A systematic review examining how gender and sex are measured and reported in research on alcohol treatment

Background: Sex- and gender-related factors are important for how interventions are designed, implemented, and evaluated. However, it remains unknown as to how alcohol treatment research accounts for sex characteristics and/or gender identities and modalities. The objective of this systematic review is to document and assesses how sex characteristics, gender identities and gender modalities are operationalised in alcohol treatment intervention research involving youth up to age 30 years. 

Methods and Findings: We searched the peer-reviewed literature using MEDLINE, Embase, Cochrane Central Registry of Controlled Trials, PsycINFO, CINAHL, LGBT Life, Google Scholar, Web of Science and grey literature from 2008 to 2021. We included articles that screened participants using AUDIT, AUDIT-C or a structured interview using DSM-IV criteria and reported genders and/or sexes of participants 30 years of age and under. Studies were limited to quantitative study designs that enrolled participants in alcohol treatment interventions.

78 articles were included for review of the 8,613 studies screened for inclusion. In this presentation, we discuss the implications that none of the studies defined, measured, and reported both sex and gender variables accurately. We also discuss the implications that only one study reported including trans participants. Finally, we describe how most of the studies used gender or sex measures as a covariate to control for the effects of sex or gender on the intervention while not including discussions about the rationale for or implications of this procedure. 

Conclusions: Our findings highlight how the vast majority of alcohol treatment intervention research with youth conflate sex and gender factors terminologically, conceptually, and methodologically. Based on the findings, we provide recommendations for advancing work in this area that are more precise and inclusive of sex and gender spectrums, including a call for research in this area that better accounts for gender modalities, identities and/or sex characteristics. We argue that this should occur throughout the research life cycle, including during study design, data collection, data analysis, and reporting. Finally, we emphasize how sex and gender variables should be used inclusively to ensure that trans youth are included in alcohol treatment research.