Better health outcomes a big step closer with new UK sex and gender policy for research

The George Institute’s MESSAGE project brought together more than 50 representatives of UK health research funders – along with regulators, patient groups, publishers and researchers – to co-design the new framework.

Sex and gender affect every aspect of health, from how conditions and symptoms present themselves, to the treatment and care we receive, and – crucially – overall health outcomes. But historically there’s been an over-representation of male participants in health research. Five times as many males as females have been used in animal studiesⁱ, for example, while only 1 in 5 participants in human trials are women.ⁱⁱ

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This has led to sex and gender data gaps across the medical evidence base, from oncology and osteoporosis to diabetes, dementia and mental health.

These gaps translate into worse clinical care and outcomes for everyone, but particularly women and girls, as well as trans, non-binary and intersex people. Sex and gender policies to address these gaps were developed in the USA (1993), Canada (2010) and Europe (2016) many years ago, but until now the UK has lagged woefully behind.

By: Kate WomersleyMESSAGE Co-Principal Investigator

The MESSAGE project

The MESSAGE (Medical Science Sex and Gender Equity) project launched in January 2023, bringing together representatives from more than 50 funders, regulators, academic publishers and patient groups to co-design a sex and gender policy framework for health and medical research funders.

Four policy labs held between May 2023 and October 2024 enabled participants to establish their vision for the research sector to enable better consideration of sex and gender, design a policy framework to achieve this vision, draft a five-year plan for implementation, and agree how to monitor change across the sector.

The final MESSAGE policy framework sets out what it means to account for sex and gender at every stage of the research cycle and will be used by research funders as a best practice template to adopt their own policies.ⁱⁱⁱ

Launch of policy framework

The framework was officially launched in November 2024 at a webinar attended by over 250 participants. Speakers included the Editor-in-Chief of The Lancet, Richard Horton, and the Chief Executive Officer of the National Institute for Health and Care Research, Lucy Chappell.

The MESSAGE team are now producing guidance to support funders develop and implement their own policies, based on the final framework, as well as working directly with individual organisations. Additional tools and resources are being created to help researchers understand and respond to the new requirements.

The MESSAGE framework has now been widely shared in numerous events, workshops and presentations (both public and academic), through articles and opinion pieces in mainstream and scientific media, and through direct recommendations to policy makers.

Implementation and impact

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We’ve been thrilled to see how engaged our stakeholders have been with MESSAGE. There’s been a feeling of how not if the group can work to improve sex and gender equity in research – and excitement about the very real difference this could make to research quality and health outcomes.

We know from the experience in Canada what a difference sex and gender policies can make. In 2010, less than one-third of health researchers accounted for sex in funding applications and gender was virtually ignored. Today, Canada is recognised as a world leader in sex and gender science. That’s exactly what we want to see in the UK.^{iv v}

Developing the MESSAGE policy with stakeholders ensured that participating organisations were positioned and motivated to implement it, and we’re already seeing organisations making concrete changes to their processes, or commitments to do so. We hope that the framework will help the sector make consideration of sex and gender routine in all UK biomedical research – which will mean more robust science and better health outcomes for all.

By: Alice WittMESSAGE Co-Principal Investigator