Sant Pau creates a new transversal research program on Women’s Health and Gender. The Research Institute of Hospital de la Santa Creu i Sant Pau – IIB Sant Pau has launched a new cross-cutting research program to promote a gender perspective in all of its research areas and groups.
With this new program, created within the framework of the Responsible Research and Innovation (RRI) Plan, IIB Sant Pau will implement actions aimed at promoting the incorporation of a gender perspective in research content, as well as promoting specific gender research to cover knowledge gaps, and putting in place the necessary means and resources to facilitate it.
Despite the fact that sex and gender differences have a significant impact on health, biomedical research continues to originate mainly from studies conducted on male cell material, animal models or men, and often does not take into account different patterns of health and disease in women and men based on sex and gender.
This lack of a gender perspective can have serious consequences. For example, women are often underrepresented in clinical trials, which can lead to improper dosing of drugs, safety issues such as unexpected adverse effects, and can also mask important differences in disease progression and treatment response.
In addition, gender bias in research can lead to a lack of understanding of specific women’s health issues, such as menstruation-related disorders, pregnancy-related complications, and menopause-related symptoms. Furthermore, beyond sex, it is necessary to incorporate the gender dimension in research, with intersectionality, which allows us to obtain scientific results that respond to real needs, contributing to increasing equity and social justice.
Dr. Jordi Surrallés, head of IIB Sant Pau, says that “it is crucial that biomedical research adopts a gender perspective to better understand the impact of sex and gender on health outcomes. For this to happen, it is essential that research centers create structures that facilitate synergies between groups, such as this new program, and that we promote change by promoting projects and dedicating resources to accompany and train scientific staff in this area. It is not enough to adhere to manifestos or sign declarations if this is not incorporated into the center’s strategy and translated into concrete actions”.
He also emphasizes that the gender perspective should also be present in “the governance of centers, whether by promoting parity in the leadership of research groups and internal and external scientific committees that advise the Institute’s management, or in institutional policies. Likewise, we have a responsibility to promote and make visible female models in research, in the scientific environment, in congresses and events, and especially in the social environment, through science dissemination and outreach activities. At IIB Sant Pau, we actively work to ensure gender equality in all these areas.”
The new transversal research program on Women’s Health and Gender is coordinated by Dr. Elisa Llurba, head of the perinatal and women’s medicine group at IIB Sant Pau and director of the gynecology and obstetrics service at Sant Pau Hospital, and by Dr. Ma Rosa Ballester, head of the Research and Responsible Innovation Unit at IIB Sant Pau.
“By prioritizing sex and gender perspectives in biomedical research, we increase the reproducibility of studies, making them free of biases, we add value to research by making it more ethical and responsible, increasing equity and social justice. With this vision, we contribute to optimizing health outcomes for all people, regardless of their sex or gender, with an intersectional approach as an explanatory element of systemic inequalities”, explains Dr. Ma Rosa Ballester. With this new cross-cutting approach, IIB Sant Pau becomes a pioneering center and firmly commits to incorporating a gender perspective in all its research areas to contribute to achieving the objectives in this field.
“It is necessary to incorporate a gender perspective throughout the process, which includes increasing the representation of women in clinical trials, considering the sex of cell lines or animal models used in basic research, analyzing gender differences in access to the healthcare system, perceptions of illness or health, diagnosis, disease progression, and response to treatment. Therefore, it is necessary to address gender bias in the design of any research project, as well as in the analysis and how we explain it to end-users,” says Dr. Elisa Llurba.
The main objectives of this cross-sectional program are:
“This program should serve as a catalyst for a real need. With this program, the IIB Sant Pau provides the framework and tools to promote it”, concludes Dr. Llurba.
Sant Pau is committed and addresses the gender agenda at all levels. The creation of the new cross-sectional program for Women’s Health and Gender Research is an example of the joint work between the research institute and the hospital.
