Why it is important to implement a sex & gender lens in obesity research
Today’s post comes from Amanda Raffoul. Amanda is a PhD Candidate in the School of Public Health and Health Systems at the University of Waterloo. She is also the current Outgoing Chair of the OC-SNP National Executive.
You know the drill – when you start planning a research project, conducting data analyses, or writing up results, you always measure, analyse, and discuss the role of “gender” in your study. But have you thought to consider why gender is important to your research question, or whether you are accurately measuring it?
Many health researchers misuse the term gender, or conflate it with sex (1), so let’s start there. Gender refers to the socially constructed roles and identities that influence our perceptions, interactions, and roles in society, while sex refers to biological and physiological features of humans and animals (2). Sex- and gender-based analysis (SGBA), then, considers how the biological and socio-cultural differences between people interact with other social determinants (e.g., age, income, race and ethnicity) to influence overall health (2,3).
So what does this mean for your research? Should you consider the use of sex, gender, or both when constructing your research project? That depends on your study goals and objectives, but one quick way to answer that is by assessing whether your outcome of interest is influenced by physiological factors (e.g., chromosomes, hormone function) and/or social and cultural phenomena (e.g., access to health services, eating and dieting behaviours). Further, any measures of sex and/or gender should accurately reflect the construct you aim to study; for example, if you ask research participants to fill out a survey with multiple-choice options for their responses, your measure of “gender” should not be limited to the response options “male” and “female”. For more information on how to accurately measure sex and gender, visit the Canadian Institutes of Health Research – Institute of Gender and Health (CIHR-IGH) website.
Obesity and weight-related research areas, such as nutrition and mental health, are incredibly complex and influenced by factors at individual, community, and broader societal levels (4). As trainees, we have a responsibility to consider the role that sex and gender play in obesity prevalence (5), and as a result, in prevention and treatment. In particular, there is a paucity of research that considers individuals with non-binary gender identities, which is concerning, considering their elevated risk of engaging in harmful weight-related behaviours (6,7); however, since non-binary gender identities are often excluded from obesity and health research more broadly (8), these populations are often under-represented in our work.
The next time you start to plan a research project, or even when you are reading someone else’s work, question the role of sex and gender in the study. CIHR-IGH (2) provides several resources for researchers and trainees alike to familiarize themselves with SGBA and its significance in health research.
- Krieger N. Genders, sexes, and health: what are the connections–and why does it matter? Int J Epidemiol. 2003;32(4):652-7.
- How to integrate sex and gender into research [Internet]. Canadian Institutes of Health Research (CIHR). 2018 [cited 14 September 2018]. Available from: http://www.cihr-irsc.gc.ca/e/50836.html
- Hankivsky O. Women’s health, men’s health, and gender and health: Implications of intersectionality. Soc Sci Med. 2012;74(11):1712-20.
- Johnston LM, Matteson CL, Finegood DT. Systems science and obesity policy: A novel framework for analyzing and rethinking population-level planning. Am J Public Health. 2014;104(7):1270-8.
- Kanter R, Caballero B. Global gender disparities in obesity: a review. Adv Nutr. 2012;3(4):491-8.
- Guss CE, Williams DN, Reisner SL, Austin SB, Katz-Wise SL. Disordered weight management behaviors, nonprescription steroid use, and weight perception in transgender youth. J Adolesc Health. 2017;60(1):17-22.
- Raffoul A, Hammond D. Correlates of weight-loss methods among young adults in Canada. Obesity. 2018;26(8):1357-64.
- Johnson JL, Greaves L, Repta R. Better science with sex and gender: Facilitating the use of a sex and gender-based analysis in health research. Int J Equity Health. 2009;8:14.