Sex and Gender Differences Between Experiences of Discrimination and Physical Health: A Systematic Review

Background: Despite a plethora of previous research on experiences of discrimination and physical health outcomes, there has been less attention to sex/gender differences, although some research suggests a greater stress-related biological and behavioral impact on women. Methods: Five databases were reviewed up to May 2023 using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We included studies that examined self-reported experiences of discrimination and physical health outcomes among adults (aged 18+) in the United States if results were either stratified by sex/gender or tested a sex/gender-by-discrimination interaction term. Results: A total of 3,397 articles were extracted, and 50 met the inclusion criteria, including 3 articles found through an external search. Ten studies reported that the measure of association between discrimination and physical health outcomes was greater among women, 7 reported a greater association among men, 21 reported homogenous associations, and 12 studies reported that the associations varied by sex/gender across multiple outcome measures or in more complex modeling analyses ( e.g., additional moderators, mediation analysis). Conclusion: Discrimination and physical health outcomes vary by sex/gender, irrespective of race/ethnicity. There are some limitations and methodological issues that were found in the literature. These considerations should be reconciled in future research for more streamlined and consistent analyses and reporting. We further provide recommendations on analyzing and interpreting sex/gender differences in future research. Future studies should also examine sex/gender differences between experiences of discrimination and mental health outcomes.