TY - JOUR N1 - © 2023 The Authors. Published by the Royal Society under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). IS - 7 AV - public VL - 10 Y1 - 2023/07// TI - Sex and gender in infection and immunity: addressing the bottlenecks from basic science to public health and clinical applications KW - Immunology KW - Sex KW - Gender KW - Research KW - Infection KW - Inclusion KW - Diversity KW - Bottlenecks A1 - Peckham, Hannah A1 - Pasin, Chloé A1 - Consiglio, Camila R A1 - Huisman, Jana S A1 - de Lange, Ann-Marie G A1 - Vallejo-Yagüe, Enriqueta A1 - Abela, Irene A A1 - Islander, Ulrika A1 - Neuner-Jehle, Nadia A1 - Pujantell, Maria A1 - Roth, Olivia A1 - Schirmer, Melanie A1 - Tepekule, Burcu A1 - Zeeb, Marius A1 - Hachfeld, Anna A1 - Aebi-Popp, Karoline A1 - Kouyos, Roger D A1 - Bonhoeffer, Sebastian CY - UK JF - Royal Society Open Science PB - The Royal Society UR - https://doi.org/10.1098/rsos.221628 ID - discovery10172945 N2 - Although sex and gender are recognized as major determinants of health and immunity, their role israrely considered in clinical practice and public health. We identified six bottlenecks preventing theinclusion of sex and gender considerations from basic science to clinical practice, precision medicineand public health policies. (i) A terminology-related bottleneck, linked to the definitions of sex andgender themselves, and the lack of consensus on how to evaluate gender. (ii) A data-relatedbottleneck, due to gaps in sex-disaggregated data, data on trans/non-binary people and genderidentity. (iii) A translational bottleneck, limited by animal models and the underrepresentation ofgender minorities in biomedical studies. (iv) A statistical bottleneck, with inappropriate statisticalanalyses and results interpretation. (v) An ethical bottleneck posed by the underrepresentation ofpregnant people and gender minorities in clinical studies. (vi) A structural bottleneck, as systemicbias and discriminations affect not only academic research but also decision makers. We specifyguidelines for researchers, scientific journals, funding agencies and academic institutions to addressthese bottlenecks. Following such guidelines will support the development of more efficient andequitable care strategies for all. ER -