Understanding Influences of Sex and Gender in Health and Disease

To learn about the terms “sex” and “gender” visit our page What are Sex & Gender?

Understanding sex and gender is critical to understanding health and to diagnosing and treating disease and illness. Disparities in the prevalence and severity of several conditions point to the need for further research in this area. For example:  

  • Women are nearly twice as likely as men to be diagnosed with depression. [1]
  • Women and men have heart attacks at similar rates, but women are more likely to die as a result. [2]
  • Women make up about 78% of patients with autoimmune diseases. [3]
  • Women are more likely to have chronic pain than men, but women are less likely to receive treatment. [4]

To better understand and address these gaps, it is important to consider how both sex and gender influence these disparities. It is also important to understand that sex and gender are interconnected but distinct concepts, and that each affect health as both independent and interactive factors. The below graphic presents a few examples of sex and gender influences across various areas of health and disease to illustrate the distinction between sex and gender and highlight the importance of understanding them as factors in health and disease. Please note that each example presented below is just one of many possible examples for each area.

Dimensions of Sex (Biological Variable) & Gender (Social and Cultural Variable) Sex dimensions are anatomy, physiology, genetics, and hormones. Gender dimensions are identity, roles and norms, relations, and power.
Mental Health icon
Mental Health
Substance Use Disorders icon
Substance Use Disorders
Cardiovascular Health icon
Cardiovascular Health
Autoimmune Diseases icon
Autoimmune Diseases
Chronic Pain icon
Chronic Pain
Environmental Exposures icon
Environmental Exposures
Trauma and Violence icon
Trauma and Violence
Female-Specific Conditions icon
Female-Specific Conditions
Musculoskeletal Health icon
Musculoskeletal Health
Cancer icon

A note on terminology:

“Male” and “female” refer to sex assigned at birth. In addition, while we use the terms “male” and “female” for the purposes of this discussion, we recognize that sex is not a binary variable and variations do occur. These variations are called differences in sex development (DSD) or intersex conditions. For more information, visit the website of NIH’s Sexual & Gender Minority Research Office.

[1] Mayo Clinic. (n.d.). Depression in women: Understanding the gender gap. Retrieved January 18, 2023, from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725

[2] American Heart Association. (2020, November 30). Women found to be at higher risk for heart failure and heart attack death than men. https://newsroom.heart.org/news/women-found-to-be-at-higher-risk-for-heart-failure-and-heart-attack-death-than-men

[3] Fairweather, D., & Rose, N. R. (2004). Women and autoimmune diseases. Emerging Infectious Diseases, 10(11), 2005–2011. https://doi.org/10.3201/eid1011.040367

[4] International Association for the Study of Pain. (n.d.). Female pain issues. Retrieved January 19, 2023, from https://www.iasp-pain.org/advocacy/global-year/pain-in-women/