Abstract
Despite broadening consideration of sex- and gender-based issues in health research, when seeking information on how sex and gender contribute to disease contexts for specific health or public health topics, a lack of consistent or systematic use of terminology in health literature means that it remains difficult to identify research with a sex or gender focus. These inconsistencies are driven, in part, by the complexity and terminological inflexibility of the indexing systems for gender- and sex-related terms in public health databases. Compounding the issue are authors’ diverse vocabularies, and in some cases lack of accuracy in defining and using fundamental sex–gender terms in writing, and when establishing keyword lists and search criteria. Considering the specific case of the tuberculosis (TB) prevention and management literature, an analysis of sex and gender sensitivity in three health databases was performed. While there is an expanding literature exploring the roles of both sex and gender in the trajectory and lived experience of TB, we demonstrate the potential to miss relevant research when attempting to retrieve literature using only the search criteria currently available. We, therefore, argue that for good clinical practice to be achieved; there is a need for both public health researchers and users to be better educated in appropriate usage of the terminology associated with sex and gender. In addition, public health database indexers ought to accept the task of developing and implementing adequate definitions of sex and gender terms so as to facilitate access to sex- and gender-related research. These twin advances will allow clinicians to more readily recognize and access knowledge pertaining to systems of redress that respond to gendered risks that compound existing health inequalities in disease management and control, particularly when dealing with already complex diseases. Given the methodological and linguistic challenges presented by the multidimensional and highly contextual nature of definitions of sex and gender, it will be important that this review task be undertaken using a multidisciplinary approach.
Acknowledgments
The authors give sincere thanks for financial support to the Shastri Indo-Canadian Institute, Collaborative grant and to the Canadian Institute of Health Research, Knowledge Synthesis Grant.
Sincere thanks also go to Aleha Aziz, Anisa Benjamin, Alisha Nicole Apale, Cristina Perez, and Alexandrine Lussier for their contributions as research assistants.
Author contributions
All authors contributed significantly to the conception and design of the study, data analysis, writing and drafting of the manuscript, and revision of the publication. All authors have approved the final version to be published and have agreed to be accountable for ensuring that questions related to the accuracy or integrity of the work will be appropriately investigated and resolved.
Disclosure
The authors report no conflicts of interest in this work.