Sex and Gender Equity in Research: Rationale for the SAGER Guidelines and Recommended Use

Overview

Journal Res Integr Peer Rev

Publisher Biomed Central

Date 2018 Feb 17

PMID 29451543

Citations 563

Authors

Shirin Heidari

Thomas F Babor

Paola De Castro

Sera Tort

Mirjam Curno

Affiliations

Soon will be listed here.

Abstract

Background: Sex and gender differences are often overlooked in research design, study implementation and scientific reporting, as well as in general science communication. This oversight limits the generalizability of research findings and their applicability to clinical practice, in particular for women but also for men. This article describes the rationale for an international set of guidelines to encourage a more systematic approach to the reporting of sex and gender in research across disciplines.

Methods: A panel of 13 experts representing nine countries developed the guidelines through a series of teleconferences, conference presentations and a 2-day workshop. An internet survey of 716 journal editors, scientists and other members of the international publishing community was conducted as well as a literature search on sex and gender policies in scientific publishing.

Results: The Sex and Gender Equity in Research (SAGER) guidelines are a comprehensive procedure for reporting of sex and gender information in study design, data analyses, results and interpretation of findings.

Conclusions: The SAGER guidelines are designed primarily to guide authors in preparing their manuscripts, but they are also useful for editors, as gatekeepers of science, to integrate assessment of sex and gender into all manuscripts as an integral part of the editorial process.

Citing Articles

Personalization of Cancer Treatment: Exploring the Role of Chronotherapy in Immune Checkpoint Inhibitor Efficacy.

Fey R, Billo A, Clister T, Doan K, Berry E, Tibbitts D Cancers (Basel). 2025; 17(5).

PMID: 40075580 PMC: 11899640. DOI: 10.3390/cancers17050732.

Exploring the impact of gender-related variables on health measures and perceived stress.

Pico-Perez M, Coelho M, Vieira R, Machado-Sousa M, Morgado P Front Psychol. 2025; 16:1500674.

PMID: 40070898 PMC: 11893839. DOI: 10.3389/fpsyg.2025.1500674.

Excess mortality and years of life lost from 2020 to 2023 in France: a cohort study of the overall impact of the COVID-19 pandemic on mortality.

Moulaire P, Hejblum G, Lapidus N BMJ Public Health. 2025; 3(1):e001836.

PMID: 40051536 PMC: 11883889. DOI: 10.1136/bmjph-2024-001836.

Effect of living in well-insulated warm houses on hypertension and cardiovascular diseases based on a nationwide epidemiological survey in Japan: a modelling and cost-effectiveness analysis.

Umishio W, Ikaga T, Kario K, Fujino Y, Kagi N, Suzuki M BMJ Public Health. 2025; 2(2):e001143.

PMID: 40018632 PMC: 11816841. DOI: 10.1136/bmjph-2024-001143.

Prevalence of unplanned first pregnancy and socioeconomic factors in Benin: a cross-sectional and analytical study.

Mintogbe M, Adje E, Dougnon V, Ahoussinou C, Sanni M BMJ Public Health. 2025; 2(2):e000878.

PMID: 40018532 PMC: 11816289. DOI: 10.1136/bmjph-2023-000878.

References

. Taking sex into account in medicine. Lancet. 2011; 378(9806):1826. DOI: 10.1016/S0140-6736(11)61795-9. View

Doull M, Runnels V, Tudiver S, Boscoe M . Appraising the evidence: applying sex- and gender-based analysis (SGBA) to Cochrane systematic reviews on cardiovascular diseases. J Womens Health (Larchmt). 2010; 19(5):997-1003. DOI: 10.1089/jwh.2009.1626. View

Zhou Q . [Recommendations for the conduct, reporting, editing and publication of scholarly work in medical journals]. Zhonghua Gan Zang Bing Za Zhi. 2015; 22(10):781-91. View

Zarin D, Tse T, Ide N . Trial Registration at ClinicalTrials.gov between May and October 2005. N Engl J Med. 2005; 353(26):2779-87. PMC: 1568386. DOI: 10.1056/NEJMsa053234. View

