Esplorazione delle definizioni di gender bias nella letteratura: una scoping review

Scritto da

BRGSLV107

in

Exploring the definitions of gender bias in healthcare literature: a scoping review

Autori

Bargeri Silvia [IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands]

Schaap Laura [Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, the Netherlands; Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands]

Innocenti Tiziano [Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; GIMBE Foundation, Bologna, Italy]

Ostelo Raymond [Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit & Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands]

Tomaiuolo Rossella [IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy]

Vidal-Itriago Andres [Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands]

Rubinstein Sidney [Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands]

Background and aims

There is a lack of clarity how gender bias is defined and understood in the literature, despite growing recognition in healthcare. Theoretical and conceptual definitions vary widely, and little is known about their relevance and transferability in different clinical contexts, including the musculoskeletal field. We aimed to systematically explore how gender bias is defined and characterized.

Methods

Study design: scoping review prospectively registered on Open Science Framework (https://osf.io/qxrwh). We searched MEDLINE, EMBASE, and Scopus up to January 2025, including studies providing structured definitions or conceptual frameworks to define and/or understand gender bias in any healthcare contexts. Analysis: General characteristics (e.g., healthcare populations, contexts) were extracted and definitions were grouped by main themes emerged. A checklist on gender constructs was adapted to describe relevance from an analytical perspective (e.g., inclusion, intersectionality) and potential for implementation (e.g., transferability in different contexts).

Results

The selection of studies has not yet been completed, however, based on the first half of full texts assessed for eligibility, 7 studies were included. All were conducted in high-income countries between 2008 and 2024. Most were theoretical papers or theory-guided reviews (71%). Gender bias was examined in multi-specialty fields (e.g., musculoskeletal, cardiology) (29%), pain-related conditions (e.g., back pain) (29%), and health systems-levels (43%). Two main themes emerged: (i) gender bias as unjustified clinical assumptions about sex or gender differences, reflected in stereotypes (e.g., brave man, emotional women) or gender neglect (43%); (ii) gender bias as structural issue driven by institutional norms and systemic inequality (e.g., embedded gender norms) (43%). From an analytical perspective, the studies on health-systems contexts used intersectional perspectives and inclusive language beyond male-female binary. In terms of potential for implementation, two studies proposed potentially transferable frameworks to other contexts.

Conclusion

Preliminary findings suggest that existing definitions of gender bias in healthcare vary in conceptual focus, with few providing inclusive, non-binary and potentially transferable frameworks for clinical context. These gaps highlight the need to better understand how gender bias is conceptualized and addressed within health systems and clinical practice, such as in the musculoskeletal field.

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