Griselda A. Cruz-Priego, Unidad de Investigación en Epidemiología Clínica, Hospital Infantil de México Federico Gómez; Facultad de Medicina, Universidad Nacional Autónoma de México. Ciudad de México, México
Patricia Clark, Unidad de Investigación en Epidemiología Clínica, Hospital Infantil de México Federico Gómez; Facultad de Medicina, Universidad Nacional Autónoma de México. Ciudad de México, México
Background: Osteoporosis and fragility fractures in individuals over 50 years of age are a public health concern. Although their prevalence is higher in postmenopausal women, other gender identities also face risks that have historically been overlooked in research and clinical care. Objective: To analyze the integration of a gender perspective in clinical studies on osteoporosis and fractures, identifying methodological gaps and structural biases. Materials and methods: A systematic review was conducted using PubMed, Cochrane Library, and TripDatabase (2000–2025), including 22 relevant studies without restriction by study design, focused on sex and gender differences in diagnosis, treatment, and outcomes. Results: Inequities in diagnosis and treatment were identified, particularly affecting individuals outside the cisgender female model. The lack of gender-disaggregated data and the absence of contextual variables limit the applicability of findings. Studies employing gendersensitive approaches show improvements in risk estimation and therapeutic equity. Conclusions: Including a gender perspective beyond the binary enhances scientific validity and promotes health equity. It is essential to adopt methodological guidelines that ensure this integration at all stages of the research process.
Keywords: Osteoporosis. Fragility fractures. Gender. Health inequities. Clinical research.