, J. P. A.; Pilote, L.; Prochaska, J. J.; Cullen, M. R.; Einstein, G.; Klinge, I.; LeBlanc, H.; Paik, H. Y.; Schiebinger, L.

This study develops a gender assessment tool for use in clinical and population research, including large-scale health surveys involving diverse Western populations. While analyzing sex as a biological variable is widely mandated, gender as a sociocultural variable is not, largely because the field lacks quantitative tools for analyzing the influence of gender on health outcomes. We conducted a comprehensive review of English-language measures of gender from 1975 to 2015 to identify variables across three domains: gender norms, gender-related traits, and gender relations. This yielded 11 variables tested with 44 items in three US cross-sectional survey populations: two internet-based (N= 2,051; N= 2,135) and a patient-research registry (N= 489), conducted between May 2017 and January 2018. Exploratory and confirmatory factor analyses distilled 11 constructs to 7 gender-related variables: caregiver strain, work strain, independence, risk-taking, emotional intelligence, social support, and discrimination. Regression analyses, adjusted for age, ethnicity, income, education, sex assigned at birth, and self-reported gender identity, identified associations between these gender-related variables and self-rated general health, physical and mental health, and health-risk behaviors. Our new instrument can be used to develop health interventions based on a fuller understanding of gender associations with health.