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Sex differences in humans
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Sex differences in humans have been studied in a variety of fields. Sex determination generally occurs by the presence or absence of a Y chromosome in the 23rd pair of chromosomes in the human genome. Phenotypic sex refers to an individual's sex as determined by their internal and external genitalia and expression of secondary sex characteristics.[1]
Sex differences generally refer to traits that are sexually dimorphic. A subset of such differences is hypothesized to be the product of the evolutionary process of sexual selection.[2][3]
Medicine
[edit]Sex differences in medicine include sex-specific diseases, which are diseases that occur only in people of one sex; and sex-related diseases, which are diseases that are more usual to one sex, or which manifest differently in each sex. For example, certain autoimmune diseases may occur predominantly in one sex, for unknown reasons. 90% of primary biliary cirrhosis cases are women, whereas primary sclerosing cholangitis is more common in men. Gender-based medicine, also called "gender medicine", is the field of medicine that studies the biological and physiological differences between the human sexes and how that affects differences in disease. Traditionally, medical research has mostly been conducted using the male body as the basis for clinical studies. Similar findings are also reported in the sport medicine literature where males typically account for >60% of the individuals studied.[4] The findings of these studies have often been applied across the sexes and healthcare providers have assumed a uniform approach in treating both male and female patients. More recently, medical research has started to understand the importance of taking the sex into account as the symptoms and responses to medical treatment may be very different between sexes.[5]
Neither concept should be confused with sexually transmitted infections, which are infections that have a significant probability of transmission through sexual contact.
Sex-related illnesses have various causes:[citation needed]
- Sex-linked genetic illnesses
- Parts of the reproductive system that are specific to one sex
- Social causes that relate to the gender role expected of that sex in a particular society
- Different levels of prevention, reporting, diagnosis or treatment in each gender
Physiology
[edit]Sex differences in human physiology are distinctions of physiological characteristics associated with either male or female humans. These can be of several types, including direct and indirect, direct being the direct result of differences prescribed by the Y-chromosome (due to the SRY gene), and indirect being characteristics influenced indirectly (e.g., hormonally) by the Y-chromosome. Sexual dimorphism is a term for the genotypic and phenotypic differences between males and females of the same species.
Through the process of meiosis and fertilization (with rare exceptions), each individual is created with zero or one Y-chromosome. The complementary result for the X-chromosome follows, either a double or a single X. Therefore, direct sex differences are usually binary in expression, although the deviations in more complex biological processes produce a variety of exceptions.
Indirect sex differences are general differences as quantified by empirical data and statistical analysis. Most differing characteristics will conform to a bell-curve (i.e., normal) distribution which can be broadly described by the mean (peak distribution) and standard deviation (indicator of size of range). Often only the mean or mean difference between sexes is given. This may or may not preclude overlap in distributions. For example, males are, on average, taller than females, but an individual female could be taller than an individual male. The extents of these differences vary across different regions and populations.[6][7] Sexual dimorphism for specific traits in humans may be due to a variety of factors such as environmental influences, genetic variation, or hormonal effects.[8][9][10][11]
The most obvious differences between males and females include all the features related to reproductive roles, notably the endocrine (hormonal) systems and their physiological and behavioral effects, including gonadal differentiation, internal and external genital and breast differentiation, and differentiation of muscle mass, height, and hair distribution. There are also differences in the structure of specific areas of the brain. For example, on average, the SDN (INAH3 in humans) has been repeatedly found to be considerably larger in males than in females.[12] A brain study done by the NIH showed that the females had greater volume in the prefrontal cortex, orbitofrontal cortex, superior temporal cortex, lateral parietal cortex, and insula, whereas males had greater volume in the ventral temporal and occipital regions.[13]
Psychology
[edit]Research on biological sex differences in human psychology investigates cognitive and behavioral differences between men and women. This research employs experimental tests of cognition, which take a variety of forms. Tests focus on possible differences in areas such as IQ, spatial reasoning, aggression, emotion, and brain structure and function.
