On the basis of sex: why I dedicated my doctoral thesis to RBG

To Ruth Bader Ginsburg, a trailblazer who saw a path to justice where others only saw barriers. I dedicate this thesis, On the Basis of Sex: The Impact of Biological Sex on the Plasmodium Liver Stage, to her. I began my PhD journey in September 2020, the month Justice Ginsburg passed away, surrounded by family, at age 87. She was more than a Supreme Court Justice – she was a champion for gender equality, a strategist of unyielding purpose, and a leader who fought tirelessly for rights that generations had been denied.

RBG’s pivotal brief in Weinberger v. Wiesenfeld marked a turning point in dismantling discriminatory statutes. By tackling gender bias where it had historically disadvantaged men, she helped lay the groundwork for protections that would extend to all. My research mirrors her approach, exploring sex-biased immune responses in males to expose gaps in basic infection mechanisms and vaccine efficacy. Her work underscored the idea that addressing inequity for one group can lead to advancements for all.

When I started my thesis research, I focused on the Plasmodium liver stage vaccines in a mouse model, investigating the role of biological sex in modifying vaccine responses. My findings revealed an overlooked dimension: testosterone reduced vaccine efficacy, rendering male mice more susceptible to infection. As my research continued, I uncovered additional complexities in human immune responses to Plasmodium parasites on the basis of sex. Together, this line of inquiry, rooted in a deep respect for sex differences data, calls for a shift in vaccine development that considers both biological differences and the biases that have long shaped this field.

Historically, vaccine research has disregarded the complexity of immune responses between sexes, favoring a one-size-fits-all approach skewed toward male biology. Only recently have more women been included in clinical trials, yet the foundational knowledge still privileges male immune responses. In a twist of irony, this imbalance has ultimately harmed both sexes. Females, studies now show, typically mount a stronger and more lasting defense against pathogens—an immunity advantage that could have offered insights had it not been neglected for so long.

Through this work, I aim to underscore the need for sex-informed research that transcends outdated biases, ensuring that vaccines and other interventions evolve to serve all people, regardless of sex or gender. It is my hope that the strides I have made here reflect RBG’s commitment to advancing justice for everyone by strategically addressing inequities, one insight at a time.