Cell Focus Issue: Sex and Gender

(Author’s note: The views expressed here are my own and do not necessarily reflect those of Cell, Cell Press, Elsevier, RELX or any of their employees).

In science, our knowledge evolves. Yet, when it comes to the science of sex and gender, particularly sex, it often seems frozen in the past. Terms such as “immutable” and “binary” hearken us back to ninth-grade biology and fetter us to antiquated, imprecise and simplistic notions of sex and gender. There is an almost Miss Havisham-like refusal to move on and acknowledge that what we once held as settled canon is, in fact, wrong.

Today, Cell publishes a special, interdisciplinary focus issue on sex and gender in science.

Notably, this issue centers the voices and perspectives of sex and gender minorities. Science has systematically excluded trans, intersex and gender diverse scientists and people from its conversations about and research on sex and gender. It has devalued their knowledge and censored their views even when the research directly impacts them. This issue of Cell is a step towards rectifying the harm such historic exclusion has caused.

In this issue, you will find articles on improving the precision of sex and gender research. These include a Perspective on enhancing the rigor and accuracy of studies involving sex-related variables. As mainstream science begins to acknowledge that sex is, in fact, a multidimensional complex construct, these researchers critique the use of “sex” in research as a categorical, binary variable and causal mechanism. Science generally demands rigor, accuracy, and precision, yet when it comes to the science of sex, we labor under the assumption that what one researcher means by the term “sex” is the same as what another does.?In this Perspective, Pape et al. urge us to move beyond facile categorizations to instead work with specific, measurable sex-related variables, the relevance of which will vary depending on research questions and context. A move from sex essentialism to sex contextualism is a move towards precision and rigor. And, to advance gender equity in health, researchers must employ rigorous methods in their sex-based analyses to generate robust and supportable conclusions.

A Benchmark from Dr. Beans Velocci, a trans historian of knowledge production, reviews the history of sex research. Their tour shows us how sex – as a categorical, binary research variable?– has come to mean “just about everything, and therefore also nearly nothing.” Sex’s ability to polymorph into whatever definition researchers need at the moment has allowed such an imprecise measure to survive so long. In science, as elsewhere, the words of author Paisley Currah hold: “Sex is as sex does.”

Deconstructing sex is critical to enhancing the precision and rigor of our science. Yet, as Dr. Velocci points out, the concept of binary sex serves a critical societal role: It is the scientific justification for a patriarchal society. Therefore, accuracy, precision and rigor butt heads with prevailing social forces. The tonic for our sex problem derives from interdisciplinary collaboration and questioning fundamentally-held truths. “Imagine,” writes Velocci, “what we might find out if we were to let go of a category that hundreds of years of history demonstrates to be more useful for maintaining social hierarchies than for generating scientific knowledge.”

Looking forward, the issue also includes a Voices piece with perspectives from eight scientists on the future of sex and gender research. They discuss, among other things, interdisciplinary collaboration, moving beyond binary conceptualizations, accounting for intersecting factors, reproductive strategies, expanding research on sex-related differences and?sex’s dynamic nature.

At the center of Cell’s sex and gender focus issue lies an unprecedented Commentary from 24 transgender (and/or family of trans) scientists on the experiences of sex and gender minorities in STEMM and why addressing systemic barriers that they face will lead not only to a just, equitable and diverse STEMM academy but also to more rigorous science.

The growing sociopolitical movement against trans people relies on co-opted, misappropriated and misused science to prop up its exclusionary aims. At its core, this movement reacts to the inconvenient fact that the existence of trans, intersex and gender diverse people threatens a patriarchal, cisheteronormative society. Their existence belies the foundations on which such a society rests — that sex is binary and immutable and gender and its roles are biologically preordained. Seventy-five years after Simone de Beauvoir wrote, "One is not born, but rather becomes, a woman," the anti-trans movement, clinging to sex essentialism and biological predeterminism, rejects her classic observation.