Chromosomal makeup is important in human psychology. Females normally have two X chromosomes while males typically have an X and a Y chromosome. The X chromosome is more active and encodes more information than the Y chromosome, which has been shown to affect behavior.[14] Genetic researchers theorize that the X chromosome may contain a gene influencing social behaviours.[15][better source needed]
Most IQ tests are constructed so that there are no overall score differences between females and males. Areas where differences have been found include verbal and mathematical ability.[16][17] IQ tests that measure fluid g and have not been constructed to eliminate sex differences also tend to show that sex differences are either non-existent or negligible.[17][18] 2008 research found that, for grades 2 to 11, there were no significant gender differences in math skills among the general population.[19] Differences in variability of IQ scores have been observed in studies, with more men falling at the extremes of the spectrum.[20][21]
Because social and environmental factors affect brain activity and behavior, where differences are found, it can be difficult for researchers to assess whether or not the differences are innate. Some studies showing that differences are due to socially assigned roles (nurture), while other studies show that differences are due to inherent differences (natural or innate).[22] Studies on this topic explore the possibility of social influences on how both sexes perform in cognitive and behavioral tests. Stereotypes about differences between men and women have been shown to affect a person's behavior (this is called stereotype threat).[23][24]
In his book titled Gender, Nature, and Nurture, psychologist Richard Lippa found that there were large differences in women's and men's preferences for realistic occupations (for example, mechanic or carpenters) and moderate differences in their preferences for social and artistic occupations. His results also found that women tend to be more people-oriented and men more thing-oriented.[25]
Hartung & Widiger (1998) found that many kinds of mental illnesses and behavioral problems show gender differences in prevalence and incidence. "Of the 80 disorders diagnosed in adulthood for which sex ratios are provided, 35 are said to be more common in men than in women (17 of which are substance related or a paraphilia), 31 are said to be more common in women than men, and 14 are said to be equally common in both sexes."[26]
Differences in male and female jealousy can also be observed. While female jealousy is more likely to be inspired by emotional infidelity, male jealousy is most likely to be brought on by sexual infidelity. A clear majority of approximately 62% to 86% of women reported that they would be more bothered by emotional infidelity and 47% to 60% of men reported that they would be more bothered by sexual infidelity.[27]
In 2005, Janet Shibley Hyde from the University of Wisconsin-Madison introduced the gender similarities hypothesis, which suggests that males and females are similar on most, but not all, psychological variables. The research focused on cognitive variables (for example, reading comprehension, mathematics), communication (for example, talkativeness, facial expressions), social and personality (for example, aggression, sexuality), psychological well-being, and motor behaviors. Using results from a review of 46 meta-analyses, she found that 78% of gender differences were small or close to zero. A few exceptions were some motor behaviors (such as throwing distance) and some aspects of sexuality (such as attitudes about casual sex), which show the largest gender differences. She concludes her article by stating: "It is time to consider the costs of overinflated claims of gender differences. Arguably, they cause harm in numerous realms, including women’s opportunities in the workplace, couple conflict and communication, and analyses of self-esteem problems among adolescents."[28] Hyde also stated elsewhere that "variations within genders are greater than variations between genders."[29] However, another paper argued that the gender similarities hypothesis was untestable as currently formulated because it does not provide a metric for the psychological importance of relevant dimensions, nor a rule for counting dimensions; a small number of relevant differences may be more significant than a massive number of trivial similarities.[30]
In 2011, Irina Trofimova found a significant female advantage in time on the lexical task and on the temperament scale of social-verbal tempo, and a male advantage on the temperament scale of physical endurance which were more pronounced in young age groups and faded in older groups. She suggested that there is a "middle age – middle sex" effect: sex differences in these two types of abilities observed in younger groups might be entangled with age and hormonal changes. The study concluded that a one-dimensional approach to sex differences (common in meta-analytic studies) therefore overlooks a possible interaction of sex differences with age.[31] This hormones-based "middle age-middle sex effect", and also specifics of the few psychological sex differences (verbal and physical) were analysed in terms of the systemic evolutional tendencies driving sex dimorphism.[32][33]
In 2021, Lise Eliot et al found no difference in overall male/female abilities in verbal, spatial or emotion processing.[34] A 2022 follow-up meta-analysis refuted these finding based on methodological flaws, and concluded that "The human brain shows highly reproducible sex differences in regional brain anatomy above and beyond sex differences in overall brain size" and that these differences were of a "small-to-moderate effect size."[35]
Behavior
[edit]Crime
[edit]Statistics have been consistent in reporting that men commit more criminal acts than women.[36][37] Self-reported delinquent acts are also higher for men than women across many different actions.[38] Many professionals have offered explanations for this sex difference. Some differing explanations include men's evolutionary tendency toward risk and violent behavior, sex differences in activity, social support, and gender inequality. In particular, Lee Ellis' evolutionary neuroandrogenic theory posits that sexual selection has led to increased exposure to testosterone in males, causing greater competitive behavior which could lead to criminality.[39]
Despite the difficulty of interpreting them, crime statistics may provide a way to investigate such a relationship from a gender differences perspective. An observable difference in crime rates between men and women might be due to social and cultural factors, crimes going unreported, or to biological factors (for example, testosterone or sociobiological theories). Taking the nature of the crime itself into consideration may also be a factor. Crime can be measured by such data as arrest records, imprisonment rates, and surveys. However, not all crimes are reported or investigated. Moreover, some studies show that men can have an overwhelming bias against reporting themselves to be the victims of a crime (particularly when victimized by a woman), and some studies have argued that men reporting intimate partner violence find disadvantageous biases in law enforcement.[40][41][42] Burton et al. (1998) found that low levels of self control are associated with criminal activity.[43]
Education
[edit]
Sometimes and in some places, there are sex differences in educational achievement. This may be caused by sex discrimination in law or culture, or may reflect natural differences in the interests of the sexes.[44]
Leadership
[edit]Research has been undertaken to examine whether or not there are sex differences in leadership. Leadership positions continue to be dominated by men.[45][46][47][48] Women were rarely seen in senior leadership positions leading to a lack of data on how they behave in such positions.[49] The two main lines of research contradict one another, the first being that there are significant sex differences in leadership and the second being that gender does not have an effect on leadership.
