Using Inclusive Language in Research Articles

What’s wrong with this paragraph?

Eleven male and nine female patients were included in the test group. Even though both male and female patients were tested, gender response differences were not the focus of this work. Females, who have lower hematocrits were included to provide a wider range of hematocrit values.

Hint: there’s nothing “default” about being male.*

Framing female <insert your parameter here> levels with respect to male levels unnecessarily reinforces a sex/gender hierarchy. It’s frustrating that there is even a discussion about whether to include female patients in clinical studies or not, let alone framing female hematocrit levels in terms of male levels.

Using more inclusive language is not hard to do. As an exercise, I’ve rewritten the paragraph and will walk through the changes I’d make.

Eleven male and nine female patients were included in the test group.

First sentence seems fine. I’d keep it the same, or potentially swap which gender appears first.

Even though both male and female patients were tested, gender response differences were not the focus of this work.

This sentence makes it sound like any study that includes both men and women inherently MUST be about gender**. I’d delete this sentence. Plenty of papers recruit both male and female participants and do not examine sex/gender response differences. If it seems necessary to include a statement about the lack of gender related analysis, I might turn the sentence around and emphasize the importance of the inclusion of both male and female patients in clinical tests.

Females, who have lower hematocrits were included to provide a wider range of hematocrit values.

This is the sentence that set me off in the first place. With male as default, females have lower hematocrits. With females as default, males have higher hematocrits. Selecting one sex as the default doesn’t make sense. I’d delete this sentence too, but the authors may be trying to emphasize that including both sexes results in a wider range of hematocrit values, which is relevant to the study. In that case I’d rewrite this sentence as: “Equal participation of both males and females provides a wide range of hematocrit values (normal female hematocrit levels range from 38% to 46% and normal male hematocrit levels range from 42% to 54%.)” This phrasing includes information about both sexes and does not compare them directly to each other.

The final rewritten version might look like:

Eleven male and nine female patients were included in the test group. Equal participation of both males and females provides a wide range of hematocrit values (normal female hematocrit levels range from 38% to 46% and normal male hematocrit levels range from 42% to 54%.)

Thinking about and using more inclusive language helps reframe thinking about who is included in clinical testing. It may seem inconsequential, but it matters and is one small step toward more equitable participation in research, more personalized interventions, and better cures.

* I’m intentionally using male and female here and throughout. See also **.

* Though the authors use the word “gender,” they likely actually mean “sex.” This opens up further discussion of intersex, trans*, and non-binary individuals in clinical testing. The use of binary genders (i.e. woman/man) would include binary identified trans* and intersex individuals, while excluding non-binary folks, and the use of binary sexes (i.e. XX/XY, female/male) would include all folks except intersex individuals. One way to be more explicit here might be to state that cisgendered men and women were included in the study (assuming that was the case). It may or may not make sense to be explicit. Additional care may also be necessary when disclosing the participation of a trans*, non-binary or intersex patient, as even demographic information may render that individual identifiable.

Thanks to Kendra Albert, who provided edits.