In this Commentary, Aghi et al. ground the current anti-trans panic in its colonial and white supremacist histories and write about the overall societal drift towards oppressing individual autonomy. The Commentary provides a call to action to combat societal and institutional transphobia. As anti-trans initiatives impact more and more trans people's lives, the Commentary invites cis people to unite with trans people toward collective action.

Our struggles, regardless of identity, are inextricably linked. We invite you to join us as scientists in community. When we fight for some of the most marginalized, we combat scientific bigotry, misinformation, and oppression. When cis and trans people alike challenge sex and gender essentialism, we enshrine bodily autonomy and intellectual freedom. When we build institutions and systems to support all who contribute, we move to rectify scientific inequity and injustice. When we include people from all walks of life, we enrich STEMM with unique perspectives that reveal new ways to explore nature’s creativity. Together, we will emancipate our science from the strictures of bias, injustice, and inequity, to liberate not just those of us subjected to sexed and gendered oppression, but all people.

This Commentary builds upon Cell’s Juneteenth and Latinas in STEM articles, which changed the way marginalized communities can talk about their struggles in the scientific literature. These pieces are not just spaces for marginalized communities to discuss their experiences. They are meant to disrupt the apathy that the majoritized often settle into when the work required for change seems too daunting. They confront us with uncomfortable truths yet build a bridge to a collective roadmap of action-oriented remedies. Fundamentally, they provide hope that if we were to come together, we could effectuate change.

The issue also contains two interviews. The first is with Dr. Shirin Heidari — an internationally known advocate for sex and gender equity in research and the lead author of the Sex and Gender Equity in Research (SAGER ) guidelines. The second is with Dr. Londa Schiebinger — an international leader in the intersection of sex, gender and science. The interviews cover topics such as the SAGER guidelines, why we need and how to improve on sex- and gender-based analyses, gender equity, intersectionality and sexual and reproductive health in forced displacement.

Importantly, both interviewees agree that peer-reviewed, scientific journals should require consideration of sex and gender as a condition for submission to their journals, drawing parallels to the International Committee of Medical Journal Editors’ (ICMJE) requirement for prospective trial registration as a condition for submission to their member journals — a crucial policy change that led to a profound increase in trial registration.

Precision and accuracy are not at odds with equity initiatives. If the science of sex and gender becomes more precise and accurate, it will also become more equitable. The reverse is true as well. But what about equity and equality for those within STEMM? Gender equity and parity within STEMM remain elusive goals. As Dr. Schiebinger notes in her interview, it’s not just a matter of “fixing the numbers.” Fixing the numbers without also fixing the institutions results in the classic scissors-graph (depicting the institutional gender imbalance that accrues with more senior positions as women leave their STEM careers). This? “drop to the top” is worse for women in STEM than for those in non-STEM careers.

The grim findings from the June 2023 Global Gender Gap Report highlight COVID’s effect on fragile gender equality gains. Although the global parity rating has recovered to pre-pandemic levels — essentially, in 2023, we were able to get back to 2019 — the rate of change has slowed. In fact, the report predicts we will reach gender parity between 53 and 189 years from now depending on the region. Most people reading this today will never, without significant change, witness gender parity in their lifetimes. Neither will most of our children.

There is some hope. Cell’s sex and gender focus issue includes a Commentary from Swiss scientists on what drives the scissors effect, why it persists and what strategies could turn the tide that pulls talented women out of academia.

One strategy that will not work is the “historic approach of simply hoping this imbalance would disappear.” To bring equality to STEM — whether for women, gender minorities or marginalized groups in general — requires a culture shift, and culture shifts occur at a glacial pace. Yet, Joyce et al. call on us to strive towards that sort of real change:

The change we seek is profound and must be far-reaching. It is a process where complacency has no place, and it demands consistent and dedicated effort to achieve lasting change.

They provide invaluable experience, suggestions and tactics that institutions must employ to see this change through.