Women and men have been surveyed by Gallup each year concerning workplace topics. When questioned about preferences of a female boss or a male boss, women chose a preference for a male boss 39% of the time, compared to 26% of men displaying preference for a male boss. Only 27% of women would prefer a boss of the same gender.[50] This preference, among both sexes, for male leadership in the workplace has continued unabated for sixty years according to Gallup surveys.
Religion
[edit]This article may incorporate text from a large language model. (September 2025) |
Social capital
[edit]Sex differences in social capital are differences between men and women in their ability to coordinate actions and achieve their aims through trust, norms and networks.[51] Social capital is often seen as the missing link in development; as social networks facilitate access to resources and protect the commons, while cooperation makes markets work more efficiently.[52] Social capital has been thought of as women's capital as whereas there are gendered barriers to accessing economic capital, women's role in family, and community ensures that they have strong networks. There is potential that the concept can help to bring women's unpaid 'community and household labor',[53] vital to survival and development, to the attention of economists. However, research analyzing social capital from a gendered perspective is rare, and the notable exceptions are very critical.[54][55][56]
Suicide
[edit]Gender differences in suicide have been shown to be significant; there are highly asymmetric rates of suicide and suicide attempts between males and females.[57] The gap, also called the gender paradox of suicidal behavior, can vary significantly between different countries.[58] Statistics demonstrate that males die much more often by means of suicide than females do.[59][60][61]
Financial risk-taking
[edit]Sex differences in financial decision making are relevant and significant. Numerous studies have found that women tend to be financially more risk-averse than men and hold safer portfolios.[62][63] Scholarly research has documented systematic differences in financial decisions such as buying investments versus insurance, donating to ingroups versus outgroups (such as terrorism victims in Iraq versus the United States), spending in stores,[64] and the endowment effect-or asking price for goods people have.[65]
See also
[edit]References
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Further reading
[edit]- Angela Saini (2018). Inferior: How Science Got Women Wrong – and the New Research That's Rewriting the Story. Beacon Press. ISBN 978-0807010037.
External links
[edit]
Media related to Biology of gender at Wikimedia Commons
Sex differences in humans
View on GrokipediaGenetic and Developmental Foundations
Chromosomal and Genetic Differences
In humans, biological sex is determined by the sex chromosomes, with females typically possessing two X chromosomes (46,XX) and males one X and one Y chromosome (46,XY).[13] The 22 pairs of autosomes are identical in number and content between sexes, but the heteromorphic X and Y chromosomes introduce fundamental genetic disparities, including differences in gene dosage, expression, and function.[14] These chromosomal distinctions drive sex-specific developmental pathways independent of gonadal hormones.[15] The Y chromosome, present only in males, spans approximately 59 million base pairs and encodes roughly 70 to 200 genes, many of which are male-specific and involved in spermatogenesis or dosage-sensitive functions.[16] Its key determinant is the SRY (sex-determining region Y) gene, a 900-base-pair sequence that acts as a transcription factor to initiate male gonadal differentiation by promoting Sertoli cell formation in the bipotential gonad around embryonic week 6 to 8.[17] In the absence of SRY, as in XX individuals, the default developmental trajectory leads to ovarian formation.[18] Mutations or translocations of SRY can result in sex reversal, such as XY females or XX males, underscoring its causal role in male sex determination. The X chromosome, carried by both sexes, is larger at about 155 million base pairs and contains approximately 900 protein-coding genes, contributing to a wide array of cellular processes including immunity, cognition, and metabolism.[19] To compensate for the double X dosage in females, one X chromosome is randomly inactivated early in embryogenesis via Xist RNA-mediated silencing, forming a condensed Barr body visible in interphase nuclei.[20] This Lyonization process equalizes X-linked gene expression between sexes but is incomplete; about 15-25% of X genes escape inactivation, particularly in the pseudoautosomal regions, leading to female-specific overexpression and contributing to baseline sex differences in phenotypes like immune response.[14] Males, being hemizygous for X-linked genes, express any variant without a second allele for buffering, which manifests in higher male prevalence for X-linked recessive disorders such as hemophilia A (factor VIII deficiency), Duchenne muscular dystrophy, and red-green color blindness, with incidence ratios often exceeding 5:1 male-to-female.[21][22] These patterns arise directly from chromosomal architecture rather than environmental factors.[23] Beyond dosage effects, sex chromosomes influence autosomal gene regulation through escapee genes and Y-linked factors, fostering cellular mosaicism in females and uniform expression in males, which can amplify differences in disease susceptibility and tissue function.[24] For instance, Y chromosome genes like TSPY may modulate tumor suppression, while X escapees such as XIST itself indirectly affect global epigenetics.[25] Empirical studies in aneuploid models (e.g., XXY vs. XO) confirm that XX complements confer distinct cellular resilience compared to XY, independent of gonadal status.[26]Prenatal Hormonal Influences
