research on gender studies

Gender Studies: Foundations and Key Concepts

Gender studies developed alongside and emerged out of Women’s Studies. This non-exhaustive list introduces readers to scholarship in the field.

Gender studies asks what it means to make gender salient, bringing a critical eye to everything from labor conditions to healthcare access to popular culture. Gender is never isolated from other factors that determine someone’s position in the world, such as sexuality, race, class, ability, religion, region of origin, citizenship status, life experiences, and access to resources. Beyond studying gender as an identity category, the field is invested in illuminating the structures that naturalize, normalize, and discipline gender across historical and cultural contexts.

At a college or university, you’d be hard pressed to find a department that brands itself as simply Gender Studies. You’d be more likely to find different arrangements of the letters G, W, S, and perhaps Q and F, signifying gender, women, sexuality, queer, and feminist studies. These various letter configurations aren’t just semantic idiosyncrasies. They illustrate the ways the field has grown and expanded since its institutionalization in the 1970s.

This non-exhaustive list aims to introduce readers to gender studies in a broad sense. It shows how the field has developed over the last several decades, as well as how its interdisciplinary nature offers a range of tools for understanding and critiquing our world.

Catharine R. Stimpson, Joan N. Burstyn, Domna C. Stanton, and Sandra M. Whisler, “Editorial.” Signs , 1975; “Editorial,” off our backs , 1970

The editorial from the inaugural issue of Signs , founded in 1975 by Catharine Stimpson, explains that the founders hoped that the journal’s title captured what women’s studies is capable of doing: to “represent or point to something.” Women’s studies was conceptualized as an interdisciplinary field that could represent issues of gender and sexuality in new ways, with the possibility of shaping “scholarship, thought, and policy.”

The editorial in the first issue of off our backs , a feminist periodical founded in 1970, explains how their collective wanted to explore the “dual nature of the women’s movement:” that “women need to be free of men’s domination” and “must strive to get off our backs.” The content that follows includes reports on the Equal Rights Amendment, protests, birth control, and International Women’s Day.

Robyn Wiegman, “Academic Feminism against Itself.” NWSA Journal , 2002

Gender studies developed alongside and emerged out of Women’s Studies, which consolidated as an academic field of inquiry in the 1970s. Wiegman tracks some of the anxieties that emerged with the shift from women’s to gender studies, such as concerns it would decenter women and erase the feminist activism that gave rise to the field. She considers these anxieties as part of a larger concern over the future of the field, as well as fear that academic work on gender and sexuality has become too divorced from its activist roots.

Jack Halberstam, “Gender.” Keywords for American Cultural Studies, Second Edition (2014)

Halberstam’s entry in this volume provides a useful overview for debates and concepts that have dominated the field of gender studies: Is gender purely a social construct? What is the relationship between sex and gender? How does the gendering of bodies shift across disciplinary and cultural contexts? How did the theorizing of gender performativity in the 1990s by Judith Butler open up intellectual trajectories for queer and transgender studies? What is the future of gender as an organizing rubric for social life and as a mode of intellectual inquiry? Halberstam’s synthesis of the field makes a compelling case for why the study of gender persists and remains relevant for humanists, social scientists, and scientists alike.

Miqqi Alicia Gilbert, “Defeating Bigenderism: Changing Gender Assumptions in the Twenty-First Century.” Hypatia , 2009

Scholar and transgender activist Miqqi Alicia Gilbert considers the production and maintenance of the gender binary—that is, the idea that there are only two genders and that gender is a natural fact that remains stable across the course of one’s life. Gilbert’s view extends across institutional, legal, and cultural contexts, imagining what a frameworks that gets one out of the gender binary and gender valuation would have to look like to eliminate sexism, transphobia, and discrimination.

Judith Lorber, “Shifting Paradigms and Challenging Categories.” Social Problems , 2006

Judith Lorber identifies the key paradigm shifts in sociology around the question of gender: 1) acknowledging gender as an “organizing principle of the overall social order in modern societies;” 2) stipulating that gender is socially constructed, meaning that while gender is assigned at birth based on visible genitalia, it isn’t a natural, immutable category but one that is socially determined; 3) analyzing power in modern western societies reveals the dominance of men and promotion of a limited version of heterosexual masculinity; 4) emerging methods in sociology are helping disrupt the production of ostensibly universal knowledge from a narrow perspective of privileged subjects. Lorber concludes that feminist sociologists’ work on gender has provided the tools for sociology to reconsider how it analyzes structures of power and produces knowledge.

bell hooks, “Sisterhood: Political Solidarity between Women.” Feminist Review , 1986

bell hooks argues that the feminist movement has privileged the voices, experiences, and concerns of white women at the expense of women of color. Instead of acknowledging who the movement has centered, white women have continually invoked the “common oppression” of all women, a move they think demonstrates solidarity but actually erases and marginalizes women who fall outside of the categories of white, straight, educated, and middle-class. Instead of appealing to “common oppression,” meaningful solidarity requires that women acknowledge their differences, committing to a feminism that “aims to end sexist oppression.” For hooks, this necessitates a feminism that is anti-racist. Solidarity doesn’t have to mean sameness; collective action can emerge from difference.

Jennifer C. Nash, “re-thinking intersectionality.” Feminist Review , 2008

Chances are you’ve come across the phrase “intersectional feminism.” For many, this term is redundant: If feminism isn’t attentive to issues impacting a range of women, then it’s not actually feminism. While the term “intersectional” now circulates colloquially to signify a feminism that is inclusive, its usage has become divorced from its academic origins. The legal scholar Kimberlé Crenshaw created the term “intersectionality” in the 1980s based on Black women’s experiences with the law in cases of discrimination and violence. Intersectionality is not an adjective or a way to describe identity, but a tool for analyzing structures of power. It aims to disrupt universal categories of and claims about identity. Jennifer Nash provides an overview of intersectionality’s power, including guidance on how to deploy it in the service of coalition-building and collective action.

Treva B. Lindsey, “Post-Ferguson: A ‘Herstorical’ Approach to Black Violability.” Feminist Studies , 2015

Treva Lindsey considers the erasure of Black women’s labor in anti-racist activism , as well as the erasure of their experiences with violence and harm. From the Civil Rights Movement to #BlackLivesMatter, Black women’s contributions and leadership have not been acknowledged to the same extent as their male counterparts. Furthermore, their experiences with state-sanctioned racial violence don’t garner as much attention. Lindsey argues that we must make visible the experiences and labor of Black women and queer persons of color in activist settings in order to strengthen activist struggles for racial justice.

Renya Ramirez, “Race, Tribal Nation, and Gender: A Native Feminist Approach to Belonging.” Meridians , 2007

Renya Ramirez (Winnebago) argues that indigenous activist struggles for sovereignty, liberation, and survival must account for gender. A range of issues impact Native American women, such as domestic abuse, forced sterilization , and sexual violence. Furthermore, the settler state has been invested in disciplining indigenous concepts and practices of gender, sexuality, and kinship, reorienting them to fit into white settler understandings of property and inheritance. A Native American feminist consciousness centers gender and envisions decolonization without sexism.

Hester Eisenstein, “A Dangerous Liaison? Feminism and Corporate Globalization.” Science & Society , 2005

Hester Eisenstein argues that some of contemporary U.S. feminism’s work in a global context has been informed by and strengthened capitalism in a way that ultimately increases harms against marginalized women. For example, some have suggested offering poor rural women in non-U.S. contexts microcredit as a path to economic liberation. In reality, these debt transactions hinder economic development and “continue the policies that have created the poverty in the first place.” Eisenstein acknowledges that feminism has the power to challenge capitalist interests in a global context, but she cautions us to consider how aspects of the feminist movement have been coopted by corporations.

Afsaneh Najmabadi, “Transing and Transpassing Across Sex-Gender Walls in Iran.” Women’s Studies Quarterly , 2008

Afsaneh Najmabadi remarks on the existence of sex-reassignment surgeries in Iran since the 1970s and the increase in these surgeries in the twenty-first century. She explains that these surgeries are a response to perceived sexual deviance; they’re offered to cure persons who express same-sex desire. Sex-reassignment surgeries ostensibly “heteronormaliz[e]” people who are pressured to pursue this medical intervention for legal and religious reasons. While a repressive practice, Najmabadi also argues that this practice has paradoxically provided “ relatively safer semipublic gay and lesbian social space” in Iran. Najmabadi’s scholarship illustrates how gender and sexual categories, practices, and understandings are influenced by geographical and cultural contexts.

Susan Stryker, Paisley Currah, and Lisa Jean Moore’s “Introduction: Trans-, Trans, or Transgender?” Women’s Studies Quarterly , 2008

Susan Stryker, Paisley Currah, and Lisa Jean Moore map the ways that transgender studies can expand feminist and gender studies. “Transgender” does not need to exclusively signify individuals and communities, but can provide a lens for interrogating all bodies’ relationships to gendered spaces, disrupting the bounds of seemingly strict identity categories, and redefining gender. The “trans-” in transgender is a conceptual tool for interrogating the relationship between bodies and the institutions that discipline them.

David A. Rubin, “‘An Unnamed Blank That Craved a Name’: A Genealogy of Intersex as Gender.” Signs , 2012

David Rubin considers the fact that intersex persons have been subject to medicalization, pathologization, and “regulation of embodied difference through biopolitical discourses, practices, and technologies” that rely on normative cultural understandings of gender and sexuality. Rubin considers the impact intersexuality had on conceptualizations of gender in mid-twentieth century sexology studies, and how the very concept of gender that emerged in that moment has been used to regulate the lives of intersex individuals.

Rosemarie Garland-Thomson, “Feminist Disability Studies.” Signs , 2005

Rosemarie Garland-Thomson provides a thorough overview of the field of feminist disability studies. Both feminist and disability studies contend that those things which seem most natural to bodies are actually produced by a range of political, legal, medical, and social institutions. Gendered and disabled bodies are marked by these institutions. Feminist disability studies asks: How are meaning and value assigned to disabled bodies? How is this meaning and value determined by other social markers, such as gender, sexuality, race, class, religion, national origin, and citizenship status?

The field asks under what conditions disabled bodies are denied or granted sexual, reproductive, and bodily autonomy and how disability impacts the exploration of gender and sexual expression in childhood, adolescence, and adulthood historical and contemporary pathologization of genders and sexualities. It explores how disabled activists, artists, and writers respond to social, cultural, medical, and political forces that deny them access, equity, and representation

Karin A. Martin, “William Wants a Doll. Can He Have One? Feminists, Child Care Advisors, and Gender-Neutral Child Rearing.” Gender and Society , 2005

Karin Martin examines the gender socialization of children through an analysis of a range of parenting materials. Materials that claim to be (or have been claimed as) gender-neutral actually have a deep investment in training children in gender and sexual norms. Martin invites us to think about how adult reactions to children’s gender nonconformity pivots on a fear that gender expression in childhood is indicative of present or future non-normative sexuality. In other words, U.S. culture is unable to separate gender from sexuality. We imagine gender identity and expression maps predictably onto sexual desire. When children’s gender identity and expression exceeds culturally-determined permissible bounds in a family or community, adults project onto the child and discipline accordingly.

Sarah Pemberton, “Enforcing Gender: The Constitution of Sex and Gender in Prison Regimes.” Signs , 2013

Sarah Pemberton’s considers how sex-segregated prisons in the U.S. and England discipline their populations differently according to gender and sexual norms. This contributes to the policing, punishment, and vulnerability of incarcerated gender-nonconforming, transgender, and intersex persons. Issues ranging from healthcare access to increased rates of violence and harassment suggest that policies impacting incarcerated persons should center gender.

Dean Spade, “Some Very Basic Tips for Making High Education More Accessible to Trans Students and Rethinking How We Talk about Gendered Bodies.” The Radical Teacher , 2011

Lawyer and trans activist Dean Spade offers a pedagogical perspective on how to make classrooms accessible and inclusive for students. Spade also offers guidance on how to have classroom conversations about gender and bodies that don’t reassert a biological understanding of gender or equate certain body parts and functions with particular genders. While the discourse around these issues is constantly shifting, Spade provides useful ways to think about small changes in language that can have a powerful impact on students.

Sarah S. Richardson, “Feminist Philosophy of Science: History, Contributions, and Challenges.” Synthese , 2010

Feminist philosophy of science is a field comprised of scholars studying gender and science that has its origins in the work of feminist scientists in the 1960s. Richardson considers the contributions made by these scholars, such as increased opportunities for and representation of women in STEM fields , pointing out biases in seemingly neutral fields of scientific inquiry. Richardson also considers the role of gender in knowledge production, looking at the difficulties women have faced in institutional and professional contexts. The field of feminist philosophy of science and its practitioners are marginalized and delegitimized because of the ways they challenge dominant modes of knowledge production and disciplinary inquiry.

Bryce Traister’s “Academic Viagra: The Rise of American Masculinity Studies.” American Quarterly , 2000

Bryce Traister considers the emergence of masculinity studies out of gender studies and its development in American cultural studies. He argues that the field has remained largely invested in centering heterosexuality, asserting the centrality and dominance of men in critical thought. He offers ways for thinking about how to study masculinity without reinstituting gendered hierarchies or erasing the contributions of feminist and queer scholarship.

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Gender Research and Feminist Methodologies

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• First Online: 03 January 2023

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This chapter is structured around the issue of gender research and what it means to conduct research with a gender perspective. Thus, it discusses research methodologies inspired by feminist ontological and epistemological approaches. Drawing on feminist standpoint theory, situated knowledge, feminist poststructuralism and intersectionality, the chapter shows how feminist scholars, especially feminist legal scholars, have adopted feminist epistemologies in challenging gender inequalities in law and society. The chapter draws on legal methods combined with feminist social theories that have assisted feminist scholars to go about legal reforms. Furthermore, focusing on qualitative methods, the chapter explains some of the methods of data collection and data analysis in gender research which have been applied interdisciplinarily across social science and humanities studies. The last part of the chapter concentrates on practical knowledge about conducting gender research that is informed with feminist epistemologies and methodologies. Finally, through some exercises, the students are given the opportunity to design and outline a gender research plan with a socio-legal approach.

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Gender Studies: A Theoretical Perspective

Gender research

• Situated knowledge
• Discursive construction of law and gender
• Feminist legal methodologies
• Intersectionality
• Research design

1 Introduction

Feminist scholars have been conducting research criticizing traditional and male dominated research and knowledge production. Therefore, feminists have proposed alternative methodologies which are informed by a variety of epistemological and ontological approaches across different disciplines including law and sociology. This chapter draws on feminist methodologies including feminist critical legal studies through a gender sensitive lens, in other words, feminist socio-legal approach in gender research (aims, objectives, outcomes).

Learning Goal

The first learning objective of the chapter is to elaborate on how feminist research methodologies are developed in order to contribute to the production of knowledge about social reality; a production of knowledge that is not based on male dominated perspectives. Thus, it stresses the distinctiveness of feminist methodologies from traditional and patriarchal mainstream methodologies. In the process of knowledge production, feminist researchers have attempted to make connection between the idea of gender, gender equality, experience, and the reality of intersectional gender discrimination. Consequently, feminist research methodologies move from the mainstream scientific methods, from only collecting data for objective purposes, towards gender sensitive data collection and analysis. Feminist methodologies aim to produce knowledge through ethical and political perspectives, which focus on the critique and overcoming of gender blind scientific approach, in addition to the articulation of gender equality contents, concepts, conceptions, aims, objectives and outcomes. Feminist methodologies also aim at producing a so-called situated knowledge, which encompasses active role of the subject of creating the knowledge in the process of knowledge production.

The second objective of the chapter is to show diversity among feminist epistemologies that opt for challenging power structure in various ways which capture complexities of gender and gender relations. It shows how feminist methodologies have developed from focusing on the category of women to moving beyond emphasizing women’s commonality, which risks suppressing important differences existing among women who live life differently. There is a diversity of experiences in different social positions; white, black, heterosexual, lesbian, poor, privileged, colonized.

The third objective of the chapter is to put an emphasis on qualitative methods in feminist research based on the feminist epistemologies presented in the chapter. Qualitative research method is thought to be the most appropriate to investigate the complex socio-historical, political, relational, structural and material existence of gender. Thus, qualitative methods of data collections such as interviews and documents are described. Qualitative methods of analysis including thematic analysis, document analysis and discourse analysis in conducting socio-legal research are also included.

Finally, the fourth objective of this chapter is to provide the necessary knowledge and practical skills on academic writing. Writing an academic paper is challenging when it is based on research. Feminist writings are grounded on gender sensitive approach to political and ethical reflections which stand out across disciplines. Such reflections ought to be weighed more in educational purposes.

The key concepts that are covered in this chapter are:

Epistemology and ontology in feminist research

Situated knowledge and women’s experiences

Reflexivity and positionality

Feminist standpoint theory

Discourse and discursive construction of power

Feminist legal methods

Feminist intersectionality research

Research design and research strategy

Thematic analysis, critical discourse analysis and document analysis

2 Gender Research

This section introduces the notion of gender research, and conducting research from a gender perspective. It explains why it is important to conduct gender research and how methodologies are adopted to carry out research within the field of law and sociology with an emphasis on gender. Applying gender perspective in research refers to the analysis of gender as a social construct that impacts all aspects of people’s lives with regards to social interactions and extends to intimate relations. Gender perspective in research questions unequal power relations in social structures. Moreover, gender perspective in social and legal research pays careful attention to the process of knowledge production in relation to power structure and contributes to development of gender equality within law and society.

The kind of research that only documents differences between the sexes offers no understanding of gender relations and gender practices, neither does it elaborate on the gendering process of laws and policies. Therefore, legal scholars have adopted methodologies with gender perspective to show an approach that recognizes multiple dimensions of gendered relations and power structure in the legal system. Gender research in sociological studies problematises hierarchical power relations between genders in everyday life and integrates diversity of social structures such as race, class, ethnicity, sexuality, socioeconomic status, age, and disability into analysis of structural inequalities. Footnote 1 What’s more, Gender researchers have addressed traditional bias by adopting alternative methods of qualitative and quantitative data collection, that not only pay attention to gender differences, but also captures the complexity of gender relations. Footnote 2

2.1 Gender Research in Law and Society

Why is it important to conduct gender research through analysing the interaction between law and society?

The emergence of gender studies as a field of research has contributed to critical study of law as being a rule of the state. Gender studies have explored law as a social process that is discursively constructed. Understanding law as a social phenomenon challenges the mainstream ‘black letter’ definition of law as fixed and immutable. Gender research that is conducted by sociolegal scholars have attended to the lack of gender sensitivity in law using critical social theories. Examples of such are matters of sexual harassment and domestic violence.

Legal policies are constituted in interaction with social norms and realities that are often gendered. Gendered social relations and practices have taken shape through historicity of sociocultural, political, and economic processes. Therefore, gender research helps to tease out the ways in which legal and social policies and practices shape people’s lives. Law is an important and constitutive element of social life and gender is an important and constitutive element of human being. Together, the two are important in such research and more pressing in educational practices of law and gender.

