Fifth anniversary of the Sex And Gender Equity in Research (SAGER) guidelines: taking stock and looking ahead

This year marks the fifth anniversary of the publication of the Sex And Gender Equity in Research (SAGER) guidelines,1 which provide recommendations to authors, journal editors, peer-reviewers and publishers for ensuring that sex and gender considerations are appropriately reported in the scholarly literature. The guidelines were developed in recognition of the persistent sex and gender gaps in research across disciplines, especially in health and biomedical research. At the time of development, there was notable resistance to implement sex and gender policies, reflecting a lack of awareness of the importance of sex and gender as critical determinants of health and well-being.2 The guidelines have now been translated into six languages, adopted by a growing number of journals, encouraged by major publishers, and extensively used by researchers.3 Despite these successes and growing awareness, there remain critical barriers to systematic implementation of sex-based and gender-based analyses in research and reporting. For example, many COVID-19 trials continue to include fewer women than men,4 and there is a persistent lack of sex-based and gender-based …