Incorporating the gender dimension into infectious disease research: how is Parasitology progressing?

Both sex (biological) and gender (socio-cultural) are increasingly recognized as important factors in disease risks and outcomes, including parasitic infections and especially those of the genital tract. Many funding agencies now require these dimensions be incorporated into research proposals, though little guidance is given regarding how, leading to confusion among those who do not specialize in this area. In this commentary, I review instances of the use of the word 'gender' in the archives of Parasitology (174 articles) to assess how parasitologists are progressing in the incorporation of this dimension and identify what can be done to improve efforts. Use of the term has increased since 1990, reflecting an enthusiasm among parasitologists for including this dimension to their work. Examination of articles which use this term reveals that correct and thorough incorporation of the gender dimension has also increased, but that these articles only account for 8.0% of all articles using the term, demonstrating widespread persistent confusion around terminology regarding sex and gender and how to best account for gender in parasitological research. Parasitologists studying animals should only refer to sex and should incorporate sex into their research design and report whether there are differences in baseline or response between sexes. Parasitologists studying humans should incorporate sex, but then also consider whether any observed differences are due to biological factors like sex hormones and immunity or gendered social variables like behavioural norms and healthcare access. These considerations will further our understanding of host-parasite interactions and improve health outcomes.