Studying a social phenomenon with an emphasis on gender at interplay between law and society is important in many ways. It analyses law in terms of its power, potential and actual shortcomings in society. It investigates social realities of gender relations and constructions within law. It explores gendered social and legal process, and practices of legislation, judgements, jurisprudence and advocacy among legal professionals and institutions.

3 Feminist Research Methodologies

This section covers the ways in which feminist epistemologies as opposed to traditional and objective epistemologies have been developed to adopt methodologies for gender research. Feminist methodologies emerged from feminist politics, being feminist theories and practices. This section reflects on three feminist methodological approaches in studying gender and gender relations, which will be explained in the following subsections.

Feminist research does not stem from a unified set of thought and perspective. However, feminist perspectives do share common ideas. These common ideas imply that feminist research reflects on marginalization of women in social and political life. Footnote 3 Moreover, feminist research criticizes dominant norms of science which maintain male superiority by problematising hierarchical gender power relations and by establishing research approaches that are based on equal grounds. Footnote 4

Methodology concerns the use of theories and methods in conducting research, which are informed by different epistemological and ontological approaches. In criticizing traditional and male dominated research, feminists have proposed alternative methodologies which are informed by their epistemology and ontology; the ways in which one understands the world and the knowledge produced about the world.

Feminist methodologies claim that knowledge is produced within a context in which meanings and experience cannot be simply distinguished. Footnote 5 In the process of knowledge production, feminist scholars and researchers have tried to make connection between idea, experience, and reality. Footnote 6 Moreover, feminist research is based on, and feeds, feminist theoretical perspectives which are a considerable part of feminist politics, challenging male-biased knowledge production and power. Thus, feminist researchers have consciously developed theories based on practice. Therefore, most researches that are conducted by feminists draw on experiences, especially women’s experiences. Footnote 7

Feminist epistemologies identify how gender influence our conception of knowledge and practices of inquiry. Footnote 8 Feminist epistemologies problematize how dominant conceptions and practices of knowledge production exclude and subordinate some groups of people, including women. Thus, feminist epistemologies offer diverse accounts of how to overcome this problem by developing new theories and methods. Central to this endeavour is situated knowledge, a kind of knowledge that reflects a particular position of the knower. Situated knowledge means that the situatedness of the subject in relation to the power structure produces a type of knowledge that problematizes the ‘universal’ male-dominated knowledge. Footnote 9 Donna Haraway reminds researchers how to tell the truth rather than proving how objective is the truth, by introducing the concept of situated knowledge. She encourages feminist researchers to hold on to the notion of partial visions instead of struggling to reduce their research to patriarchal knowledge. Footnote 10

Feminist epistemologies focus on how the social location of an individual affects everyday life experiences, and how social structures are based on factors such as; gender, sexuality, ethnicity, race, age, place and socioeconomic status. These factors are imbued with power which ultimately results in situated knowledge. Thus, feminist epistemologies have opted for various ways to understand social phenomena and the ways in which knowledge is produced. This chapter explains standpoint theory, poststructuralism and intersectionality. However, it should be mentioned that feminist methodologies are developed across disciplines, adopting different approaches including; critical realism, historical materialism, new materialism and social structuralism to name but a few. Footnote 11

Feminist researchers in various disciplines, including feminist legal scholars, have discussed how to incorporate feminist theories, women’s experiences and knowledge production through gendered social relations into their analyses. That is to say, the following methodological approaches: standpoint theory, poststructuralism, intersectionality have also been employed by feminist researchers in legal studies. It should be mentioned that the following methodologies are chosen for students to understand how only some feminist methodologies are applied due to the limited scope of this chapter. Therefore, it does not imply rigid classification of these methodologies nor does it suggest they should be prefered in conducting gender research.

3.1 Feminist Standpoint Theory

This approach emerged in the 1970s out of discussions among feminists regarding masculinist science defining ‘women’ based on biology. Sandra Harding and Nancy Hartstock are known to be pioneer of this approach. Feminist standpoint theory finds out how knowledge production is entrenched with power relations. Feminist standpoint varies as different approaches are taken among feminists, which itself informs variety of feminist epistemological positions.

Feminist standpoint’s central conception is that women’s experiences speak the truth, resulting in the creation of knowledge that is situated in relation to power. Footnote 12

In privileging women’s standpoint, this epistemological stand presents strong reasons for how women understand the world differently from men in social division of labour. Feminist standpoint essentially adds gender to the already existing class analysis in scientific research.

Taking a feminist standpoint approach means to emphasize women’s lives as they experience life differently from men. This is required to fully understand the relationship between experience, reality and knowledge, meaning it would be possible to remedy the kinds of misrepresentation and exclusion of women from dominant knowledge. According to Patricia Hill Collins, making knowledge claims about women must involve women’s concrete experience to make that knowledge claim credible. Women’s experiences refer to activities in everyday life including emotions and embodiment. Footnote 13

For feminist standpoint theorists, knowledge is partial and does not implicate universal truth. Instead, it indicates the relations between power and knowledge. Empirical study is needed to investigate the specific forms of power, social relation and social positionality. Footnote 14

Knowledge is constituted through everyday life. The everyday life of people is authoritative knowledge, as Dorothy Smith describes through ‘work knowledge’. Footnote 15 A woman’s standpoint begins to unravel the underpinnings of gender. However, experience must be spoken or written for it to come in to existence, meaning it does not exist before its entry to language as authentic. Therefore, experience is already discursively determined by the discourse in which it is spoken. Footnote 16

Feminist legal scholars have adopted feminist standpoint theory to draw on women’s point of view and experiences of matters in life which have been systematically excluded from legislations and supportive legal mechanisms. (Please see all the other chapters of the Textbook especially Sociology of Law chapter).

3.2 Feminist Poststructuralism

Influenced by literary criticism, poststructuralism emerged in the 1960s in France. Many thinkers of this philosophy such as Jacque Derrida, Michel Foucault and Julia Kristeva were initially structuralist thinkers who became critical to structuralism and abandoned the idea. Therefore, poststructuralism was created. It is fair to say that the work of thinkers who were initially known as structuralists, was developed to a more fluid and complex kind of idea called poststructuralism.

Poststructuralism upholds that language produces meanings which constitutes subjects. Poststructural theories explain how discourse produces subjects. How do discourses function and what are their effects in society.

The lines between postmodernism and poststructuralism are blurry and many have argued that the two cannot be assumed separately. Postmodern theory emerged in response to the limitation of modernism and the metanarratives produced by modernists. Footnote 17 Poststructuralism (i.e. Derrida) is usually associated with a theory of knowledge and language, while postmodernism (i.e. Foucault and Lyotard) is often linked to theory of society, culture and history. Footnote 18

Feminists allied with postmodern and post-structural themes on fluidity of identities, and some have opted for deconstruction of identities, such as category of woman. Furthermore, the rejection of epistemology altogether is also said to be taken by postmodern feminists who aim to abandon any attempt to claim knowledge. Footnote 19

Feminist poststructuralism transcends situatedness by stressing on locality, partiality, contingency and ambiguity of any view of the world. Footnote 20 Feminists started to revise the standpoint theory. Hartstock, for example, made a revision to her original presentation of standpoint approach, in which she says that emphasizing women’s commonality will risk suppressing important differences existing between women and their life experiences in different social positions; white, black, heterosexual, lesbian, poor, privileged, colonized and so on. Footnote 21 According to poststructuralism, reality is socially and discursively constructed. Thus, feminist poststructuralists do claim that gender is socially and discursively constructed as a result of the effect of social regulations.

Postmodern feminist researchers criticize feminist standpoint and feminist empiricism for being essentialists in the ways they use identity categories such as women, due to their focus on gender differences that are portrayed as essential and universal. Footnote 22 Poststructuralist scholar Joan Scott criticizes standpoint theory and its focus on women’s experience which she argues exists in language and discourse, hence the discourses of women’s experiences are constructed beyond the speaker or writer’s intention. Footnote 23 In poststructuralist epistemology, power is understood as discursive and not the property of one gender. Thus, agency of the subject, according to feminist poststructuralist view is not free from discursive power.

Feminist poststructuralism, usually known as third wave feminism, problematizes the binary category of male and female, and argue that language and discourse create gendered subject through interactive process of everyday life. Footnote 24 It shows how relations of power are produced and reproduced. Thus, it subscribes to knowledge being produced discursively through particular social and historical contexts. According to feminist poststructuralism, the subject is basically dead, one’s subjectivity and understanding of self is constructed through discourse. Hence, the agency of the subject is limited, as Judith Butler holds that ‘the subject is not just a product a constitutive force of her discursive practices, it rather is a disruptor of the process through which she is constituted’. Footnote 25

Feminist legal scholars’ approach to law as a social phenomenon, seeing law as being discursively constructed, has led them to decentralize the states’ power and push forward for gender equal legal reforms. (please see Sociology of Law chapter).

3.3 Feminist Intersectionality

The concept of intersectionality is said to be developed by Black feminism in 1980s, particularly by Kimberlé Crenshaw who focused on the intersection of gender and race. She defined the concept of intersectionality as a different way in which the factor of race, along with gender, affect the ways black women experience employment and social life. The experiences of women of colour were excluded and lost in forms of multiple discrimination and marginalization. Footnote 26 It is worth noting that long before the inception of the concept of intersectionality, feminists had already been analysing gender at intersection with other structures of dominations such as class. For example, US feminist anti-slavery movement in the nineteenth century. Footnote 27 Therefore, we can say that the early use of the concept of intersectionality in feminist practice was based on the intersection of at least two axes of domination. This included gender and race, or gender and class, yet was not considered in either politics or research. Intersectionality has brought a conceptual shift in feminist philosophy and research through which scholars understand social actors.

Feminist intersectionality focuses on multidimensional and multi layered understandings of power and knowledge. To understand power relations in production of knowledge, it is important to know how subjects are situated; the situatedness or social location of people in the intersections of power. Situatedness engender knowledge from specific circumstances where power struggle is immediately at work, and when a particular type of knowledge is generated.

The recent work of feminists on intersectionality focuses on multiple forms of systems of dominations and privileges. Thus, in intersectionality research, the perspective of multiple marginalized groups is included in analysis, including the social experiences of privileged groups. The consequence here is to problematise and challenge universalisation. Footnote 28 For example, the category of woman as a universal aspect is challenged. Furthermore, intersectionality research illustrates that no one single factor is the reason for marginalisation and dominance; they are part of a broader pattern. According to Kathy Davis, “intersectionality is the interaction between gender, race, and other categories of difference in individual lives, social practices, institutional arrangements and cultural ideologies and the outcomes of these interactions in terms of power”. Footnote 29

Power is an important element in intersectional analysis. Feminist studies, together with anti-racist, postcolonial, queer studies, masculinity and disability studies, continue to enhance how norms are constructed and how power relations interact with each other. “Intersections of power can be found in all relations, at all levels of social structure from individual actions to institutional practice”. Footnote 30

The aim of employing intersectionality in feminist research is not to simply add as many categories as possible to our analysis, but to broaden the perspective and reflect on what factors may be relevant in a particular context, with specific socio-historical and spatial context. “An intersectional approach goes beyond just identifying power patterns. It is applied to problematizing the underlying social categories and see how these are reinforced or challenged”. Footnote 31

Feminist legal scholars have critically analysed the one-dimensional approach of law through intersectional perspective. Intersectional analysis has enabled feminist legal scholars in their legal analysis and judgments to scrutinize the multiplicity of underpinning social structures of both oppression and privilege at macro, meso and micro levels. Thus, relationality of social structures of gender, sexuality, class, race, ethnicity, religion, age, (dis)ability is being analysed with respect to socio-historicity of the context.

The formation of intersectionality has not been without criticism. Scholars often remain critical towards the use of intersectionality as an additional component of research. The critiques extend to debate that in trying to present multiple forms of discrimination and oppression, the grounds of intersectionality are used as additive and multiplicative approaches. This often reduces oppression to discrete categories of sexism, racism, heterosexism, classism. Footnote 32

4 Feminist Legal Methodologies

This section provides an overview of the development of feminist legal methods in doing and making laws. This extends from asking the woman’s question, to addressing other genders and multiple forms of gender inequality approach, through methods such as feminist judgments and gender mainstreaming applying intersectional analysis (i.e., gender, race, class, sexuality etc.).

4.1 Feminist Legal Methods

What are feminist legal methods? Feminists have long been criticizing law and what the law should entail. Therefore, they have proposed legal reforms which recognize women and other marginalized groups, including provision for, and protection of, their needs and rights in different areas of law.

In order to challenge power structures, feminists have defined their own methods of legal analysis; without having methods, feminists claims about law would have been dismissed. Footnote 33 Bartlett explains that “feminists like other lawyers use a range of methods of conventional legal reasoning such as deduction, induction, analogy and general techniques”. However, what distinguishes feminist legal methods from the traditional legal methods is that feminist legal methods try to “unveil legal issues which are overlooked and suppressed by traditional methods”. Footnote 34

Feminist legal methods are strongly imbued with feminist theoretical and methodological approaches. The following sections explain how feminist legal methods have adopted standpoint theory, by including women’s and other ‘marginalized’ genders into law making and legal reasonings adopting feminist intersectional approach. Furthermore, the section explains how feminist socio-legal scholars have adopted poststructuralist methodologies to problematize gendered power relations. This is achieved through discursive analysis and active engagement with practices of law and society, to rewrite judgments and policies through gender perspective.

4.1.1 From women’s Question to Multiple Gender Inequality

Feminist legal methods are seen as contributor to the modification of traditional legal methods, dominated by heterosexual male perspective. Legal methods were first initiated and adopted by feminists for practical reasoning and consciousness raising on issues experienced by women. Feminist legal methods, according to Bartlett, is about discussions over what kind of methodology feminist legal theory should adopt to identify and problematize the existing legal structure. Footnote 35 Feminist legal methods started to develop by problematising those parts of law that are discriminatory towards women. In other words, including women’s perspectives into legal methods and ask questions from women’s point of views.

Feminist legal methods, three methods as explained by Bartlett, are as follows. The first method is about asking the question of women, which is applied to expose how the substance of law subtly excludes the perspectives of women. So, feminist legal method considers the experience of women and asks the women’s question in law.

The case of Myra Bradwell vs. State of Illinois in 1873 asked the United States Supreme Court about why women are excluded from practicing law and why women are not included in the privileges and immunities of citizenship according to 14th amendment. This led to Illinois legislation prohibiting gender discrimination in occupation. Footnote 36

The second method regards feminist practical reasoning that is applied to move beyond the traditional notion of legal relevance in legal decision making. Practical reasoning is more sensitive to the cases, instead of simply reflecting already established legal doctrine. In this method, the reasoning is dependent on women’s context and experiences, which are unique.

The issue of abortion among teenagers is contingent on specific situations. Actual and specific circumstances might not be in favour of pregnant children who ought to obtain their parents’ consent, as it might lead to abusive behaviours of parents forcing pregnancy on the child.

The third method covers consciousness raising, which is applied to examine how legal principles correspond directly with people’s personal experience. Footnote 37 Consciousness raising is a process through which one reveals experience for collective empowerment. Personal experience becomes a political matter.

Women employ consciousness raising method when they share their experiences of rape and sexual assault publicly through MeToo campaign.

Critiques have raised some shortcomings with regards to the practicality of feminist legal methods focusing on women only. They have argued that the focus on the elimination of bias against women is limiting and such methods will be used by legal professionals who are not necessarily feminists, and certainly not all legal decision makers are concerned about the women’s question. Moreover, feminist legal method is criticized for its biased focus on women and women’s way of thinking, which is discussed to be elevating women over other issues such as disability, racism, poverty and ethnicity to name but a few. It is argued, as a consequence, this would ultimately lead to privilege of women’s experiences over other groups of people. Footnote 38

4.1.2 Intersectional Perspective in Law

Previously, the dominant kind of civil society activism within the EU had usually focused on one particular identity category when acted against discrimination which resulted in a way that, “the EU equality and anti-discrimination policies addressed specific groups of people as being subject of inequality and discrimination. For example, women, ethnic minorities, sexual minorities were only targeted in relation to one single dimension of inequality and discrimination such as either gender or ethnicity or sexuality”. Footnote 39 Instead of foregrounding one category over others for addressing discrimination, Hancock has proposed academic researchers should adopt multiple approach to inequality. This approach recognizes that people are not one-dimensional with grounds of inequality being manifold and multiple. In turn, this demands recognition of multiple discriminations in law. Footnote 40 However, an intersectionality approach has been argued to replace ‘multiple discrimination’ approach in research, because the multiple discrimination approach might lead to focusing on inequality grounds at individual level, rather than accounting for discrimination at structural level.

Intersectionality and intersectional perspective in law and policies concerning European institutions has not yet been adequately used to deal with intersectional violence and discrimination. Intersectionality within law reveals and tackles violence against women who are marginalized due to the interplay of different structural and individual reasons. Footnote 41 Intersectionality in law is not just about understanding the ways in which discrimination is experienced on grounds of race, ethnicity, gender, sexuality and so on. Intersectional perspective in law also unveils the structural barriers that produce social inequalities.

Intersectionality in law has been discussed in relation to antidiscrimination laws and gender-based violence in Europe. The problem with law is that it does not acknowledge fluidity and intersecting elements of people’s lives. It often focuses on one element of a human being. Most laws tend to adopt a one-dimensional approach. For example, in law on violence against women, the law usually addresses violence as crime that occurred on one ground and that is usually identity. Footnote 42 Other grounds of inequality such as sexuality, class, age, ethnicity, disability in protecting violence against women are rarely considered by legal policies.

Although the legal framework of the Council of Europe’s Convention for Protection of Human Rights and Fundamental Freedoms (ECtHR) allows lawyers and judges to have an intersectional perspective, Footnote 43 it has remained less practiced on the ground among legal professionals and within legal culture. Namely, given the behaviour and attitudes of legal professionals towards law, it is rare to examine, for example, the intersection of heterosexism or patriarchy in relation to sexist or racial behaviour. To demonstrate this, the cases of forced sterilization of Muslim Roma women in the Czech Republic, Slovakia and Hungry at ECtHR which were either settled or declared inadmissible in 2016 Footnote 44 did not involve intersectional analysis of gender, age, class, ethnicity and religion. Bello discusses how the application of intersectionality within legal reasoning can contribute to protection of Roma women’s rights. Footnote 45

An Intersectional approach is also hugely missing within European national and international laws with regards to LGBTQIA+ groups of people who are immigrants, refugees, sex workers, domestic workers, and disabled. The EU policies have not adequately taken an intersectional approach addressing inequalities among and within LGBTQIA+ groups who experience violence and discrimination differently. Moreover, laws and policies often homogenize lesbian, gay, bisexual, transgender, queer, and intersex people as one identity category, lumping them altogether into one cluster of entity. This has often overlooked people’s different needs. An inequality ground for a gay person may not be a concern for a trans persons. The intersectional approach within and among each group would allow for specific and common policy objectives. Footnote 46

4.2 Feminist Socio-Legal Methods

The term socio-legal has a broad definition that might differ in different contexts. The main component of socio-legal study is that it acknowledges the law is not just the product of the state. Rather, it is a product of social processes and practices. Footnote 47 Feminists have adopted social theories in combination with legal methods to criticize the role of law, not as law in the books, instead law in the context in creating and reinforcing gendered relations and practices. During the past few decades, feminist socio-legal scholars have worked with feminist methodological approaches, including poststructuralism and intersectionality, to highlight the “the implications of gendered power relations in law and society”. Footnote 48 (see chapter on Sociology of Law).

