The Sex and Gender Equity in Research (SAGER) guidelines: Implementation and checklist development

Understanding sex and gender differences is fundamental to rigorous and inclusive research, whether studying disease pathophysiology, sociodemographic determinants of health, or the benefits and harms of medical or social interventions. The inclusion of gender-diverse study populations has improved, but the reporting of sex and gender variables in research is still incomplete. The Sex and Gender Equity in Research (SAGER) guidelines, published in 2016, have been widely endorsed, but few scientific journals and organizations have incorporated them into formal editorial guidance and publication policies. To facilitate monitoring of and adherence to the SAGER guidelines in Lancet journals, we carried out an informal pilot study and developed a checklist to enable rapid editorial checks, promote uptake of the guidelines by other editors and journals, and raise awareness among peer reviewers and authors. By using this checklist as part of manuscript assessment and peer-review processes, journal editors can support best reporting practices when considering sex and gender as variables, improving the generalizability of the research they publish.