Sex and gender: More than just demographic variables

LAY SUMMARY Taking as a starting point that sex and gender are not the same thing, a principal understanding of Gender-Based Analysis Plus (GBA+), this article reviews research published in 2020 on the health and well-being of Veterans and currently serving members of the Canadian Armed Forces. The purpose of this review was to see how sex and gender were referred to in this published literature. The published research tended not to differentiate between sex and gender, often using the two terms as though they referred to the same thing. Possible reasons for why this has happened are explored, as is the importance of treating sex and gender as fundamentally different things. Introduction: Although the roll-out and implementation of Gender-Based Analysis Plus (GBA+) is an important move, there is concern that this means of understanding the role and impact of gender in relation to psychosocial health may be misunderstood or misapplied. Medical research has a long history of conflating biological sex (male, female), gender (man, woman, transgender), and sexual orientation (lesbian, gay, bisexual, transgender, queer, and others). This article examines how sex and gender are being used in current psychosocial health research in the Canadian military and Veteran context. Methods: Content analysis of articles published in 2020 was conducted. Results: The published research continues to problematically conflate sex and gender and does not appropriately utilize a GBA+ framework. Discussion: Although there is recognition that research needs to implement GBA+, this is being done in ways that treat sex and gender as demographic variables without paying close attention to how they are intimately tied to the creation and embodiment of self and social identity and how these identities affect health issues. Even when the diversity of genders and sexual orientations are considered, the literature presents a pattern of lumping all of them into one category, gender diverse, resulting in an erasure of the complexity of intersectionality, and therefore fails to give this diversity the attention it deserves, particularly in regard to the importance of intersectionality in the construction of self-identity and understanding of lived experience. Researchers need to be more attentive to the complexity of gender and its relation to social determinants of health.