Prenatal hormonal influences on sex differences in humans primarily involve androgens, such as testosterone, secreted by the fetal gonads following genetic sex determination. In typical male development, the testes form around the 7th gestational week and produce testosterone, which peaks between weeks 8-24, driving masculinization of both somatic structures and the central nervous system through organizational effects that establish enduring sex-dimorphic patterns in brain circuitry and behavior.[27] In females, the absence of such androgen surges allows for default feminization, though low-level estrogen exposure may also contribute to subtle differences.[28] These effects are considered organizational, meaning they occur during critical developmental windows and are relatively irreversible, distinct from activational influences of circulating hormones later in life.[29] Human evidence for these influences derives largely from clinical conditions and biomarkers. Females with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency experience elevated prenatal androgen exposure from adrenal sources, leading to masculinized behaviors such as increased rough-and-tumble play, preference for male-typical toys (e.g., trucks over dolls), and higher aggression levels compared to unaffected females.[30] [31] These shifts persist despite postnatal hormone normalization and rearing as females, indicating a direct causal role for prenatal androgens rather than socialization alone.[32] Males with complete androgen insensitivity syndrome (CAIS), who possess testes but lack functional androgen receptors, exhibit female-typical behaviors and gender identity, further supporting androgen mediation.[33] The second-to-fourth digit ratio (2D:4D) serves as a noninvasive proxy for prenatal testosterone exposure, with males typically showing lower ratios (≈0.95) than females (≈1.0) due to androgen effects on limb development.[34] Lower 2D:4D correlates with male-typical traits, including enhanced spatial abilities, physical aggression, and toy preferences in children, as well as adult behaviors like risk-taking and athletic performance, independent of postnatal hormone levels.[35] [36] Recent neuroimaging confirms that CAH females display more male-like brain connectivity and structure in regions linked to social cognition and visuospatial processing, aligning with behavioral masculinization.[37] While prenatal hormones explain substantial variance in sex differences, variability exists; for instance, not all CAH females show complete behavioral reversal, suggesting interactions with genetic or environmental factors.[38] Studies of synthetic progestins with androgenic properties administered prenatally for miscarriage prevention have yielded mixed results, with some evidence of defeminization in exposed females but weaker masculinization compared to CAH.[39] Overall, convergent data from these models underscore prenatal androgens as a primary causal mechanism for many human sex differences, with implications for understanding disorders of sexual development.[40]Brain Structure Differences from Birth
Males exhibit larger total brain volumes than females at birth, with differences persisting into early infancy even after adjusting for body size and birth weight.[41] This volumetric disparity, averaging around 8-11% in neonates, aligns with prenatal trajectories observed in fetal MRI studies, where male cortical gray matter volumes exceed female volumes by approximately 5% by late gestation.[42] Such findings derive from large-scale analyses of structural MRI data from hundreds of newborns, demonstrating that these patterns are not artifacts of postnatal growth but emerge in utero.[43] Regional structural variations also manifest at birth. Females display proportionately greater cortical gray matter relative to total brain volume, while males show higher white matter proportions, potentially reflecting differences in neuronal density and myelination influenced by prenatal sex hormones.[41] For instance, studies of preterm and term infants using volumetric segmentation reveal sex-specific asymmetries in subcortical structures, such as larger male amygdala volumes corrected for overall size, consistent with androgen-driven dimorphism during fetal development.[44] These observations hold across diverse cohorts, including those scanned within days of birth, underscoring their innateness rather than experiential origins.[45] Longitudinal tracking from birth confirms stability in these dimorphisms. Early postnatal MRI data indicate that male-female differences in total and regional volumes remain consistent through the first months of life, with males maintaining an absolute size advantage despite similar growth rates when scaled to intracranial volume.[43] Exceptions in specific locales, like potentially thicker female cortical mantles in frontal regions, appear early but require further replication; however, the predominant pattern favors sexually differentiated architectures from the outset, challenging notions of brain equivalence at birth.[46] Peer-reviewed syntheses emphasize that while overlap exists due to individual variation, group-level disparities are robust and replicable across methodologies, from manual tracing to automated pipelines.[47]Physiological and Anatomical Differences
Reproductive and Secondary Sexual Characteristics
