The Emergence of Gender-Specific Medicine
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Like many people I got interested in sex and gender issues early. There was a story that my parents like to tell about my “bris” (circumcision) when I was eight days. When my foreskin was cut, it was said, I let out a scream and arced a stream of pee that hit my father in the eye. Many years later I wrote a book called The Warrior’s Journey Home: Healing Men, Healing the Planet. In the book I made the case that genital mutilation, whether performed on baby girls or baby boys, was a form of child sexual abuse.
When I attended medical school I was taught a kind of gender-neutral medicine that suggested that men and women were essentially the same, except for the obvious differences in genitals and breasts. However, a new science is emerging that is changing the way we look at issues of health, sex, and gender. Here are some things we are learning.
Sex and gender differences are central to our lives.
We all think about them, struggle with them, and seek to better understand them. From Professor Henry Higgins in My Fair Lady who lamented “Why can’t a woman be more like a man” to Sigmund Freud who wondered “What do women really want?” to our nursery rhymes which taught us to believe that “Little girls are made of sugar and spice and everything nice,” while “Little boys are made of snakes and snails and puppy-dogs tails” to Charles Boyer who proclaimed Vive La Différence!
Sex and Gender Differences Are Important to Our Health
In her book, Eve’s Rib: The New Science of Gender-Specific Medicine written in 2002 Marianne J. Legato, MD says,
“Eve’s Rib is not just about women’s health, but about the health of both sexes and the new science of gender-specific medicine.” She concludes that “Everywhere we look, the two sexes are startlingly and unexpectedly different not only in their internal function but in the way they experience illness.”
Gender-specific medicine is helping us to better treat everything from depression and chronic pain to fatigue and arthritis.
There are 10 trillion cells in human body and every one of them is sex specific.
This based on the research of David C. Page, M.D., professor of biology at the Massachusetts Institute of Technology (MIT) and director of the of the Whitehead Institute, where he has a laboratory devoted to the study of the Y-chromosome.
It has been said that our genomes are 99.9% identical from one person to the next.
“It turns out that this assertion is correct,” says Dr. Page, “as long as the two individuals being compared are both men. It’s also correct if the two individuals being compared are both women. However, if you compare the genome of a man with the genome of a woman, you’ll find that they are only 98.5% identical.”
“In other words,” says Dr. Page, “the genetic difference between a man and a woman are 15 times greater than the genetic difference between two men or between two women.”
Like every other part of us, the male and female brains are significantly different.
Louann Brizendine, M.D. is a professor of clinical psychiatry at the University of California, San Francisco and Co-director of the UCSF Program in Sexual Medicine. Dr. Brizendine graduated from UC, Berkeley in Neurobiology, Yale University in Medicine and Harvard Medical School in Psychiatry. Here are some of the important differences she sees in the structure and function of male and female brains:
- The Anterior Cingulate Cortex weighs options and makes decisions.
- It’s the worry-wort center, and it’s larger in women and smaller in men.
- The Medial Preoptic Area is the area for sexual pursuit.
- It’s 2.5 times larger in the male.
- The Temporal Parietal Junction is the solution seeker.
- It’s more active in the male brain, comes on-line more quickly, and races toward a “fix-it-fast” solution.
- The Hippocampus is the center for emotional memory.
- It’s the elephant that never forgets a fight, a romantic encounter, or a tender moment—and won’t let you forget it either. It’s larger and more active in women.
Welcome to the world of gender-specific medicine.
My latest book, Stress Relief for Men, explores these issues in more depth and I’m working on a new book on gender-specific approaches to hormonal health in men and women. Stay tuned.
Even mainstream medicine is waking up to this emerging new field. In a recent invited commentary in JAMA Internal Medicine titled “The Case for Sex- and Gender-Specific Medicine” C. Noel Bairey Merz, MD; Vera Regitz-Zagrosek, MD say,
“Sex- and gender-specific medicine is the most ready-for translation approach among the genomic, proteomic, and metabolic personalized medicine approaches.”
Dr. Page, at MIT, concludes that we need a new form of medicine and health care that is
Feature photo:Stefan Neuweger/Flickr, Arm Wrestle hectorir/Flickr, Brains: neil conway/Flickr“XX and XY informed rather than our current gender neutral stance. We need a tool kit that recognizes the fundamental difference on a cellular, organ, system, and person level between XY and XX. I believe that if we do this, we will arrive at a fundamentally new paradigm for understanding and treating human disease.”
This is very interesting. But it only deals with gender as binary which it isn’t. What about folks who are transgender or identify their gender in another way? Does medical school currently deal with all genders and physical/social transition for folks who undergo operations for bodily change to feel congruent with their gender identity? I am sad that this article does not make any mention of this and I do hope that research is underway.
Donata,
You make good points. I agree that we need to continue our research to refine and explore in more depth the differences that may be present in transgender and other groups of people. Ultimately we want a kind of medicine that can be helpful on an individual basis, but sex and gender-specific medicine is a step in the right direction.
I am glad to hear this but I know this is a very long way off and only offering the binary when there are so many folks who do not fit the cisgender model can serve to further culturally marginalize folks on the continuum of gender. I am cisgender but have many friends who are not. And I know that med school does not take into consideration bodies others than cisgender folks. Even now. Not only is it not fair to anyone who is not cisgender but it enforces incorrect stereotypes and false cultural norms. In addition to gender, what… Read more »