4.2.1 Feminist Judgements

As part of critical legal scholarship and legal reforms, feminist legal scholars, judges, lawyers and activists have engaged in specific cases to provide critical analyses of law in construction of gender. In their attempt to re-write judgments, they tackle power relations and problematise judicial and legal norms embedded in society. Footnote 49 Feminist judgements have impacted legal understanding and gender equality policies through socially engaging with matters such as marriage, parenthood, sexual consent, rape, and domestic violence. Moreover, feminist judgements consider the concept of judging as a ‘social practice’ which does not take place in isolation. Footnote 50 (Please see chapter on Feminist Judgement).

4.2.2 Gender Mainstreaming

Feminists have defined and debated gender mainstreaming differently, although the transformative potential of gender mainstreaming, that is revealing patriarchal structures and bringing marginalized issues into the centre of policy and law making, has been consistently valued.

Gender mainstreaming became the focus of international attention through adoption of the Beijing platform for action at the UN conference in 1995. The Amsterdam treaty imagined gender equality within all activities in the EU in 1997. The Council of Europe defined gender mainstreaming as a way to call for “incorporation of gender equality perspective into all policies at all levels and stages of policy making”. Footnote 51 Gender mainstreaming involves discursive analysis of the process and practices, through which laws and policies are created. Dragica Vujadinović emphasizes the necessity of gender mainstreaming to a gender sensitive approach within legal education. Vujadinovic shows how this is mostly non-existent in universities across the globe, including universities in developed ‘Western countries’ and the European Union. Footnote 52 Introducing gender mainstreaming projects in different countries depends on their approach to gender equality. For example, a broader approach to gender equality rather than conceiving it in terms of equal opportunities and equal treatment, allows for incorporating gender mainstreaming or a gender sensitive approach in educational practices.

Moreover, gender mainstreaming has provided opportunities for feminists to problematize ‘gender blindness’ at an institutional level, in public services and private matters.

5 Feminist Empirical Methods of Gender Research

This section describes the steps in conducting empirical sociological and qualitative research with a gender perspective. It explains the process of research including research design, research plan, research methods and method analysis. It should be noted that feminist research can be based on empirical as well as theoretical studies.

5.1 Feminist Positionality and Reflexivity

Feminist researchers study power relations, and yet unequal power relations are always present between the researcher and the subjects of research. Therefore, it is crucial to reflect upon the existing unequal power relations between the researcher and the research participants throughout the process of knowledge production. One should begin by clarifying one’s own positionality in relation to the research, as well as one’s position in relation the research participants. Conducting qualitative study based on fieldwork and sharing the findings collected from people, would be best done through destabilising power hierarchies. This is a task that feminist researchers have achieved by applying reflexivity into their theory and methods. Feminist researchers tend to define their positionality within research to avoid claiming objective truth in the process of knowledge production. Footnote 53

Feminist approaches to mainstream methodology vary, because they try to discover reliable accounts of socially constituted ‘reality’ rather than reproducing the ‘objective’ truth. Feminists have taken different approaches to challenge mainstream scientific methods of knowledge production, which aim to criticize universal criteria for knowledge claim. The feminist approaches that are elaborated in this chapter are: feminist standpoint theory or epistemology, feminist post-structuralism and feminist intersectionality.

As for research ethics, conducting empirical research based on interviews, for example, require researchers to obtain ethical approval; the practical aspect of research ethics. Ethical considerations in research are not limited to obtaining permissions. Ethics involve the ways in which the researcher relates to the research participants, and the data and information gathered from the research participants. Feminist research ethics emphasizes on the coproduction of knowledge with the research participants. Footnote 54 Researchers need to address ethical issues in qualitative research with regards to informed consent, privacy, and protection of information and lives of research participants, during and after the fieldwork.

5.2 Qualitative and Quantitative Research

Due to feminists’ criticism of traditional research being reliant on quantitative methods in the social sciences, increased use of qualitative research is suggested to better understand people’s social life. The dialogue between quantitative and qualitative researchers has continued for decades, as to which method better captures complexities of social issues. The use of quantitative data in conjunction with qualitative material is encouraged by feminist researchers to develop feminist theories.

Quantitative research has a numeric and statistical approach. It employs strategies and methods of data collection such as surveys and other statistical instruments through which information can be quantified. Footnote 55 Quantitative research consists of experiments that either test or confirm the existing theories. Therefore, the research is independent of the researcher in a quantitative method, tending to give an objective account of reality.

Three broad classifications of quantitative research are identified: descriptive, experimental, and causal comparative. The descriptive approach examines the current situation as it exists. The experimental approach investigates an independent variable in a study and then measures the outcome. The causal comparative approach examines how an independent variable is affected by a dependent variable, before analysing the cause-and-effect relationships between the variables. Footnote 56 Moreover, different methods of examination are used in quantitative research such as correlational design, observational studies, and survey research.

Qualitative research has a holistic approach. It does not entail a fixed definition, as the nature of qualitative research is deemed ‘ever-changing’. This is due to the variety of frameworks and approaches within which researchers conduct qualitative inquiry. Footnote 57

Common characteristics of qualitative research are: (1) it is conducted in a natural setting, (2); directed by the researcher; (3) involving inductive and deductive reasoning; (4) it focuses on participants’ views; (5) conducted in a specific context; (6) involves flexibility and creativity during the research process and; (7) is based on the researcher’s complex interpretation of the issue, but involves reflexivity. Footnote 58 Qualitative research engages with matters in everyday life, discourses, experiences and practices in a variety of dimensions. Poststructuralists have shown particular interests in qualitative research. Feminist research has had a significant impact in developing qualitative research as exists today. Qualitative methods, particularly face-to-face in-depth interviews, have become definitive of feminist qualitative research. Here we focus on interviews and documents as methods of data collection in qualitative research.

5.3 Research Plan, Design and Strategy

Before going through the steps of planning research, the following aspects need to be addressed:

In order to conduct the research, there are a few fundamental matters that the researcher needs to address. First, the researcher should know about the nature of the phenomenon, entities or the social reality that are in question. What is the research about? Second, the researcher must have an ontological and epistemological position as to how the researcher thinks the world exists, how knowledge about the world is produced and what social reality is made of. These are the epistemological questions: how social phenomenon can be known and how knowledge can be demonstrated.

If the researcher thinks that social reality is constituted of people, relations, institutions, structures, social process, discourses, practices, and rules, the researcher ought to establish how to investigate the social phenomenon in question, within this framework of understanding of social reality.

The answers to such questions form the strategy of the research. Research strategy is about how the researcher outlines the epistemological and ontological approaches to investigate the subject matter of their research. For instance, a socio-legal approach is a way to strategise research.

The next step is to clarify the aim of the research, that is to find out exactly why the researcher wants to conduct the research. It should be noted that the research objectives are less broad than the research aims and they basically pave the way to achieve the research aims.

If the aim of a research is to reduce violence against women in the workplace, the research objectives to achieve this aim would be: (1) understand how violence in workplace is perceived by employers, (2) explore all forms of violence experienced by women during their employment, and (3) investigate employment laws and policy.

The next step is to design the research. Designing research starts after ascertaining the position and approach in conducting the research. Research design is a kind of planning that maps out the ways through which the researcher conducts a study; helping the researcher to conduct an organised and coherent study. Footnote 59 In qualitative research, designing starts from the moment the researcher starts to formulate the research questions, problems or hypotheses. A qualitative research design consists of research questions, methods of data collection, methods of analyses and findings. After investigating the topic and reading the literature, the researcher drafts research questions. The questions can be refined later during the research process. After defining the questions, the researcher maps out relevant information for each question. This information concerns the sources of data and material, how to gather data and how to analyse the data.

In studying violence against women in the workplace, one research question could be how violence against women in the workplace is defined by law and policy makers? To answer this question, the researcher needs information or data from specific sources that can answer the question. The sources of data collection to answer the questions would be legal documents and interviews with stake holders. How to collect data from these sources could be gathered through documents and interviews. After gathering the data, the analysis could be done by applying critical discourse analysis and/or policy analysis. This outline is called research design.

5.3.1 Socio-Legal Research Strategy

How to design research which investigates the subject matter through a socio-legal approach? One way is to examine how policies and practices of gender at individual, meso and macro levels are influenced by, and influence the subject matter in question, within a specific context that is also contingent on socio-historical background.

Studying ‘law in context’ Footnote 60 as one of the approaches within social-legal research contributes to the production of knowledge that is informed by people’s experiences and existing social issues. In turn, these are tied to the processes of making and implementing law.

The policy research approach to socio-legal research is concerned with issues related to social policy, regulations, implementation, and enforcement. For example, examining how efficient implementation of law can affect access to justice, can be a policy research. The use of survey to evaluate a piece of legislation is another common policy research. Footnote 61

5.4 Methods of Data Collection in Qualitative Research

Based on the methodological approaches explained in previous sections, the following methods of data collection have been adopted by feminist researchers cross disciplines, including socio-legal scholars.

5.4.1 Interviews

An interview is understood to be a simple conversation that constitutes everyday life. It is a valuable method for gathering knowledge from an individual’s experience. An interview constitutes a further way to collect intellectual information in a social process from people. Footnote 62 As Kvale and Brinkmann suggest, the act of interviewing is a craft, which means it is based on practical skills and the decisions made by the interviewer during every step of the process. Footnote 63 Interview in social research is a guided, informal conversation through which the interviewee and the interviewer contribute to the process of knowledge production. The two sides interact with each other ethically and politically. Footnote 64

Learning how to conduct interviews for social research can be achieved only through engaging in actual interviews. In other words, one learns by doing. However, it is important to consider that interviewing is composed of several general steps. The interviewer logically follows these steps, including; identifying the population, classifying the questions, reaching out to the population, designing the interview guide, determining the location of interviews, recording interviews, transcribing interviews and analysing interviews. Footnote 65

It is up to the researcher to determine what type of interviews are deemed more suitable for answering the research questions; either structured interviews or semi-structured interviews. Semi-structured interviews involve the researchers asking a set of questions from each interviewee. The nature of these interviews, however, allows the interviewee to raise ideas and issues about which the researcher has not thought. This type of interview is flexible and gives the opportunity for the researcher to receive new questions or change the existing ones.

5.4.2 Documents

What are documents? Documents contain texts and sometimes images that have been produced without the researcher’s involvement. Footnote 66 Documents in social research could include a variety of materials, from personal journals to official organisational records or state datasets. Researchers have also identified other documents for social research, such as maps, photographs, newspaper reports, autobiographies, and even social media or SMS conversations. Electronic and digital documents constitute a significant part of documents in our world today, especially within organizations and institutions.

Documents can also be the sort of data and evidence through which people, groups, institutions, and organizations are accounted for. Documents here are tools to enable understanding of social and organizational practices. Footnote 67 Documents exist in many varieties such as legal, medical, financial, personal and so on. In terms of their form, documents can be literary, textual, or visual devices that create information. Therefore, documents are artifacts produced for a particular purpose, representing social conventions, being the analytical component of documents. Amanda Coffey maintains: “documents are social facts which means they are produced, shared and used in socially organized ways”. Footnote 68 Policy documents, legislations, strategic plans, press release, annual reports, newspaper articles are included as such.

5.5 Methods of Analysis in Qualitative Research

Based on the methodological approaches explained in previous sections, the following methods of data collection have been adopted by feminist researchers cross disciplines including socio-legal scholars.

Analysis is a process of generating, developing and verifying concepts. Footnote 69 The process of analysis begins even before starting the research project, as researchers choose a topic in which they have prior ideas. Footnote 70 Researchers require to have some ideas while collecting information about their studies; these ideas continue to develop during the research process and might modify along the way, by going back and forth between ideas and collected information. Analysis is not the last phase of research, as some might think. It is rather a process that actively involves information gathering. Footnote 71 Nevertheless, no consensus is achieved among scholars on what analysis means. Despite this lack of consensus, there are common characteristics to all methods of qualitative analysis. These are; reflexivity of the researcher, systematic but not rigid analytical approach, organizing the data, and inductive (that is data led) analysis. In addition, methodological knowledge is required. This does not mean that one should subscribe to one approach only and follow through the entire process. Flexibility and reflexivity should be counted. Footnote 72

Analysis involves interpretation where qualitative researchers translate other people’s acts and words. It is not straightforward to convey exact meanings, and therefore, some details may be lost in translation. Footnote 73 Interpretation consequently becomes a never-ending process, as researchers must always consider their data; reflect, reinterpret or amend interpretations. This may lead the researcher to new ideas. The process of analysis according to Denzin and Lincoln, is neither terminal nor mechanical. It is an ongoing emergent unfinished, changeable process. Footnote 74

5.5.1 Thematic Analysis

As a method of analysing data, thematic analysis searches for themes that emerge from the data or information to describe the phenomenon. “The process of analysis involves identifying themes through reading of the data. These themes become categories of analysis for the researcher”. Footnote 75

Thematic analysis can be applied within many ontological and epistemological frameworks. The researcher should make their theoretical approach explicit to the reader, as thematic analysis is a theoretical independent method of analysis. Footnote 76 Thematic analysis does not concern counting predetermined words or phrases, rather, it identifies implicit and explicit ideas in the data.

Thematic analysis is ‘a method for identifying, analysing and reporting patterns (themes) within data’ inductively or deductively. Footnote 77 Due to its flexibility, thematic analysis is suitable for analysing a wide range of data types, for instance; interviews, focus group discussion, textual data (i.e., qualitative surveys, diaries), online discussion forums and other textual and visual media sources. Footnote 78

Applying this method in research requires the identification of patterns, paying particular regard to important issues in relation to the research questions and theoretical framework, which must form some level of prevalence across the whole data. Similar to many other qualitative methods, thematic analysis is not a linear process. The researcher moves back and forth between different phases of the process of analysis. A six-phase analytic process is introduced by Terry et al., which are: “1) familiarising with the data, 2) generating codes, 3) constructing themes, 4) reviewing potential themes, 5) defining and naming themes, and 6) producing the report”. Footnote 79

5.5.2 Document Analysis

In qualitative research, document analysis is applied to close examination of documents to understand how they are authored or produced, including how they are used. Much of the organizational knowledge is stored in documents. Social actors are the authors of documents, and the examination of those documents is one way of understanding how social structure operates. Footnote 80 Documents also represent reality, albeit in a distorted and selective fashion, and can be used as a medium through which the researcher can find correspondence with the subject of study. However, they cannot be read separately from the social, historical and political contexts. Footnote 81

‘Document analysis is a systematic procedure for reviewing and evaluating both printed and electronic materials. Footnote 82 Document analysis starts with finding the documents, selecting and synthesizing information in the documents, which then can be organized into themes or categories and interpretation. This process involves content analysis that entails identifying meaningful and relevant passages of the text. Scholars have discussed applying thematic analysis to analyse documents, involving the recognition of patterns within the data and consequently exposing emerging themes. Footnote 83

Document analysis involves data selection instead of collection . Content information in documents is what the researcher analyses without being involved in gathering it, which is said to be unaffected by the research process. Many documents are publicly available, making it easier for the researcher to access.

Document analysis is used as a single method, in a triangulation, or mixed-methods, where two or more methods are used in research. For example, questionnaires and interviews in research are used in combination with document analysis. Footnote 84 As an illustration, gathering and analysing documents such as state laws and institutional regulations, as a stand-alone method provides the researcher in-depth knowledge about the purpose and intentions of the creators of the documents, and how they are used to shape people’s lives.

5.5.3 Discourse Analysis

Discourse analysis is a method which investigates how meanings are produced within narratives of, for example, conversation, newspapers or interviews. Discourse analysis refers to a set of approaches that can be used to examine the ways in which power relations are reproduced, through the function of language within texts and narratives. Discourse analysis is the result of Foucault’s work on discursive construction of power. Hence, it focuses on how power relations are constructed by means of language. Within social science research, discourse analysis takes a political approach by finding out who is constructed as marginalized and who gains hegemony in social relations. Thus, discourse analysis pays attention to the socio-political context of discourse and conveys how people are positioned by dominant discourses. Footnote 85

Discourse analysis method aims to move away from finding truth, instead working towards the functionality of discourse critically. Critical discourse analysis is an interdisciplinary type of discourse studies, examining how ‘social practices become contextualized as they are represented in discourse in instances of communication’. Footnote 86 Furthermore, critical discourse analysis concentrates on the role of language and communication in discursive construction of social domination, discrimination and social injustice. Footnote 87 The analysing process of research, focuses on the use of language to understand how people, practices and processes are represented, and what the underlying forces of such representations are. However, critical discourse analysis does not simply regard texts, rather, establishing what connects the text to a social context where people and events are produced. Footnote 88

Identifying discourses vary among researchers as there is no one way. In common, discourse analysis involves general steps, as any other qualitative methods, such as; formulating research questions, selection of sample, gathering data (i.e., records and documents etc.) and transcribing, coding data before writing up.

Critical discourse analysis of legal documents such as judicial opinions, statutes, constitutions, procedural laws and administrative laws can reveal the subtle and invisible nature discrimination based on gender, sexuality, race, ethnicity, class, religion, nationality etc.

Discourse analysis of a supreme court’s judgement on refusing a request of a trans woman to gain the custody of her child or visitation, unravels the discrimination based on discursive practices and policies of creating gendered subjects, gendered roles, womanhood and parenthood.

6 Writing a Research Paper

This section elaborates basic knowledge on how to write a scholarly paper; a paper that is the result of either an empirical or conceptual/theoretical research on gender.

Feminist researchers have published extensively on writings of research, especially research based on fieldwork. Feminist writings have paid special attention to reflexivity or reflection, by emphasizing the complex relationship between the researcher and the research participants in the process of knowledge production in various contexts. Writing on issues related to gender requires critical engagement and more of an explanatory than descriptive writing.

Essential skills for writing rationally and effectively are discussed in many textbooks. Footnote 89 These skills include using arguments, building arguments, understanding the cause-and-effect relations, making comparison, using references and describing visual and textual materials.

6.1 Structuring a Paper

The structure of the paper is proven to be the most difficult part of writing for writers. The main and few substantial components of a research paper are basically comprised of the introduction, the main text (theory, methods, analysis), the conclusion and references.

