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A Victory For Women And Medical Research

The New York Times reports that a pair of influential scientists are calling for an end to gender bias in medical research, starting with a warning that researchers must “begin testing their theories in female lab animals and in female tissues and cells.”

From the article:

Name a new drug or treatment, and odds are researchers know far more about its effect on men than on women. From sleeping pills to statins, women have been blindsided by side effects and dosage miscalculations that were not discovered until after the product hit the market.

Now the National Institutes of Health says that this routine gender bias in basic research must end.

In a commentary published on Wednesday in the journal Nature, Dr. Francis Collins, director of the N.I.H., and Dr. Janine A. Clayton, director of the institutes’ Office of Research on Women’s Health, warned scientists that they must begin testing their theories in female lab animals and in female tissues and cells.

The N.I.H. has already taken researchers to task for their failure to include adequate numbers of women in clinical trials. The new announcement is an acknowledgment that this gender disparity begins much earlier in the research process.

“Most scientists want to do the most powerful experiment to get the most durable, powerful answers,” Dr. Collins said in an interview. “For most, this has not been on the radar screen as an important issue. What we’re trying to do here is raise consciousness.”

Women now make up more than half the participants in clinical research funded by the institutes, but it has taken years to get to this point, and women still are often underrepresented in clinical trials carried out by drug companies and medical device manufacturers.

Dr. Paula Johnson (courtesy)

Dr. Paula Johnson (courtesy)

Score a point for Dr. Paula Johnson, executive director of the Connors Center for Women’s Health and Gender Biology
and a professor of medicine at Harvard Medical School and Brigham and Women’s Hospital. Johnson, earlier this year, led a coalition of doctors, policymakers and others calling for an overhaul of clinical trials and medical research to address the gender gap.

I asked Johnson for her take on the new NIH stance, and she offered this update:

In March of 2014, the National Policy Summit on Women’s Health brought together policymakers, practitioners, advocates and academics who, for the first time, gathered specifically on the issue of sex and gender inequity in biomedical science. For discussion was a new report, “Sex Specific Medical Research: Why Women’s Health Can’t Wait.” Continue reading

Coerced Sex Common For Teen Boys And Young Men, Study Finds

A few nights ago, unable to wind down, I was searching for something to watch and stumbled across the film “Adore.” It’s about a pair of lifelong friends (grown women) who end up having affairs with each other’s young, hunky, 19- or 20-year-old sons. My first reaction was the same as one Netflix commenter:

“…if this had been two pals and each other’s teen daughter; well, you get the point. The movie would not have been made, or if so, it would have had an entirely different hue-to say the least. DOUBLE STANDARDS.”

Or, as A.O Scott wrote in his New York Times review:

“It is worth noting that the same movie about a couple of dads sleeping with each other’s 20-year-old daughters would need, at a minimum, to confront the ickiness of the situation. Really, such a movie would be unlikely to make it into theaters, in spite of the commonness of real-life relationships between older men and younger women.”

(Dustin Hoffman, Anne Bancoft in "The Graduate"; Movie-Fan/flickr)

(Dustin Hoffman, Anne Bancoft in “The Graduate”; Movie-Fan/flickr)

The film isn’t about sexually coercion; but it is about boundary breaking, and I thought of it again reading this new study on the pervasive, but largely unexamined problem of sexual coercion among boys and young men.

The study, published in the journal Psychology of Men and Masculinity, found that coerced sex is fairly common for teenage boys and college-age men and can lead to psychological distress and risky behavior, such as sexual risk-taking and alcohol use.

From the American Psychological Association news release:

A total of 43 percent of high school boys and young college men reported they had an unwanted sexual experience and of those, 95 percent said a female acquaintance was the aggressor…

“Sexual victimization continues to be a pervasive problem in the United States, but the victimization of men is rarely explored,” said lead author Bryana H. French, PhD, of the University of Missouri. “Our findings can help lead to better prevention by identifying the various types of coercion that men face and by acknowledging women as perpetrators against men.” Continue reading

On Gender Nightmares: Men Dream Of Floods, Women Of Relationships

A post last month on Slate about gender differences and nightmares got me thinking, yet again, about the profound, fundamental divide between men and women. We communicate differently, we eat differently and now, it turns out, we dream differently.

This particular story focused on research out of Canada that found men’s nightmares tend to be about natural disasters like floods and earthquakes, while women’s are about relationships. Here’s more from Katy Waldman’s post:

Analyzing themes and emotional content, the researchers found that men were more likely to report having nightmares about natural disasters (floods, earthquakes, fires, volcanoes), chase or pursuit, and insects. Women’s nightmare records more often featured interpersonal conflicts, such as an argument with a spouse and more frequently involved feelings of humiliation, frustration, or inadequacy.

