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Sex, gender or occupational psychology: what matters most to preventing heat-related illnesses and improving outcomes for women in ground close combat?
  1. Robert M Gifford1,2,
  2. N Taylor2,
  3. M Stacey2 and
  4. D R Woods2,3
  1. 1 British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
  2. 2 Academic Department of Military Medicine, HQ Joint Medical Group, Birmingham, UK
  3. 3 Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University Carnegie Faculty, Leeds, UK
  1. Correspondence to LtCol M Stacey, Academic Department of Military Medicine, HQ Joint Medical Group, Birmingham B15 2SQ, UK; michael.stacey{at}


Since the advent of women in ground close combat (WGCC) roles, the impact on women of the attendant risk of heat stress and heat illness has been considered. Much emphasis has been placed on sex differences in thermal physiology. This article considers the application of evidence of sex-associated thermoregulatory variation to the occupational and environmental setting of WGCC, and weighs the relative importance of physiological differences arising from biological sex, and behaviour associated with gender normatives. Quantifying the risk of heat illness to WGCC should draw on data from their real-world occupational context.

  • occupational & industrial medicine
  • physiology
  • sex steroids & HRT

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  • Contributors All authors developed the ideas and structure of the manuscript jointly. RMG and MS drafted the manuscript. DRW and NT reviewed, edited and agreed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.