The article by Mansukhani et al1 in this issue of JAMA Surgery reveals that, despite the introduction of the National Institutes of Health Revitalization Act of 1993 to ensure that female participants were included in clinical trials, males and females currently are not included in surgical clinical research in equal numbers. Specifically, the reviewed data showed that analysis and discussion included sex as an independent variable in less than 33% (432 of 1303) of surgical clinical research studies. Often, the sex of the participants was not stated.