Sex differences in the acute effects of cannabis: the need for hypothesis-driven research

Sex and gender can impact cannabis use and related harms, yet the field has historically centered men and male bodies. In our recent systematic review of sex differences in the acute cognitive effects of cannabis, just six of 29 human studies found evidence that female and male participants differed in cognitive responses to cannabis. The goal of this Commentary is to discuss methodological limitations of published studies that complicate interpretation of data and to suggest priorities for future research to move this topic forward. We highlight inadequate statistical power, poor definition and measurement of sex, lack of consideration of sex- or gender-related characteristics, and no inclusion of transgender and gender-diverse individuals in prior studies. Future research should take an intersectional perspective, incorporate hypothesis-driven sex- and gender-informed designs, ensure adequate power for interaction analyses, and consider sex-related variables across the lifespan. This approach is necessary to advance scientific rigor and promote equitable health outcomes related to cannabis use.