The Journal of Sex- and Gender-Specific Medicine in an ever-changing context

Luca De Fiore

Director, Il Pensiero Scientifico Editore, Rome, Italy

In the last two decades, the scientific and medical publishing ecosystem has been continuously changing. Progress in data management and informatics disrupted the usual pathways of the publishing process, fostering a closer relationship between researchers and readers. This landscape is still evolving as the ongoing debate on the application of artificial intelligence to academic publishing confirms.

Among the major changes, the pressure for a transformation to open research pushed all the stakeholders towards a new publishing model: open access. “Public digital libraries and open access promise great benefits for science and society: equity, more effective practice of science, and reduction in overall costs”.1 The words of Harold Varmus explain the vision that inspired the movement that actually opened a new perspective: open data, open science, open and wider dissemination of research became the mantra for a generation of new researchers and health professionals. Surely, sharing of data, code, protocols, and statistical analysis plans, “can have a transformative effect”2.

Actually, the transparency of research methods and results has not substantially improved in recent years. Also, “while the original intent of open access was to limit or destroy [the large commercial publishers], the exact opposite has happened”.3 Scientific and medical publishing has been held hostage by big players, and the mode in which open access has been proposed has done nothing to alter the publishing oligopoly.4

Adding to the dominance of a few large publishing companies is the emergence of so-called mega-journals capable of publishing thousands of papers each year on the most diverse topics.2 This is an alarming phenomenon that – in addition to undermining the oldest and best-known journals (both general medicine and specialist journals) – is distorting the very sense of the journal as a cultural project: “mega-journals may perpetuate and accentuate an already dysfunctional system of scientific evaluation and publication”.2 All mega-journals follow the open access model.

Recent researches show that the cost of open access publishing is rising, and this doesn’t influence the habits of researchers in the richest countries: they are simply not aware of the fees their institutions are paying.5 On the contrary, high open access fees heavily impact the authors from the low-income regions.6 Eventually, the cost of publishing is always paid by institutions, whether it is to pay to write or to pay to read. But paying to publish, however, is undermining the very value of producing information useful for knowledge construction.

In an environment that is constantly changing and still difficult to discern, the Journal of Sex- and Gender-Specific Medicine has chosen not to follow the open access model. However, we are working to make it freely accessible to clinicians and researchers at institutions in low-and middle-income countries in the near future, as part of the bundle of journals published by Il Pensiero Scientifico Editore.

Our choice not to follow open access will be an additional reason to ensure the best quality of the Journal’s content and to give the readers back their right to access the information they consider most interesting: to better understand what is happening to health care, to be able to choose and distinguish between so much confusing and often contradictory information, to be able to recognise oneself in a cultural project, in a community of readers oriented towards evidence-based medicine and aware of the critical issues in contemporary healthcare.


1. Varmus H. The art and politics of science. New York: W.W. Norton & Company, 2009.

2. Ioannidis JPA, Pezzullo AM, Boccia S. The rapid growth of mega-journals: threats and opportunities. JAMA. Published online March 20, 2023.

3. Holley RP. Open access: current overview and future prospects. Library Trends. 2018;67(2):214-40.

4. Rodrigues RS, Abadal E, DeArauio BK. Open access publishers: the new players, PLOS One. 2020;15(6):e0233432.

5. Koo S. Increasing open access publication serves publishers’ commercial interests. The Conversation. Published: June 16, 2019.

6. Kwon D. Open-access publishing fees deter researchers in the global south. Nature. 2022 Feb 16. Epub ahead of print.