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The SAGER guidelines (Sex and Gender Equity in Research) are an editorial reporting standard, published in 2016 by the European Association of Science Editors (EASE) Gender Policy Committee, that tell authors, editors and reviewers how to report sex and gender accurately and consistently in research manuscripts. They were introduced in the paper “Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use,” led by Shirin Heidari and colleagues and published in the journal Research Integrity and Peer Review. A companion checklist, developed to give editors a fast, section-by-section way to check a manuscript against the guidelines, was later published in European Science Editing.
SAGER sits in the same family as PRISMA, CONSORT and STROBE: a reporting guideline, not a study-design method. It does not tell a researcher how to run a study — it tells them, and the journal editing it, what needs to be stated explicitly once the study is written up. The gap it closes is specific: for decades, “sex” and “gender” were routinely used as interchangeable labels in published research, which obscured whether a reported difference was biological, social, or an artifact of how a variable was collected and analyzed in the first place.
Why a reporting guideline for sex and gender exists
Before SAGER, most journals had no explicit editorial policy distinguishing sex and gender, and manuscripts commonly used the terms interchangeably without defining either. That mattered practically, not just semantically: a study reporting a “gender difference” in a lab assay involving no self-reported identity data was actually reporting a sex difference (a biological, chromosomal/hormonal variable), and conflating the two obscures whether an observed effect is biological, social, or a mix of both — which in turn affects whether the finding generalizes, and to whom.
This wasn’t happening in isolation. The same year SAGER was published, the U.S. National Institutes of Health implemented its Sex as a Biological Variable (SABV) policy, requiring NIH-funded researchers to factor sex into the design, analysis and reporting of vertebrate animal and human studies. SAGER and SABV address the same underlying problem — sex-blind or sex/gender-conflated research design — from two different levers: SABV is a funder mandate on study design; SAGER is an editorial/reporting standard applied at the manuscript stage, regardless of who funded the work.
The distinction SAGER draws between sex and gender
The guidelines define the two terms precisely, and the definitions are the foundation everything else in the checklist rests on:
- Sex refers to the biological characteristics that distinguish male and female organisms — chromosomes, gonads, hormones, and reproductive/anatomical structures. It is the relevant variable in most non-human research (animal models, cell lines) and in human biology/physiology.
- Gender refers to socially constructed roles, behaviors, expressions and identities — shaped by culture and social context, and applicable to human study populations, not to animals or cells.
SAGER’s core instruction is simple to state and, the guidelines’ authors argue, routinely skipped in practice: use the term that actually matches what was measured, define both terms as used in the paper if there’s any risk of ambiguity, and never treat “sex” and “gender” as synonyms of convenience.
The SAGER checklist, section by section
The checklist maps directly onto standard manuscript structure, which is what makes it fast for an editor or reviewer to apply:
- Title: if sex and/or gender are relevant to the study’s design, analysis or interpretation, that should be reflected in the title rather than left implicit.
- Abstract: if data were collected on both sexes/genders, the abstract should report whether outcomes were analyzed and presented separately, and summarize any differences found — not just aggregate results that could obscure a real difference.
- Introduction: the manuscript should describe what is already known about sex and/or gender differences relevant to the research question, giving the reader context for why the study’s approach to sex/gender does (or doesn’t) matter here.
- Methods: authors should state the sex of animals or cells used (and justify single-sex designs where used), describe how sex and gender of human participants were determined or self-reported, and specify whether and how the analysis plan accounted for sex/gender.
- Results: where relevant data exist for both sexes/genders, results should be presented disaggregated by sex and/or gender rather than pooled by default — pooling should be a deliberate, stated choice, not the silent default.
- Discussion: findings should be interpreted in light of sex and/or gender, including a candid discussion of any observed differences (or their absence) and what that means for how far the results generalize.
Because “sex” doesn’t apply to cell lines and non-vertebrate models the way “gender” applies to human participants, EASE’s checklist was developed in two versions: one for studies involving human participants (where both sex and gender may be relevant, and where self-report matters), and one for studies that don’t (animal and cell-based research, where sex — not gender — is the applicable variable). Applying the human-participant checklist to an animal study, or vice versa, produces exactly the kind of category error SAGER exists to prevent.
