# Table 1 Typology of sex S and gender G effects on a health outcome Y

Name

Definitions

Examples of counterfactual formulation

Total effect of sex (TES)

The difference in the value of Y had the whole population been born female “S = f” versus the whole population been born male “S = m

Corresponds to the total effect of being born male (versus being born female) on Y value, whatever the mechanisms explaining these differences

$$E\left({Y}_{S=m}\right)-E\left({Y}_{S=f}\right)$$

Socially mediated indirect effect of sex (SMIES)

The difference in the value of Y, had the sex been set to a constant level (for example “S = m”), and gender been change from Gf to Gm in the whole population

Corresponds to the indirect effect of sex which is explained/ mediated by social mechanisms G

$$E\left({Y}_{S=m;G={G}_{m}}\right)-E\left({Y}_{S=m;G={G}_{f}}\right)$$

Direct or residual effect of sex (RES)

The difference in the value of Y had the sex been changed from female “S = f” to male “S = m” in the whole population, while the gender variable been set constant to $${G}_{f}$$

Corresponds to the direct effect of sex which does not pass through G

$$E\left({Y}_{S=m;G={G}_{f}}\right)-E\left({Y}_{S=f;G={G}_{f}}\right)$$

Sex-controlled gender effect (SCGE)

The difference in the value of Y had the whole population been gendered in some way “G = f versus the other way “G = m”. Correspond to the total effect G → Y. In this case, the sex and the environment are confounding factors, it will therefore be necessary to adjust for them

Corresponds to the effect on G of Y “whatever the sex”

$$E\left({Y}_{G=f}\right)-E\left({Y}_{G=m}\right)$$

1. With: S for Sex, G for Gender, Y for outcome