Sex as a Biological Variable in Tissue Engineering and Regenerative Medicine

Annu Rev Biomed Eng. 2023 Jun 8:25:311-331. doi: 10.1146/annurev-bioeng-092222-030857. Epub 2023 Apr 27.


Although sex differences have been noted in cellular function and behavior, therapy efficacy, and disease incidence and outcomes, the adoption of sex as a biological variable in tissue engineering and regenerative medicine remains limited. Furthering the development of personalized, precision medicine requires considering biological sex at the bench and in the clinic. This review provides the basis for considering biological sex when designing tissue-engineered constructs and regenerative therapies by contextualizing sex as a biological variable within the tissue engineering triad of cells, matrices, and signals. To achieve equity in biological sex within medicine requires a cultural shift in science and engineering research, with active engagement by researchers, clinicians, companies, policymakers, and funding agencies.

Keywords: precision medicine; sex characteristics; sex differences; sexual dimorphism; stem cells; tissue models.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Male
  • Precision Medicine
  • Regenerative Medicine*
  • Tissue Engineering*