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Wierenga LM, Ruigrok A, Aksnes ER, Barth C, Beck D, Burke S, Crestol A, van Drunen L, Ferrara M, Galea LAM, Goddings AL, Hausmann M, Homanen I, Klinge I, de Lange AM, Geelhoed-Ouwerkerk L, van der Miesen A, Proppert R, Rieble C, Tamnes CK, Bos MGN. Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100283. [PMID: 38312851 PMCID: PMC10837069 DOI: 10.1016/j.bpsgos.2023.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 02/06/2024] Open
Abstract
There are prominent sex/gender differences in the prevalence, expression, and life span course of mental health and neurodiverse conditions. However, the underlying sex- and gender-related mechanisms and their interactions are still not fully understood. This lack of knowledge has harmful consequences for those with mental health problems. Therefore, we set up a cocreation session in a 1-week workshop with a multidisciplinary team of 25 researchers, clinicians, and policy makers to identify the main barriers in sex and gender research in the neuroscience of mental health. Based on this work, here we provide recommendations for methodologies, translational research, and stakeholder involvement. These include guidelines for recording, reporting, analysis beyond binary groups, and open science. Improved understanding of sex- and gender-related mechanisms in neuroscience may benefit public health because this is an important step toward precision medicine and may function as an archetype for studying diversity.
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Affiliation(s)
- Lara Marise Wierenga
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Amber Ruigrok
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Eira Ranheim Aksnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dani Beck
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Sarah Burke
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lina van Drunen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Maria Ferrara
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Liisa Ann Margaret Galea
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Lise Goddings
- University College London Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Markus Hausmann
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Inka Homanen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Ineke Klinge
- Dutch Society for Gender & Health, the Netherlands
- Gendered Innovations at European Commission, Brussels, Belgium
| | - Ann-Marie de Lange
- Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Lineke Geelhoed-Ouwerkerk
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Anna van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ricarda Proppert
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Carlotta Rieble
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Christian Krog Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Marieke Geerte Nynke Bos
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
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Massa MG, Aghi K, Hill MJ. Deconstructing sex: Strategies for undoing binary thinking in neuroendocrinology and behavior. Horm Behav 2023; 156:105441. [PMID: 37862978 DOI: 10.1016/j.yhbeh.2023.105441] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/22/2023]
Abstract
The scientific community widely recognizes that "sex" is a complex category composed of multiple physiologies. Yet in practice, basic scientific research often treats "sex" as a single, internally consistent, and often binary variable. This practice occludes important physiological factors and processes, and thus limits the scientific value of our findings. In human-oriented biomedical research, the use of simplistic (and often binary) models of sex ignores the existence of intersex, trans, non-binary, and gender non-conforming people and contributes to a medical paradigm that neglects their needs and interests. More broadly, our collective reliance on these models legitimizes a false paradigm of human biology that undergirds harmful medical practices and anti-trans political movements. Herein, we continue the conversations begun at the SBN 2022 Symposium on Hormones and Trans Health, providing guiding questions to help scientists deconstruct and rethink the use of "sex" across the stages of the scientific method. We offer these as a step toward a scientific paradigm that more accurately recognizes and represents sexed physiologies as multiple, interacting, variable, and unbounded by gendered preconceptions. We hope this paper will serve as a useful resource for scientists who seek a new paradigm for researching and understanding sexed physiologies that improves our science, widens the applicability of our findings, and deters the misuse of our research against marginalized groups.
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Affiliation(s)
- Megan G Massa
- Department of Neuroscience and Behavioral Biology, Emory University, Atlanta, GA, United States of America.
| | - Krisha Aghi
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, CA, United States of America.
| | - M J Hill
- Department of Sociology, University of California Los Angeles, Los Angeles, CA, United States of America.
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Zhao H, DiMarco M, Ichikawa K, Boulicault M, Perret M, Jillson K, Fair A, DeJesus K, Richardson SS. Making a 'sex-difference fact': Ambien dosing at the interface of policy, regulation, women's health, and biology. SOCIAL STUDIES OF SCIENCE 2023; 53:475-494. [PMID: 37148216 DOI: 10.1177/03063127231168371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The U.S. Food and Drug Administration's (FDA) 2013 decision to lower recommended Ambien dosing for women has been widely cited as a hallmark example of the importance of sex differences in biomedicine. Using regulatory documents, scientific publications, and media coverage, this article analyzes the making of this highly influential and mobile 'sex-difference fact'. As we show, the FDA's decision was a contingent outcome of the drug approval process. Attending to how a contested sex-difference fact came to anchor elite women's health advocacy, this article excavates the role of regulatory processes, advocacy groups, and the media in producing perceptions of scientific agreement while foreclosing ongoing debate, ultimately enabling the stabilization of a binary, biological sex-difference fact and the distancing of this fact from its conditions of construction.
