Marina Politis, Rachel Fowden-Hulme, Alice Witt, Kate Womersley
{"title":"Sex and gender considerations in UK clinical guidelines: a systematic review of 197 NICE guidelines.","authors":"Marina Politis, Rachel Fowden-Hulme, Alice Witt, Kate Womersley","doi":"10.3399/bjgp25X742353","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Despite growing recognition of sex and gender differences in disease presentation and treatment responses, clinical guidelines often fail to address these variables, risking patient safety.</p><p><strong>Aim: </strong>This study aimed to determine how many NICE clinical guidelines incorporate sex and/or gender considerations, and to analyse gender composition of guideline committees.</p><p><strong>Method: </strong>The study reviewed 197 non-sex-specific NICE guidelines, evaluating whether they mentioned sex or gender beyond pregnancy and childbirth. Secondary outcomes included whether sex and/or gender were considered in disease risk, presentation, and management and perceived gender of guideline committee chairs and members.</p><p><strong>Results: </strong>Of 223 guidelines, 197 assessed a non-sex-specific condition. 120 referenced sex or gender related terminology, of which only 81 deployed this terminology outside of pregnancy and childbearing. Only 4 (2%) of guidelines stated sex/gender differences related to disease pathophysiology, 18 guidelines (9%) related to disease presentation, 29 (15%) related to investigations, and 38 (19%) related to epidemiology.Of 162 published committee chairs, 126 (76%) were men. Committees chaired by women produced clinical guidelines which better account for sex and gender.</p><p><strong>Conclusion: </strong>Recommendations related to sex and gender are underreported in NICE guidelines. Women are underrepresented as committee chairs, failing to reflect participation in the healthcare workforce. Meaningful change will require systematic, whole sector progress to integrate sex and/or gender disaggregated research into clinical guidelines. In the UK, the MESSAGE project has co-design a sex and gender policy framework for funding and regulatory organisations, supporting policy implementation across the UK research sector.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":"75 suppl 1","pages":""},"PeriodicalIF":5.2000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The British journal of general practice : the journal of the Royal College of General Practitioners","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3399/bjgp25X742353","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"Print","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Despite growing recognition of sex and gender differences in disease presentation and treatment responses, clinical guidelines often fail to address these variables, risking patient safety.
Aim: This study aimed to determine how many NICE clinical guidelines incorporate sex and/or gender considerations, and to analyse gender composition of guideline committees.
Method: The study reviewed 197 non-sex-specific NICE guidelines, evaluating whether they mentioned sex or gender beyond pregnancy and childbirth. Secondary outcomes included whether sex and/or gender were considered in disease risk, presentation, and management and perceived gender of guideline committee chairs and members.
Results: Of 223 guidelines, 197 assessed a non-sex-specific condition. 120 referenced sex or gender related terminology, of which only 81 deployed this terminology outside of pregnancy and childbearing. Only 4 (2%) of guidelines stated sex/gender differences related to disease pathophysiology, 18 guidelines (9%) related to disease presentation, 29 (15%) related to investigations, and 38 (19%) related to epidemiology.Of 162 published committee chairs, 126 (76%) were men. Committees chaired by women produced clinical guidelines which better account for sex and gender.
Conclusion: Recommendations related to sex and gender are underreported in NICE guidelines. Women are underrepresented as committee chairs, failing to reflect participation in the healthcare workforce. Meaningful change will require systematic, whole sector progress to integrate sex and/or gender disaggregated research into clinical guidelines. In the UK, the MESSAGE project has co-design a sex and gender policy framework for funding and regulatory organisations, supporting policy implementation across the UK research sector.