The microgenderome defines the interaction between microbiota, sex hormones and 
the immune system. Our recent research inferred support for the microgenderome 
by showing sex differences in microbiota-symptom associations in a clinical 
sample of patients with myalgic encephalomyelitis / chronic fatigue syndrome 
(ME/CFS). This addendum expands upon the sex-specific pattern of associations 
that were observed. Interpretations are hypothesized in relation to genera 
versus species-level analyses and D-lactate theory. Evidence of sex-differences 
invites future research to consider sex comparisons in microbial function even 
when microbial abundance is statistically similar. Pairing assessment of 
clinical symptoms with microbial culture, DNA sequencing and metabolomics 
methods will help advance our current understandings of the role of the 
microbiome in health and disease.