“Sex and Gender Are Important Factors – But Only Two Among Several”

Gender medicine is changing the way we look at research and healthcare. But its goal is not to reduce people to their sex or gender. Rather, medicine should be tailored more precisely to the individual, says Sabine Oertelt-Prigione.

 Interview: Marita Fuchs, Freelance Journalist

Prof. Dr. med. Sabine Oertelt-Prigione

Professor Oertelt-Prigione, will gender medicine eventually make itself obsolete?

Sabine Oertelt-Prigione: In the long term, we want to understand which treatment is best suited to each individual – depending on age, stage of life, metabolism, and other biological and social influences. This includes biological sex, such as chromosomes, hormones, or metabolism, as well as gender, which shapes our roles, living conditions, and behaviors. Both influence health – often at the same time.

If sex and gender are important, why are they still not enough?

Because sex and gender alone can quickly lead to overly broad generalizations. Women are not a homogeneous group, and neither are men. A 35-year-old woman and a 75-year-old woman often differ more biologically and socially than two people of different sexes who are the same age. As we age, hormones, metabolism, comorbidities, and social circumstances change – all of which influence how diseases develop, are diagnosed, and are treated.

Take two 75-year-olds, a woman and a man: Both have diabetes and high blood pressure. Yet they may process medications differently, have different comorbidities, or receive different levels of support in their daily lives. Age, sex, and social circumstances interact. That is why the future is not about medicine for women or men, but about medicine for the individual.

How do we move closer to this goal?

We need to work on several aspects at the same time: Sex- and gender-sensitive research must be considered from the very beginning. When planning a study, it should already be clear who will be included and whether the data will be analyzed separately by sex and gender. Transparency in scientific publications is equally important. Only then can we assess to whom the results apply.

Many researchers are concerned about the additional effort involved. What could convince them otherwise?

Examples from research are the most convincing. Often, all it takes is a closer look at the data. A colleague used video recordings to study how people with Parkinson’s disease move. It was only when he made his study group more balanced and included equal numbers of women and men that he identified differences in movement patterns that had previously remained hidden.

This shows that sex- and gender-sensitive research is not an end in itself, nor is it simply additional work. It improves the quality of scientific findings – and, as a result, medical care.

Research is one thing – how can this knowledge be transferred into healthcare as quickly as possible?

Primarily through education and medical guidelines. Students need to learn when sex and gender are medically relevant – and when perceived differences are more likely to be based on stereotypes. Guidelines, in turn, translate research into practice. Sex- and gender-sensitive medicine is not an additional specialty; it is a hallmark of high-quality medicine.

You have studied European guidelines. Where do you see the greatest shortcomings?

Our analysis showed that fewer than one percent of recommendations take sex- and gender-sensitive aspects into account – and when they do, it is usually in connection with pregnancy or fertility. That does not go far enough.

We are also concerned with questions such as: Do medications work the same way in women and men? Do they require different dosages or diagnostic approaches? In many cases, the necessary data are still lacking. Guidelines should identify these gaps in knowledge more clearly. This improves healthcare and makes it clear where further research is needed.

What would success look like to you?

When we no longer need to discuss whether sex and gender should be taken into account, but only how we can make medicine more precise overall. Sex and gender are important building blocks in this process. Ultimately, it is not about medicine for women or medicine for men. It is about medicine that is better suited to each individual.

About Sabine Oertelt-Prigione

Looking Beyond Borders: Different Paths, a Common Goal

Sabine Oertelt-Prigione has studied or worked in Italy, the United States, the United Kingdom, Germany, and the Netherlands. This international experience also shapes her perspective on sex- and gender-sensitive medicine.

“There is rarely only one right way to address medical and scientific challenges,” she says. Social, political, and organizational conditions differ from country to country – and research and healthcare therefore develop differently as well.

She cites Germany and the Netherlands as examples. In Germany, the current focus is on building structural foundations. At the Faculty of Medicine in Bielefeld, curricula are being further developed, courses are being reviewed, and faculty members are being supported in systematically integrating sex and gender aspects into medical education.

In the Netherlands, by contrast, new ideas can often be tested more quickly in everyday clinical practice – for example, digital applications or chatbots for sex- and gender-sensitive communication.

For Oertelt-Prigione, both approaches are important: One creates sustainable structures, while the other accelerates innovation. What matters is not one particular model, but finding an approach that fits the respective healthcare system and societal culture.