The purpose of the introduction in a research paper is firstly, to provide a rationale for the paper and explain why a particular question within the topic of the paper is being investigated. Secondly, it is important to illuminate on why it is interesting for the reader to know about the topic of the paper, particularly the issue in question.

The theory section describes the theoretical tools and concepts that are used to interpret and analyse data. The method section in the main text of the paper elaborates on what kind of data have been gathered for the purpose of this paper and how. It further draws on the methodological approach that has been adopted.

The section on analysis in the paper discusses the interpretation of data within the adopted theoretical framework.

The conclusion is the final section of the paper. The purpose is to summarize the main points of the paper, restates the thesis of the paper and makes final comments of the arguments of the paper.

To write a clear and organized paper, the writer should be especially confident about the ideas contained within. Moreover, it is important that the topic is written with passion.

Some general strategies are suggested for writing which focus on how to manage an academic paper in a timely manner. Planning and revising are the two general strategies that have been found in writing research.

6.2 Referencing and Plagiarism

Since writing a scholarly paper depends on the research and studies conducted by others, it is crucial for the writer to indicate the used sources. Providing references and citations are important as it shows that first, the writer has read other people’s work on the subject and is aware of the existing literature. As a second function, it allows the reader to find further sources on the topic. Lastly, it prevents plagiarism. Footnote 90

The use of the sources in a research paper can be presented as a citation, summary/paraphrasing or quotation. A list of references including all sources cited in the paper is provided at the end of the paper. There are various referencing systems in academia. Therefore, it is important to know which system to use, and thereafter maintain consistency in referencing throughout the paper.

Plagiarism happens when someone uses an intellectual property that belongs to another without acknowledging or referencing accurately. For example, copying or paraphrasing of texts, images or any other data without correct citation, or acknowledging the source, is plagiarism.

7 Exercises

The aim of these exercises is to encourage students to use the knowledge they have acquired in the course and deepen their understanding about feminist methodology and gender research in a practical way.

Understanding feminist Epistemologies in research

Formulate a research question that investigates a matter in relation to violence and law. Explain the problem and how you understand the problem and why you have chosen to explore it? In your explanation elaborate on your epistemological and ontological approach for carrying out this research.

Designing research

Following previous exercise, in a structured manner, map out how you plan to investigate the research question. Specify the data and material, sources, place and time, methods of data collection as well as methods of analysis for each material or data. You are required to justify your choices.

Structuring a scholarly paper

Following the last two exercises, write a disposition (no longer than 1 page) where you elucidate how you are about to write this paper based on your research. Explain how each section unfolds in the paper including theory, methods, and analysis.

Further Reading

Callaway H (1992) Ethnography and experience: gender implications in fieldwork and texts. Anthropol Autobiogr 29:29–49

Carastathis A (2014) The concept of intersectionality in feminist theory. Philos Compass 9:304–314

Conaghan J (2008) Intersectionality and the feminist project in law. Routledge-Cavendish, London

DeVault ML (1996) Talking back to sociology: distinctive contributions of feminist methodology. Annu Rev. Sociol 22:29–50

McEwan C (2001) Postcolonialism, feminism and development: intersections and dilemmas. Prog Dev Stud 1:93–111

McLeod J (2020) Beginning postcolonialism. Manchester University Press, Manchester

Mills J, Birks M (2014) Qualitative methodology: a practical guide. SAGE Publications, New York

Nash JC (2008) Re-thinking intersectionality. Fem Rev 89:1–15

Wolf DL (2018) Situating feminist dilemmas in fieldwork. In: Wolf DL (ed) Feminist dilemmas in fieldwork. Routledge, London, pp 1–55

Verloo M (2005) Displacement and empowerment: reflections on the concept and practice of the Council of Europe approach to gender mainstreaming and gender equality. Soc Polit Int Stud Gender State Soc 12:344–365

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• 28 May 2024

Heed lessons from past studies involving transgender people: first, do no harm

• Mathilde Kennis 0 ,
• Robin Staicu 1 ,
• Marieke Dewitte 2 ,
• Guy T’Sjoen 3 ,
• Alexander T. Sack 4 &
• Felix Duecker 5

Mathilde Kennis is a researcher in cognitive neuroscience and clinical psychological science at Maastricht University, the Netherlands.

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Robin Staicu is a neuroscientist and specialist in diversity, equity and inclusion at Maastricht University, the Netherlands.

Marieke Dewitte is a sexologist and assistant professor in clinical psychological science at Maastricht University, the Netherlands.

Guy T’Sjoen is a clinical endocrinologist and professor in endocrinology at Ghent University Hospital, Belgium, the medical coordinator of the Centre for Sexology and Gender at Ghent University Hospital, and one of the founders of the European Professional Association for Transgender Health.

Alexander T. Sack is a professor in cognitive neuroscience at Maastricht University, the Netherlands.

Felix Duecker is an assistant professor in cognitive neuroscience at Maastricht University, the Netherlands.

You have full access to this article via your institution.

Over the past few decades, neuroscientists, endocrinologists, geneticists and social scientists have conducted numerous studies involving transgender people, meaning those whose gender identity does not conform to that typically associated with the sex to which they were assigned at birth. Justifications for doing such research have shifted over the years and, today, investigators are increasingly focused on assessments of transgender people’s mental health or the impact of hormone therapies.

But such work raises challenges. Despite researchers’ best intentions, these studies can perpetuate stigmas and make it even harder for transgender people to access appropriate medical care.

Here we focus on neuroscientific approaches to the study of transgender identity to explore how investigators might navigate these concerns.

Brain scanning

In 1995, neuroscientists at the Netherlands Institute for Brain Research in Amsterdam published findings from a post-mortem study, which included six transgender individuals 1 . They found that the volume of part of the brain’s hypothalamus — called the bed nucleus of the stria terminalis, which tends to be larger in men than in women — corresponded to the gender identity of the transgender individuals, not to their sex assigned at birth. Although the data were only correlative, the researchers suggested that people identify as transgender because of changes in the brain that happen before birth — in other words, that someone can be born with a male-typical body and brain characteristics more typical of a female brain, and vice versa.

Sex and gender in science

Since it was published, the paper has been cited more than 1,000 times, and at least a dozen researchers have probed this theory and related ones using tools such as structural and functional magnetic resonance imaging (MRI).

Although the results of these analyses have been inconsistent, several ideas have nonetheless arisen about a neurobiological basis for gender dysphoria — the distress associated with a person’s gender identity not aligning with the sex they were assigned at birth. These include the ‘own-body perception’ theory 2 , which proposes that a reduced structural and functional connectivity between certain brain networks is responsible. (Previous work has associated these networks with brain regions thought to be involved in people’s ability to link their own body to their sense of self 3 .)

As analytical tools and methods advance, brain research is becoming more sophisticated. The number of neuroscientific studies that include transgender participants has increased considerably since 1991 (see ‘On the rise’).

Some neuroscientists are using functional MRI to study the effects of hormone therapy on brain structure 4 and to examine cognitive processes such as face perception 5 . Others are applying machine-learning techniques to establish whether features in brain scans of cis- and transgender people correlate with their gender identity 6 . Researchers are also trying to assess whether particular features identified in brain scans make it more likely that transgender individuals will benefit from gender-affirming hormone therapy 7 . And some are conducting ‘mega-analyses’ — pooling the brain scans of hundreds of participants — to identify brain characteristics that are specific to transgender people 8 .

Help or harm?

One concern arising from such studies is that neuroscientific findings related to transgender identity could make it even harder for some people to access medical treatment that could help them.

In countries or regions where gender-affirming medical treatment is available, individuals often need a diagnosis of ‘gender dysphoria’ or ‘gender incongruence’ to be eligible for hormone therapy or gender-affirming surgery, and to be reimbursed for such treatments. Results from brain scans could be included in the suite of measurements used to assess whether someone is experiencing gender dysphoria or incongruence.

Those in favour of such requirements argue that it is necessary to prevent people taking irreversible steps that they might regret. Hormonal therapy can have adverse effects on fertility, for instance 9 . However, many transgender people argue that whether someone can receive gender-affirming hormone therapy or other treatment shouldn’t depend on a health-care practitioner deciding that they experience ‘enough’ gender dysphoria to be eligible 10 . The current approach, combined with a shortage of specialists qualified to make such diagnoses, has been linked to long waiting lists. In the Netherlands, waiting times can be more than two years .

A second possibility is that neuroscientific findings related to transgender identity will fuel transphobic narratives 11 .

Take the debate on social media and other platforms about gendered public spaces in countries such as the United States , the United Kingdom and Brazil 12 . Some people argue that allowing transgender women to access infrastructure, such as public toilets or women’s prisons, threatens the safety of “real women” . Neuroscientific research is sometimes misused to bolster flawed claims about what ‘real’ means.

Moreover, such studies could exacerbate tensions between scientific and transgender communities.

Scientists are aiming to identify brain characteristics that are specific to transgender people. Credit: Alain Jocard/AFP/Getty

Although cis- and transgender researchers have taken steps to improve people’s understanding, there is a history of tension between the scientific and transgender communities 13 . In the late 1980s, for instance, a sexologist argued that trans women who are mainly attracted to women experience sexual arousal from their own expression of femininity. He described their feelings of gender dysphoria as resulting from paraphilia — a sexual interest in objects, situations or individuals that are atypical 14 . This theory has not held up under broader scientific scrutiny 15 , but it has become notorious in the transgender community and, from our discussions with transgender people and discussions by other groups 16 , it is clear that such studies have reduced transgender people’s trust in science.

How four transgender researchers are improving the health of their communities

In 2021, for example, a neuroimaging study with transgender participants was suspended in the United States after backlash from the transgender community. The study would have involved showing participants images of themselves wearing tight clothes, with the intention of triggering gender dysphoria — an experience that is associated with depression, anxiety, social isolation and an increased risk of suicide. The study’s researchers had acquired ethical approval from their research institute and obtained informed consent from the participants. Yet they had failed to anticipate how the transgender community would perceive their experimental procedure.

In 2022, to learn more about how transgender people view current neuroscientific approaches to the study of transgender identity, we conducted focus-group interviews that lasted for three hours with eight transgender participants — all of whom had differing levels of knowledge about the topic.

The group expressed concern that studies that look for a neurological basis to transgender identities could have a pathologizing effect. “I think questions of aetiology are just inherently wrong,” one participant said. “We don’t ask ‘Why is someone’s favourite colour blue?’. These are questions that come from wanting to pathologize.” Participants also agreed that a biological-determinist approach does not do justice to the complex and layered experience of identifying as transgender.

Decades of work aimed at establishing how science can benefit minority groups 17 suggest that neuroscientists and other scholars could take several steps to ensure they help rather than harm transgender, non-binary and intersex individuals and other people who don’t conform to narrow definitions around sex and gender. Indeed, the four actions that we lay out here are broadly applicable to any studies involving marginalized groups.

Establish an advisory board. Researchers who work with transgender participants should collaborate with an advisory board that ideally consists of transgender people and members of other groups with relevant perspectives, including those who have some understanding of the science in question. Funding agencies should support such initiatives, to help prevent further distrust being sown because of how studies are designed.

Set up multidisciplinary teams. Researchers trained in neuroscience will view phenomena such as transgender identity through a different lens from, say, those trained in psychology. To prevent the outcomes of neuroscientific and other studies being described and published in an overly deterministic and simplistic way 18 , research teams should include social scientists. Ideally, such collaborations would also include transgender researchers or others with diverse gender identities, because their input would help to prevent a cis-normative bias in study design and in the interpretation of results. Indeed, our own group has benefited from this diversity (one of us is transgender).

Prioritize research that is likely to improve people’s lives. Neuroscientists and others engaged in research involving transgender participants, non-binary people or individuals with diverse gender identities should prioritize research questions that are likely to enhance the health of these groups. Although the applications of basic research can be hard to predict, investigations into the neurobiological impacts of hormone treatment on the brain, for instance, could be more directly informative to health-care practitioners and transgender individuals than might investigations into the underlying bases of transgender identity.

Rethink how ethical approval is obtained. Ethical boards at universities typically consist of scientists with diverse backgrounds. But it is unrealistic to expect them to be educated on the sensitivities of every minority group, whether in relation to gender, religion, ethnicity or anything else. One way to address this problem is for ethical boards to require researchers to state what feedback and other information they have gathered through community engagement. A university’s ethical review committee could then evaluate whether the researchers have done enough to understand and address people’s concerns and sensitivities.

Our aim is not to halt scientific enquiry. But when it comes to transgender identity, knowledge cannot be pursued in isolation from the many societal factors that shape how that knowledge is received and acted on.

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A sex- and gender-based analysis of alcohol treatment intervention research involving youth: A methodological systematic review

Roles Conceptualization, Formal analysis, Writing – original draft, Writing – review & editing

Affiliations British Columbia Centre on Substance Use, Vancouver, Canada, Institute for Gender, Race, Sexuality and Social Justice, University of British Columbia, Vancouver, Canada

Roles Formal analysis, Methodology, Writing – original draft, Writing – review & editing

Affiliations British Columbia Centre on Substance Use, Vancouver, Canada, Department of Medicine, University of British Columbia, Vancouver, Canada

Roles Data curation, Formal analysis, Writing – review & editing

Affiliation British Columbia Centre on Substance Use, Vancouver, Canada

Roles Data curation, Writing – review & editing

Roles Conceptualization, Formal analysis, Methodology, Writing – review & editing

Affiliation Centre on Drug Policy Evaluation, Saint Michael’s Hospital, Toronto, Canada

Roles Conceptualization, Formal analysis, Funding acquisition, Methodology, Project administration, Resources, Supervision, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations British Columbia Centre on Substance Use, Vancouver, Canada, Université de Montréal, École de santé publique, Montréal, Canada, Centre de recherche en santé publique (CReSP), Montréal, Canada

• A. J. Lowik, 
• Caroline Mniszak, 
• Michelle Pang, 
• Kimia Ziafat, 
• Mohammad Karamouzian, 

• Published: June 3, 2024
• https://doi.org/10.1371/journal.pmed.1004413
• Reader Comments

This is an uncorrected proof.

While there is widespread consensus that sex- and gender-related factors are important for how interventions are designed, implemented, and evaluated, it is not currently known how alcohol treatment research accounts for sex characteristics and/or gender identities and modalities. This methodological systematic review documents and assesses how sex characteristics, gender identities, and gender modalities are operationalized in alcohol treatment intervention research involving youth.

Methods and findings

We searched MEDLINE, Embase, Cochrane Central Registry of Controlled Trials, PsycINFO, CINAHL, LGBT Life, Google Scholar, Web of Science, and grey literature from 2008 to 2023. We included articles that reported genders and/or sexes of participants 30 years of age and under and screened participants using AUDIT, AUDIT-C, or a structured interview using DSM-IV criteria. We limited the inclusion to studies that enrolled participants in alcohol treatment interventions and used a quantitative study design. We provide a narrative overview of the findings.

Of 8,019 studies screened for inclusion, 86 articles were included in the review. None of the studies defined, measured, and reported both sex and gender variables accurately. Only 2 studies reported including trans participants. Most of the studies used gender or sex measures as a covariate to control for the effects of sex or gender on the intervention but did not discuss the rationale for or implications of this procedure.

Conclusions

Our findings identify that the majority of alcohol treatment intervention research with youth conflate sex and gender factors, including terminologically, conceptually, and methodologically. Based on these findings, we recommend future research in this area define and account for a spectrum of gender modalities, identities, and/or sex characteristics throughout the research life cycle, including during study design, data collection, data analysis, and reporting. It is also imperative that sex and gender variables are used expansively to ensure that intersex and trans youth are meaningfully integrated.

Trial registration

Registration: PROSPERO, registration number: CRD42019119408

Author summary

Why was this study done.

• Both sex and gender are important factors for intervention design, implementation, and evaluation, including with regards to alcohol treatment interventions for young people. However, little is known about how alcohol treatment research accounts for sex and gender factors.

What did the researchers do and find?

• We systematically searched the peer-reviewed literature to identify alcohol treatment intervention studies that reported genders and/or sexes of participants 30 years of age or younger.
• Of the 86 articles included in our review, we found that none of them defined, measured, and reported both sex and gender variables accurately. Approximately 37% ( n = 32) of the studies defined, measured, and reported either sex or gender accurately. Only 2 studies reported including trans participants.
• Most of the studies ( n = 54) used sex or gender measures to control for their effects on the intervention but did not discuss the implications of this procedure.

What do these findings mean?

• Our findings identify how the vast majority of alcohol treatment intervention research with youth conflates sex and gender factors, including terminologically, conceptually, and methodologically.
• To advance sex and gender science in alcohol treatment intervention research, it is essential that researchers clearly articulate why they are choosing to include measures related to sex, gender or both, and to advance study designs and procedures that can account for sex and gender.
• It is also imperative that sex and gender variables are used in a way that ensures that intersex and trans people are meaningfully integrated so that both research and intervention can address their alcohol-related needs.

Citation: Lowik AJ, Mniszak C, Pang M, Ziafat K, Karamouzian M, Knight R (2024) A sex- and gender-based analysis of alcohol treatment intervention research involving youth: A methodological systematic review. PLoS Med 21(6): e1004413. https://doi.org/10.1371/journal.pmed.1004413

Academic Editor: Lars Åke Persson, London School of Hygiene and Tropical Medicine, UNITED KINGDOM

Received: September 19, 2023; Accepted: May 8, 2024; Published: June 3, 2024

Copyright: © 2024 Lowik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: This work was funded by the Canadian Institutes of Health Research (Ref# CTW1555550) and by a scholar award from the Fonds de Recherche du Quebec (Santé) (Ref# 2023-2024 CB 330116), both to RK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: IPV, intimate partner violence; RCT, randomized controlled trial; SAGER, Sex and Gender Equity Research; TIDieR, Template for Intervention Description and Replication

Introduction

While there is widespread consensus that sex- and gender-based factors are important for how interventions are designed, implemented, and evaluated [ 1 , 2 ], it is not currently known how alcohol treatment intervention research accounts for sex characteristics and/or gender identities and modalities. This knowledge gap is particularly salient for youth who experience harms from alcohol more intensely, given that experiences with regular or high-risk binge drinking during early phases of the life course (e.g., adolescence, young adulthood) increases the risks for alcohol-related harms to occur during subsequent phases of the life course [ 3 – 5 ]. Critically, both acute and chronic alcohol-related outcomes are impacted by a variety of sex- and gender-related factors. For example, epidemiological data across a variety of settings identifies how adolescent boys tend to initiate alcohol use earlier than adolescent girls, and that young adult men tend to drink in excess more regularly than young adult women [ 6 ] (note: we attempted to specify whether the literature cited is trans -inclusive or cis -specific; however, in most cases, this was not possible as the literature reviewed does not specify whether the study population included trans people). Research also documents how lifetime risks of health harms increases more steeply for women than for men when alcohol consumption occurs above low levels and when initiated from an early age, including during adolescence and young adulthood [ 1 , 5 ]. More recently, there has been a narrowing of the differences in chronic health outcomes associated with long-term drinking patterns between men and women, despite a long-standing body of evidence indicating that these outcomes are more persistently reported among men compared to women. This trend is observed in some settings, including the United States [ 7 ]. There is also a small but growing evidence base documenting how trans people experience higher rates of alcohol use when compared to their cisgender counterparts [ 7 – 10 ], though youth-specific data remains limited.

