PT - JOURNAL ARTICLE AU - Antonella LoMauro AU - Andrea Aliverti TI - Sex and gender in respiratory physiology AID - 10.1183/16000617.0038-2021 DP - 2021 Dec 31 TA - European Respiratory Review PG - 210038 VI - 30 IP - 162 4099 - http://err.ersjournals.com/content/30/162/210038.short 4100 - http://err.ersjournals.com/content/30/162/210038.full SO - EUROPEAN RESPIRATORY REVIEW2021 Dec 31; 30 AB - Sex is a biological concept determined at conception. Gender is a social concept. Medicine recognises sex as a biological variable and recommends including sex as a factor in clinical practice norms and as a topic of bench and clinical research. Sex plays a role in respiratory physiology according to two pathways: hormones and anatomy, with females characterised by smaller dimensions at every level of the respiratory system. Sex hormones also play specific roles in lung inflammatory processes, breathing control and in response to diseases. The literature is extremely controversial because many factors need to be considered to avoid erroneous comparisons. The main difficulty lies in creating homogeneous groups of subjects according to age, body weight, lung/airway size, fluctuations in circulating hormone levels, and exercise protocol. Because almost all of the knowledge available in physiology is based on research in males, medicine for women is therefore less evidence-based than that being applied to men. Finally, the number of transsexual people is increasing and they represent new challenges for clinicians, due to the anatomical and physiological changes that they undergo.Gender is a social concept. Sex is a biological concept that plays a role in respiratory physiology according to hormones and anatomy. Medicine is less evidence-based for women, while transsexual people represent new challenges for the clinicians. https://bit.ly/3wErYoY