Gender-sensitive research in ProtAct-Us: why it matters

Ottavia E. Ferraro, Anna Morandi, Cristina Montomoli

The International Day of Women and Girls in Science on 11 February and the International Women’s Day on 8 March offer an important opportunity to reflect on what gender-sensitive research means concretely for ProtAct-Us. These occasions are not only symbolic celebrations, but also timely reminders that research becomes stronger, fairer, and more valuable when it considers differences in a thoughtful way.

Gender is a core dimension of rigorous and equitable science, not an “add-on” to research quality. Medicine and clinical research have too often regarded the male body as the default reference; women, instead, have been underrepresented in studies, and sex-related differences in exposure, response, and recovery have not been sufficiently explored. Paying attention to these dimensions is essential not only for scientific accuracy, but also for the development of more appropriate and inclusive knowledge. Another important methodological point regards the distinction between sex and gender: sex refers to biological characteristics, while gender relates more broadly to psychosocial, cultural, and behavioural dimensions. Keeping this distinction in mind helps prevent misleading conclusions and improves the relevance of research findings for real populations.

This perspective is particularly meaningful in the field of road traffic injury research. Road trauma is often perceived as gender-neutral. Actually, the circumstances surrounding exposure to risk, the way injuries occur, and recovery pathways may differ between women and men. A gender-sensitive approach helps us look beyond the event itself and consider a wider range of factors: mobility patterns, social roles, stress responses, behaviours, healthcare experiences, and long-term outcomes. It also orients researchers to more targeted questions and to data analysis that emphasizes important differences. For this reason, gender analysis should be considered as part of the study plan, including sex-disaggregated estimates, subgroup analyses, when feasible, attention to the interaction between age and gender, and transparent reporting of limitations. When statistically supported differences emerge, gender-specific recommendations should be provided to strengthen prevention, care, and recovery strategies.

The stratified analyses from our previous study (https://rehabil-aid.hmu.gr/) help to show why this perspective matters. Although the sample included more men than women, data revealed meaningful differences in characteristics and behaviours. Overall, men tended to report greater mobility and more frequent risk-related habits, such as smoking and alcohol consumption, while women were more often involved in traffic dynamics as pedestrians, bicyclists, or car passengers rather than as drivers. These are not simply descriptive observations. They suggest that exposure to road traffic risk may substantially differ between women and men, and that the circumstances leading to injury are often shaped by broader behavioural and social patterns. Hence, looking at these aspects from a gender-sensitive perspective can help us better understand not only how injuries occur, but also how prevention strategies should be designed and communicated.

The same data also suggest that recovery after a crash not always follows the same pattern for everyone. Specifically, women appeared to report a heavier burden in some emotional and psychosocial dimensions over time: earlier phases of follow-up pointed to lower energy level and emotional well-being, as well as worse social participation. At a later stage they also appeared to experience greater limitations linked to emotional problems. Even when final outcomes do not show sharp differences, these patterns remain important, because they suggest that men and women may experience a partially different recovery, especially when psychological and social aspects are considered. This is particularly important in trauma research, where the consequences of an injury often extend beyond physical events and affect mental health, functional status, social participation, and quality of life.

At the same time, gender-sensitive research should not be reduced to merely ensuring equal representation of women and men in any study. In the context of road traffic trauma, participation depends on accidental events rather than on planned enrolment targets, and this limits the possibility of controlling sample composition in advance. For ProtAct-Us, the issue is therefore not enforcing numerical balance but keeping scientific rigour and attentiveness. The key priority is to ensure that potential differences are acknowledged, measured where feasible, and carefully taken into account throughout data collection, analysis, and interpretation. In other words, gender sensitivity in this context is less focused on quota-based inclusion and more on analytical awareness.

This also means acknowledging that gender bias may affect both women and men. Bias is not limited to representation alone: it can also emerge through differences in exposure patterns, behaviours, care pathways, symptom recognition, access to support, or the ways recovery is understood and managed. Everyday habits, risk-taking behaviours, social expectations, and even assumptions about who is more vulnerable or more resilient may all shape both the occurrence of injury and the experience of recovery afterwards. Hence, a gender-sensitive approach is not designed to benefit a single group. Rather, it enables research to become more precise, more inclusive, and better responsive to the diversity of people lived experiences. In this sense, for ProtAct-Us celebrating 11 February and 8 March has not only symbolic meaning. By integrating results stratified by gender, the project can contribute to stronger evidence and more person-centred knowledge for prevention, care, and long-term recovery.