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Thorpe H, Bekker S, Fullagar S, Mkumbuzi N, Nimphius S, Pape M, Sims ST, Travers A. Advancing feminist innovation in sport studies: A transdisciplinary dialogue on gender, health and wellbeing. Front Sports Act Living 2023; 4:1060851. [PMID: 36685066 PMCID: PMC9845704 DOI: 10.3389/fspor.2022.1060851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/01/2022] [Indexed: 01/06/2023] Open
Abstract
Athlete health and wellbeing requires a holistic, multidimensional approach to understanding, supporting, and treating individual athletes. Building more supportive, inclusive, and equitable environments for the health and wellbeing of women and gender expansive people further requires gender-responsive approaches that promote broader cultural change. Feminist sport and exercise medicine practitioners, sports scientists, and social science researchers are increasingly coming together in their efforts to do this work. However, working across disciplines inevitably includes an array of ontological, epistemological, and political challenges. In this paper, we offer a curated 'dialogue' with a group of feminist scholars engaged in research and practice across disciplines, bringing them together to discuss some of the most pressing gendered issues in sport today (i.e., ACL injury, concussion, menstruation in sport, mental health, gender categories). In so doing, we amplify the voices of those working (empirically and clinically) at the disciplinary intersections of gender, sport and health, and learn about some of the current and future possibilities for transdisciplinary innovations and strategies for building (responsiveness to) cultural change.
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Affiliation(s)
- Holly Thorpe
- School of Health, University of Waikato, Hamilton, New Zealand,Correspondence: Holly Thorpe
| | - Sheree Bekker
- Department for Health, University of Bath, Bath, United Kingdom
| | - Simone Fullagar
- Department of Tourism, Sport and Hotel Management, Griffith University, Nathan, AU-QLD, Australia
| | | | - Sophia Nimphius
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, AU-WA, Australia
| | - Madeleine Pape
- Institute of Sports Science, Université de Lausanne, Lausanne, Switzerland
| | - Stacy T. Sims
- AUT Sports Performance Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - A. Travers
- Department of Sociology and Anthropology, Simon Fraser University, Burnaby, BC, Canada
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DiMarco M, Khalifa K. Sins of inquiry: How to criticize scientific pursuits. STUDIES IN HISTORY AND PHILOSOPHY OF SCIENCE 2022; 92:86-96. [PMID: 35152065 DOI: 10.1016/j.shpsa.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Criticism is a staple of the scientific enterprise and of the social epistemology of science. Philosophical discussions of criticism have traditionally focused on its roles in relation to objectivity, confirmation, and theory choice. However, attention to criticism and to criticizability should also inform our thinking about scientific pursuits: the allocation of resources with the aim of developing scientific tools and ideas. In this paper, we offer an account of scientific pursuitworthiness which takes criticizability as its starting point. We call this the apokritic model of pursuit. Its core ideas are that pursuits are practices governed by norms for asking and answering questions, and that criticism arises from the breach of these norms. We illustrate and advertise our approach using examples from institutional grant review, neuroscience, and sociology. We show that the apokritic model can unify several indices of criticizability, that it can account for the importance of criticizing pursuits in scientific practice, and that it can offer ameliorative advice to erstwhile pursuers.
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Affiliation(s)
- Marina DiMarco
- Department of History and Philosophy of Science, University of Pittsburgh, 1101 Cathedral of Learning, 4200 Fifth Avenue Pittsburgh, PA 15260, United States.
| | - Kareem Khalifa
- Department of Philosophy, Middlebury College, Middlebury, VT 05753, United States.
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Pape M. Lost in translation? Beyond sex as a biological variable in animal research. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2021; 30:275-291. [PMID: 34448683 DOI: 10.1080/14461242.2021.1969981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
In this article, I develop a feminist posthumanist account of biomedical policymaking as a material-discursive intervention that shapes the emergence of phenomena in the scientific laboratory. The setting is United States (U.S.) biomedicine, where a recent policy of the National Institutes of Health has mandated the consideration of sex in basic and preclinical research. Called Sex as a Biological Variable (SABV), the mandate configures cell lines and animal models as the next frontier in the project of advancing gender equity in biomedical research. Given sex and gender are increasingly recognised as having complex, entangled, and dynamic effects on human health and illness, how do laboratory animals respond to their attempted enrolment in this regulatory intervention? Through a qualitative analysis of this policy domain, I show how laboratory animals reveal the context-specific character of sex, its multiplicity and elusiveness as a so-called biological variable, and the considerable work needed to shore up human ideologies of sex as a pervasive cross-species form of binary difference. I suggest that while regulatory interventions constrain patterns of mattering, they also serve as agential openings in which laboratory animals can 'kick back' and reconfigure the pursuit of knowledge, particularly as it relates to difference and health.
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Affiliation(s)
- Madeleine Pape
- Institute of Sports Sciences, University of Lausanne, Lausanne, Switzerland
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8
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Epstein S. Cultivated co-production: Sexual health, human rights, and the revision of the ICD. SOCIAL STUDIES OF SCIENCE 2021; 51:657-682. [PMID: 33928808 DOI: 10.1177/03063127211014283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
STS scholars frequently have shown how science and sociopolitical arrangements are 'co-produced', typically tracing how scientific actors themselves keep 'science' and 'politics' far apart. Revealing co-production is therefore deemed the work of the STS analyst, who unearths linkages that the actors might be unaware of, or might ignore or deny. By contrast, the creation of a new chapter on 'sexual health' in the recent revision of the International Classification of Diseases (ICD) offers a case of what might be termed 'cultivated co-production'. Neither oblivious to the linkages between science and politics nor invested in obscuring them, the designers of the sexual health chapter sought support for their work by demonstrating, transparently, how science, ethics, and human rights might properly be aligned. The intentional and visible character of co-production in this case indicates awareness of the need to manage the contested nature of gender and sexuality at a transnational level. It also reflects two changes in the organization of medical politics and medical classification: a widespread recognition of the necessity of reaching out to lay stakeholders and advocates, and the rise of an emphasis on 'conventions' as the backbone of transnational biomedical consensus processes.
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