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USPSTF Approach to Addressing Sex and Gender When Making Recommendations for Clinical Preventive Services.

Aaron B Caughey1, Alex H Krist2, Tracy A Wolff3

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Summary

The US Preventive Services Task Force (USPSTF) is updating its methods to include sex and gender diversity in clinical preventive service guidelines. This ensures recommendations better serve all individuals, addressing evidence gaps for diverse populations.

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Area of Science:

  • Public Health
  • Clinical Guidelines
  • Health Equity

Background:

  • Clinical preventive service recommendations aim for broad applicability.
  • Studies informing guidelines often overlook biological sex and gender identity, creating challenges for diverse populations.
  • Existing recommendations may not adequately address the needs of transgender, gender nonbinary, and gender nonconforming individuals.

Purpose of the Study:

  • To outline the US Preventive Services Task Force's (USPSTF) updated methods for incorporating sex and gender diversity into clinical preventive service guidelines.
  • To address challenges in evaluating and communicating recommendations for diverse gender identities.
  • To enhance the inclusivity and applicability of preventive care guidelines.

Main Methods:

  • Systematic review of past USPSTF recommendations regarding sex and gender.
  • Analysis of approaches used by other guideline-developing bodies.
  • Pilot testing of strategies to address sex and gender diversity in guideline development.
  • Developing an inclusive approach to identify and assess sex and gender-related issues throughout the guideline process.

Main Results:

  • The USPSTF will proactively identify sex and gender considerations at the outset of guideline development.
  • Evidence reviews will specifically assess applicability, variability, and quality concerning sex and gender.
  • The USPSTF will use clear, inclusive language, including gender-neutral terms where appropriate, and specify when recommendations apply to specific biological sexes or gender identities.
  • Identified evidence gaps related to gender identity in preventive care.

Conclusions:

  • The USPSTF is adopting a more inclusive methodology to ensure clinical preventive service recommendations are relevant to all individuals, regardless of gender identity.
  • Clearer language and targeted evidence assessments will improve the utility of guidelines for diverse populations.
  • Further research is needed to address limited evidence for the preventive care of populations based on gender identity.