Why gender-inclusive language still isn't standard in consent forms
A recent review of consent forms found something worth sitting with: recruitment materials for the same studies were far more likely to use inclusive language than the consent forms participants actually went on to sign. The document with the most legal and ethical weight is the one lagging furthest behind.
| Document type | Used inclusive language |
|---|---|
| Recruitment materials | 76% used only inclusive language |
| Consent forms | 79% contained some inclusive language, but 91% still used gendered terms somewhere |
The consent form numbers only make sense once you notice they overlap: most forms had at least some inclusive phrasing, but nearly all of them still had gendered language sitting alongside it, usually left over from an older template rather than a deliberate choice.
The gap is usually not intentional
Nobody drafts a consent form to exclude anyone. The gendered language tends to survive because consent templates get copied from study to study, reviewed for regulatory completeness rather than for language, and rarely revisited once approved. A form written years ago, before inclusive language was a routine consideration, keeps getting reused because it already passed ethics review once and nobody wants to reopen that process for wording alone.
Precision and inclusion are not in conflict
Some of the resistance to changing this comes from a real, reasonable concern: certain sections of a consent form need to be precise about biology, not identity, particularly around contraception requirements or pregnancy-related risk. A recent analysis of 289 consent forms looked at exactly this tension, and found that no form in the sample used exclusively gender-inclusive language. The large majority mixed inclusive language, biological-sex-specific language, and gendered language all in the same document, often without a clear reason for which sections used which.
The researchers' main finding is a useful corrective to the assumption that fixing this requires a full rewrite: many of the forms could reach fully inclusive language through minor revisions, particularly by rewording section headings that referenced biological-sex-specific contraceptive methods rather than the biological requirement itself. In practice, that means a phrase like "person with a uterus" or "sperm-producing partner" describes the fact a study needs without assuming everyone reading the form identifies with a particular gender. Precision and inclusion turn out to be compatible once the language is built around what the study actually needs to know, not around a default assumption of who is reading it.
Where the language actually needs to change
Reviewing a consent template line by line usually turns up the same handful of patterns:
- General study information, contact sections, and withdrawal procedures, where "he/she" appears but "they" does the same job with no loss of clarity
- Contraception and pregnancy-risk sections, where sex-specific language is genuinely needed but should describe the biological requirement directly rather than defaulting to gendered assumptions
- Emergency contact and next-of-kin sections, where "spouse" or "partner" is often narrower than the relationships participants actually have
- Boilerplate legal language inherited from a much older template, which is frequently the single largest source of unnecessary gendered wording in the whole document
IRB and ethics committee attitudes are shifting, unevenly
A nationwide survey of IRB professionals found substantial endorsement of gender-neutral language in principle, but actual usage remained limited in practice. The barriers the researchers identified weren't attitude at all: they were resource constraints and the absence of clear regulatory guidelines to point to, leaving individual reviewers to decide for themselves without institutional direction either way. That gap between support and default practice is exactly where a study sponsor or platform can make a real difference, by building inclusive defaults into templates rather than leaving it to whichever reviewer happens to notice.
Where to start if you're revising a template
Recruitment materials are usually the easier win, and the research suggests most studies have already made progress there. Consent forms deserve the same attention, and the fix is rarely a full rewrite: it's finding the sections that don't actually require gendered language, changing those first, and being deliberate and precise about the sections where sex-specific language is genuinely needed.
None of this requires a new legal framework or a lengthy ethics resubmission to get right. It requires treating the consent form with the same care already being given to recruitment materials, since it's the document participants are actually asked to sign, and the one place inclusive language matters most.