In recent years awareness of the need to integrate sex/gender more comprehensively into epidemiological health research has increased. However, a discrepancy between gender theoretical concepts on one hand and epidemiological practice on the other hand still remains. A conceptualization of a static, individual characteristic sex/gender (often only dichotomous as male/female) does not capture variability, multidimensionality and contextuality of sex/gender. Moreover, interactions between sex-linked biology and gender relations, processes of embodiment as well as intersectionality in terms of power relations and processes of privilege or discrimination are hardly considered. This is especially true for environmental health research.

The presentation will draw on experiences gathered in two ongoing research projects: INGER and AdvanceDataAnalysis. The collaborative research project INGER (Integrating gender into environmental health research) developed a multidimensional sex/gender concept from an intersectionality perspective. This concept guided operationalizations for sex/gender-related data collection in a population-based study. Decision tree methods are currently applied to assess the relevance of several sex/gender dimensions when identifying subgroups with especially high environmental exposures. The subproject AdvanceDataAnalysis as part of the collaborative research project AdvanceGender focuses on the more in-depth analysis of already existing data to support gender-sensitive health reporting. One approach is to define ‘solution-linked’ variables that indicate modifiable societal and contextual factors and help to explain heterogeneity across social dimensions.

With INGER and AdvancDatAnalysis as examples, challenges in operationalization of sex/gender based on gender theoretical concepts, and in statistical analysis of the impact of multiple sex/gender dimensions on exposure variation and effect modification will be discussed.

Improvements in the integration of theoretically sound sex/gender concepts in epidemiological health research will enhance its validity and significance and, in perspective, contribute to more health equity.