Could it be that the higher rate of knee injuries in female recreational alpine skiers is due to the fact that predominantly males have been responsible for the development of standards for ski binding settings? If yes, one could argue that males will rather develop standards for males, thereby neglecting actual needs for females. Thus, a sex-balanced composition of the standardization group would be highly desirable but may not always be the case. At the moment, there are only 4 females (11%) out of 35 members of the expert group that deals with the ISO 11088 standard for binding setting values, likely as a consequence of an existing “engineering gender gap”. This fact, whether it is socially acceptable or desirable for women to participate in various spheres of life, has already been discussed by Parsons et al. [2]. The existence and consequences of such an underrepresentation of women especially in the field of engineering have recently been emphasized by Peters [9] in a somewhat different context. Similar to the ski binding issue, Peters [9] concluded that “a male-dominated engineering profession has made critical errors, from cars that are safer for men than women to a dearth of women-sized space suits”. This example not only underlines the complexity by which biological conditions could be influenced by a variety of environmental factors, but also draws attention to the importance of identifying possible sex-related key factors or improved understanding and interpreting gender aspects of sex differences. We fully agree that the ACL injury cycle requires a holistic and intersectional approach [2].