Clinical research has documented how sex-related factors are important in understanding how alcohol is absorbed, metabolized, and eliminated in bodies that are assigned male and female at or before birth, including via human physiology, anatomy, hormones, enzymes, genetics, and neurobiology [ 2 , 5 ]. Overall, this body of research documents that above low levels of alcohol consumption, female-assigned bodies are more likely to experience organ and other bodily damage and disease [ 1 , 5 ]. Social scientific, behavioral and epidemiological research also documents how gender-related factors impact population-level alcohol use patterns and outcomes, including with regards to gender roles and norms, gender relations, gender identities, and institutionalized gender [ 1 ]. For example, sociocultural and gender norms contribute to patterns in which men, on average, tend to drink in excess more than women and are also more likely to engage in high-risk behavior when intoxicated [ 11 ]. Indeed, the higher prevalence among young men of alcohol-impaired driving collisions [ 12 ] and other alcohol-related medical emergencies and health problems—including death [ 11 ]—are largely attributed to gender factors. Elevated rates of alcohol use among trans people of all genders are also attributed to social and structural factors, including exposure to minority stressors such as stigma, violence, and discrimination [ 8 , 13 ]. It has also been documented that, when intoxicated, cis girls and women and trans people of all genders are more vulnerable to sexual assault [ 14 ] and intimate partner violence (IPV) [ 11 ]; conversely, cisgender men and boys are more likely to be involved as perpetrators of alcohol-related violence [ 15 ].

Given that sex- and gender-based differences are critically important to alcohol-related outcomes among youth, it is important that the science informing alcohol treatment intervention development in this area attends to sex and gender concepts accurately [ 16 , 17 ]. For the current review, we turn our attention towards research involving alcohol treatment interventions that seek to address problematic alcohol use among youth, including psychosocial or behavioral interventions (e.g., cognitive behavioral therapy) and pharmacological treatments (e.g., antagonist treatment therapies). Behavioral therapies, such as cognitive-behavioral therapy and motivational therapy, as well as family-based approaches, have all demonstrated varying degrees of efficacy in treating alcohol use disorders among youth [ 18 ]. Although pharmaceutical therapies are not commonly used to treat alcohol use disorders among youth in most jurisdictions, research has demonstrated that these approaches can be helpful in some circumstances [ 18 ], particularly when combined with psychological and behavioral treatments [ 19 , 20 ]. Given that little is known about how sex- and gender-related factors are assessed and reported within the youth-focused alcohol treatment intervention evidence base, the objective of this study is to provide a methodological systematic review to document and assess how sex characteristics, gender identities, and gender modalities are operationalized in alcohol treatment intervention research involving youth, including adolescents and young adults. Our overarching research question is: How are gender and sex measured and reported in research on alcohol treatment for youth up to age 30?

We registered our study protocol on PROSPERO (registration number: CRD42019119408) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist for reporting [ 21 ]. Changes to our PROSPERO protocol are inventoried in Appendix A in S1 Appendices .

Search strategy

We searched MEDLINE (Ovid), Embase (Ovid), Cochrane Central Registry of Controlled Trials (CENTRAL), PsycINFO (EBSCOhost), CINAHL (EBSCOhost), LGBT Life (EBSCOhost), the first 300 citations on Google Scholar (22), and Web of Science for studies involving alcohol treatment among youth. Grey literature was identified using GreyMatter, des Libris ( http://deslibris.ca ), OpenGrey ( www.opengrey.eu ), and via custom Google searches; each source was last consulted as of January 4, 2024. As part of the review process, we manually examined the reference lists of all included articles, as well as the articles that cited them, and any review papers identified during the screening stage to identify additional relevant articles. The search was restricted to articles published between January 1, 2008 and December 31, 2023, to keep the work feasible and relevant. See Appendix B in S1 Appendices or the full search details for Medline.

Eligibility criteria

The population, interventions, comparisons, outcomes, and study designs considered for review are listed in Table 1 .

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Data extraction, analysis, and quality assessment

Authors CM and MP (for articles dated to 2021) and CM and AL (for articles dated 2022 and 2023) independently reviewed the title and abstract of each identified article and assessed for inclusion/exclusion using Covidence (Veritas Health Innovation, Melbourne, Australia, available at www.covidence.org ). In the second screening stage, full-text articles were obtained for all articles deemed by both reviewers relevant or possibly relevant (categorized as “yes” or “maybe”) based on the initial title and abstract review. Four authors/research assistants (MP, AL, CM, and EZ) independently assessed each of the full-text articles to determine their eligibility. Each article was reviewed by at least 2 team members to ensure consistency. Conflicts between the reviewers were discussed and resolved during regular screening resolution meetings with the senior author.

Authors MP and KZ (for articles dated to 2019), CM and MP (for articles dated 2020 and 2021), and CM and AL (for articles dated 2022 and 2023) independently extracted data from each of the 86 eligible articles. A data extraction spreadsheet was designed to extract information, such as the sociodemographic characteristics of the participants (e.g., sex/gender, age, race/ethnicity, socioeconomic status), study type, which alcohol screening tool(s) was/were used to assess problematic alcohol use, recruitment methods and study enrollment, characteristics of the interventions described in each study (e.g., how the intervention was delivered, by whom, where, when, modifications, and fidelity), and intervention outcomes, including attention to outcome data based on sex characteristics and/or gender identity.

Sex and gender considerations

The language of male and female when referring to sex is often used to describe a body’s biological, anatomical, and chromosomal qualities, but where those qualities are often presumed rather than explicitly measured [ 26 – 28 ]. Importantly, sex development is often more complicated than the male/female binary suggests (i.e., in so far as intersex people exist, and in so far as many sex-based characteristics are more bimodal than binary) [ 26 – 28 ]. Further, many of these sex-based characteristics are subject to change later in life, so that a person’s sex assignment at or before birth may tell us little about their current anatomy or physiology [ 27 ]. Gender, conversely, is used to describe all of the culturally, temporally, and socially specific expectations, norms, roles, and characteristics [ 28 ]. Gender identity, specifically, refers to how someone identifies in relation to the culturally available gender identity categories, such as man, woman, nonbinary [ 28 , 29 ]; with further specificity involving markers of gender modality—whether someone’s current gender identity aligns with the identity they were assigned at or before birth (with sex as a proxy for the assigned gender identity). With regards to our use of language throughout, we use the term “trans” as an inclusive term, in which “trans” is a gender modality concept which refers to anyone who identifies differently than the gender they were assigned, and which captures transsexual, transgender, nonbinary, genderqueer people among others, including people who do not claim “trans” as part of their identity. Cisgender or cis is used to refer to people who currently identify with the gender they were assigned [ 10 ].

Informed by the Sex and Gender Equity Research (SAGER) guidelines [ 30 , 31 ], we designed our data extraction to assess the role of sex and gender in each article, for example, whether the terms sex and gender were used with precision, whether the study sample was homogenous in regards to sex and/or gender, whether sex and/or gender was a covariate in the study, whether justification was provided for the relevance of sex and/or gender as a consideration in the study, and whether the article relied on sex-based and/or gendered assessments of problematic alcohol use. Specifically, we assess sex and gender considerations within description and/or discussions regarding: eligibility criteria, participant/sample descriptions, data collection and measurement, analyses and interpretations of results, study limitations, and recommendations for future research.

Risk of bias assessment

Considering the methodological nature of this systematic review focusing on how sex and gender are conceptualized, measured, and interpreted in a group of interventions aimed at addressing problematic alcohol use among youth, assessing the risk of bias in the included interventions was not directly relevant to our specific research question. Indeed, our review was primarily concerned with how sex and gender were accounted for in the included studies, rather than evaluating the overall quality or validity of the study findings. Therefore, the risk of bias assessment, which typically evaluates the internal validity of the individual studies, was not directly applicable to our study and interpretation of findings. To assess the quality of reporting of the interventions described in the articles, however, we used the Template for Intervention Description and Replication (TIDieR) checklist and guide [ 32 ] to extract data relating to each of the 12 items in the TIDieR checklist because it was developed to improve completeness of reporting of interventions, in an effort to improve replicability of research findings.

The extracted data from the final pool of articles was analyzed and synthesized using narrative techniques to assess how sex and gender information was collected, measured, and reported.

Study selection

Our search strategy identified a total of 14,006 studies, of which 8,019 unique eligible records were reviewed for inclusion. Abstract and full-text screening resulted in a total of 86 studies ( Fig 1 ).

https://doi.org/10.1371/journal.pmed.1004413.g001

Study characteristics

A total of 86 articles are included in the review ( Table 2 ). Most of the included studies used AUDIT or AUDIT-C to screen participants for alcohol use ( n = 77). Most of the included studies are randomized controlled trials (RCTs).

https://doi.org/10.1371/journal.pmed.1004413.t002

Sex and gender in the eligibility criteria and participant descriptions

Fifty-four (62.8%) of the 86 included studies inaccurately used sex-specific terminology to describe participants’ gender identities by stating that the participants’ genders were male and female (rather than men and women) [ 34 – 36 , 40 , 42 , 44 – 47 , 49 , 50 , 52 – 56 , 58 , 59 , 61 – 63 , 67 , 69 – 72 , 74 , 75 , 77 – 79 , 81 – 83 , 86 , 87 , 89 – 91 , 94 – 97 , 101 , 105 , 108 – 111 , 114 – 118 ]. For example, one study described how randomization was stratified by gender but inaccurately operationalized this by indicating each condition is comprised of equal proportions of “male” and “female” students [ 110 ]. Two articles (2.3%) used gender-specific terminology to describe participants’ sexes by stating that the participants’ sexes were men and women (rather than male and female) [ 81 , 83 ].

Twenty studies (23.3%) accurately used sex terminology to refer to their samples featuring either male or female participants and did not report on the gender identities of participants [ 39 , 41 , 43 , 48 , 51 , 60 , 68 , 73 , 76 , 80 , 85 , 93 , 98 – 100 , 102 – 104 , 106 , 107 ]. Conversely, 3 studies (3.5%) used the terminology related to gender identity accurately to refer to their samples featuring men and women and did not report on the sexes of the participants [ 33 , 84 , 113 ].

Among the 9 (10.5%) studies that limited enrolment to participants of only 1 sex or only 1 gender, sex- and gender-specific terminology was not defined and how these identities were assessed or measured was unclear [ 37 , 38 , 57 , 64 – 66 , 88 , 92 , 112 ]. Three of these studies (3.5%) stated that their eligibility criteria were limited to women, and these studies accurately deployed gender-specific terminology to describe eligible study participants [ 57 , 88 , 112 ], but it was unclear how the gender of study participants was measured. In one of these studies, the authors justified their decision to focus on one gender (women) due to the importance of alcohol interventions relating to certain reproductive capacities and experiences, including pregnancy, childbearing, and postpartum experiences [ 112 ]. As such, the authors accurately used the language of gender to refer to women participants in their study; however, in limiting their eligibility only to women, they nevertheless conflated sex and gender, since pregnancy, childbearing, and postpartum are experiences limited to female sex-assignment, where people who do not identify as women can and do get pregnant. The accurate use of gender/sex concepts expands beyond how participants are themselves described and is also an important part of determining eligibility criteria. Prospective participants may be inadvertently excluded from a study, despite being eligible, if gender identity is used instead of a more appropriate shared characteristic for sex-based rationale, specifically with regards to reproduction, including pregnancy, childbearing, and the postpartum experiences [ 30 ]. Six (7.0%) of the studies which limited their study populations to a single sex were limited to male participants; 5 included specifically young Swiss males who were subjected to a mandatory army recruitment process for all male citizens beginning at the age of 19 [ 37 , 38 , 64 – 66 ]. These participants were described in the article as both male and men interchangeably, without indicating as to whether the participants were asked about sex and/or gender. One of the studies (1.2%) which only included male participants did not explain or justify why they decided to do so [ 88 ].

Therefore, from the 16-year timespan of 2008 to 2023, among the 23 articles that reported either sex or gender accurately (but not both, since none of the articles included reported both accurately), in addition to the 9 articles that limited enrolment to participants of only 1 sex or only 1 gender and did so accurately (though with some problems as described above), 15 of 44 (34.1%) were published in the first 8 years of 2015 and earlier and 17 of 42 (38.6%) were published in the next 8 years of 2016 to 2023. While this represents an increase of approximately 4.5%, the difference is not significant ( P = 0.54); therefore, we did not observe improvements in how sex or gender were reported over time ( Fig 2 ).

https://doi.org/10.1371/journal.pmed.1004413.g002

Overall, none of the 86 studies included intersex people and none acknowledged the limitations of binary sex assignment for the purposes of interpretation. That is, none of the studies stated explicitly whether their male/female participants were intersex or endosex (that is, not intersex). The language of male/female was used without further qualification. Further, none detailed how male/female may be insufficient for determining the current anatomy or physiology of participants. Further, only 2 studies reported the inclusion of trans participants [ 84 , 110 ]. By characterizing the sample as featuring male, female, and transgender participants, the first study conflated gender modality (transgender) with sex (male, female) [ 110 ]. The second characterized the sample as featuring women, men, and “gender-diverse” participants at some points in the article and women, men and “other gender identity” at others [ 84 ], thereby conflating gender identity and gender modality. Given the authors did not report on gender modality (trans and cis), we are unable to assess if trans people are also included in the categories of men and women. Further, neither study differentiated between trans people of different genders in their respective “transgender” and “gender-diverse/other gender identity” categories; these participants were instead aggregated together into a single category, likely comprised of trans men, trans women, nonbinary people, and others.

Collection and measurement

We assessed the 86 articles for how they collected and measured the sexes and/or gender identities of study participants and how they described the measurement process. Eighteen (20.9%) of the studies used self-reporting instruments to collect the sexes of their participants and the articles neither specified whether the participants were offered options beyond male or female, nor whether participants were asked whether they had a variation in their sex development/were intersex. The articles also did not clearly indicate whether participants were asked specifically for their at-birth sex assignments (for example, as compared to their legal sexes, which may be different) [ 50 , 51 , 59 , 73 , 74 , 78 , 81 , 83 , 85 , 90 , 97 – 100 , 102 , 103 , 106 , 107 ]. Ten of these 18 studies were found in the previous section above to have accurately used sex terminology [ 51 , 73 , 85 , 98 – 100 , 102 , 103 , 106 , 107 ]; however, information about the self-reporting measures were not provided so it is not possible to determine whether sex was accurately measured since the sex terms male and female can be used to describe both at-birth assignment and legal sex, and since neither sex assignment nor legal sex is sufficient to ascertain anatomy or physiology. Eight of the 18 studies [ 50 , 59 , 74 , 78 , 81 , 83 , 90 , 97 ] were among those that conflated sex and gender terminology and, as such, we are unable to determine precisely what was measured—sex assignment, legal sex, gender identity, or some other variable.

Twenty-nine studies (33.7%) used self-reporting instruments to collect the gender identities of their participants. Similarly to reporting “sex,” articles did not specify whether gender identity was self-reported using open-text or, if researcher-provided response options were used, which identities were provided [ 33 , 34 , 36 , 40 , 42 , 46 , 49 , 53 , 58 , 61 , 67 , 72 , 82 , 87 , 89 , 91 , 94 – 96 , 101 , 105 , 109 – 111 , 113 – 117 ]. Only 2 of these 29 studies were previously determined to have accurately mobilized gender identity-related terminology [ 33 , 113 ]. The remaining 27 articles were among those that conflated sex and gender terminology [ 34 , 36 , 40 , 42 , 46 , 49 , 53 , 58 , 61 , 67 , 72 , 82 , 87 , 89 , 91 , 94 – 96 , 101 , 105 , 109 – 111 , 114 – 117 ]. It is therefore unclear what was ultimately measured and how. For example, it is unclear whether participants were offered only the binary gender identity options of man and woman. Based on the pervasive conflation of gender and sex in these studies, it is possible that some studies asked participants for their gender identities, but offered sex terms (e.g., male or female) as response options, despite using gender terms to later describe their samples.

Thirteen (15.1%) of the studies reported that they collected the sexes of participants [ 39 , 41 , 43 , 44 , 48 , 60 , 68 , 76 , 79 , 80 , 93 , 104 , 118 ]. A further 14 (16.3%) studies reported collecting the genders of participants [ 45 , 47 , 52 , 54 – 56 , 62 , 63 , 70 , 71 , 75 , 77 , 84 , 86 ]. However, none of these 27 studies (31.4%) described how they undertook the task of assessing, collecting, and measuring the sexes and/or genders of the participants. Among the 9 studies (10.5%) that included participants of only one sex or gender, no details are provided about how the sexes or genders of those participants were collected and measured [ 37 , 38 , 57 , 64 , 65 , 66 , 88 , 92 , 112 ]. Without describing their data collection methods and measures, it was unclear how these 36 studies collected and measured participants’ gender identities and/or sexes, making it difficult to assess whether these were used precisely, accurately, and inclusively in their approaches to data collection and measurement.

Sex and gender in the analyses and interpretations of results

In 54 of the studies (63.0%), sex and/or gender was used as a covariate in the analysis, and this was often done to control for the effects of sex and/or gender on their intervention [ 33 – 35 , 39 – 51 , 53 – 56 , 58 – 61 , 63 , 70 , 71 , 75 – 78 , 80 – 84 , 86 , 89 , 90 , 93 , 96 , 99 – 103 , 105 , 106 , 109 – 111 , 114 , 117 , 118 ]. For example, Tello and colleagues [ 105 ] considered gender as a potential factor in the a priori power analysis but ultimately found that it did not impact their dependent variable and therefore excluded it from their subsequent analyses. However, they noted that their participants were mostly female (which is a sex term) and that although they “did not find any effect of gender on [the] results, further research is needed to test whether evaluation conditioning is equally efficient across gender” [ 105 ]. Given the conflation of sex and gender terms throughout the article, it is not possible to determine whether the authors ultimately controlled for sex or for gender, as well as whether they were suggesting that more testing is needed across gender-related factors, sex-related factors, or both.