Leopold S, Beadling L, Dobbs M, Gebhardt M, Lotke P, Manner P . Fairness to all: gender and sex in scientific reporting. Clin Orthop Relat Res. 2013; 472(2):391-2. PMC: 3890179. DOI: 10.1007/s11999-013-3397-5. View

Doull M, Welch V, Puil L, Runnels V, Coen S, Shea B . Development and evaluation of 'briefing notes' as a novel knowledge translation tool to aid the implementation of sex/gender analysis in systematic reviews: a pilot study. PLoS One. 2014; 9(11):e110786. PMC: 4220945. DOI: 10.1371/journal.pone.0110786. View

Linder A, Schick S, Hell W, Svensson M, Carlsson A, Lemmen P . ADSEAT--Adaptive Seat to Reduce Neck Injuries for Female and Male Occupants. Accid Anal Prev. 2013; 60:334-43. DOI: 10.1016/j.aap.2013.02.043. View

Nieuwenhoven L, Klinge I . Scientific excellence in applying sex- and gender-sensitive methods in biomedical and health research. J Womens Health (Larchmt). 2010; 19(2):313-21. DOI: 10.1089/jwh.2008.1156. View

Jakobsson L, Norin H, Svensson M . Parameters influencing AIS 1 neck injury outcome in frontal impacts. Traffic Inj Prev. 2004; 5(2):156-63. DOI: 10.1080/15389580490435989. View

10.

Panic N, Leoncini E, De Belvis G, Ricciardi W, Boccia S . Evaluation of the endorsement of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement on the quality of published systematic review and meta-analyses. PLoS One. 2014; 8(12):e83138. PMC: 3873291. DOI: 10.1371/journal.pone.0083138. View

11.

Greenspan J, Craft R, LeResche L, Arendt-Nielsen L, Berkley K, Fillingim R . Studying sex and gender differences in pain and analgesia: a consensus report. Pain. 2007; 132 Suppl 1:S26-S45. PMC: 2823483. DOI: 10.1016/j.pain.2007.10.014. View

12.

Clayton J, Collins F . Policy: NIH to balance sex in cell and animal studies. Nature. 2014; 509(7500):282-3. PMC: 5101948. DOI: 10.1038/509282a. View

13.

Nowatzki N, Grant K . Sex is not enough: the need for gender-based analysis in health research. Health Care Women Int. 2011; 32(4):263-77. DOI: 10.1080/07399332.2010.519838. View

14.

Hoffmann D, Tarzian A . The girl who cried pain: a bias against women in the treatment of pain. J Law Med Ethics. 2001; 29(1):13-27. DOI: 10.1111/j.1748-720x.2001.tb00037.x. View

15.

Schulz K, Altman D, Moher D . CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010; 152(11):726-32. DOI: 10.7326/0003-4819-152-11-201006010-00232. View

16.

Plint A, Moher D, Morrison A, Schulz K, Altman D, Hill C . Does the CONSORT checklist improve the quality of reports of randomised controlled trials? A systematic review. Med J Aust. 2006; 185(5):263-7. DOI: 10.5694/j.1326-5377.2006.tb00557.x. View

17.

Kim E, Menon V . Status of women in cardiovascular clinical trials. Arterioscler Thromb Vasc Biol. 2009; 29(3):279-83. DOI: 10.1161/ATVBAHA.108.179796. View

18.

Geller S, Koch A, Pellettieri B, Carnes M . Inclusion, analysis, and reporting of sex and race/ethnicity in clinical trials: have we made progress?. J Womens Health (Larchmt). 2011; 20(3):315-20. PMC: 3058895. DOI: 10.1089/jwh.2010.2469. View

19.

Kilkenny C, Browne W, Cuthill I, Emerson M, Altman D . Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol. 2010; 8(6):e1000412. PMC: 2893951. DOI: 10.1371/journal.pbio.1000412. View

20.

Johnson J, Greaves L, Repta R . Better science with sex and gender: Facilitating the use of a sex and gender-based analysis in health research. Int J Equity Health. 2009; 8:14. PMC: 2689237. DOI: 10.1186/1475-9276-8-14. View