Importance Biological sex and sociocultural gender represent major sources of diversity among patients, and recent research has shown the association of sex and gender with health. A growing body of literature describes widespread associations of sex and gender with cells, organs, and the manner in which individual patients interact with health care systems. Sex- and gender-informed medicine is a young paradigm of clinical practice and medical research founded on this literature that considers the association of sex and gender with each element of the disease process from risk, to presentation, to response to therapy. Observations Characteristics that underlie sex and gender involve both endogenous and exogenous factors that change throughout the life course. This review details clinical examples with broad applicability that highlight sex and gender differences in the key domains of genetics, epigenomic modifiers, hormonal milieu, immune function, neurocognitive aging process, vascular health, response to therapeutics, and interaction with health care systems. These domains interact with one another in multidimensional associations, contributing to the diversity of the sex and gender spectra. Novel research has identified differences of clinical relevance with the potential to improve care for all patients. Conclusions and Relevance Clinicians should consider incorporating sex and gender in their decision-making to practice precision medicine that integrates fundamental components of patient individuality. Recognizing the biological and environmental factors that affect the disease course is imperative to optimizing care for each patient. Research highlights the myriad ways sex and gender play a role in health and disease. However, these clinically relevant insights have yet to be systematically incorporated into care. The framework described in this review serves as a guide to help clinicians consider sex and gender as they practice precision medicine.

中文翻译：

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改善所有人健康的性与性别知情医学临床进展

重要性 生理性别和社会文化性别是患者多样性的主要来源，最近的研究表明性和性别与健康有关。越来越多的文献描述了性和性别与细胞、器官以及个体患者与医疗保健系统互动的方式的广泛关联。性和性别知情医学是基于该文献的临床实践和医学研究的年轻范式，它考虑了性和性别与疾病过程中从风险、表现到对治疗的反应的每个要素的关联。观察 性和性别背后的特征涉及在整个生命过程中发生变化的内源性和外源性因素。这篇综述详细介绍了具有广泛适用性的临床实例，突出了遗传学、表观基因组修饰符、激素环境、免疫功能、神经认知衰老过程、血管健康、对治疗的反应以及与卫生保健系统的相互作用等关键领域的性别差异。这些领域在多维关联中相互作用，导致性别和性别谱的多样性。新的研究已经确定了临床相关性的差异与改善所有患者护理的潜力。结论和相关性 临床医生应考虑在其决策中考虑性别和性别，以实践整合患者个性基本要素的精准医疗。认识到影响病程的生物学和环境因素对于优化每位患者的护理至关重要。研究强调了性和性别在健康和疾病中发挥作用的无数方式。然而，这些临床相关的见解尚未系统地纳入护理。本综述中描述的框架可作为指导，帮助临床医生在实践精准医学时考虑性别。