Why might this be? My first thought was that, while women may not mind admitting to researchers that an ex-boyfriend still haunts them, men were only reporting the more cataclysmic plots. (Tsunami!) On the other hand, “dream content is tied into waking concerns,” [researcher Antonio] Zadra explained over the phone.

Last night I attended a forum where women discussed how they cope with serious illness (more on this later). All of the guests were women and the takeaway, for me, was about how vitally important — even therapeutic — the act of sharing, connecting and reaching out to our “village” is when we are sick and under intense, hair-raising stress. For men, it’s all about fixing the problem; for women, it’s all about being heard and understood. Not a newsflash, I know, but often, a reality.

So, in that vein, here’s my current favorite battle-of-the-sexes commentary: “It’s Not About The Nail.” Even my husband doubled over with laughter:

(Hat tip to Kayla, a wise 22-year-old who passed this along.)

Doll Dangers: Girls Imagine Fewer Career Options After Playing With Barbies

Charles (dollstuff.net)/flickr

Charles (dollstuff.net)/flickr

I grew up in the era of Marlo Thomas’ Free To Be You And Me, with gender-liberated lyrics like this: “Some mommies are ranchers or poetry makers, or doctors or teachers or cleaners or bakers, some mommies drive taxis or sing on TV, yeah, mommies can be almost anything they want to be.”

Indeed, Barbie dolls — with their overly sexualized, crazy-making-body-image implications — had no place in our little Brooklyn apartment.

Apparently, that was a smart move.

A small, but novel new study exploring gender roles and how kids imagine their future careers found something disturbing: little girls who were asked about 10 different jobs told researchers that boys could take on “significantly more occupations” than they could themselves. What’s more, according to the study, girls who played with Barbie dolls before being interviewed indicated fewer career options compared to boys, while girls who played with the far less sexy Mrs. Potato Head reported a smaller difference between future job options as compared to boys. The jobs mentioned to the kids were: teacher, librarian, day care worker, flight attendant, nurse, construction worker, firefighter, pilot, doctor, and police officer

allieosmar/flickr

allieosmar/flickr

The study (which I’m now calling “Mrs. Potato Head Rules” but is actually titled “Boys Can Be Anything”: Effect of Barbie Play on Girls’ Career Cognitions,”) involved 37 girls, ages 4-7. The research, led by Aurora M. Sherman, an associate professor in the School of Psychological Science Oregon State University with Sherman and Eileen L. Zurbriggen of the University of California, Santa Cruz, was published in the journal Sex Roles.

I asked Sherman via email how the project originated. She said that while there have been studies on what girls thought about fashion dolls like Barbie, there’d been “no actual experiments that could test whether playing with one kind of doll or another kind caused a difference in kids’ thinking.”

Sherman continued:

“I thought it would be interesting to test ideas girls have about careers as the outcome because there is a lot of emphasis on the 130+ careers Barbie has been dressed for, so it was logical to ask whether a Barbie costumed as a career professional (Dr. Barbie) would give girls a “boost” in their ideas about careers. However, that boost did not appear in my study…The lack of difference between Dr. Barbie and Fashion Barbie surprised me the most; it seems from our data that just a professional title and costume isn’t enough to expand the career horizons of girls when they play with Barbie.”

And while Sherman says she was interested in Barbie dolls as a child, “my parents didn’t allow them in my house. I didn’t have very many dolls of any kind as a kid, actually — my parents were more into providing games and books.” Continue reading

His? Her? They? Understanding The Latest Gender Identity Language

We took a close look at transgender issues last week through the eyes of one teenager and his family. We heard from many readers who wanted to know more about the way teenagers and 20-somethings think about gender. Of course, not all younger people are rethinking gender and not all the people rethinking gender are young, but there is something happening that wasn’t when I graduated from college in 1984. So, if you want to learn more, here’s one personal story: It’s written by Alex, a Smith College undergrad who uses the pronoun “they.” Alex identifies as gender queer, but is not out to family members, so we’ve agreed not to use Alex’s last name.
–Martha Bebinger

New terminology (from a pamphlet on gender identity written by a gender queer college student in New England)

New terminology (from a pamphlet on gender identity written by Carlin Soos, a gender queer college student in New England)

The name my parents gave me means ‘grace.’ It never quite fit me, my clumsiness manifest in the tables I bump into, the ink smears in my writing, the awkwardness with which I try to reclaim and adjust to a body that has never felt like it belonged to me. This body, short and thick, with a uterus that is incapable of regulating itself without additional hormones and breasts too large to hide, is a body that marks me, irrefutably in most people’s eyes, as ‘female,’ or ‘woman.’ Even when I cover up, wear tight sports bras and loose sweaters, I get called ‘girl’ or ‘she,’ and it makes the pit in my stomach tighten. But at the same time, the few times I have been called ‘sir,’ I haven’t felt any better, and I have no desire to become instantly recognizable to the general public as male, no sense that testosterone-fueled facial hair or having my breasts removed would make me feel more at home. Neither extreme fits the person I know I am.