Primary reproductive characteristics, present from birth, encompass the gonads and genitalia essential for gamete production and sexual reproduction. In males, the testes produce spermatozoa and secrete testosterone, while the penis and scrotum facilitate sperm delivery and temperature regulation for spermatogenesis. In females, the ovaries produce ova and secrete estrogen and progesterone, with the uterus enabling implantation and gestation, and the vagina serving as the birth canal and receptacle for semen.[48][49] Secondary sexual characteristics emerge predominantly during puberty, driven by surges in gonadal sex steroids following hypothalamic-pituitary-gonadal axis activation. In females, estrogen initiates thelarche (breast budding) at a mean age of 9.8 years, progressing to full development by 14.2 years, alongside pubic hair growth starting at 10.2 years and hip widening due to pelvic bone remodeling and fat redistribution. These changes reflect estrogen's role in promoting mammary gland proliferation and gynoid fat patterning, with breast development typically preceding pubic hair by about five months initially.[50][49] In males, rising testosterone levels, peaking post-puberty, induce genital enlargement (testicular volume increase from stage 2 at 10.3 years to completion by 14.8 years), laryngeal growth causing voice deepening around ages 12-15, and androgen-dependent hair growth including facial, axillary, and pubic hair (latter starting at 11.3 years). Testosterone also drives broader shoulders, increased muscle mass via protein anabolism, and adam's apple prominence, with genital maturation preceding pubic hair by approximately 1.1 years.[50][51] Pubertal onset differs by sex, with females typically beginning 1-2 years earlier than males—breast development or adrenarche around ages 8-13 versus gonadal activation in males at 9-14—correlating with earlier peak heights and menarche around 12.5 years in girls. These timelines vary by ethnicity, with Black children showing earlier stages by 7-12 months compared to White peers, influenced by genetic and environmental factors but fundamentally tied to sex-specific hormonal thresholds.[52][50][49]Physical Strength, Size, and Morphology
Males are, on average, taller than females worldwide, with adult men measuring approximately 171 cm and women 159 cm, representing a dimorphism of about 7-8%.[53] In the United States, adult men average 175 cm in height and 90 kg in weight, while women average 161 cm and 78 kg.[54] These differences emerge during puberty and are influenced by sex-specific growth patterns, with males exhibiting greater linear growth in stature and skeletal frame size.[55] Body composition further diverges between sexes, with males possessing substantially more skeletal muscle mass—approximately 36% greater than in females, even after accounting for differences in body weight and height.[56] Adult males typically have 18-24% body fat as a proportion of total weight, compared to 25-31% in females, reflecting higher lean mass in males and adaptive fat storage in females for reproductive demands.[57] Fat distribution patterns differ markedly: males accumulate more visceral adipose tissue around the abdomen, whereas females preferentially store fat subcutaneously in gluteofemoral regions, a pattern linked to estrogen-mediated effects.[58] [59] Skeletal morphology shows sexual dimorphism in bone size and density, with males having larger, denser bones overall, contributing to greater mechanical strength and fracture resistance.[60] Males exhibit higher bone mineral density (BMD) across sites, particularly in youth and adulthood, correlating positively with lean mass and negatively with fat mass in some cohorts.[60] Muscular strength displays pronounced sex differences, with males outperforming females substantially in absolute terms across various metrics. A meta-analysis of physical ability tests found males superior in muscular strength measures, with effect sizes indicating consistent dimorphism.[61] In adults, males demonstrate approximately 50% greater upper-body strength and 30% greater lower-body strength than females, driven by higher muscle cross-sectional area and fiber type composition.[55] Grip strength, a proxy for overall upper-body power, shows males averaging 40-60% higher values than females in population studies.[3] These disparities are evident prepubertally at ~10% but amplify postpuberty to adult levels due to androgen-driven muscle hypertrophy.[62]| Metric | Male Average Advantage | Source |
|---|---|---|
| Upper-body strength | ~50% | [55] |
| Lower-body strength | ~30% | [55] |
| Skeletal muscle mass | 36% greater | [56] |
| Grip strength | 40-60% higher | [3] |
Sensory, Immune, and Metabolic Variations
Females outperform males in olfactory abilities across detection, discrimination, identification, and memory tasks, according to a meta-analysis of studies showing consistent advantages with small effect sizes (Hedges' g ≈ 0.2-0.3).[64][65] In color vision, females demonstrate greater accuracy in hue discrimination, particularly for red and green wavelengths, and complete color-matching tasks more rapidly than males.[66][67] Auditory thresholds are lower in females for high-frequency tones, conferring superior sensitivity in that range, though females exhibit heightened vulnerability to noise-induced cochlear damage.[68] Pain perception differs markedly, with females displaying lower thresholds and higher ratings of intensity for experimental noxious stimuli, including thermal, mechanical, and electrical modalities; effect sizes range from moderate (d ≈ 0.5) to large (d > 0.8) in meta-analyses of healthy adults.[69][70][71] Sex differences in immunity arise from chromosomal, hormonal, and genetic factors, leading females to produce stronger antibody responses to vaccines and pathogens, alongside elevated circulating immunoglobulin levels and B-cell counts.