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Using a data-driven approach, we developed a composite gender score based on sociodemographic and psychosocial variables showing sex differences in a sample of psychiatric emergency patients upon admission (N = 1708; 39.4% birth-assigned females; mean age = 40 years; age standard deviation = 14). This gender score was extracted from a confirmatory factor analysis (CFI = 0.966; RMSEA = 0.044, SRMR = 0.030) and could predict a person\u2019s birth-assigned sex with 67% accuracy. This score allowed the further identification of differences on impulsivity measures that were absent when looking solely at birth-assigned sex. Female birth-assigned sex was also associated with higher rates of mood and personality disorder diagnoses, while higher feminine gender scores were related to higher proportions of anxiety and mood disorder diagnoses. By contrast, male birth-assigned sex and higher masculine gender scores were associated with higher proportions of psychotic and substance use disorder diagnoses. Patients with undifferentiated gender scores (i.e., scoring between masculine and feminine threshold defined by terciles) were more represented in the psychotic disorder group. Considering both sex and gender in psychiatric research is essential and can be achieved even when using secondary data to index gender comprised of demographic and psychosocial variables.<\/jats:p>","DOI":"10.1371\/journal.pone.0296880","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T18:38:58Z","timestamp":1706207938000},"page":"e0296880","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["A step-by-step and data-driven guide to index gender in psychiatry"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7762-1521","authenticated-orcid":true,"given":"Enzo","family":"Cipriani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eug\u00e9nie","family":"Samson-Daoust","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-6412","authenticated-orcid":true,"given":"Charles-Edouard","family":"Gigu\u00e8re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Kerr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8020-1544","authenticated-orcid":true,"given":"C\u00e9cile","family":"Lepage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert-Paul","family":"Juster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"pone.0296880.ref001","article-title":"Gender\/sex\/ual diversity and biobehavioral research.","author":"SM van Anders","year":"2022","journal-title":"Psychol Sex Orientat Gend Divers"},{"key":"pone.0296880.ref002","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1037\/amp0000307","article-title":"The future of sex and gender in psychology: Five challenges to the gender binary.","volume":"74","author":"JS Hyde","year":"2019","journal-title":"Am Psychol"},{"key":"pone.0296880.ref003","article-title":"What is gender? 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