Such change demands institutional resources — people, money and time —dedicated to achieving equity goals. Equity work is not a side hustle. It is difficult work that institutions must elevate to at least the same level as other work to prevent the people who do this work — most often the marginalized — from suffering the effects of the diversity, cultural or minority tax. Equity, diversity and inclusion “are proven crucial drivers of innovation and progress.”? We are righting wrongs wrought across centuries.?And that isn’t a part-time job. There is no such thing as too much equity work in science. Equity work and good science are inseparable.

A first step towards this sort of long-lasting change is to “recognize and acknowledge whom our scientific and institutional processes harm and how.” This is true for systemic racism in STEMM. It’s also true for systemic sexism in STEMM. And where you find systemic racism and sexism, you can be certain that systemic transphobia and transmisogyny lurk as well. These oppressive beliefs are entrenched so insidiously and deeply in our institutions’ structures, that equity initiatives can seem like the band that played on. The music sounds nice, and we feel better listening to it, but we’re still on a sinking ship.

However, we should remember the goals of equity work. Joyce et al. write, “achieving the goal of a more equitable and inclusive academic environment is undoubtedly worth the effort. Such a transformation will not only benefit women but will also enrich the entire scientific community and society at large.” And Aghi et al. remind us that “When we build institutions and systems to support all who contribute, we move to rectify scientific inequity and injustice.” By “include[ing] people from all walks of life, we enrich STEMM with unique perspectives that reveal new ways to explore nature’s creativity.”

To secure such a tomorrow is the reason we fight today.

The work ahead of us is multi-faceted. Interdisciplinary collaboration is needed to truly advance the science of sex and gender. To get there we will have to overcome, as Dr. Rebecca Jordan-Young writes, the “uneven institutional power and epistemic authority among disciplines whereby biosciences are afforded primacy over other disciplines.” This issue of Cell is an example of what can come from collaborations where we bring together what Dr. Velocci describes as, “different ways of knowing”. We can move beyond the binary and begin to deconstruct sex into meaningful variables and causal mechanisms, a process that will improve our science, move us closer to health equality across genders and allow for unrestrained discovery and innovation. In her Voices contribution, Dr. Elle Lett imagines such a world:

It’s not just the what of our science that needs work. It’s the who as well. And diversifying the “who” of our science in ways that are just, equitable and inclusive is a message that we can’t hear often enough. Advancing gender equity — with respect to both gender identity and modality — is critical work needed to ensure that “our science reflects and looks like the full spectrum of the people it serves.” Until it does, it’s operating well below capacity. These are messages that every single scientific journal should, in one form or another, sound across every single one of its issues until the day when they are no longer needed.

Acknowledgments:

Authors: Thank you to all the authors who made this issue happen! Brian Aguado, Ph.D. Daniel Jeffries, Rebecca Jordan-Young Sabra Klein Elle Lett Nina Stachenfeld Jessica Tollkuhn Xiaohong Xu Johanna Joyce Slavica Masina Liliane Michalik Caroline Pot Christine Sempoux Francesca Amati Krisha Aghi Brendan Anderson Bria Castellano, PhD Avery Cunningham Maggie Delano Evyn Dickinson Lexy von Diezmann Sofia Kirke Forslund-Startceva Dori Grijseels Sebastian Groh Eartha Mae Guthman Izzy Jayasinghe Julie Johnston Sam Long Jess McLaughlin Maeve McLaughlin Miriam Miyagi Bittu Rajaraman Fátima S. Ayden Scheim, PhD Simón(e) Sun Ffion Dylan Titmuss Reubs Walsh Zara Weinberg Madeleine Pape Stacey Ritz Marion Boulicault Sarah Richardson Donna Maney Beans Velocci Shirin Heidari Londa Schiebinger

Art: Thank you to two of my art colleagues for their incredible work on this issue. Julie Ho Sung ...See more of her work here. And Phillip Krzeminski ...see more of his work here.