Sex remains underreported in biomedical research, contributing to a dearth of medical research on women’s health, per study data published in the Lancet.

Investigators conducted a bibliometric analysis of more than 11.5 million papers indexed in Web of Science and PubMed between 1980 and 2016. Sex-based reporting was identified per the Medical Subject Headings of each study. In addition, for papers published between 2008 and 2016, the investigators assessed the sex distribution of authors, using a sex assignment algorithm. The algorithm determined the perceived sex of first and last authors by name. Papers were subsequently grouped into 3 disciplinary categories: biomedical research, clinician medicine, and public health. Regression analyses were performed to study the association between the sex of authors and frequency of sex-related reporting. Analyses were adjusted for number of authors, representation of women in specific diseases, geographic location, year, and research specialty.

Between January 1, 1980, and December 31, 2016, sex-related reporting increased from 59% to 67% in clinical medicine, and from 36% to 69% in public health research. Sex-based reporting increased more quickly in public health research than in clinical medicine: In 2016, 50% of public health papers indicated sex-related reporting compared with 43% of clinical medicine papers. For biomedical research, however, sex remained underreported: just 31% of biomedical papers in 2016 reported the sex of study samples. When both first and last authors were women, papers had a significantly increased probability for sex-related reporting (odds ratio, 1.26; 95% confidence interval, 1.24-1.27). Compared with North America, papers from other regions, particularly Africa, were more likely to report sex. Sex-related reporting was not as common in high-impact journals as in low-impact journals. In fact, for publications in 2016, sex-related reporting of both men and women was associated with a reduction of −0.51 (95% confidence interval, −0.54 to −0.47) in journal impact factor.

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This large-scale bibliometric analysis underscores a lack of sex-related reporting in biomedical research, despite efforts to include more women in health-based studies. Sex-related reporting is important to developing appropriate therapies and interventions for women’s health issues; further research is needed to explore the means to improve sex inclusivity in biomedical research.


Sugimoto CR, Ahn Y-Y, Smith E, Macaluso B, Laviere V. Factors affecting sex-related reporting in medical research: a cross-disciplinary bibliometric analysis. Lancet. 2019;393:550-559.