Sex/gender-sensitive and intersectional health reports should offer interpretations and explanations in addition to the description of data. Currently, the interpretation and explanation of findings often refer to a mixture of different elements such as theorems (e.g. doing gender) or socio-political conditions considered relevant (e.g. legal regulations, changing values). This is problematic when interpretations and explanations remain speculative, are not backed by empirical evidence, or are used selectively. For example, when interpreting health-related behaviour, (sex/gender-related) motives for action are sometimes assumed (e.g. risk-seeking in men) that cannot be supported by quantitative or qualitative data. The following challenges and suggestions for a sex/gender-sensitive and intersectional explanation of findings were developed in the AdvanceGender project.

I. Identification of a conceptual framework for the interpretation of findings

1. Health reporters should be aware of their preconceptions about sex/gender and gender diversity, and question how these influence the interpretation and explanation of findings.
2. A scientifically sound definition of sex/gender should be used which seeks to distinguish between biological and social aspects of sex and gender. The explanatory value of both aspects and their connections should, where possible, be made clear in a thematically-specific way.
3. Topic-related explanatory approaches should be well-researched and implemented (e.g. doing gender in the context of nutritional behaviour).

Specific risks should not be explained by group membership alone, but above all by the social mechanisms underlying health inequities (e.g. minority stress among sexual minorities).

II. Grouping individuals into categories of analysis

1. If people are grouped under one umbrella term (e.g. women with a migration background), attention should be drawn to the risk of erroneous generalisations.

III. Evidence for explanations, dealing with research gaps

1. Empirical study results should be used to support explanations for reported sex/gender differences. This includes qualitative, participatory and mixed-methods studies.
2. The level of evidence explaining sex/gender differences should be made transparent: the number and quality of the studies used should be given and contradictions in the findings should be made explicit. The danger of reinforcing gendered stereotypes (e.g. studies with a strong binary understanding of sex/gender) should be acknowledged.

IV. Involving external expertise

1. If sex/gender-sensitive and intersectional reports are published on specific life situations or social groups, experts in sex/gender and intersectionality research at universities should be involved in the implementation of the recommendations.
2. Experts in sex/gender and intersectionality research should also be involved in the final quality assurance of the manuscripts.
3. Sustainable collaborations between academic institutions in the field of sex/gender and intersectionality research (e.g. through dissertations and teaching PHMR-relevant knowledge) will enable continuous knowledge exchange.

V. Managing limited resources

1. If resources are scarce, a theoretically and empirically sound classification of the findings can be achieved by focusing only on a few selected topics.

The challenges of and suggestions for a sex/gender-sensitive and intersectional interpretation and explanation of findings formulated here are based on leading scientific discussions on sex/gender-sensitive and intersectional research and reporting, on original research and a desk review. In addition, the expertise of scientists, health reporters and civil society representatives was included in a structured way. A Delphi survey showed a high level of agreement with the recommendations developed by the project team. For the area "sex/gender-sensitive and intersectional interpretation and explanation of findings", important suggestions were made that should be taken into account in implementation.

Overall, it was frequently noted that many of the suggestions can be very challenging for standard PHMR formats at the municipal or state level. For instance, all suggestions formulated here are tailored to a specific type of PHMR that aims to report on the health of social groups in heterogeneous gender-related situations. With the aim of preventing misconceptions and stereotyping, this type of PHMR is costly and hardly compatible with the rapid data provision often required at the municipal or state level.

The implementation of recommendations, for example to reflect on one’s own assumptions or to include scientific evidence, should therefore, insofar as possible, take place in a team. In addition, as suggested, opportunities for cooperation with recognised research institutions and experts should be sought, and sufficient resources need to be available. The possibility of working on a few selected topics together with recognised experts should be considered if resources are scarce.