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Gender Competency Gender Competency Training for Medical Training for Medical
EducatorsEducators
2828thth of April 2003 of April 2003
Evidence of gender difference Evidence of gender difference and its clinical significanceand its clinical significance
Ann-Maree NobeliusAnn-Maree NobeliusFaculty of Medicine, Nursing and Health SciencesFaculty of Medicine, Nursing and Health Sciences
Monash University AustraliaMonash University Australia
women are the major consumers of women are the major consumers of health carehealth care
women are the primary decision makers women are the primary decision makers in family health care in family health care
women are the major consumers of women are the major consumers of prescription drugsprescription drugs
2/3 of all pharmaceuticals used to treat 2/3 of all pharmaceuticals used to treat both men and women have only been both men and women have only been tested in mentested in men
2/3 of all diseases that affect men and 2/3 of all diseases that affect men and women have only been researched in women have only been researched in menmen
women have only made up 7% of all women have only made up 7% of all cardiac research subjectscardiac research subjects
more developed medical research systems in more developed medical research systems in countries with white populations of European countries with white populations of European genetic originsgenetic origins
greater levels of funding in these countries with greater levels of funding in these countries with white populations of European genetic originswhite populations of European genetic origins
the teratogenic risk associated with involving the teratogenic risk associated with involving women in clinical trails while in their women in clinical trails while in their reproductive years and potential longer-tem reproductive years and potential longer-tem outcomes for offspring outcomes for offspring
Of these categories of difference gender Of these categories of difference gender is the largest and most obviousis the largest and most obvious
more than 50% of the world’s population more than 50% of the world’s population are womenare women
more or less you are either one or the more or less you are either one or the other on the basis of biological difference other on the basis of biological difference
NIH in the US has recognised the significance of gender blindness NIH in the US has recognised the significance of gender blindness in research and its clinical consequencesin research and its clinical consequences
instituted a policy of requiring research of disease that affect both instituted a policy of requiring research of disease that affect both men and women to include gender as a variable of researchmen and women to include gender as a variable of research
allocates funding in line with this policyallocates funding in line with this policy
resulting in increasing numbers of publications citing difference resulting in increasing numbers of publications citing difference even where none is foundeven where none is found
This information has profound consequences for clinical practice This information has profound consequences for clinical practice
Columbia University’sColumbia University’s
Journal of Gender Specific Medicine Journal of Gender Specific Medicine
http://www.mmhc.com/jgsm/http://www.mmhc.com/jgsm/
Some of the areas of difference Some of the areas of difference that are important for clinical that are important for clinical practice:practice:
Coronary heart diseaseCoronary heart disease Cardiovascular disease and arrhythmiaCardiovascular disease and arrhythmia Brain differences including number of neurons and Brain differences including number of neurons and
plasticityplasticity Differential addiction timesDifferential addiction times Responses to pain medicationResponses to pain medication Eating and digestionEating and digestion Differential drug metabolismDifferential drug metabolism Differential treatment of dyslipidaemiaDifferential treatment of dyslipidaemia Differential carcinogenic and toxic effects of Differential carcinogenic and toxic effects of
tobacco smoketobacco smoke
Differential risk of lung cancerDifferential risk of lung cancer Differential HIV viral loads and treatment optionsDifferential HIV viral loads and treatment options Depression from a genetic levelDepression from a genetic level Sex hormones and cognitive functionSex hormones and cognitive function Differential dietary treatment for obesityDifferential dietary treatment for obesity Gender differences in pre-pubertal childrenGender differences in pre-pubertal children Differential lifetime medical costsDifferential lifetime medical costs Cataract SurgeryCataract Surgery Stress responses and the sympathetic nervous Stress responses and the sympathetic nervous
system system (Taylor et al, in Psychological Review(Taylor et al, in Psychological Review
July 2000, Vol 107. No.3 p411-429)July 2000, Vol 107. No.3 p411-429)
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