Gender medicine: Lessons from COVID-19 and other medical conditions for designing health policy

Abstract

Gender-specific differences in the prevalence, incidence, comorbidities, prognosis, severity, risk factors, drug-related aspects and outcomes of various medical conditions are well documented. We present a literature review on the extent to which research in this field has developed over the years, and reveal gaps in gender-sensitive awareness between the clinical portrayal and the translation into gender-specific treatment regimens, guidelines and into gender-oriented preventive strategies and health policies. Subsequently, through the lens of gender, we describe these domains in detail for four selected medical conditions: Asthma, obesity and overweight, chronic kidney disease and coronavirus disease 2019. As some of the key gender differences become more apparent during adolescence, we focus on this developmental stage. Finally, we propose a model which is based on three influential issues: (1) Investigating gender-specific medical profiles of related health conditions, rather than a single disease; (2) The dynamics of gender disparities across developmental stages; and (3) An integrative approach which takes into account additional risk factors (ethnicity, socio-demographic variables, minorities, lifestyle habits etc.). Increasing the awareness of gender-specific medicine in daily practice and in tailored guidelines, already among adolescents, may reduce inequities, facilitate the prediction of future trends and properly address the characteristics and needs of certain subpopulations within each gender.

Keywords: Gender medicine; Adolescent health; Model; Risk factors; Guidelines and policy; Asthma; COVID-19; Obesity; Chronic kidney disease

Core tip: An accumulating body of evidence demonstrates gender-specific differences in medical conditions, in terms of prevalence, incidence, prognosis, severity and comorbidity. Yet, little has been translated into an approach to gender-specific treatments, guidelines and prevention strategies. The evidence and gaps are discussed by providing four examples: asthma, obesity, chronic kidney disease and coronavirus disease 2019. We propose a broader approach to gender medicine that integrates information regarding medical profiles of coexisting medical conditions, rather than focusing on a single disease, considers the dynamics of medical profiles across developmental stages, focuses on adolescence, paving the way for adulthood morbidity, and is adjusted to diverse risk factors, and hence tailored to diverse subpopulations.