The presentation of sex/gender-related health problems is a challenge because the framing of results and the use of specific figures of speech can be implicitly associated with gender stereotypes and negative assessments of particular social groups and lifestyles. In addition, people may feel discriminated against if the self-designations of social groups (e.g. People of Colour) are not used. However, these self-designations are not always established in society at large and are sometimes controversial within the respective communities as well (e.g. transgender or queer). A further challenge may lie in a politically motivated misuse of information on the health of specific social groups with discriminatory intent.

A conscious use of terms and phrases in health reports can help to prevent misunderstandings and minimise the risk that statements are discriminatory or stigmatising. The following challenges and suggestions for non-discriminatory language in health reports and responsible communication of results were developed in the AdvanceGender project.

I. Assessment, use of figures of speech and framing of results 

1. Existing guidelines and recommendations for sex/gender-sensitive and diversity-oriented language should be researched and discussed in order to be able to apply them.
2. The presentation of results as well as the assessment of the health of specific (gender) groups should be evaluated for their risk of being discriminatory, and adjusted if necessary.
3. Figures of speech should be assessed regarding their risk of containing stereotyping content and, if in doubt, should not be used.
4. Reporting should not be exclusively deficit-oriented but should also emphasise the health resources of the groups under consideration.
5. A final quality assurance through a four-eyes-principle, or the involvement of external expertise, should identify and eliminate implicit evaluations in the report.

II. Dealing with self-designations of social groups

1. Glossaries or info boxes should introduce and explain the self-designations of social groups (e.g. LGBTQIA*, People of Colour).
2. If there is no consensus within communities regarding such self-designations, different self-designations should be mentioned and the term used in the report should be justified. Claims to general validity should not be made.

III. Mitigating the risk of politically motivated misuse of information, especially for socially marginalised groups

1. Results should be contextualised in order to prevent politically motivated abuse (e.g. refugees as carriers of infections).
2. Formulations used should be checked for the risk of politically motivated misuse and adapted if necessary.

The challenges and suggestions for non-discriminatory language and responsible communication formulated here are based on leading scientific discussions on sex/gender-sensitive and intersectional health research and reporting, on original research and a desk review. In addition, the expertise of scientists, health reporters and civil society stakeholders 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 "non-discriminatory language and responsible communication in health reports", important suggestions were made that should be taken into account in implementation.

First, while the consideration of self-designations is important, it may not be relevant to every format of PHMR. When health reports deal with social groups such as lesbian, gay, bisexual or trans/intersex people, they should make conscious use of these terms and introduce them in a generally understandable way.

Second, challenges were raised in terms of identifying the risks of discrimination in specific formulations, as it is difficult to always reach agreement on such issues. The procedure to identify such risks should take place systematically and be made as transparent as possible.

Third, it is difficult to completely rule out political misuse. However, in the context of reporting on social groups, PHMR should offer a balanced, evidence-based classification of the findings in order to counteract the exploitation of its results as much as possible.

Finally, the suggestion to report not only on deficits and risks but also on the resources of social groups was very well received. Such an approach could also be achieved by reporting not only on epidemiological differences but also on similarities. It was highlighted, however, that deficits could be better translated into action at the policy level; in order to mitigate this dilemma, health reports should focus on concrete approaches for resource promotion in addition to the goals of risk reduction.