[11][72] This robust adaptive immunity reduces female susceptibility to severe viral infections and certain bacterial diseases but elevates risks for autoimmunity, with females comprising 75-80% of cases for conditions like systemic lupus erythematosus and multiple sclerosis.[73][74] Innate responses also diverge, as females generate higher pro-inflammatory cytokine levels (e.g., IL-6, TNF-α) post-stimulation, enhancing pathogen clearance yet potentially exacerbating chronic inflammation.[11][75] Males exhibit higher basal metabolic rates, averaging 1,696 kcal/day versus 1,410 kcal/day in females, driven by 10-15% greater fat-free mass and higher skeletal muscle proportion, which accounts for ~70% of sex variance in resting energy expenditure.[76][77][78] During prolonged submaximal exercise, females oxidize a greater percentage of energy from fats (up to 50% more than males at matched intensities), reflecting estrogen-mediated shifts in substrate preference and mitochondrial efficiency.[79] Adipose distribution varies sexually, with males favoring intra-abdominal visceral fat (comprising 10-20% of total fat) and females subcutaneous deposits, influencing insulin sensitivity and cardiometabolic risk profiles.[79][78]Health and Medical Differences
Disease Incidence and Susceptibility
Females exhibit higher incidence rates for autoimmune diseases, comprising approximately 78% of cases overall, with ratios reaching up to 4:1 in conditions such as rheumatoid arthritis, multiple sclerosis, and systemic lupus erythematosus.[80][81] This disparity is attributed to factors including X-chromosome-linked immune gene dosage, where the inactivated second X chromosome in females may reactivate and trigger autoantibody production, and the influence of sex hormones like estrogen, which enhances immune responses but predisposes to self-attack.[81][82] In contrast, males show lower susceptibility to autoimmunity but experience more severe outcomes in certain infectious diseases. Males demonstrate greater vulnerability to infectious diseases, particularly bacterial and viral infections, with epidemiological data indicating higher incidence and mortality rates across respiratory tract infections, tuberculosis, and sepsis.[83][84] For instance, during the COVID-19 pandemic, males faced approximately 45% higher in-hospital mortality risk compared to females, linked to dimorphic immune responses where females mount stronger antibody production but males exhibit impaired viral clearance due to testosterone-mediated suppression of immunity and Y-chromosome genetic variations affecting pathogen resistance.[85][86] Childhood data further corroborate this, with males under age 4 showing 16% higher incidence for various infections, consistent with genetic hypotheses involving X-linked protective genes.[87] Cancer incidence displays marked sex differences, with males exhibiting 2- to 3-fold higher rates for most non-reproductive site cancers, including lung, colorectal, bladder, and esophageal, across all age groups and ancestries, except in younger adults (20-39 years) where female rates may predominate for thyroid and skin cancers.[88][89] These patterns persist globally, potentially driven by sex chromosome influences on tumor suppression—such as X-linked genes providing females added protection—and higher male exposure to carcinogens alongside weaker immune surveillance.[74] Cardiovascular diseases also onset earlier in males, with coronary heart disease typically manifesting around age 55-65 versus 72 in females, reflecting androgen-accelerated atherosclerosis and pre-menopausal estrogen cardioprotection in women.[90][91]| Disease Category | Sex with Higher Incidence | Approximate Ratio (Male:Female or Female:Male) | Key Sources |
|---|---|---|---|
| Autoimmune | Female | 4:1 | NIH, CDC |
| Infectious (bacterial/viral) | Male | 1.16-2:1 (incidence/mortality) | ASM, PNAS |
| Non-reproductive cancers | Male | 2-3:1 | PMC, Cancer |
| Cardiovascular | Male (earlier onset) | N/A (age gap ~10 years) | Harvard, PMC |
Longevity, Mortality, and Aging
Females consistently outlive males in human populations worldwide, with the global life expectancy gap averaging about 5 years as of 2023 data, though this varies by region and has widened in some countries like the United States to 5.8 years between 2019 and 2021.[92][93] This disparity emerges early and persists, with female infant mortality lower even under stressors like famines, where female infants survive harsh conditions better than males due to physiological resilience.[94] Male mortality exceeds female rates across most causes and ages, contributing to the longevity gap. External causes—unintentional injuries, suicides, and homicides—account for a substantial portion, with males dying at rates up to three times higher, particularly between ages 15 and 40, though these do not solely explain the overall difference as the gap maximizes at older ages from chronic diseases.[95] Cardiovascular diseases manifest earlier and more fatally in males, while females face elevated risks from certain cancers and later-life conditions, yet their overall age-specific death rates remain lower.[92] Lifestyle factors, including higher male rates of smoking, alcohol use, and occupational hazards, amplify these patterns, but residual differences persist after controlling for behaviors.[96] Biological mechanisms underpin much of the female advantage, including the dual X chromosome configuration, which enables cellular compensation for genetic defects via X-inactivation mosaicism, reducing vulnerability to mutations.[97] Estrogen provides cardioprotective effects, delaying atherosclerosis and related mortality, while testosterone may exacerbate risks through influences on behavior and metabolism.[98] Evolutionary pressures favoring female survival for offspring investment further manifest in innate immune advantages and lower baseline metabolic rates, conserving resources during scarcity.