Examining Sex-Based Inequities in Pediatric Sports Medicine Research: A Systematic Review.
John H Sonnier, Neeraj M Patel, Samantha L Watson et al.
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In 30 seconds
This Level IV systematic review examined sex-based inclusion in original pediatric sports medicine research published from 2020 to 2024 in 12 interdisciplinary journals. Across 409 studies, 30% enrolled only male athletes, 10% only female athletes, and 60% included both; overall, the median sample was 61% male and 39% female. Female athletes were particularly underrepresented in single-sport studies and in higher-level evidence designs examining patient-reported outcomes, injury, reinjury, or return to play. Inclusion did not differ in studies of mental health outcomes.
Key findings
- Across 409 studies, median inclusion was 61% male and 39% female athletes.
- Among 234 single-sport studies, 48.7% included only males, 15.4% only females, and 35.9% both (P <0.001).
- Female athletes were underrepresented in higher-level evidence designs examining patient-reported outcomes, injury, reinjury, or return to play.
- The review found no difference in inclusion in studies examining mental health outcomes.
Why it matters
Unequal representation can limit how confidently findings from pediatric sports medicine research apply to female athletes, particularly for commonly studied outcomes such as injury and return to play. The review identifies a research evidence gap rather than demonstrating differences in clinical outcomes, underscoring the importance of assessing who is included when interpreting study findings.
What to keep in mind
The review was limited to original research in 12 selected journals published from 2020 to 2024; its findings describe representation in that literature and do not establish the effects of underrepresentation on clinical outcomes.