How SAGER relates to other reporting guidelines
SAGER is a cross-cutting guideline rather than a study-design-specific one — it applies alongside, not instead of, the reporting guideline that matches a study’s design. A randomized trial should follow both the CONSORT checklist and SAGER’s sex/gender items; an observational study should follow both STROBE and SAGER; a systematic review should follow both PRISMA and SAGER where the included studies’ sex/gender reporting is itself being assessed. Animal research specifically already has its own dedicated reporting standard for this exact variable — the ARRIVE guidelines require reporting the sex of animals used, which overlaps directly with SAGER’s non-human checklist and reinforces the same underlying requirement from the animal-research side. The EQUATOR Network, the umbrella registry that indexes reporting guidelines by study type, is the reference point for finding which design-specific guideline SAGER should be paired with for a given manuscript.
SAGER also belongs to the same family of editorial checklists CASRAI covers elsewhere: diagnostic and prediction-model studies use STARD and TRIPOD+AI; clinical AI/ML models use MINIMAR; qualitative research uses COREQ and SRQR; observational meta-analyses use MOOSE; quality-improvement studies use SQUIRE 2.0; and clinical practice guidelines themselves are appraised with AGREE II. An editorial office assembling submission requirements, or a systematic reviewer using JBI critical appraisal checklists to assess included studies, will typically be applying several of these guidelines to the same manuscript at once — SAGER is the one that specifically catches sex/gender conflation, which none of the design-specific checklists above test for on their own.
Where SAGER fits in journal policy and editorial practice
SAGER was written to be adopted at the editorial-policy level, not applied case-by-case at a reviewer’s discretion — EASE’s own guidance frames the checklist as something an editorial office builds into its submission requirements and desk-review process, the same way a journal requires a completed ICMJE conflict-of-interest form or a CONSORT checklist for trial reports. Several major biomedical journal families have referenced or required SAGER-consistent reporting in their author guidelines since 2016, and it is regularly cited alongside NIH’s SABV policy as one of the two concrete mechanisms (funder-side and journal-side) that pushed sex/gender-aware research design and reporting from a recommendation into an operational requirement. For a research administrator, the practical takeaway is procedural: check a target journal’s author instructions for an explicit SAGER or sex/gender-reporting requirement before submission, the same way you’d check for a required reporting-guideline checklist for the study’s design.
Applying SAGER in the methods and results sections
Two of SAGER’s checklist items — describing how sex/gender of participants was determined, and stating whether the analysis was designed to detect sex/gender differences — are easy to satisfy retroactively in a methods section but far harder to satisfy if the study wasn’t designed with disaggregation in mind. A study that collects sex/gender data but analyzes outcomes only in aggregate can still comply with SAGER’s reporting requirement (by stating that a pooled analysis was used and why), but it cannot retroactively produce a disaggregated result it never ran. Authors working on a reproducible methods section should treat sex/gender disaggregation as a design-stage decision, not a reporting-stage afterthought, if the study population includes both sexes or genders and the research question could plausibly differ between them.
Frequently asked questions
Is SAGER mandatory?
Not universally — SAGER is a voluntary editorial guideline, not a legal or regulatory requirement. Whether it’s mandatory for a given submission depends on the target journal: some biomedical and health-science journals have built SAGER-consistent reporting into their author guidelines and editorial checks, in which case it functions as a real submission requirement for that venue, while others reference it only as recommended practice.
Does SAGER apply to animal and cell-based research?
Yes, but through a separate checklist version. The non-human checklist asks authors to state the sex of animals or cells used and justify single-sex study designs, since “gender” as a social construct doesn’t apply to non-human subjects — only sex does. This is the same reporting expectation the ARRIVE guidelines set for animal research more broadly.
How is SAGER different from the NIH’s Sex as a Biological Variable (SABV) policy?
SABV is a funder-side mandate: it requires NIH-funded researchers to factor sex into study design and analysis from the outset. SAGER is a journal-side reporting standard applied when the resulting manuscript is written up and submitted, regardless of who funded the study. A study can be SABV-compliant in its design and still need to check its manuscript against SAGER’s reporting checklist before submission — they operate at different stages of the research lifecycle.
What’s the difference between sex and gender under SAGER?
Sex is the biological classification (chromosomes, hormones, reproductive anatomy); gender is the socially constructed role, behavior and identity associated with being a man, woman or another gender, applicable only to human participants. SAGER’s central instruction is to use whichever term actually matches what was measured or reported, rather than treating the two as interchangeable.
See CASRAI’s Reporting Guidelines entry for how SAGER fits alongside the broader family of study-type-specific reporting standards, and the Publishing cluster hub for related editorial-workflow and peer-review content.
