Redesigning medicine: integrating sex and gender for better health outcomes.

Both the biological sex and the socio-cultural gender play a central role in medical care, influencing diagnosis, disease progression, and treatment decisions. Despite well-established and substantial differences between men and women, sex-specific differentiation in guidelines, and dosing protocols remain limited. This gap in care has deep historical roots: for decades, women were systematically excluded from clinical trials resulting in a pronounced sex bias in medical research. Although recent efforts have been made to address these inequalities, women are still under-represented in many clinical trials. However, recent inclusive research has highlighted the relevance of a sex- and gender-sensitive medicine for women and men. It is becoming increasingly acknowledged that diseases that preponderately affect women, such as breast cancer or depression, can also manifest in men. This recognition has prompted the development of sex- and gender-sensitive diagnostic tools, for example in the assessment of depression. Similarly, in the context of myocardial infarction, it is now well established that the classical signs of a heart attack are predominantly male-specific manifestations, while women experience a range of symptoms that do not fully overlap with the symptoms in males. Here, we will take a closer look at sex- and gender-specific differences in medicine, highlight key historical developments and milestones and discuss prospects for the future sex- and gender sensitive medicine.