[99] In aging processes, sex differences reveal trade-offs: females exhibit slower epigenetic clocks and reduced genomic instability, correlating with extended lifespan, yet they accumulate higher frailty indices and multimorbidity in extreme old age, often outnumbering males in centenarian cohorts but with diminished physical function.[100][101] Males, conversely, maintain better grip strength and mobility into late life despite accelerated telomere attrition and mutation rates in some tissues.[102] Tissue-specific gene expression shifts during senescence differ by sex, with females showing alterations in lipid and amino acid metabolism pathways that may prolong vitality but heighten late-life vulnerabilities.[103] These patterns hold across wild mammals, suggesting conserved dimorphisms beyond human behaviors.[104]Pharmacological and Treatment Responses
Sex differences in pharmacokinetics and pharmacodynamics contribute to varied responses to pharmacological treatments between males and females. Females generally exhibit higher rates of adverse drug reactions (ADRs), with evidence indicating nearly twice the incidence compared to males, and a 1.5- to 1.7-fold greater risk for clinically relevant events.[105][106] These disparities arise from physiological factors, including females' higher body fat percentage (affecting drug distribution), slower gastric emptying (impacting absorption), differences in cytochrome P450 enzyme activity (influencing metabolism), and lower renal clearance (altering elimination).[106] For instance, females have a smaller volume of distribution for hydrophilic drugs like ethanol (0.45 L/kg versus 0.62 L/kg in males), leading to higher blood concentrations at equivalent doses.[106] Pharmacokinetic differences strongly predict sex-biased ADRs, particularly in females, where 96% of drugs showing female-biased pharmacokinetics (e.g., higher plasma concentrations or prolonged exposure) correlate with elevated ADR rates; this predictive link holds in 88% of evaluated cases across 59 drugs but is weaker for male-biased patterns.[105] These effects persist even after adjusting for body weight, suggesting mechanisms beyond size, such as sex-specific enzyme expression (e.g., higher CYP3A4 activity in females accelerating metabolism of substrates like olanzapine, resulting in elevated levels and risks like weight gain).[105][106] In pharmacodynamics, females often display heightened sensitivity; for example, theophylline has a shorter half-life in non-smoking females (6.0 hours versus 9.3 hours in males), while diazepam exhibits prolonged effects due to increased volume of distribution in adipose tissue.[106] Clinical evidence highlights sex-specific responses in key drug classes. Cardiovascular medications pose higher risks for females, including prolonged QT intervals leading to Torsades de Pointes from agents like amiodarone or sotalol.[107] Psychotropic drugs show differences, with females requiring dose adjustments for antiepileptics like lamotrigine during pregnancy due to altered clearance, and antipsychotics like olanzapine yielding higher plasma levels in females.[107][106] Regulatory responses include the U.S. FDA's 2013 recommendation for lower zolpidem doses in females owing to greater next-day impairment from slower clearance.[106] These findings underscore the need for sex-disaggregated analyses in trials, where female underrepresentation historically obscured differences, and advocate for tailored dosing to mitigate overexposure in females.[107][105]Psychological and Cognitive Differences
Spatial Abilities and Mental Rotation
Spatial abilities encompass visuospatial skills such as navigation, object manipulation visualization, and perspective-taking, with empirical studies consistently demonstrating an average male advantage across multiple measures.[108] A meta-analysis of 286 effect sizes from diverse spatial tests, including mental rotation and spatial perception tasks, reported moderate to large sex differences favoring males (Cohen's d ranging from 0.44 to 0.73), with the largest effects observed in mental rotation paradigms.[108] These differences persist across age groups, from childhood through adulthood, and are evident in both self-reported and performance-based assessments, though self-reports show smaller gaps (d ≈ 0.20-0.40).[109][110] Mental rotation, a core component of spatial abilities, involves imagining the rotation of three-dimensional objects to determine their orientation or match, and is typically assessed via tasks like the Shepard-Metzler paradigm or Purdue Spatial Visualization Test: Rotations (PSVT:R). Males outperform females on these tasks by approximately 0.6 to 1.0 standard deviations, a gap larger than in other cognitive domains such as verbal fluency.[108][111] This advantage holds under time-limited conditions, where males process rotations more efficiently, though the gap narrows slightly without time constraints due to compensatory strategies in females.[112] Effect sizes remain robust even among STEM professionals, indicating that domain-specific expertise does not fully eliminate the disparity.[113] The male advantage in mental rotation emerges early, detectable by elementary school age (around 6-7 years), with meta-analytic evidence showing increasing effect sizes through adolescence (d ≈ 0.5-0.9).[114] Cross-cultural replications, including in non-Western samples, support the universality of this pattern, suggesting biological underpinnings over purely cultural influences, though experiential factors like play patterns may modulate performance.[115] Neuroimaging studies link superior male performance to greater activation in parietal and frontal regions during rotation tasks, correlating with anatomical differences in brain lateralization.[113] Prenatal testosterone exposure accounts for only a portion of the variance, as evidenced by null associations in some longitudinal digit ratio studies, implying multifactorial causation including genetic and developmental elements.[116] Despite debates on etiology, the empirical consistency of the sex difference underscores its reliability as a cognitive dimorphism.[117]Verbal, Memory, and Emotional Processing
