Author(s): VAN DER HOUT, L., VAN DER MARS, S., KLOUS, L., DE HOOGH, I., Institution: TNO, Country: NETHERLANDS, Abstract-ID: 1343

INTRODUCTION:
Sex-based differences in anthropometry, biomechanics, exercise physiology, and thermoregulation might influence operational performance, load carrying capacity, and injury risk among military personnel. Understanding these differences is essential for designing equipment, training protocols, and environmental preparation strategies that support the performance, deployability and safety of female soldiers.
METHODS:
This literature review synthesizes evidence from systematic reviews, meta analyses, and primary studies across four performance relevant domains: anthropometry, biomechanics, exercise physiology, and thermoregulation . Studies were critically assessed for methodological rigor and analysed to identify consistent sex-specific physical differences, potential operational implications, and research gaps.
RESULTS:
Women generally exhibit smaller body dimensions, lower muscle mass, and less robust bone geometry than men, increasing the relative burden of standardized military loads and raising musculoskeletal injury risk. Biomechanically, women show greater range of motion and balance but lower absolute strength, resulting in distinct gait and postural compensation strategies under load, such as increased trunk lean and reduced knee motion. These adaptations can heighten stress on the spine, pelvis, and knees. Physiologically, women demonstrate higher fatigue resistance and enhanced lipid oxidation during submaximal tasks, yet experience smaller lung volumes, reduced overall strength, and slower cardiac and respiratory recovery after intense exercise. These differences increase internal workload and fatigue during prolonged marches, repeated high intensity efforts, and for instance casualty evacuation tasks, potentially reducing readiness when recovery opportunities are limited. Thermoregulatory differences further affect performance. Lower sweating capacity, greater reliance on vasodilation, and higher thermal discomfort can increase heat strain and discomfort during exertion in hot environments or under protective gear. In cold environments, a higher surface area to mass ratio and lower peripheral temperatures elevate discomfort and the risk of local cold injuries. These potentially impair dexterity and fine motor performance, which can be hazardous for mission-critical tasks such as weapon handling, operating communication or navigation devices.
CONCLUSION:
Sex-based physical differences could meaningfully affect performance and injury risk during military tasks. Uniform equipment sizing, training loads, and acclimation protocols may disproportionately challenge female soldiers compared to male soldiers. Sex-informed strength development, adjusted recovery periods, optimized load distribution, and tailored clothing and protective systems might mitigate these challenges. Addressing current knowledge gaps is critical for improving operational readiness, safety, and sustainable performance of female personnel.