Integration of Sex and Gender in Clinical Practice Guidelines

Abstract Background Clinical Practice Guidelines (CPGs) are key tools for evidence-based decision-making in healthcare systems. However, they frequently fail to integrate sex and gender analysis, leading to inequities in healthcare access, safety, effectiveness, and quality. This gap perpetuates structural biases and can compromise public health goals. The present study aims to analyse the integration sex and gender perspectives in CPG. Methods We the incorporation of a sex and gender perspective in the CPGs registered on the GIN platform, the open data base of Guidelines International Network (https://g-i-n.net), from 2019 to march 2024. We used a scrapping process to search for relevant key words (ex. Gender, male, female, man, women, intersexual). CPG were analysed both quantitatively and qualitatively through statistical and content analysis. We also analysed the gender balance on authorship. Results We retrieved 245 CPGs from the GIN (platform. Preliminary analysis indicates that only a small proportion of these guidelines adopt a comprehensive sex and gender perspective. However, several provide valuable examples of meaningful integration. The extent of sex and gender integration varies depending on the CPG target: guidelines addressing conditions primarily affecting women or children showed a higher frequency of relevant keywords, whereas those on technical or procedural issues showed the lowest. Moreover, some guidelines adopt a strong sex/gender approach and commit to the incorporation of sex and gender considerations consistently across sections of the guidelines; while some include this perspective in introductory content or population descriptions, and oftenly absent from key components such as PICO questions, results, or clinical recommendations Conclusions Despite increasing evidence of sex and gender impacts on health outcomes, these variables remain under-addressed in the development of CPGs. Key messages • There is a lack of mainstreaming of the integration of sex and gender in Clinical Practice Guidelines. • This study makes it possible to highlight the areas in which the integration of sex and gender in Clinical Practice Guidelines can be improved.