There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex–gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global health, avoiding systematic errors that generate results with low validity. Care for people should consider the single individual and his or her past and present life experiences, as well as his or her relationship with care providers. Therefore, intersectoral and interdisciplinary studies are urgently required. It is desirable to create teams made up of men and women to meet the needs of both. Finally, it is also necessary to build an alliance among regulatory and ethic authorities, statistics, informatics, the healthcare system and providers, researchers, the pharmaceutical and diagnostic industries, decision makers, and patients to overcome the gender gap in medicine and to take real care of a person in an appropriate manner.

The Person's Care Requires a Sex and Gender Approach.

Chasing red herrings and wild geese: Sex differences versus sex dimorphism.

ABSTRACT Background Recent years have shown an increased application of prospective trajectory-oriented approaches to posttraumatic stress disorder (PTSD). Although women are generally considered at increased PTSD risk, sex and gender differences in PTSD symptom trajectories have not yet been extensively studied. Objective To perform an in-depth investigation of differences in PTSD symptom trajectories across one-year post-trauma between men and women, by interpreting the general trends of trajectories observed in sex-disaggregated samples, and comparing within-trajectory symptom course and prevalence rates. Method We included N = 554 participants (62.5% men, 37.5% women) from a multi-centre prospective cohort of emergency department patients with suspected severe injury. PTSD symptom severity was assessed at 1, 3, 6, and 12 months post-trauma, using the Clinician-Administered PTSD Scale for DSM-IV. Latent growth mixture modelling on longitudinal PTSD symptoms was performed within the sex-disaggregated and whole samples. Bayesian modelling with informative priors was applied for reliable model estimation, considering the imbalanced prevalence of the expected latent trajectories. Results In terms of general trends, the same trajectories were observed for men and women, i.e. resilient, recovery, chronic symptoms and delayed onset. Within-trajectory symptom courses were largely comparable, but resilient women had higher symptoms than resilient men. Sex differences in prevalence rates were observed for the recovery (higher in women) and delayed onset (higher in men) trajectories. Model fit for the sex-disaggregated samples was better than for the whole sample, indicating preferred application of sex-disaggregation. Analyses within the whole sample led to biased estimates of overall and sex-specific trajectory prevalence rates. Conclusions Sex-disaggregated trajectory analyses revealed limited sex differences in PTSD symptom trajectories within one-year post-trauma in terms of general trends, courses and prevalence rates. The observed biased trajectory prevalence rates in the whole sample emphasize the necessity to apply appropriate statistical techniques when conducting sex-sensitive research. HIGHLIGHTS We investigated sex differences in PTSD symptom trajectories over one-year post-trauma. We observed modest differences. Symptom courses were mostly similar. Yet, the recovering trajectory was more prevalent in women, while the delayed onset trajectory was more prevalent in men.

https://www.tandfonline.com/doi/pdf/10.1080/20008198.2022.2031593?needAccess=true

Sex-differential PTSD symptom trajectories across one year following suspected serious injury

In the last two decades, social psychologists have identified several key spending strategies that promote happiness such as making time-saving purchases (buying time) and spending money on others (prosocial spending). Although the emotional benefits of these two spending strategies are well-documented in the current literature, it is unclear whether the effectiveness of these strategies vary depending on individual characteristics. To address this research gap, we surveyed an economically diverse sample of 15,545 Americans about their subjective well-being, spending behavior, personal values and beliefs, as well as demographics including age, gender, and income. Across demographic groups, spending money on others was robustly related to happiness. Spending money on others was also associated with greater happiness regardless of whether participants believed that they would be happier spending money on others. In contrast, the relationship between buying time and happiness was somewhat less reliable. Although gender and personal income did not moderate the relationship between buying time and happiness, the relationship was only marginally significant for men, and non-significant within each income bracket. Our results also indicated that those who valued money over time were significantly happier when they used money to buy time, whereas those who valued time over money reported similar levels of happiness whether or not they bought time. Taken together, the present research shows that the relationship between prosocial spending, buying time, and subjective well-being is largely consistent across the different demographic groups we examined.

/pdf/are-the-benefits-of-prosocial-spending-and-buying-time-2kn7ma77.pdf

Are the benefits of prosocial spending and buying time moderated by age, gender, or income?

Sex and gender differences are seen in cognitive disturbances in a variety of neurological and psychiatry diseases. Men are more likely to have cognitive symptoms in schizophrenia whereas women are more likely to have more severe cognitive symptoms with major depressive disorder and Alzheimer’s disease. Thus, it is important to understand sex and gender differences in underlying cognitive abilities with and without disease. Sex differences are noted in performance across various cognitive domains – with males typically outperforming females in spatial tasks and females typically outperforming males in verbal tasks. Furthermore, there are striking sex differences in brain networks that are activated during cognitive tasks and in learning strategies. Although rarely studied, there are also sex differences in the trajectory of cognitive aging. It is important to pay attention to these sex differences as they inform researchers of potential differences in resilience to age-related cognitive decline and underlying mechanisms for both healthy and pathological cognitive aging, depending on sex. We review literature on the progressive neurodegenerative disorder, Alzheimer’s disease, as an example of pathological cognitive aging in which human females show greater lifetime risk, neuropathology, and cognitive impairment, compared to human males. Not surprisingly, the relationships between sex and cognition, cognitive aging, and Alzheimer’s disease are nuanced and multifaceted. As such, this chapter will end with a discussion of lifestyle factors, like education and diet, as modifiable factors that can alter cognitive aging by sex. Understanding how cognition changes across age and contributing factors, like sex differences, will be essential to improving care for older adults. 

Sex Differences in Cognition Across Aging.

Sex differences exist in a variety of neurological and psychiatric diseases in terms of prevalence, manifestation, and treatment but most past research has been conducted in males. Multiple mandates have been initiated across funding agencies (National Institute of Health, Horizon Europe, Canadian Institute for Health Research) and scientific publishers (Sex and Gender Equity in Research) for biomedical and clinical research to include both males and females in research and reporting. Although more studies are including males and females in their research there are issues in how studies are incorporating males and females in their experiments, as about a third of studies that use males and females do not report sample size and only half are conducting any analysis by sex. Furthermore, what has been lacking in the literature is a detailed assessment of not only how sex is reported in papers (e.g. sample sizes disclosed, balanced design, sex used consistently throughout the experiments) but also how the variable sex is included in any analyses (e.g. covariate). Here we investigated all papers in 2009 and 2019 in three high ranking journals for each of Neuroscience and Psychiatry. We found that there was a 30% increase in the percentage of papers that included both sexes from 2009 to 2019 such that 68% of studies in Neuroscience and Psychiatry used both males and females in 2019. Despite this increase, in 2019 only 19% of all studies used an optimal design for discovery of possible sex differences and only 5% analyzed with sex as a discovery variable. Of the studies that used males and females - 25% of studies do not disclose sample sizes, 36% of studies used an unbalanced design, and 15% of studies did not use both sexes consistently throughout the paper. The percentage of single sex papers remains unchanged across the ten years at 3% for female-only studies compared to 27% for male-only studies across both disciplines. Neuroscience had fewer papers that analyzed by sex at 20% compared to 61% of Psychiatry papers. We hope that these data will make it evident that more needs to be done to improve the inclusion of males and females in future studies to improve the health of men and women.

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Splinter Tf

Papers

Harnessing the Power of Sex Differences: What a Difference Ten Years Did Not Make