{"doi":"10.1186/s13293-021-00366-3","title":"Gender-related variables for health research","abstract":"<h4>Background</h4>In this paper, we argue for Gender as a Sociocultural Variable (GASV) as a complement to Sex as a Biological Variable (SABV). Sex (biology) and gender (sociocultural behaviors and attitudes) interact to influence health and disease processes across the lifespan-which is currently playing out in the COVID-19 pandemic. This study develops a gender assessment tool-the Stanford Gender-Related Variables for Health Research-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.<h4>Methods</h4>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 = 2051; N = 2135) and a patient-research registry (N = 489), conducted between May 2017 and January 2018.<h4>Results</h4>Exploratory and confirmatory factor analyses reduced 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.<h4>Conclusion</h4>Our new instrument represents an important step toward developing more comprehensive and precise survey-based measures of gender in relation to health. Our questionnaire is designed to shed light on how specific gender-related behaviors and attitudes contribute to health and disease processes, irrespective of-or in addition to-biological sex and self-reported gender identity. Use of these gender-related variables in experimental studies, such as clinical trials, may also help us understand if gender factors play an important role as treatment-effect modifiers and would thus need to be further considered in treatment decision-making.","journal":"Biology of Sex Differences","year":2021,"id":9830,"datarank":0.8157118963384794,"base_score":5.438079308923196,"endowment":5.438079308923196,"self_citation_contribution":0.8157118963384794,"citation_network_contribution":0.0,"self_endowment_contribution":0.8157118963384794,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":229,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.0357,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-02-22","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":75616,"name":"Marcia L. Stefanick","orcid":"0000-0002-0284-6996","position":1,"is_corresponding":false},{"id":75617,"name":"Diana Peragine","orcid":null,"position":2,"is_corresponding":false},{"id":75618,"name":"Torsten B. Neilands","orcid":"0000-0001-7936-9123","position":3,"is_corresponding":false},{"id":148,"name":"John P. A. Ioannidis","orcid":"0000-0003-3118-6859","position":4,"is_corresponding":false},{"id":75619,"name":"Louise Pilote","orcid":"0000-0002-6159-0628","position":5,"is_corresponding":false},{"id":75620,"name":"Judith J. Prochaska","orcid":"0000-0001-7925-326X","position":6,"is_corresponding":false},{"id":11024,"name":"Mark R. Cullen","orcid":"0000-0001-7996-1864","position":7,"is_corresponding":false},{"id":75621,"name":"Gillian Einstein","orcid":"0000-0002-0770-5471","position":8,"is_corresponding":false},{"id":75622,"name":"Ineke Klinge","orcid":"0000-0002-0703-9149","position":9,"is_corresponding":false},{"id":75623,"name":"Hannah LeBlanc","orcid":null,"position":10,"is_corresponding":false},{"id":75628,"name":"Hee Young Paik","orcid":"0000-0002-4026-0881","position":11,"is_corresponding":false},{"id":75625,"name":"Londa Schiebinger","orcid":"0000-0003-3438-3081","position":12,"is_corresponding":false},{"id":75626,"name":"Mathias Wullum Nielsen","orcid":"0000-0001-8759-7150","position":13,"is_corresponding":false},{"id":75627,"name":"Diana E. Peragine","orcid":"0000-0002-6696-799X","position":14,"is_corresponding":false},{"id":75615,"name":"Mathias W. Nielsen","orcid":null,"position":0,"is_corresponding":true}],"reference_count":85,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}