Exposomics as a tool to investigate differences in health and disease by sex and gender

Abstract

The health and disease of an individual is mediated by their genetics, a lifetime of environmental exposures, and interactions between the two. Genetic or biological sex, including chromosome composition and hormone expression, may influence both the types and frequency of environmental exposures an individual experiences, as well as the biological responses an individual has to those exposures. Gender identity, which can be associated with social behaviors such as expressions of self, may also mediate the types and frequency of exposures an individual experiences. Recent advances in exposome-level analysis have progressed our understanding of how environmental factors affect health outcomes; however, the relationship between environmental exposures and sex- and gender-specific health remains underexplored. The comprehensive, non-targeted, and unbiased nature of exposomic research provides a unique opportunity to systematically evaluate how environmental exposures interact with biological sex and gender identity to influence health. In this forward-looking narrative review, we provide examples of how biological sex and gender identity influence environmental exposures, discuss how environmental factors may interact with biological processes, and highlight how an intersectional approach to exposomics can provide critical insights for sex- and gender-specific health sciences.

Keywords: gender and sexual minorities; gender-specific medicine; intersectionality; occupational health; personal care products; sex-specific medicine.

Figure 1.

Overarching structural factors create systems that mediate sex- and gender-specific exposome. Exposures interact with biological processes in a sex- and gender-dependent manner to influence health outcomes.

Figure 2.

Toward sex- and gender-specific exposome: (1) characterizing sex- and gender-specificity in exposomics, (2) determining how sex- and gender-specific exposome are linked to health outcomes, and (3) utilizing the findings from exposomics to inform policy and enable sex- and gender-specific medicine and improved health sciences.