On the one hand, the Hospital de la Santa Creu i Sant Pau was one of the first Catalan centers to create the Health and Gender Commission, which impacts on healthcare, research, and teaching. In parallel, the Sant Pau Research Institute – IIB Sant Pau – developed the Research and Innovation and Responsibility Plan (RRI), prioritizing the gender agenda, with measures and actions that involve, for example, talent management and the promotion of scientific careers in women, methodological support, and training in incorporating a gender perspective in research, and the creation of the cross-sectional research group presented today.
The IIB Sant Pau is launching more and more projects that incorporate a gender perspective from their initial approach. One of the paradigmatic examples is cardiovascular diseases. There is increasing evidence of the significant differences that exist in both the evolution and clinical manifestations of different cardiovascular disorders and that these variables can have an impact on prevention and treatment.
In this area, projects are underway such as RETROVE, which seeks mathematical algorithms to define the individual risk of suffering venous thrombosis, or another study that analyzes beta-blocker treatment in patients with atrial fibrillation according to sex.
For example, the group led by Dr. Lina Badimon is carrying out a personalized medicine project in a national cohort with a genetic diagnosis of familial hypercholesterolemia, where sex specificity is one of the study’s objectives when identifying and determining the importance of new molecular biomarkers.
In the field of cardiovascular health, Dr. Elisa Llurba, together with researchers from the Perinatal and Women’s Medicine Research Group, the Biochemistry Research Group, and the Cardiovascular Diseases Research Group, is leading three studies funded by the Carlos III Health Institute on the impact of different reproductive processes on cardiovascular health in three key stages: prior to conception in women undergoing assisted reproduction, during pregnancy, and 3-6 years after childbirth. One of the objectives is to study how placental-origin diseases can impact maternal and neonatal cardiovascular health.
In the area of research on neurological, neuroscience, and mental health diseases, led by Dr. Juan Fortea, several gender perspective projects are also underway. Among them, gender differences in frontotemporal dementia and in the link between Alzheimer’s disease and Down syndrome, or therapeutic response to Parkinson’s disease based on sex, are being studied. In stroke, sex-stratified studies and the search for specific genetic factors in complex diseases are also being conducted.
There are also various ongoing studies in the field of genetic diseases that take into account the gender perspective, such as the detection of women at high risk of having children with genetic diseases prior to pregnancy, the identification of predictive variants of severe toxicity in patients with colorectal cancer treated with fluoropyrimidines, pharmacogenetic studies in psychiatric patients treated in mental health centers, or pharmacogenetic and pharmacokinetic studies in patients undergoing hematopoietic progenitor cell transplantation receiving busulfan conditioning, among others.
In addition, there are specific projects that directly stem from gender differences, such as research on endocrine and metabolic disease in pregnancy or the study of neurological changes in perimenopausal women, as well as all the research projects in the Obstetrics and Gynecology area led by Dr. Llurba, where the gender perspective goes even further and works on psycho-bio-social aspects such as the impact of early reproductive losses, citizen co-creation in the experience of women suffering from endometriosis, or the study of obstetric violence. And also, research conducted by the Gynecological and Peritoneal Oncology Group, led by Dr. Virtudes Céspedes, which studies endometrial and ovarian cancers with grants from the Marató de TV3 and the Carlos III Health Institute, among others.
In the field of public health research, for years, the research groups of the Barcelona Public Health Agency of the IIB Sant Pau have incorporated the gender perspective in a significant part of their studies. In early 2023, the report “Gender Inequalities in Health in Barcelona” was published, which examines gender inequalities in the social determinants of health, health problems, health-related habits, and utilization of health services, whose intersectional perspective considers social class, country of birth, and life course. They have also examined gender inequalities from an intersectional perspective in mental health, collected in the report “Situation of the Mental Health of the Population of Barcelona and its Determinants.” Intersectionality is key in gender perspective studies in health, as most include determinants such as work, housing, and violence. For example, research led by Dr. Lucía Artazcoz studies gender inequalities in health related to the balance of work and family life, part-time work, or long working hours.
These examples clearly show the need to incorporate the gender perspective in all stages of research: design, execution, and analysis of results, but also in all its fields: basic, preclinical, clinical, and public health research.
Last update: 15 de May de 2023