Women exhibit a small but consistent advantage over men in overall verbal abilities, with a meta-analysis of 165 studies encompassing nearly 1.4 million participants yielding a weighted effect size of d = 0.11 favoring females.[118] This advantage persists in specific domains such as verbal fluency, where a 2022 meta-analysis of 496 effect sizes from 355,173 participants found women outperforming men in phonemic fluency tasks (d ≈ 0.2-0.3), though differences in semantic fluency were negligible.[119] These patterns hold across age groups and cultures, potentially linked to greater female variability in neural language processing regions, though effect sizes remain modest and overlap substantially between sexes.[120] In memory performance, females demonstrate superior verbal and episodic memory recall compared to males. A review of sex influences on memory types indicates women excel in tasks involving verbal material and autobiographical events, with advantages attributed to differences in hippocampal function and estrogen modulation.[121] For instance, longitudinal data show females maintaining higher baseline episodic memory scores, with sex differences enduring into advanced age (e.g., beyond 80 years), where women retain better verbal memory despite age-related decline.[122][123] Men, conversely, show greater within-sex variance in verbal episodic memory, leading to more extreme high and low performers, while women predominate in average performance levels.[124] Working memory differences are less pronounced, with no consistent sex effect in overall accuracy but potential female resilience to stressors like temperature variations.[125] Sex differences in emotional processing favor females in self-reported empathy and compassion, but objective measures reveal smaller or absent gaps. Meta-analytic evidence from behavioral tasks confirms women score higher on empathy questionnaires and compassion ratings (e.g., d ≈ 0.3-0.5), aligning with stereotypes of greater nurturance, yet fMRI studies show no reliable female superiority in neural responses to others' pain or emotion recognition accuracy.[126][127] Women report elevated personal distress in empathy subscales, potentially reflecting heightened affective reactivity rather than superior cognitive perspective-taking, where sexes perform equivalently.[128] These discrepancies suggest self-report biases, such as social desirability, may inflate perceived differences, with behavioral empathy tasks indicating minimal sex effects after controlling for gender roles.[129] Developmental trajectories show early female advantages in emotional expression recognition, but these attenuate with age and measurement type.[130]Personality Traits and Interests
Sex differences in personality traits are observed across the Big Five model, with women scoring higher on average in Neuroticism (d ≈ 0.50), reflecting greater emotional reactivity and vulnerability, and Agreeableness (d ≈ 0.40), encompassing traits like altruism and sympathy.[131][132] Men tend to score higher in emotional stability (inverse of Neuroticism) and assertiveness facets within Extraversion.[133] These patterns emerge consistently in meta-analyses of self-report inventories, with effect sizes typically small to moderate (d = 0.10–0.50), though larger in specific facets such as women's elevated anxiety (d > 0.50) and men's reduced tender-mindedness.[134][135] Cross-cultural studies reinforce these findings, analyzing data from over 55 nations and showing that differences persist and often amplify in gender-egalitarian, prosperous societies, where women report even higher Neuroticism and Agreeableness relative to men.[131][136] This counterintuitive pattern—larger gaps in low-pathology environments—aligns with reduced social pressures allowing biological predispositions to manifest more freely, rather than pure cultural imposition.[137] Longitudinal and twin studies further indicate moderate heritability (h² ≈ 0.30–0.50) for these traits, with sex-specific genetic influences contributing to divergence.[138] Vocational interests exhibit pronounced sex differences along the people-things dimension, a core axis in models like Holland's RIASEC framework, where men preferentially orient toward realistic and investigative activities involving objects and systems (d = 0.93), while women favor social and artistic pursuits centered on interpersonal relations.[139] This large effect, derived from meta-analyses of over 500,000 participants across decades (1970s–2000s), remains stable temporally and culturally, explaining substantial occupational sex segregation, such as men's overrepresentation in engineering (things-oriented) and women's in nursing (people-oriented).[140][141] Prenatal androgen exposure correlates with things-oriented interests in both sexes, supporting a biological component alongside any socialization.[142]| Big Five Trait/Facet | Female Advantage (d) | Male Advantage (d) | Source |
|---|---|---|---|
| Neuroticism (overall) | 0.50 | - | Schmitt et al. (2008)[131] |
| Agreeableness (altruism/sympathy) | >0.50 | - | Kajonius & Johnson (2018)[135] |
| Extraversion (assertiveness) | - | 0.20–0.40 | Feingold (1994)[133] |
| Vocational Interests (things-people) | -0.93 (people) | 0.93 (things) | Su et al. (2009)[139] |