In 64 of the studies (74.4%), the authors did not discuss whether sex or gender were relevant to their hypothesis or analysis [ 33 , 35 – 41 , 43 – 56 , 58 – 60 , 62 , 66 – 89 , 93 , 95 – 97 , 106 – 109 , 111 , 113 – 116 , 118 ]. Half of the 86 studies in the sample ( n = 43, 50%) did not mention sex or gender in their discussion sections, neither as variables which were significant or relevant to their findings, nor as factors that they explicitly featured in their recommendations for practice or policy based on their findings [ 33 , 35 , 39 , 41 , 47 – 49 , 51 – 56 , 58 – 60 , 66 – 70 , 73 , 77 – 78 , 80 , 82 – 84 , 86 , 88 , 90 , 91 , 93 , 94 , 99 – 104 , 110 , 114 , 116 ]. Although the authors conflated sex and gender terms throughout their article, Bewick and colleagues addressed how sex/gender affected study results by stratifying the results by sex, discussing how the regression analysis “showed that males entered the study with a higher total number of units consumed over the last week,” and how these findings are in agreement with other literature [ 40 ].

Sex, gender, and study strengths and limitations

Twelve studies (14.0%) identified the relative homogeneity of their sample (i.e., samples that were composed of entirely or mostly 1 sex or gender) as a limitation of their research [ 37 , 38 , 44 – 46 , 64 , 76 , 87 , 93 , 97 , 105 , 113 ]. For example, Canale and colleagues [ 46 ] described how their sample being comprised predominantly of female participants was a study limitation and argued that future research ought to better integrate and consider sex and/or gender variables. Five studies (5.8%) described gender-related limitations in terms of the generalizability of their findings [ 34 , 50 , 85 , 89 , 96 ]. For example, Miller and colleagues [ 89 ] reported that having a higher proportion of women in the control than the intervention group was a limitation.

Seven studies (8.1%) both discussed sex and/or gender within the context of their findings and recommended that sex and gender ought to be more fulsomely integrated into future research in the area of youth alcohol interventions [ 40 , 42 , 57 , 61 , 62 , 65 , 106 ]. A further 3 studies (3.5%) recommended that sex and gender ought to be integrated into future research, though they did not discuss sex and/or gender within the context of their own findings [ 43 , 107 , 115 ]. One study recommended that future research ought to explicitly explore intervention outcomes among sexual and gender minority populations [ 43 ]. One study (1.2%) discussed sex and/or gender only insofar as they provided citations from previous research studies but did not discuss sex and/or gender in the context of their current findings [ 112 ]. Thirteen studies (15.1%) discussed sex and/or gender in relation to their current findings but did not expand on how sex and/or gender impact alcohol interventions and other broader implications [ 36 , 63 , 71 , 72 , 75 , 81 , 92 , 98 , 108 , 109 , 111 , 117 , 118 ]. For example, Gajecki and colleagues [ 63 ] discuss the gender differences in participant outcomes in the study (e.g., “Analyses by gender showed that men in the intervention group compared to men in the assessment-only control group had higher odds ratios for not having excessive alcohol consumption than women in the intervention group compared to women controls”) but did not expand on the implications of these findings. Finally, concerns over generalizability were limited to how or whether the findings could be generalized to all men and women or males and females. None of the studies discussed the relevance or generalizability of the findings for intersex and trans people.

Quality of reporting of intervention characteristics.

Overall, the quality of reporting about interventions in the included articles was good. Only 4 articles addressed every item on the TIDieR checklist with all relevant details [ 39 , 56 , 58 , 84 ], but most articles ( n = 48, 56%) included all relevant details for 8 of the 12 items in the TIDieR checklist ([ 32 ]; Table 3 ).

https://doi.org/10.1371/journal.pmed.1004413.t003

Our findings identify how the vast majority of alcohol treatment intervention research with youth are conflating sex and gender factors, including terminologically, conceptually, and methodologically. None of the 86 studies defined, measured, and reported both sex and gender variables accurately and consistently. Most of the studies reviewed used gender and/or sex as a covariate to control for the effect of sex and/or gender on the intervention. Many studies identified limitations regarding sex and/or gender, including sample homogeneity, generalizability of findings, and the need for more research. Only 2 of 86 articles acknowledged the presence of trans people, albeit in ways that conflated gender modality with sex or gender identity. The incorrect conflation of sex and gender terms occurred across the studies and persisted over time (from 2008 to 2023), and only a small subset ( n = 32) of the studies defined, measured, and reported either sex or gender identity accurately. None of the studies described how they assessed participants’ sexes, gender identities, or modalities (e.g., the measures they used), though just over half of the studies indicated that this was done using self-reporting instrument tools. Despite these shortcomings, the overall quality of reporting about interventions as assessed by the TIDieR checklist was good.

The omission and exclusion of trans people in research is a long-standing issue and is particularly dangerous when trans people have elevated risk for harms, as is the case for substance use [ 119 ] and alcohol use [ 8 , 120 ]. In the absence of a clear integration of sex and gender terms and measures, we worry that a lack of rigour in this area could result in the systematic assignment of sex and/or gender variables to participants and samples based on crude proxies, assumptions, or guesses about participants’ sexes and/or genders. For example, despite referring to the participant sample as being comprised of a certain number of men and women, and accurately calling this classification “gender,” there is a real possibility that the authors were assuming that the participants were men and women based on presumptions about the participants’ gender expressions, sexed bodies or based on other factors, including when this is done in cisnormative ways (e.g., where a person with breasts, who is wearing a dress, is assumed to be a woman, despite their identifying as nonbinary). At this juncture, it is clear that the body of youth alcohol intervention research widely relies on data collection and reporting approaches that presume (and therefore replicate) sex and gender binaries, thereby resulting in the systematic exclusion of intersex and trans people.

While long-standing confusions and conflations of terminology in the sex and gender field are well documented [ 1 , 2 , 121 ], we are also concerned that the lack of precision and analytic rigour is inhibiting progress with regards to youth alcohol treatment interventions capacity to account for sex- and gender-related factors. For example, we found that most of the study designs seem to be based on a “sex differences” paradigm, an approach in which sex measures are collected to examine the differences between bodies that were assigned male or female [ 121 ]. However, at the level of analysis, sex differences tended to be used almost exclusively for descriptive rationale and discussed and interpreted only in ways that treated these differences as separate, dichotomous, and non-overlapping [ 1 , 2 ]. Similarly, for the subset of studies that would ostensibly fall within a “gender differences” paradigm—an approach that seeks to understand the social and cultural experiences within and across genders [ 121 ]—gender differences were also used almost exclusively for describing the sample and not considered within the analysis or interpretation of results. Given that the use of both sex and gender paradigms are largely used primarily to describe (accurately and inaccurately) study samples, it remains unlikely that this approach to sex and gender science will have the capacity to advance interventions that fulsomely account for or address sex- and gender-related factors.

None of the studies included in our review were designed in a way that they could identify both sex- and gender-related factors (i.e., the components, factors, and/or processes associated with sex and those associated with gender) impacting alcohol- and intervention-related outcomes. For example, given that rudimentary and foundational understandings of sex and gender factors were absent, it is perhaps unsurprising that none of the studies assessed or considered sex and gender interactions (experiences of having a sexed body in a gendered social context) and the real-world experiences and impacts of these interactions on alcohol treatment intervention outcomes for intersex and endosex, cis and trans youth of all genders [ 1 , 2 ]. We do not necessarily consider this as a problem, as it may be the case that either sex- or gender-related factors are irrelevant to a given research question or intervention (e.g., behavioral interventions where sex factors like anatomy and physiology are not part of the mechanistic processes) and it is therefore reasonable to only include one or the other. Indeed, it is important from both ethical and methodological perspectives that researchers define, measure, and report only those measures that are relevant to their research questions and mechanistic hypotheses, rather than reifying the importance of variables like sex in research where sex does not feature in the mechanistic hypothesis. Further, where sex is deemed relevant to a given study or intervention, it is imperative that researchers identify the sex-specific factors that impact outcomes (e.g., hormones), recognizing that male and female (as assignments or legal categories) are not appropriate proxies for these more specific and precise factors (e.g., where there are people assigned male with low testosterone and people assigned female with high testosterone, which could only be ascertained by measuring not sex, but hormone levels). Still, there are research questions and interventions that should include measurements of both sex and gender (identity and modality), including, for example, pharmacological interventions that seek to assess the impacts of human physiology, anatomy, hormones, enzymes, genetics, and neurobiology (sex-related factors) when combined with behavioral or structural interventions that may feature impacts or outcomes associated with gender roles and norms, gender relations, gender identities, gender modalities, and institutionalized gender.

In addition to issues with the terminology (which impacts not only how participants are described, but inclusion/exclusion criteria, and which is an important part of data collection and measurement), the studies in our review also relied on validated tools for assessing problematic alcohol use which themselves likely contributed to the misuse and exclusionary approach to gender and sex in the scientific research described in this review. Although we do not hold the authors of the 77 studies who used AUDIT and AUDIT-C accountable for the sex- and gender-based limitations of these tools, we note that none of these studies did so in a way which indicated an awareness of the cisnormative assumptions embedded within these tools and the resulting shortcomings to their applicability [ 122 , 123 ]. We note that it is also likely that the cisnormative conflation of sex and gender at the level of these alcohol screening tools contributes to “knock-on” effects in other areas of the research design in which sex and gender are deployed inaccurately. We argue that if the screening tools substantiated their use of different thresholds for different kinds of people through a more careful articulation of sex and/or gender concepts, those working in this area (including clinicians who use these tools in their clinical practice) would be compelled to consider sex and gender constructs more precisely and accurately [ 123 ]. At this juncture, we follow Flentje and colleagues and the Canadian Centre on Substance Use and Addiction’s conclusions regarding the need for gender-inclusive AUDIT scores [ 5 , 122 , 123 ].

Until these issues are more fulsomely addressed in alcohol treatment intervention science, inclusivity considerations are likely to remain unaddressed in this area. For example, while an emerging evidence base reveals that trans people have higher rates of alcohol use as compared to their cisgender counterparts [ 7 ], the alcohol treatment intervention research does not account for trans youth. Based on our review, it appears that sex and gender minority populations are being systematically excluded from research, thereby resulting in imprecise or non-inclusive recommendations for these populations in the design and implementation of treatment interventions. Intersex and trans people have well-established and justifiable mistrust with academics, researchers, and clinicians alike, an issue that is likely exacerbated by study protocols and tools that do not provide opportunities for meaningful inclusion [ 124 – 129 ]. Arguably, even if intersex and trans people had been recruited to the studies we reviewed, it remains unclear as to whether the studies would have had the tools to meaningfully, accurately, and inclusively measure their specific sex- and gender-based factors in the study protocols and whether the researchers would have had the skill and expertise to meaningfully analyze the resulting data.

To our knowledge, our review is the first to consider over a decade of research on how gender and/or sex are mobilized in alcohol interventions for youth. We are unaware of any other review investigating the mobilization of sex and/or gender in substance use interventions that has screened over 8,000 articles. Furthermore, this review also used rigorous methods to ascertain to what extent sex and/or gender were incorporated in all facets of research design, including eligibility criteria, sample descriptions, data collection processes, analyzes, results and discussion sections, implementation considerations as well as study-specific strengths and limitations. Because of this careful screening, we were able to identify with confidence that alcohol intervention research with youth is consistently misusing sex and gender terminology in the reporting of various stages of the research cycle [ 8 ]. Another strength of this paper is that the quality of reporting of the included articles was assessed using the TIDieR checklist [ 32 ].

In terms of limitations, where sex and/or gender sociodemographic variables are considered, we would argue that these can never be divorced from race, age, class, or disability. Our systematic review does not undertake an intersectional analysis of these variables, and instead looks at how the 86 studies mobilize sex and/or gender variables in isolation rather than in an intersectional way. Furthermore, there is currently no scale to quantify or qualify the degree to which dominant norms such as endosexnormativity (the presumption that humans are naturally sexually dimorphic and where endosex lives are anticipated and valued) and cisnormativity (the presumption that binary sex and binary gender will align in predictable ways, and where cisgender lives are anticipated and valued) featured within various facets of the studies.

Finally, while our review provides answers to some of our narrowly defined review questions, we did not assess how these variables were mobilized in the interventions themselves, including whether there were sexed and/or gendered impacts of the interventions. However, had we done so, based on our findings, we anticipate that these intervention-specific results were likely also written in ways that conflated and confused these variables. For example, we do not consider whether and how interventions were tailored based on sex- and/or gender-related factors and subsequently whether the study results vis-à-vis the intervention are therefore reliable based on how that tailoring was undertaken.

To advance sex and gender science in this domain, our findings underscore the importance of including checklists for reporting on sex and gender in medical research as a necessary requirement by funders and peer-reviewed journals (e.g., the SAGER checklist [ 31 ]). By implementing these requirements and adopting improved reporting practices, authors would be compelled to consider and address, where relevant, sex and gender factors in their interventions. This would not only enhance the quality and relevance of interventions in addressing harmful alcohol use among youth but also ensure that these interventions take into account the nuanced influences of sex and gender on individual responses to different alcohol treatment approaches. As a result, more accurate findings can be obtained, leading to better-informed decision-making and improved health outcomes among youth who use alcohol. Nevertheless, challenges remain with how to advance guidelines such as SAGER across the health sciences ecosystem; indeed, the current review observed no statistically significant improvements with regards to how sex and/or gender are reported pre- and post- the 2016 publication of the SAGER guidelines, likely due to resource limitations at journals, concerns about mandating changes, and lack of awareness or resistance [ 130 ]. We agree with others that improving research and reporting practices will require wider involvement of pertinent parties from across journals, universities, professional societies, ethics committees, funders, industry, and policy makers [ 130 ].

To move the science forward in this area, it will also be important that researchers clearly articulate whether the mechanistic hypotheses are related to sex, gender, or both, and to advance study designs and procedures that can accurately, precisely, and inclusively account for sex and gender. As we have argued elsewhere, intervention research should also be designed to assess differential effects, including by gender. To measure gender differences, steps such as conducting stratified analyses, testing for interaction effects, and performing subgroup analysis should be followed. Indeed, even in an RCT with balanced groups of (cis and trans) men and women, gender differences in response to the intervention can still exist [ 131 ]. Stratifying the analysis by gender will provide statistical insights into subgroup differences, assessments of clinical relevance, and allow for further exploratory analyses based on gender differences. Ultimately, stratifying the analysis by gender—including in ways that are attentive to nonbinary gender identities—and employing appropriate statistical methods will help identify meaningful differences in treatment responses between and across different genders.

There is also a need to include intersex and trans people in study designs that accurately describe study samples using the appropriate and corresponding sex and/or gender language. Descriptions and discussions of the limits to generalizability are needed if subgroups are excluded, including if intersex and trans people are underrepresented. Drawing on the sex and gender science methods literature about best practices for measuring gender modality (e.g., the commonly used two-step method [ 132 ]) and providing corresponding details about the approach used for measuring participants’ sexes, gender identities, and/or gender modalities, including by listing measures and response options in text or via supplemental data files, will be important to moving this field forward. Finally, ensuring that sex and/or gender data are analyzed, interpreted, and discussed in ways that attend to the complex sexed and/or gendered factors which impact the lives and alcohol-related experiences of study participants will be critical in our efforts to advance youth alcohol treatment interventions.

In summary, the significant methodological problems identified in our review expose an evidence base that lacks the capacity to inform sex- or gender-based approaches to alcohol treatment intervention responses for youth. Moving forward, it will be imperative for researchers to deploy sex and gender as unique and specific variables with appropriate terminology available to measure, describe, and assess the implications, where precision in understanding and interpreting these constructs will improve the overall quality of the evidence base to address alcohol-related harms. It is also imperative that sex and gender variables are used in a way that ensures that intersex and trans people are meaningfully integrated so both research and intervention can address their alcohol-related needs [ 133 – 138 ].

Supporting information

S1 prisma checklist. prisma 2020 checklist..

https://doi.org/10.1371/journal.pmed.1004413.s001

S1 Appendices.

Appendix A. Amendments to information provided at PROSPERO registration. Appendix B. Medline search strategy.

https://doi.org/10.1371/journal.pmed.1004413.s002

Acknowledgments

Thank you to Ehsan Moazen Zadeh and Julien Quesne for your contributions to this systematic review during full-text screening and data extraction, respectively.

• 1. Greaves L, Poole N, Brabete AC, Wolfson L. Sex, Gender and Alcohol: What Matters for Women in Low-Risk Drinking Guidelines? Ottawa, Ontario: Canadian Centre on Substance Use and Addiction; 2022. Available from: https://www.ccsa.ca/sites/default/files/2022-08/CCSA-LRDG-Sex-Gender-and-Alcohol-what-matters-for-Women-in-LRDGs-en.pdf (accessed 2024 Apr 5).
• View Article
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• 10. Ashley F. ‘Trans’ is my gender modality: A modest terminological proposal. Trans bodies, trans selves. 2nd ed. Laura Erickson-Schroth, Oxford University Press; 2022.
• 20. Kirkland AE, Gex KS, Bryant BE, Squeglia LM. Treatment of Adolescents. In: Mueller S, Heilig M, editors. Alcohol and Alcohol-related Diseases. Cham: Springer; 2023. p. 309–328.
• 27. Costello CG. Beyond binary Sex and Gender ideology. The Oxford Handbook of the Sociology of Body and Embodiment. Oxford: Oxford University Press; 2020. p. 199.
• 129. Ansara YG. Intersex-centered sex therapy and relationship counselling: Six commonly neglected concerns of intersex adults. Chapter in: Erotically Queer: Taylor & Francis; Edited by Neves, S and Davies, D. 2023; p. 89–109. Available from: https://www.taylorfrancis.com/chapters/oa-edit/10.4324/9781003260608-7/intersex-centred-sex-therapy-relationship-counselling-gávriel-ansara (accessed 2024 Apr 5).

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" I chose SFU because of my supervisor, Dr. Shannon Zaitsoff, and because of the unique clinical training opportunities offered as a part of the clinical psychology program. The program's diverse focus on treatment modalities and varied research programs attracted me to the university."

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Clinical Psychology doctoral student in the Faculty of Arts and Social Sciences

Tell us a little about yourself, including what inspires you to learn and continue in your chosen field.

I always knew mental health advocacy and clinical psychology research were passions of mine! However, it became clear that research on eating disorders was of the utmost importance to me when I was in my undergraduate Introduction to Psychopathology course at McGill University. In the course, I distinctly remember coming across a small section in my course textbook on eating disorders. The section was less than 1/6 of a page - less than half the size of other sections on mental illnesses - and stated that eating disorders are one of the most prevalent and life threatening disorders. I remember wondering: why then do they only get 1/6th of a page of this textbook? Eating disorders continue to rise in prevalence, and yet, little research and funding is dedicated to understanding how and why they manifest. This fact, paired with eating disorders high mortality rates, continue to motivate me.

Why did you choose to come to SFU?

I chose SFU because of my supervisor, Dr. Shannon Zaitsoff, and because of the unique clinical training opportunities offered as a part of the clinical psychology program. The program's diverse focus on treatment modalities and varied research programs attracted me to the university.

How would you describe your research or your program to a family member?

