Major UK funders launch first-of-their-kind sex and gender policies for biomedical, health and care research

We are thrilled to celebrate a landmark moment for UK health research: the launch of new sex and gender policies by Wellcome, the National Institute for Health and Care Research (NIHR) and the British Heart Foundation (BHF). These important policies set the expectation that applications for research funding demonstrate a robust plan for consideration of sex and gender from the first stages of study design, underlining that sex and gender are essential dimensions of scientific excellence. The policies mark a major step towards more rigorous and equitable science, helping to ensure that research fully represents the diversity of all people it aims to serve. This progress complements recent changes to funding processes adopted by medical research charities including Breakthrough T1D, Cystic Fibrosis Trust and Fight for Sight.

Why this matters

Historically, biomedical, health and care research has under-represented non-male participants and rarely disaggregates data by sex and/or gender during analysis and when reporting research results. This critical limitation undermines scientific accuracy, limits generalisability and worsens health outcomes, especially for female patients, trans and non-binary people, and people with variations of sex characteristics.

The role of MESSAGE

Over 2023-24, the MESSAGE project led co-design of the UK’s first sex and gender policy framework for funders. MESSAGE convened over 50 stakeholders from across the research ecosystem including funders, regulators, academic publishers, researchers, clinicians, government officials and patients. Across four Policy Labs, we led the UK research sector through a consensus-building process to develop joint best practice for consideration of sex and gender in research and provided tools for effective adoption of sex and gender policies. Adoption of policies based on the new framework will mean that funding applicants must provide a robust plan for consideration of sex and gender from the first stages of study design as a condition of funding.

The MESSAGE projects really champion this sector wide approach. We need everyone to come with us looking at the best practices, coordinated strategies, doing it similarly across many funders, which we know is important… I really welcome the steps being taken by MESSAGE to tackle this and [they have] the support of the NIHR.

Lucy Chappell, Chief Scientific Advisor at DHSC and Chief Executive of the NIHR (MESSAGE launch webinar) 

The policy framework sets out clear expectations for researchers to consider sex and gender at every stage of their research. It provides guidance on the meaning and use of the terms “sex” and “gender” in the context of health and care research, and breaks down what it means to account for sex and gender in practice into four key elements:

Sex and/or gender characteristics
Whether sex and/or gender will be accounted for, which sex and/or gender characteristic(s) will be considered, and which research participants will be included to reflect these characteristic(s).  

Sample distribution by sex and/or gender
The target distribution of subjects/participants by sex and/or gender, and why this distribution has been selected to answer the research question.

Equitable recruitment
Planned strategies for recruiting and retaining the target sex and/or gender distribution of human participants, or for procuring and housing the target sex distribution of pre-clinical study subjects. For research involving the use of secondary data, a description of the sex and/or gender distribution in the original dataset should be provided.

Sex and/or gender-disaggregated analysis
An analysis plan, including details of any planned sex and/or gender-disaggregated analyses. If researchers are not planning to perform a sex and/or gender-disaggregated analysis, they must explain why.

I so much welcome [the MESSAGE] recommendations, which have come from the kind of collaboration that I have never seen before in 25-30 years of working in UK medical research… It just doesn’t happen and should happen more often. At The Lancet we are super excited by the opportunity that the MESSAGE project presents… We will do everything we can to see its vision is fully realised.

Richard Horton, Editor-in-Chief of The Lancet (MESSAGE launch webinar) 

Click here to find out more about the policy framework.

MESSAGE has provided a toolkit for funders provided detailed guidance on where and how to make changes across the granting process to embed requirements and nudges about new expectations around sex and gender dimensions. You can read the toolkit here.

What the funder policies say

The Sex and gender in health research policy (Wellcome), Sex and gender in research policy (NIHR) and Diversity in research design policy (BHF) require that researchers consider sex, gender or both throughout the whole research lifecycle, including research design, participant recruitment, data collection, analysis and output dissemination. While not every study will need to account for sex/gender in the same way, and for some studies it may be appropriate to only investigate single sex/gender samples, policies underline above all that researchers must provide a robust justification for their approach.

The MESSAGE project aims to integrate sex and gender as a fundamental consideration in health research. Wellcome is super supportive of this. This aligns seamlessly with our vision of a future where health research is fully utilised to solve urgent health challenges… In addition, we want research to be inclusive, impactful, and responsive to societal needs… By supporting MESSAGE, Wellcome is helping to forge a path towards a research culture that readily embraces diversity, leads with integrity, and delivers benefits equitably.

Diego Baptista, Head of Research and Funding Equity at Wellcome Trust (MESSAGE launch webinar) 

What does this mean for people working in medical research?

For researchers

• Explicit consideration of sex/gender must be integrated into funding applications from the outset to be competitive.
• Where sex/gender will not be accounted for, this will need to be justified. The default expectation is that sex/gender will be accounted for unless strong justification is provided.
• Research papers must be transparent about the sex and gender dimensions of the study. This means reporting sex and/or gender-disaggregated data in papers and highlighting inadequate sex and gender inclusion as a study limitation. Reporting of disaggregated data is essential so that meta-analyses can be used to identify significant sex and gender differences even if individual studies are not powered to do so.
• Upskilling will be necessary across the sector. The MESSAGE team, in partnership with Imperial College London, have developed a short course to upskill researchers, policymakers, clinicians and other professionals working within the health and research sectors on how to address sex and gender inequity in health research. Click here to find out more and register.

For funders and universities

• The MESSAGE policy framework represents a new gold standard for consideration of sex and gender in medical research, and a growing list of new funder policies underline that sex and gender equity is a requirement of high-quality research that is good value for money. Other funders now have an opportunity to build on this momentum and align with emerging best practice.
• Adoption of sex and gender policies is key for bringing funders in line with international best practice set by Canada, the US and the EU.
• Universities and research institutes must support researchers to meet new funder requirements, including embedding information on sex and gender equitable research into research training and upskilling grant management staff to account for new funder requirements.

For patients and the public

• Research that accounts for sex and gender is more likely to identify differences in risk, disease presentation or effectiveness of treatments between sex and/or gender groups. Generating this evidence is critical for delivering personalised medicine and improving health outcomes for all people.

The journey ahead

The MESSAGE team, leading the way for improved consideration of sex/gender in biomedical, health and care research in the UK, is delighted that key funders are committing to equity and quality in research. MESSAGE is continuing to work with funders, regulators, publishers and research institutes to embed consideration of sex and gender as a norm of research excellence.

Our priorities include:

• Providing accessible guidance and training for researchers on how to integrate sex and gender in medical research. Our website hosts an e-learning module for researchers and a library of best practice sex and gender research. February 2026 will see the launch of our short course Integrating sex and gender in health research and policy, which offers comprehensive training for anyone working in healthcare research, policy or delivery.
• Working with funders to develop and embed robust systems for monitoring and evaluating the effectiveness of sex and gender policies and areas where further work is needed.
• Collaborating with publishers and journals to implement the Sex and Gender Equity in Research (SAGER) guidelines, which require transparent reporting of sex and gender disaggregated data and analyses in academic papers. Publishing requirements ensure continuity and accountability of expectations from design to publication.
• In addition, our programme of work aims to improve translation of evidence on sex and gender differences (and similarities) into clinical practice, and we are working with key UK stakeholders to make change in this area.

The launch of UK sex and gender research policies signals that sex and gender are no longer ‘nice-to-have’ or peripheral considerations, but core determinants of research quality, reproducibility and equity. At MESSAGE, we warmly celebrate this milestone and invite the research community to take the time to familiarise themselves with the new requirements to ensure that biomedical, health and care research is designed for everyone.