ABSTRACT

Gender is a particularly complex social determinant of health because it interacts with, and is closely identifi ed with, biologic dimensions of vulnerability. Research efforts to understand ‘what gender does’ to health are challenging for several reasons, including the fact that sex and gender are frequently confl ated in the epidemiologic and medical literature. While a growing number of health studies claim to include an analysis of gender, they use the terms sex and gender interchangeably, and go no further than including sex/gender as one bivariate category in their analysis. By using the terms gender and sex interchangeably, the public health literature implicitly endorses the notion that gender is an extension of sex. Recent studies offer us disaggregated data by sex, but such data alone does little to further our understanding of whether observed sex differentials are attributable to underlying chromosomal sex differences, to gender experience, or a combination of factors.