My research broadly focuses on better understanding how eating disorders present across the gender spectrum, with the goal of improving existing prevention and intervention efforts.

What three (3) keywords would you use to describe your research?

Gender diversity, eating disorders, intervention

How have your courses, RA-ships, TA-ships, or non-academic school experiences contributed to your academic and/or professional development?

My coursework, research, and teaching experiences have helped me become a better clinician and researcher overall. The opportunity to connect with students and research participants better informs the kinds of questions I ask in my research. My coursework has provided me with a foundation in clinical skills that has been expanded upon in my research experiences. Ultimately, these skills have also informed how I interact with my students and have helped me become an attentive, informed, and motivated teacher and student.

Have you been the recipient of any major or donor-funded awards? If so, please tell us which ones and a little about how the awards have impacted your studies and/or research

I have been the recipient of several donor funded awards, all of which have supported me in becoming a better researcher and clinician! Most notably, I have been the recipient of the Judith Mappin Award for Research in Women's Health, the Soroptimist Foundation of Canada Award, the Joseph-Armand Bombardier Canada Graduate Master’s Scholarship, and the Kruger Products Bicultural Entrance Award. Each of these awards have provided me with funding to pursue and delve deeper into my research program.

What have been the most valuable lessons you've learned along your graduate student journey (or in becoming a graduate student)?

The most valuable lesson I have learned is that everything will get done and failure is a very normal part of the process! Graduate school is very busy and there is a never-ending to do list. If you let it, the work will consume you. Instead, you have to take charge and set boundaries. In my experience, this means I have a "hard out" for my working hours and days. I remember being very overwhelmed with responsibilities in my first term of graduate school and a friend saying to me: "How do you eat a whale? One bite at a time." That is graduate school in a nut shell.

What are some tips for balancing your academic and personal life?

Some tips I would share are to have a strong sense of hierarchy of your priorities. I don't have time for all of the things I would like to do, but I never miss seeing my friends. My non-negotiables are my social life!

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Biochemistry and molecular biology alumna shrinks gender gaps in scientific research

As a doctoral student, Kiandra Smith ’18 is at the forefront of new scientific discoveries. A biochemistry and molecular biology major at The College of Wooster, Smith is currently pursuing a doctorate in biomedical science and master’s degree in clinical research from the Morehouse School of Medicine, where she is working to research female health disparities related to the circadian clock within the realm of neuroscience, metabolism, and genetics, while also working to improve diversity and equity in scientific research.

At Wooster, Smith split her time between the laboratory, a variety of extracurriculars, and serving as a leader on campus. After noticing that minority groups weren’t as well represented in her STEM classes, she collaborated with students and faculty in the chemistry department and helped to found Wooster’s Minorities in STEM student organization. MiSTEM encourages students who are part of minority groups to get involved in STEM-based activities to attract, recruit, and retain more students in scientific fields. She also served as a STEM Success Initiative STEM mentor during her time at Wooster and has continued to mentor students in higher education.

Coming to Wooster as a Posse Scholar, a program through the Posse Foundation that brings students to one school as a group with full-tuition scholarships and mentorship, Smith valued the mentorship she received from Tom Tierney, emeritus professor of sociology and anthropology, who served as the mentor for her posse. “I feel like we would not have survived without him. He was amazing at shaping who I was on campus. Just being able to talk to somebody in a safe space was super helpful,” she said. Her experience led her to serve on the Posse Foundation’s national alumni representatives board and Posse Atlanta’s advisory board, connecting with current Posse students and alumni and helping them to network within the organization in ways that she came to value through her experience at Wooster.

Smith also works to connect undergraduate students with different opportunities in STEM fields that they may not have known about initially. During her undergraduate career, Smith thought she wanted to go to medical school but, after working as a research assistant, realized that medicine was not the path for her. “In high school, we don’t necessarily hear a lot about things that we can do outside of going to medical school” she explained. “I want to be that mentor to other people, because I didn’t necessarily get the opportunity to learn about those things before college.”

The opportunities Smith had to explore research and leadership helped her immensely as she made the transition to graduate school. “I.S. was especially helpful,” she said. “I appreciate the entire process because it helped prepare me for where I am now. It taught me how to think about things, how to multitask, and be independent in the lab.” As she conducts research to complete her doctorate, she has only continued to develop these skills. Smith’s research focuses on differences in the circadian clock between male and female mice, a lesser-known area of research. “Nobody has seen what I’ve seen in the field, especially from a circadian and female health context,” Smith explained.

Smith’s talents and dedication to research have not gone unnoticed by the scientific community. In 2023, she was selected as a Gilliam Fellow by the Howard Hughes Medical Institute , the first from her graduate school to receive such an honor and one of the first from a historically Black college or university. The prestigious Gilliam Fellowship recognizes graduate students and their advisors who have performed outstanding research in their respective fields and who are working towards creating a more inclusive scientific world.

By applying what she learned from Wooster’s liberal arts curriculum, Smith has made strides in her career, combining a variety of interests to create a path she loves, researching ways to close gender gaps in health, and mentoring students to encourage the next generation of STEM leaders. “As a double minority in STEM, I learned to use my experiences to shape my work by providing a different perspective, which will take me a long way in my career. My liberal arts education at Wooster helps me think more holistically, which is an important skillset in whatever career you go into,” she said.

Posted in Alumni on June 3, 2024.

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Call for Papers: Law, colonialism and gender in the Muslim world, July 1, 2024 (Conference: December 19-20, 2024)

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This conference aims to bring together scholars working on the legal history of the Muslim world who focus on the colonial period and are interested in ‘gender-coded law’ (i.e. all legal domains that automatically invoke connotations of gender).

The conference will be held at the  University of Amsterdam on December 19 and 20, 2024.  It   will be a small (max. 15 participants) research seminar/workshop. Applications for participation, including 250-word abstracts and a 100-word brief biography should be sent to  [email protected]  by  July 1, 2024 . If selected, the conference organization provides for travel and accommodation. The conference will be held at the historical building of the Allard Pierson Museum in the city centre of Amsterdam, which is close to Central Station.

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• Treatment for a substance use disorder during pregnancy such as behavioral interventions and medication for opioid use disorder reduces health risks, including preterm delivery and low birth weight. Treatment also helps people with substance use disorders stay employed, take care of their children, and engage with their families and communities. However, pregnant people with substance use disorders often face challenges when seeking treatment, including fear, stigma and access to care.
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Documenting Research with Transgender, Nonbinary, and Other Gender Diverse (Trans) Individuals and Communities: Introducing the Global Trans Research Evidence Map

Zack marshall.

1 School of Social Work, Faculty of Arts, McGill University, Montreal, Canada.

2 Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Canada.

Vivian Welch

3 Bruyère Research Institute, Ottawa, Canada.

4 School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.

Michelle Swab

5 Health Sciences Library, Faculty of Medicine, Memorial University, St. John's, Canada.

Fern Brunger

Chris kaposy, associated data.

There is limited information about how transgender, nonbinary, and other gender diverse (trans) people have been studied and represented by researchers. The objectives of this study were to: (1) increase access to trans research; (2) map and describe trans research across subject fields; and (3) identify evidence gaps and opportunities for more responsible research. Eligibility criteria were established to include empirical research of any design, which included trans participants or their personal information and that was published in English in peer-reviewed journals. A search of 15 academic databases resulted in 25,230 references; data presented include 690 trans-focused articles that met the screening criteria and were published between 2010 and 2014. The 10 topics studied most frequently were: (1) therapeutics and surgeries; (2) gender identity and expression; (3) mental health; (4) biology and physiology; (5) discrimination and marginalization; (6) physical health; (7) sexual health, HIV, and sexually transmitted infections; (8) health and mental health services; (9) social support, relationships, and families; and (10) resilience, well-being, and quality of life. This map also highlights the relatively minor attention that has been paid to a number of study topics, including ethnicity, culture, race, and racialization; housing; income; employment; and space and place. Results of this review have the potential to increase awareness of existing trans research, to characterize evidence gaps, and to inform strategic research prioritization. With this information, it is more likely that trans communities and allies will be in a position to benefit from existing research and to hold researchers accountable.

Introduction

Systematic review methodologies, including scoping reviews and evidence maps, provide an opportunity to study detailed aspects of knowledge production, including what topics are researched, who tends to be studied, what types of methods are used, and how people interact with the products of research. In this way, reviews turn the focus of attention toward the research process and researchers themselves, uncovering new information and increasing the visibility of diverse fields of study.

The aim of this review is to map and describe how transgender, nonbinary, and other gender diverse (trans) people have been studied and represented within and across research in the fields of social sciences, humanities, health, sciences, business, and education. The term “trans” refers to people who “do not conform to prevailing expectations about gender” (Terminology section, para. 1) 1 and includes transgender, transsexual, and other gender diverse people of all ages. In contrast, the term cisgender refers to people who identify with the gender they were labeled at birth. 2 While trans is a self-identification, it also relates to a psychiatric diagnosis. 3 Transsexual and transgender people diagnosed with gender identity disorder or gender dysphoria have been the subjects of medical and psychiatric research and are described in clinical and social science literature. In this review of trans research, we have opted for a broad trans conceptualization 4 that incorporates diverse gender identities and expressions across global contexts. This includes transgender and transsexual people as well as drag queens, butch femmes, Two-Spirit people, hijra, travesti, cross-dressers, and additional nonbinary and gender diverse identities and expressions.

Knowledge about the scope of research focusing on trans individuals and communities is incomplete. Because many people are unaware of the extent of research that has been carried out, this leads to miscommunication and misinterpretations. Such misunderstandings may be particularly troublesome if trans community members are not aware of existing research evidence related to the questions they have about their lives. Systematic research detailing the nature of studies that have been conducted provides new insights into the evidence that does exist and can aid in identifying opportunities for more responsible research 5 with trans individuals and communities.

Multiple challenges constrain our ability to conduct reviews in the field of trans research. The first relates to the language used to describe transgender and nonbinary people and the ways this impacts search strategies. Terminology to describe gender diverse people differs across stakeholder communities, including language used within communities, medical diagnoses, and phrases distinct to linguistic or cross-cultural groups. As this language develops over time, 6 it adds to the diversity of terms that should be incorporated into effective search strategies. A second barrier relates to indexed subject headings, both in terms of their inability to remain up to date, and the ways these headings reflect the spectrum of trans experience. 7 These complications require searches that go beyond subject headings, a process that is made more convoluted because it is difficult to search terms such as “trans” or “gender identity” by themselves due to the lack of specificity of these terms and the consequent number of extraneous results this produces. Search strategies also need to include database-specific headings and independent search terms such as vaginoplasty or mastectomy that may be germane to both cisgender and transgender experiences. Once searches are complete, screening is impacted by problems identifying whether the study includes any trans participants, or whether the research is trans focused, due to incomplete and/or unclear information in the title and abstract. For example, these difficulties arise when reviewing references that include trans participants within larger studies with lesbian, gay, bisexual, trans, Two-Spirit, and queer (LGBT2Q) communities, and surgery-related case reports. In their recent systematic review of gaps and opportunities in primary care preventative health services for trans people, Edmiston et al. 8 reported similar challenges.

Despite these circumstances, some researchers have attempted to increase awareness of the types of trans research available. One of the earliest examples was published by Denny as an annotated bibliography in 1994, 9 including a classification of books, articles, and community reports. Since then, the number of systematic reviews has slowly increased. Primarily health focused, 10 researchers have conducted trans-focused reviews related to mental health, 11 gender dysphoria, 12 learning disabilities, 13 aging, 14 cancer care, 15 and HIV. 16 More commonly, trans research is included as part of larger reviews centering men who have sex with men (MSM), LGBT2Q communities, or other marginalized populations. 17 , 18

Combining a comprehensive search strategy, text mining, and evidence map, this investigation has the potential to enhance knowledge in several fields. There are currently no evidence maps of trans research. By documenting this broad field of study, this review will enhance awareness of existing trans research, highlight evidence gaps, and inform strategic research prioritization. 19 Publishing the map online will also expand access to research for key stakeholders, including community members, policymakers, and health care providers.

Materials and Methods

Evidence maps are an emerging research method 20 to “collate, describe, and catalog” knowledge across a broad field of study. 21 This information can then be leveraged by stakeholders to inform policy and clinical decision-making. 21 This evidence map was developed using the four-step framework introduced by Hetrick et al. 22 : identify objectives, describe characteristics to be mapped and eligibility criteria, screen the literature, and chart the study within the map. The protocol for this evidence map was previously published 23 in agreement with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). 24

Aim and objectives

The aim of this study was to map and describe how trans people have been studied and represented within and across multiple fields of research. The objectives were to

• (1) increase access to research that includes trans people for community members, health care providers, and policymakers by establishing an online evidence map, including a searchable reference database;
• (2) document trans research in the fields of social sciences, health, sciences, education, humanities, and business, including information about sample demographics, study topic, and study design; and
• (3) characterize evidence gaps and opportunities for more responsible research with trans individuals and communities.

Eligibility criteria

It is suggested that researchers clarify concepts and engage key stakeholders as part of the process of developing evidence maps. 25 Accordingly, one-on-one consultations were held with members of trans and cisgender communities to discuss search scope, terminology, and possible uses of an evidence map. Based on the results of pilot searches and consultations, the eligibility criteria were established to include empirical research studies of any design with human participants, which identifiably included trans people or their personal information, and were reported in English in peer-reviewed journals.

Information sources

The identification of academic databases was informed by the larger goal of locating trans research from multiple fields. A secondary emphasis was to gather research on a global scale. For example, to appropriately identify research related to gender diverse Indigenous people, three databases focused on Indigenous and First Nations research were included.

Fifteen databases were selected to ensure diverse study design identification, 26 including Academic Search Premier, Anthropology Plus, Bibliography of Native North Americans, CINAHL, First Nations Periodical Index, Indigenous Studies Portal, LILACS, ProQuest Social Sciences Premium (contains ERIC, Social Services Abstracts & Applied Social Sciences Index and Abstracts, and Sociological Abstracts,), PsycINFO, PubMed, SciELO, Scopus, Social Work Abstracts, Web of Science, and Women's Studies International.

Search strategy

Search terms concentrated on transgender, non-binary, and other gender diverse experiences and identities. Because there are multiple terms used for (and/or by) trans people, and this language continues to evolve over time, 6 the full list of search terms was wide-ranging and comprised terms linked to gender identity (e.g., “trans woman”), diagnoses (e.g., “gender dysphoria” and “gender identity disorder”), therapeutics and surgical procedures (e.g., facial feminization), language that was used historically (e.g., transvestite), and words used in a range of cultures and countries (e.g., waria, travesti, Two-Spirit, and hijra). A sample search strategy for one academic database is provided in Supplementary Data S1 .

Data management

A health sciences librarian reviewed the draft search. Pilot searches were conducted in January 2015 in all 15 databases for each search string to ensure that the search was specific, but not overly sensitive. Full searches were then carried out between January 25 and February 22, 2015. Searches resulted in a total of 63,004 references ( Table 1 ). After eliminating duplicates, the total number of references included in the review was 25,230 ( Fig. 1 ).

PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Review and Meta-Analysis.

Search Results

Selection process

Screening on title and abstract.

The first author developed the initial approach to screening and 2 reviewers conducted a pilot review of a random sample of 100 references. This was followed by a follow-up review of a random sample of ∼10% of the dataset (2,393 references). Differences were reconciled through discussion and clarification, leading to a refinement of the eligibility criteria. After this, references were randomly allocated into groups of 1,000. Two reviewers screened the first two groups, reconciling differences through dialogue and discussion.

Reference screening was conducted based on the content of the title and abstract (level 1). Studies were excluded if they were not written in English, if they were not empirical research, if they did not include humans, or if they included only cisgender heterosexual people or people diagnosed with disorders of sex development (DSD; sometimes referred to as intersex people). If a reference was not excluded at level 1, the article was uploaded so that the full text could be reviewed (level 2). Any reference with no abstract was automatically screened on full text.

Whether there were any trans participants included in studies was often not clear from the abstracts. For example, in research with a diversity of LGBT2Q participants, authors might have presented the total number of participants in the abstract, or the study may have included trans participants, but they were not necessarily mentioned at this level. Early in the screening process, it became clear that many disagreements between reviewers were linked to a lack of specificity about sample characteristics in the abstract. As a result, it was necessary to automatically include references with LGBT2Q or MSM samples for screening on full text. In addition, due to the connections between HIV, sex work, and trans populations, all references that mentioned sex workers or people living with HIV as participants were automatically screened on full text. Lack of specificity was also a challenge with some clinical case studies. As a result, any study that mentioned trans-specific surgeries or therapeutics was automatically included. Finally, due to diversity within the general population, any study with a sample size over 1,000 was included. The rationale for this was to verify in the full-text article whether surveys included demographic questions inclusive of trans identities, and whether any trans participant had self-identified.

Screening on full text

For full-text screening, two team members reviewed each reference, and any difference was reconciled through discussion. The goal of level 2 screening was to identify original research that included trans participants or their personal information. In addition, at this level, we identified three different types of studies: trans focused, LGBT2Q/MSM, and mixed. Trans-focused studies included those with only trans participants as well as those with a cisgender control group. LGBT2Q/MSM studies were studies that included trans people as part of larger studies with sexual and gender diverse participants. Mixed studies were those with both cisgender and trans participants. In addition, studies with photographs were also flagged at this level of screening. The purpose of identifying this information at level 2 was to support data extraction. The evidence map presented in this study included only trans-focused studies.

Data items for mapping

Data extraction focused on developing an evidence map that emphasized the distribution and extent 27 of trans research studies. The following information was collected for mapping: year of publication, study topic, study design, trans sample demographics, data sources, geographic location of data collection, and open access availability. This article focuses on data related to study topic and study design.

Data analysis

Study topics.

To develop a list of study topics for the map, the team started with the social determinants of health 28 and frameworks that incorporate both structural health perspectives and individual health behaviors. Models by Ansari et al. 29 and Brennan Ramirez et al. 30 inspired early conceptualizations of topic areas. After piloting, additional subjects were added to the map that helped to expand the coding framework beyond a health focus. New topics that were added included the following: arts and creativity; sex work; resilience, well-being and quality of life; and resistance and activism.

In the first phase of data extraction, one reviewer went through each reference to identify key study topics. In coding for study topic, we focused on the stated purpose as identified by the study author(s). While there was no set limit to the number of study topics that could be selected, we aimed for a range of two to four study topics per reference. In the next phase, a second team member reviewed groups of references by study topic. For example, all references within the study topic of aging or physical health were verified for consistency and topic cohesion. In this phase, some of the more traditional social determinant topics were also renamed to better communicate the subject matter included in that category. For example, natural built environments were reconceptualized as space and place.

In this phase, the second reviewer also conducted word searches within the set of included studies to verify that no relevant references had been excluded. For example, in searching for articles about aging, the dataset was searched for any reference that included relevant search terms such as “age,” “aging,” “elder,” “senior,” and “old” in the title and/or abstract. This not only produced larger sets of references for checking but also helped to ensure that studies relevant to each topic were captured within the map.

