1 VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA.
2 OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA.
3 GN Hearing, Ballerup, Denmark.
4 Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
5 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
6 Department of Medical Engineering and Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA.
7 Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
8 Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
9 Institute f

There is robust evidence that sex (biological) and gender (behavioral/social) differences influence hearing loss risk and outcomes. These differences are noted for animals and humans-in the occurrence of hearing loss, hearing loss progression, and response to interventions. Nevertheless, many studies have not reported or disaggregated data by sex or gender. This article describes the influence of sex-linked biology (specifically sex-linked hormones) and gender on hearing and hearing interventions, including the role of sex-linked biology and gender in modifying the association between risk factors and hearing loss, and the effects of hearing loss on quality of life and functioning. Most prevalence studies indicate that hearing loss begins earlier and is more common and severe among men than women. Intrinsic sex-linked biological differences in the auditory system may account, in part, for the predominance of hearing loss in males. Sex- and gender-related differences in the effects of noise exposure or cardiovascular disease on the auditory system may help explain some of these differences in the prevalence of hearing loss. Further still, differences in hearing aid use and uptake, and the effects of hearing loss on health may also vary by sex and gender. Recognizing that sex-linked biology and gender are key determinants of hearing health, the present review concludes by emphasizing the importance of a well-developed research platform that proactively measures and assesses sex- and gender-related differences in hearing, including in understudied populations. Such research focus is necessary to advance the field of hearing science and benefit all members of society.