Posted tagged ‘gender’

The implications of male and female brain differences: A discussion

July 17, 2017

Photo by George Hodan

Men and women are equal, but they and their brains aren’t the same, according to a growing pile of scientific evidence. So why is most research still performed on only male animals and men? A panel of researchers explored this question and its implications on a recent episode of KALW’s City Visions radio show.

“It’s important to study sex differences because they are everywhere affecting everything,” said panelist Larry Cahill, PhD, a professor of neurobiology and behavior at the University of California, Irvine. “Over the last 20 years in particular, neuroscientists and really medicine generally have discovered that there are sex differences of all sizes and shapes really at every level of brain function. And we can’t truly treat women equally if we continue to essentially ignore them, which is what we’ve been doing.”

Neuropsychiatrist and author Louann Brizendine, MD, went on to say that many prescription medicines are only tested on male animals and men, even birth control pills designed for women. This is because the researchers don’t want the fluctuations of hormones associated with the menstrual cycle to “mess up” the research data, she said.

However, this practice can lead to dangerous side effects for women, she explained. For example, the U.S. Food and Drug Administration determined that many women metabolized the common sleep aid, Ambien, more slowly than men so the medication remained at a high level in their blood stream in the morning, which impaired activities like driving. After reassessing the clinical data on Ambien, Brizendine said, the FDA reset the male dose to 10 mg and the female dose down to 5 mg.

Niaro Shah, MD, PhD, a professor of psychiatry and behavioral sciences and of neurobiology at Stanford, said this action by the FDA was a sign of progress. “Decisions like what were made about Ambien represent people starting slowly to wake up and realize that we’ve been assuming that we don’t have to worry fundamentally about sex. And in not worrying about it, we are disproportionally harming women. Bare in mind, women absolutely, clearly and disproportionally bear the brunt of side effects of drugs and medicine.” In fact, he explained, eight out of ten drugs are withdrawn from the market due to worse side effects in women. He later added, “This issue is deeply affecting medical health, especially for women.”

So why are most researchers still studying only male animals or men?

According to Cahill, researchers have a deeply ingrained bias against studying sex differences, believing that sex differences aren’t fundamental because they aren’t shared by both men and women. He also said that resistance to this research boils down to the implicit and false assumption that equal has to mean the same. “If a neuroscientist shows that males and females (be that mice or monkeys or humans) are not the same in some aspect of brain function, then [many people think] the neuroscientist is showing that they are not equal — and that is false.”

Cahill offered advice for consumers: “You can go to the FDA website and for almost any approved drug you can get the essentials on how the testing was done. You’re going to find a mixed bag. For some drugs, you’re going to find there is pretty darn good evidence that the drug probably has roughly equal effects in men and women. On the other hand, you’re going to find a lot of cases when the testing was done mostly or exclusively in males and basically people don’t know [the effects in women].”

“You should be discerning and do your homework,” Brizendine agreed.

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.

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FemInEM blog facilitates conversations about women in emergency medicine

July 14, 2017

Photo by LIOsa

As a female PhD physicist, I was often the only woman in the room as an undergraduate and graduate student and as a research scientist. I faced sexism, unwanted attention and personal criticism — particularly early in my career. So I can relate to the gender equity issues that prompted Dara Kass, MD, an emergency medicine physician at New York University, to found FemInEM.

FemInEM is a blog that explores a variety of issues centered on the development and advancement of women in emergency medicine. Kass said their overarching goal is to make it easier for women in medicine to stay at work, despite conflicting priorities like family commitments, career objectives and personal health issues.

“I started FemInEM because I wanted to build a community amongst the women in emergency medicine,” Kass told me. “I had seen so many women solve their own problems around the expected life changes — like maternity leave, lactation and promotion — but they weren’t talking to each other. FemInEM seemed like a way to solve that problem. I didn’t want others to have to figure it out on their own, like I did.”

In addition to the blog, Kass said they use the power of social media — Facebook, Twitter, Instagram, and Snapchat — to amplify the conversation. “There are about 12 to 15 thousand women practicing in emergency medicine in our country, and we probably reach about half of them on a regular basis. The coolest part is that we reach all levels of learners from all over the world,” Kass said.

Kass explained that the online medium is important because it is “extraordinarily accessible and inclusive.” She emphasized that when discussing something like gender equity and the careers of women in medicine, it can never be only about the women. The conversation has to include men and allow them to reflect on their careers as well.

“We do this in a very inclusive way, so it’s really never about ‘us verses them,’” said Kass. “We’re talking about things like parental leave or salary equity. We base our discussions on data, but more importantly we focus on needing to all work together towards real solutions. Men are cool with it.”

Given the goal of inclusion, the blog uses an open-access submission process. “We take submissions from men, from people not in emergency medicine and from people around the world who have very different issues,” Kass said. “Anyone that wants to write for us just needs to submit an interesting piece that somehow speaks to the issue around gender equity in medicine.”

Kass particularly enjoys writing and reading posts on the struggles of having “multiple personalities.” One of her favorite posts is titled, “They call me #badassdoctormom.” “The #badassdoctormom post was written by a woman physician who talked about her daughter,” she told me. “This woman saved a guy at a train accident by cutting off his leg in the field, which is extraordinary. Her friend called her a bad ass. That night, during a bedtime story, her daughter asked whether she should call her doctor or Mommy. In her mind, she thought ‘How about bad ass doctor mom?’ In reality, her 5-year-old daughter now calls her a real-life superhero — that’s a really cool story.”

However, Kass told me that this blog post and others have gotten backlash from the female spouses of male physicians. This may be because the wives feel like they are being judged if they don’t work outside the home. Kass hopes this will change. Her advice to all women: “Just be who you are. Be happy. Our goal is to make people feel centered about the life they have in front of them and the choices they’ve made.”

Today Kass is spreading her message on how to support women in medicine when she gives grand rounds to Stanford’s emergency medicine residents. She is also expanding beyond online conversations to an in-real life event called the FemInEm Idea Exchange. Kass said this conference, being held in October in NYC, will make in-person conference networking more accessible to help develop women’s careers quickly and provide motivation.

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.


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