Study design

Because this review included a broad range of quantitative, qualitative, and clinical study types, it was not possible to use an existing evidence-based categorization scheme. As a result, two of the coauthors developed a coding framework, including the following options: (1) systematic review of randomized controlled trials; (2) randomized controlled trial; (3) nonrandomized controlled trial; (4) case–control study; (5) cohort study; (6) systematic review of descriptive or qualitative studies; (7) cross-sectional study; (8) qualitative study with interviews or focus groups; (9) ethnography or phenomenological qualitative study; (10) historical research; (11) case report, case study, or case series; (12) autoethnography; (13) basic science; and (14) community-based research or other forms of participatory research.

Clear definitions of each study design were identified using the following sources: systematic reviews, 31 case–control, cohort, and cross-sectional studies, 32–34 case studies, 35 and case reports and case series. 36 To be categorized as a systematic review, studies needed to include a clear search strategy or method to identify studies, and to explicitly state their methods of study selection. Because there are limited systematic reviews in the field of trans studies and this evidence map aimed for broad inclusion, we did not require the third criteria from the PRISMA-P definition of a systematic review (explicitly described methods of synthesis) 31 in order for studies to be included.

One reviewer extracted information about study design and data collection methods from all trans-focused studies. A second reviewer verified the first 10% of the data extraction. After clarifying any difference in coding, additional questions about how to code particular studies were discussed with a third member of the study team. Based on this information reviewer, two checked the references within each study design, grouping for accuracy and consistency.

A total of 25,230 references were screened based on title and abstract content (level 1). Around 14,579 references were excluded for the following reasons: 8,133 based on study design, 2,926 were not in English, 1,608 because they gave no indication that trans people had been participants, 794 did not include human participants (i.e., they were based on animal models or relied on documents for analysis), 723 were articles about surgery that did not suggest trans participation, and 395 focused on intersex or DSD experience. A total of 6,915 references met the inclusion criteria based on title and abstract, and an additional 3,736 were included based on no abstract being available ( Fig. 1 ).

A total of 10,651 references were eligible for screening on full text. Due to resource constraints, the decision was made to focus the first version of the evidence map on the most recent 5-year period. As a result, 3,533 references published between 2010 and 2014 were screened on full text.

A total of 1,667 articles met the inclusion criteria. Six hundred ninety articles were trans focused, 462 included LGBT2Q and/or MSM participants, and 515 included mixed samples. A total of 1,866 studies were excluded based on the following criteria: not empirical research (787 references); no trans participants (552 references); LGB or MSM, but explicitly no trans participants (273 references); no human participants (96 references); not written in English (62 references); book reviews (52 references); not journal articles (19 references); case summary or composite only (14 references); or focused on intersex participants or people diagnosed with DSD (11 references).

The 690 trans-focused articles form the basis of the remaining data analysis for this article (see Supplementary Data S2 for a full list of the trans-focused references). Data on study topics and study design are the focus of the next section, and are summarized in Supplementary Data S3 . Combining data about topic and study design provides additional insights into how researchers have chosen to explore trans research topics, including information about areas of overemphasis and underemphasis, topics that could benefit from knowledge synthesis, and areas that need further attention.

The map included a total of 37 study topics ( Table 2 ). The top 10 study topics were as follows: (1) therapeutics and surgeries; (2) gender identity and expression; (3) mental health; (4) biology and physiology; (5) discrimination and marginalization; (6) physical health; (7) sexual health, HIV, and sexually transmitted infections (STIs); (8) health and mental health services; (9) social support, relationships, and families; and, (10) resilience, well-being, and quality of life ( Fig. 2 ).

Top 10 study topics.

Summary Table of Study Topics and Frequencies

STIs, sexually transmitted infections.

Therapeutics and surgeries

The number one topic area was therapeutics and surgeries, with 224 references. This study topic included gender-affirming processes and procedures such as cross-gender hormone treatment, feminizing or masculinizing procedures such as facial feminization surgery, silicone injection, or electrolysis/laser hair removal, and studies focusing on gender-affirming surgeries such as orchiectomy and vaginoplasty, chest reconstruction, hysterectomy, and phalloplasty. Also included in this category were studies that detailed surgical procedures and outcomes, research and case reports describing side effects of therapeutics or surgeries, and studies exploring levels of satisfaction with gender-affirming medical therapeutics or procedures.

Gender identity and expression

Gender identity and expression was the second most common study topic with 203 references. While it was not surprising that a trans research evidence map would include a large number of studies focused on gender identity, efforts were made to clearly distinguish this topic area so that it did not include all studies in the review. Areas of focus included the following: the experience of gender identity, including trans gender identity development; nonbinary and other gender diverse identities; gender dysphoria; gender identity disclosure; medical and social transition; and gender identity assessment and diagnosis.

Mental health

Mental health was the third most common study topic with 124 references. This included diagnoses and/or experiences of depression, anxiety, suicide, and other co-occurring mental health diagnoses. This category also included studies documenting the interaction between discrimination, structural oppression, and mental health, and the medicalization and pathologization of gender identity.

Biology and physiology

Including 106 studies, the category of biology and physiology includes research at the cellular level, neurological research, bone density studies, and genetic and chromosomal research. In some cases, these studies explored the impacts of medical transition on the physical body. In others, researchers were attempting to identify the etiology of trans gender identity through twin studies, handedness, and measures of cortical thickness.

Discrimination and marginalization

There were a total of 99 articles on the topic of discrimination and marginalization. This included studies about different aspects of discrimination such as harassment, bullying, microaggressions, cisgenderism, transphobia, and other forms of oppression. In addition, this topic included research on the topic of social exclusion, stigma, and marginalization. This topic was distinct from violence and trauma, a subject area that included 47 studies. Verbal abuse, physical abuse, and any other form of violence or trauma were included in the latter category.

Physical health

The area of physical health had 97 studies, including research related to diabetes, cancer, eating disorders, granulomas, meningiomas, and cardiovascular disease. Some studies explored the link between trans-related therapeutics and longer term health, where others documented complications as a result of surgeries or other medical procedures. Physical health as a study topic was distinct from side effects and impacts of therapeutics and surgeries, and there was little overlap between these two areas of the map. Short-term impacts or complications from surgeries such as chest reconstruction or vaginoplasty were coded within the area of therapeutics and surgeries, whereas longer term health impacts that needed their own intervention were classified under the area of physical health.

Sexual health, HIV, and STIs

The category of sexual health, HIV, and STIs included 97 studies about sexual behaviors, and HIV and other STIs. The HIV and STI literature included articles linked to testing, treatment and treatment adherence, transmission, and co-infection, as well as literature that connected HIV and STIs to broader syndemic factors. Sexual health literature included studies about sexual behaviors, communication and negotiation of safer sex behavior, and research related to sexual risk factors. Sexual health was differentiated from the study topic of sexuality, which included 52 references and referred more specifically to sexual attraction and sexual identity.

Health and mental health services

Health and mental health services was a relatively large area of the map, including 89 references. These studies investigated barriers and access to health and/or mental health services, experiences with mental health services, discrimination in health care, patient satisfaction, studies of interactions between patients and providers from the trans person's perspective, waitlists, cost-effectiveness, and models of care. This research also explored the impact of barriers to health services on health and mental health.

Social support, relationships, and families

Social support, relationships, and families included 70 references. This element of the map included references related to social support and communities, relationships with friends and family, as well as romantic and/or sexual relationships. Social support has been measured and investigated as a factor in relation to health incorporating mental health, physical health, and sexual health. In addition, there were a number of articles related to family support, including family responses to trans children, siblings, or parents.

Resilience, well-being, and quality of life

The review included 61 articles on the topic of resilience, well-being, and quality of life. In these strength-based articles, researchers often explored alternate, nonpathologizing conceptualizations of trans lives, including experiences of hope, resilience, and community support.

Of the 37 study topics that we categorized, the top 10 most common (listed above), each included at least 50 references. In the mid-range (i.e., between the top 10 and the bottom 10), categories included the following: sexuality; ethnicity, culture, race, and racialization; violence and trauma; early life experiences; resistance and politicization; therapeutic process; intersectionalities * ; space and place; education; law and criminalization (crime, prisons, incarceration, and policing); research methods; employment; arts and creativity; sex work; substance use; and parenting, reproduction, and assisted reproduction. The bottom 10 topics in the map all included less than 15 references. These were as follows: disability; age and aging; historical perspectives; religion and spirituality; ethics; income; sports and physical activity; housing; Indigeneity; and migration and refugee experiences ( Fig. 3 ).

Bottom 10 study topics.

Exploring the intersections between study topic and study design

Of the 690 studies in the review, the emphasis was on observational research. Less than 2% were experimental. The frequency of study design across the trans-focused dataset was: (1) cross-sectional studies (250 references); (2) case reports, case studies, and case series (182 references); (3) qualitative study with interviews or focus groups (99 references); (4) cohort studies (56 references); (5) ethnographies or phenomenological studies (37 references); (6) basic science (23 references); (7) systematic reviews of descriptive or qualitative studies (20 references); (8) community-based research or other participatory research (15 references), (9) autoethnographies (8 references); (10) case–control studies (7 references); (11) nonrandomized controlled trials (7 references); (12) historical research (4 studies); and (13) randomized controlled trials (3 references) ( Fig. 4 ).

Frequency of study designs.

The most common research was cross-sectional, emphasizing information gathered at one point in time. Within the top 10 study topics, cross-sectional research was most common in the areas of (1) mental health; (2) gender identity and expression; (3) sexual health, HIV, and STIs; (4) biology and physiology; and (5) therapeutics and surgeries. Cross-sectional research most often involved survey research and clinical measures.

Case reports, case studies, and case series were also very common within the dataset, specifically within the areas of therapeutics and surgeries, and physical health. In these situations, case reports were often used to document novel procedures, surgical complications, or physical side effects related to therapeutics. We also saw the use of case reports and case studies in relation to mental health; gender identity and expression; therapeutic processes; health and mental health services; and sexual health, HIV, and STIs. In the case of health and mental health services, and therapeutic processes, some clinicians reported on client demographics within their clinic, or on the process with specific patients.

Ninety-nine studies included qualitative interviews or focus groups. These methods were particularly relevant when exploring gender identity and expression; discrimination and social exclusion; and social support, relationships, and families. While cross-sectional studies were more frequently used in each of these areas, qualitative interviews or focus groups were the second most common study design for all of these study topics.

Conclusions

Topics that received the most attention.

Study topics that received the most attention from researchers were as follows: (1) therapeutics and surgeries; (2) gender identity and expression; (3) mental health; (4) biology and physiology; (5) discrimination and marginalization; (6) physical health; (7) sexual health, HIV, and STIs; (8) health and mental health services; (9) social support, relationships, and families; and (10) resilience, well-being, and quality of life. Comparing these results to Reisner et al.'s 10 review of health-related outcome categories, there were similarities and differences. For example, both reviews share an emphasis on the following topics: (1) mental health; (2) sexual and reproductive health; (3) stigma and discrimination; and (4) general health. In contrast, two topics that were highlighted in Reisner et al.'s 10 review—substance use, and violence and victimization—did not include a large enough number of studies to be included in the top 10 topics of the evidence map. Some of these differences were linked to Reisner et al.'s 10 emphasis on quantitative health research. Having a broader subject and methodological focus in this study meant that it was possible to incorporate greater diversity into the evidence map, including research related to therapeutics and surgeries, health and mental health services, social support, and resilience.

Topics that received the least attention

Topics that have received the least attention include several factors linked to the social determinants of health such as ethnicity and culture, housing, income, employment, and space and place. This review highlights the relatively minor attention invested to date in these study topics and underscores the need to assess whether additional research focused in these areas would be beneficial. For example, given the challenges many trans people face in obtaining employment, research centering on poverty and employment in trans communities, including barriers and facilitators to employment, may be called for. These studies could provide insight into these topics beyond their consideration as risk factors in relation to health and/or mental health.

Areas that have been systematically reviewed and opportunities for knowledge synthesis

Examining the overlap between the study topics that have received the most attention and existing systematic reviews, there was some positive overlap. For example, gender identity and expression is one of the most researched subject areas and is the topic of five systematic reviews. Similarly, mental health received good attention from researchers and was the focus of five systematic reviews. Sexual health, HIV, and STIs has been the subject of three reviews.

As discussed, therapeutics and surgeries was the most commonly investigated study topic. On the one hand, the ability to conduct reviews in this area was complicated by study designs that tended to emphasize case reports. That said, researchers have taken several approaches to synthesizing knowledge in this area, including case series and analysis of outcomes linked to specific therapeutic interventions or surgeries (e.g., long-term impact of cross-gender hormone treatment, or complications from silicone injection). In addition, although they were not included in this study because they did not meet the criteria for systematic reviews, some authors who are also surgeons review their experiences with surgical procedures, including outcomes and advances in technique.

While 20 systematic reviews of descriptive and qualitative studies have been conducted, there are opportunities for additional knowledge synthesis related to the following: specific aspects of gender identity and expression such as disclosure, or social or medical transition; discrimination and marginalization; physical health; health and mental health services; social support, relationships, and families; and resilience, well-being, and quality of life. Other topics in the map that received less attention (although they each included at least 15 studies) were as follows: sexuality; ethnicity, culture, race, and racialization; violence and trauma; early life experiences; resistance and politicization; education; law and criminalization; employment; arts and creativity; and sex work. These are all relevant and important topics for future systematic or scoping reviews.

Limitations

The primary limitations of this study relate to resources and technology. Time and financial resources necessitated limiting the map to studies published between 2010 and 2014. To complete the full map, it will be necessary to screen an additional 7,118 references on full text, and references that meet the inclusion criteria will need further data extraction. In addition, to update the map to 2017 would require the searches to be updated and these references would then need to be screened on title and abstract, and where relevant on full text.

Resource constraints have also limited the type of research included in the evidence map. This project is focused on documenting research with trans people from the perspective of human subjects research ethics. As a result, all studies in the map include at least one trans participant. One drawback is that this also means studies about trans topics that do not include trans people are not currently a part of the evidence map. For example, a study to evaluate the knowledge and awareness of health care providers in relation to trans health would not be included, unless it explicitly also included one or more trans participants. While these types of studies form part of the larger field of trans research, this work is not visible in this dataset.

Similarly, the evidence map contains empirical research published in English in peer-reviewed journals. In stating this, it is also important to acknowledge that it does not include solely theoretical, conceptual, or historical work, unless that work is based on original or secondary data analysis with trans participants. There are also no community research reports (sometimes referred to as “gray” literature) or book chapters. In focusing on one aspect of research with trans participants, our intent was not to contribute to making this other work less visible or to imply that it does not constitute an important aspect of the broader field of trans studies.

That the map is already out of date before being published points to the critical need for different ways of working. In time, promising new developments in text mining, automation, and semiautomation will allow us to complete large, living reviews and share this information with key stakeholders in a more timely manner.

Hesitations: the implications of mapping

There is great potential for this evidence map and the accompanying database to be useful to community members, researchers, clinicians, and policymakers. There are also limitations to how useful it can be to community members if information is not presented in an accessible manner. In addition, research itself can be damaging. As noted by Ansara and Hegarty, 37 some research continues to perpetuate pathologizing beliefs and to misgender participants from multiple angles.

The selection of the term “evidence map” is informative. Building on the work of Ahmed, 38 and her approach to following multiple meanings of words and concepts, it is useful to be circumspect about the concept of evidence in relation to evidence-based practice, and about research as a form of evidence. One should be mindful of the implicit goals of empirical research, and question evidence as “evidence of what?,” and “evidence for what?.” In addition to providing data, the research articles in this review are themselves a form of evidence, documenting the actions and decisions of researchers and clinicians.

In speaking of evidence maps, we refer as well to evidence gaps. What do gaps mean in the context of research about trans people? The word gap suggests that something is absent. However, we should ask whether what is missing is something that should be there. What do these gaps hinder and what purpose might they also serve, and perhaps more importantly, whom do they serve? This analysis leads to larger questions about who and what gets studied, who makes these decisions, and what motivates researcher attention.

Critical Data Studies 39 highlights the connections between “the spatial nature of data” and “the processes of data production and accumulation” (p. 1). Data visualizations such as maps are built on templates of those that have come before. In some ways, this map is no different. It mirrors a tradition of evidence mapping and borrows from longer standing frameworks related to social determinants of health and medical framing of experiences. Where this project is different is in the ways we consider the potential of digital evidence maps as living documents 40 that can be leveraged to document previous ways of working and to “challenge the legacies of colonialism—to emphasize local knowledge and local control” (p. 422). 41

In identifying future directions for research and knowledge synthesis, it is critical to engage trans communities and other stakeholders in local and global contexts to determine research priorities. Engagement is about more than participation: rather we advocate for the centering of trans people, and more specifically trans women of color. 42 There are many excellent examples of these forms of engagement, including Marvellous Grounds: Queer of Colour Spaces in Toronto 43 and the work of Reisner et al. at the Fenway Institute. 44 These types of involvement will help to ensure that the knowledge that is produced is relevant to trans communities and to stakeholders such as policy-makers, health care providers, and educators. Within this study, we have taken the approach that it is better for people to be aware of the types of research that are being conducted. These insights make it clearer as to whose knowledge and perspectives are centered in this work, and it is more likely that trans communities and our allies will be in a position to benefit from existing research and hold researchers accountable as community awareness increases.

Supplementary Material

Acknowledgments.

The authors wish to acknowledge the generous contributions of community members who provided consultation on search terms and data extraction. In addition, we are grateful for the work of a large team of research assistants who supported this project at different stages of the review process. This work would also not have been possible without the librarians, library assistants, and library technicians at Memorial University, Dalhousie University, the University of Waterloo, and others who retrieved and processed 1,192 Interlibrary Loan requests. During this study, Z.M. was supported by a doctoral fellowship funded by the Canadian Institutes of Health Research and the Research and Development Corporation (RDC) of Newfoundland and Labrador, and by the Canadian Mental Health Association-Newfoundland and Labrador (CMHA-NL). V.W. holds an Ontario Early Researcher Award.

Abbreviations Used

* The articles that were categorized within the intersectionalities study topic explicitly explored the impact of interacting or interlocking identities. For example, if the article was about trans women with disabilities, or trans people of color, the authors needed to address the ways these experiences intersected to produce specific structural dynamics, rather than exploring these as stand-alone topics.

Author Disclosure Statement

No competing financial interests exist.

Supplementary Data S1

Supplementary Data S2

Supplementary Data S3

Cite this article as: Marshall Z, Welch V, Minichiello A, Swab M, Brunger F, Kaposy C (2019) Documenting research with transgender, non-binary, and other gender diverse (trans) individuals and communities: introducing the global trans research evidence map, Transgender Health 4:1, 68–80, DOI: 10.1089/trgh.2018.0020.