Most people see gender as a binary — male/female — with no or little wiggle room. However, I have always seen it more as a spectrum, with masculinity at one end and femininity at the other and lots of murky grey space in-between. I occupy this grey space, this unknowingness, this refusal to fit into one prescribed box. I happen to belong somewhere between neutral and masculine, flitting between men’s clothes and women’s depending on how much I want my body to be on display. I am most at home in women’s jeans and a men’s sweater. Continue reading

Answers To Your Sex, Language And Transgender Medical Questions

We wrap up our series on living transgender with your questions from our Friday live chat:

Why are so many young people comfortable with the idea of “genderqueer”?
How’s sex after sex reassignment surgery?
Which sports team do transgender students play on?

Answers from you and the panelists follow.

0121_trans-live-chat

From left to right: Unger, Moureau and Levi. (Courtesy)

Dr. Cecile Unger, OB/GYN who trained at Brigham and Women’s and Massachusetss General Hospital and is currently a fellow at the Cleveland Clinic where she is training in Female Pelvic Medicine & Reconstructive Surgery and developing a subspecialty in transgender women’s surgery and health.

Bianca Moureau, transgender advocate. A former patient at Boston Children’s Hospital, Bianca transitioned from male to female when she was 14. She was the first person in the country to have Medicaid pay for her surgery. Now 26, Bianca is applying to law school.

Jennifer Levi, runs the Transgender Rights Project at GLAD and specializes in transgender legal issues.

Question from Margaret: Is there an age cutoff for surgery? That is, can someone be “too old” for gender-changing surgery? I have a good friend, born male, who has been transitioning to female for about two years now. She’s in her mid-50s and has been taking hormones most of that time.

Response from Cecile Unger: Margaret, as someone who sees these patients, I can say that there is absolutely no age cut-off.ne-third of patients discover their identity later in life while some patients choose to wait. Many individuals undergo surgery in late adulthood.

Comment From Kelly: [I ] would love to hear you discuss the concept of “genderqueer” and the generational divide. Continue reading

TV Message To Tween Girls: ‘Do Anything, Just Be Attractive’

My 8-year-old daughter recently rose at the crack of dawn to wash her naturally wavy hair so it wouldn’t be “puffy” for a school assembly. She’d previously begged to have it straightened. Did I mention she’s 8?

While we all work diligently to tell our daughters how smart and strong and brave they are — and de-emphasize looks as much as possible — it’s a jungle out there when it comes to girls and self-image. A new study by U.S. researchers published in the journal Sex Roles reaffirms the uphill battle parents face. Here’s the headline: “Looks are all important for girls on tween TV.” And the not-so-subtle messaging, according to the researchers: “Girls can participate in everything that boys can, but while doing so they should be attractive.”

To arrive at this sad but not terribly surprising conclusion, Ashton Lee Gerding of the University of Missouri and Nancy Signorielli of the University of Delaware, reviewed “gender ideals” as conveyed by American television programs geared toward tweens ages 8-12.

Here’s what they found, from the news release:

Characters in 49 episodes of 40 distinct American tween television programs aired in 2011 on Disney Channel, Disney XD, Nickelodeon, and the Turner Cartoon Network were analyzed in terms of their attractiveness, gender-related behavior, and personality characteristics such as bravery and handiness with technology. Two specific genres were examined: teen scene (geared towards girls) and action-adventure (geared towards boys).

girls watching tv

…Overall, compared to males, females were portrayed as more attractive, more concerned about their appearance, and received more comments about their looks. Females were presented similarly in both genres. Overall, males were shown in varying levels of attractiveness, and were portrayed as more stereotypically brave in the action adventure genre.

A critical finding was that tween programs still portray females as more attractive and more concerned about their appearance than males. Continue reading

Quick, What’s The Girl’s Sport Most Linked To Catastrophic Injuries?

Considering lacrosse for my 7-year-old I imagined the worst: head injuries, a fracture or two, an inevitable trip to the ER.

But it turns out there’s another girls sport I should be even more worried about: cheerleading.

heraldpost/flickr

heraldpost/flickr

The Washington Post reports that cheerleading ranks number one when it comes to risky sports for girls, accounting for more than half of catastrophic injuries to female athletes. Here’s a snippet:

With or without government regulation, cheerleading poses by far the greatest risk of catastrophic injury to young female participants of any sport. According to a 2012 report and policy statement by the American Academy of Pediatrics, cheerleading “accounted for 65 percent of all direct catastrophic injuries to girl athletes at the high school level and 70.8 percent at the college level” between 1982 and 2009.

The overall number is small — 110 closed-head injuries, skull fractures and cervical spine injuries that resulted in “permanent brain injury, paralysis or death” over that period — and the number of participants in cheerleading is large, an estimated 3.6 million nationwide, the academy found. (A number of other girls suffered cardiac problems and heat stroke.) But the disproportionate number of severe injuries in this one activity is striking.

Continue reading

Knees, Food, Periods: Top 10 Medical Tips If Your Daughter Plays Sports

(AP Photo/Gerald Herbert)

(AP Photo/Gerald Herbert)

You could call this “Title IX Medicine.”

Title IX, of course, refers to the landmark 1972 anti-discrimination law that gave huge added impetus to school sports programs for girls, helping create cohorts of more athletic grrrrrrrls.

In Title IX’s 40-plus years, American girls’ participation in high-school and college sports has jumped more than 10-fold to well over 3 million. That means many stronger, healthier girls — but it also means more girls at risk for sports-related injuries and what’s known as the Female Athletic Triad, a worrisome mix of poor nutrition, menstrual dysfunction and danger to bone health.

This week, Boston Children’s Hospital announced the creation of its new “Female Athlete Program,” aimed at treating “the entire female athlete – not just a single injury.”

“We know that the build of girls — both their musculature and bone structure — is different than boys’, as is their hormonal milieu,” said the program’s co-director, Dr. Kathryn Ackerman. “We really need to start tailoring our care of these athletes in a slightly different way.”

Certain specific issues need extra attention among girl athletes, she said. They’re at a five to eight times higher risk of anterior cruciate ligament knee injuries. “Aesthetic” activities like ballet tend to be linked with higher risks of eating disorders. If menstrual cycles become abnormal, bone development could suffer.

Some articles suggest that girls’ soccer is second only to men’s football in terms of concussions.

The new program aims to contrast with the traditional piecemeal approach to girls’ injuries and other health issues, Dr. Ackerman said. For example, “A girl comes in having sustained multiple stress fractures, and no one has asked her about her menstrual status or her calcium or Vitamin D intake or her overall caloric intake.” Some studies, she said, suggest that up to 60 percent of girl athletes have at least one component of the Female Athlete Triad: eating dysfunction, loss of menstrual cycle or low bone density.

Dr. Ackerman, herself a former national team rower, and the program’s co-director, Dr. Martha Murray, an orthopedic surgeon with a swimming background, kindly generated this list of their top 10 tips for parents of girl athletes. Dr. Ackerman expands in the comments below.

Dr. Kathryn Ackerman (Courtesy BCH)

Dr. Kathryn Ackerman (Courtesy BCH)

1. Your daughter can minimize her risk of ACL (anterior cruciate ligament) injury with a simple training program.

It would include hamstring strengthening, landing bio-mechanics, core stability and overall muscular balance. More details in the program’s ACL handout.

2. She needs to be getting good nutrition to play well, especially enough calories and the right amount of calcium and vitamin D.

Calorie counts depend on a girl’s level of activity and growth, but she should be getting 1,300 milligrams of calcium a day until she’s 19, then 1,000 milligrams a day until menopause, when calcium again needs an increase. Vitamin D recommendations vary, but many bone experts recommend at least 800 international units a day for a blood level of at least 30. More details on nutrition here. Continue reading

Study: AA Benefits Men and Women In Different Ways

The notion that women and men think, speak and act like they’re from different planets is widely acknowledged and pretty much accepted. So the idea of a gender gap among recovering alcoholics isn’t that surprising — but it is intriguing.

(Jordan/flickr)

Now, researchers at Massachusetts General Hospital report that among those participating in Alcoholics Anonymous, men and women found different aspects of the program particularly beneficial in terms of maintaing sobriety. They offer this example: for men, avoiding buddies who encourage drinking and social situations in which drinking is common had more powerful benefits, while for women the increased confidence of being able to abstain from drinking while feeling sad, depressed or anxious was more important.

The study, published online in the journal Drug and Alcohol Dependence, seems to underscore the very different ways in which men and women make AA work for them. Interestingly, the research was initiated in part because, as the authors note, AA began as a male organization and is now only about one-third female. So the question is whether women are getting the same benefits? While the program appears to help both men and women, the researchers note that the magnitude and manner of those benefits are quite gender-specific. Continue reading