Jed Diamond, PhD, discusses critical health issues for men and the need for gender based medicine.
There is a Spanish proverb that translates, “A man too busy to take care of his health is like a mechanic too busy to take care of his tools.” The truth is males, as a group, are not doing a great job at taking care of our health. “Men need to take as good care of their bodies as they do of their cars and trucks, and they don’t,” says Ken Goldberg, M.D., a urologist and the author of How Men Can Live as Long as Women.
According to the national, non-profit, Men’s Health Network, “There is an ongoing, increasing and predominantly silent crisis in the health and well-being of men. Due to a lack of awareness, poor health education, and culturally induced behavior patterns in their work and personal lives, men’s health and well-being are deteriorating steadily.”
Here are some facts about men’s health:
- Men die at higher rates than women from the top 10 causes of death and are the victims of over 92% of workplace deaths.
- In 1920, women lived, on average, one year longer than men. Now, men, on average, die almost six years earlier than women.
- Women are 100% more likely to visit the doctor for annual examinations and preventive services than men.
- The male fetus is at greater risk of miscarriage and stillbirth and 25% more newborn males die than females.
- 60% of Sudden Infant Death (SIDS) victims are boys.
- We know that men commit more violent crimes than do women, but men are also more often the victims of violence. The chance of being a homicide victim places African-American men at unusually high risk. The chance of being a homicide victim is 1 in 30 for black males vs. 1 in 132 for black females. If you’re a white male your chances of being a homicide victim are 1 in 179 vs. 1 in 495 if you are a white female.
- Suicide rates are 3 to 18 times higher for males than for females. For those in their 20s, the suicide rate is nearly 5 times higher for males than for females. For those in their 30s, the rate is 3.5 times higher for males. For those in their 40s and 50s it is 3 times higher. But for men 60 and older, the suicide rate skyrockets and is over 6 times higher for men 65 to 74, 7 times higher for men 75-84 and 18 times higher for males 85 or older.
The Advent of Gender-Specific Medicine is Good For Women and Men
In 1992, Marianne J. Legato, M.D. published The Female Heart: The Truth About Women and Coronary Artery Disease and revealed that women’s presenting symptoms of heart disease are taken less seriously than men–and when women undergo cardiac surgery, they are less likely than men to survive.
To address the unique health needs of women, Dr. Legato founded the Partnership for Women’s Health at Columbia University in 1997, but soon changed the name to the Partnership for Gender-Specific Medicine to reflect her belief that we needed to focus the gender lens on both men and women.
In her book, Eve’s Rib: The New Science of Gender-Specific Medicine written in 2002 she 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.”
Why Sex Matters: Men and Women Are Different From Head to Toe
There has been a lot of fear to acknowledge sex differences. For too long differences were used to discriminate against women, telling them that they were too weak or not suited for “manly” professions. We need to continue to insure that differences aren’t used to limit the horizons of women or men, but we need to accept the reality that there are differences and those differences are important for men’s and women’s health.
When my son, Jemal, was born in 1969, I made a vow to him that I would be a different kind of father to him than my father was able to be for me. I also embarked on a journey to help improve the health of men, knowing that this would be good for men, women, and children. I founded MenAlive that year and have continued to offer services to all those who care about men’s health.
We used to believe that the only sex differences we needed to be concerned about were ones related to our genitals. We would focus on such things as erectile dysfunction. But we now know that men and women also differ in how our brains are constructed, how they function, and how they affect our health. Louann Brizendine, M.D. has spent her professional life looking at the differences in the male and female brains.
Dr. Brizendine is a professor of clinical psychiatry at the University of California, San Francisco and Co-director of the UCSF Program in Sexual Medicine. She graduated from UC, Berkeley in Neurobiology, Yale University in Medicine and Harvard Medical School in Psychiatry. In 1996 she wrote the The Female Brain and in 2010, The Male Brain. She says, “Simplifying the entire male brain to just the ‘brain below the belt’ is a good setup for jokes, but it hardly represents the totality of a man’s brain.”
But new research demonstrates it’s not only our brains that are different, but we are different in every cell, organ, and system of our body. There are 10 trillion cells in human body and every one of them is sex-specific. This is 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% 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.” Welcome to the real world of gender-specific medicine.
Even in this era of genetic research, this fundamental difference has been overlooked.
“We’ve had a unisex vision of the human genome,” says Dr. Page. “Men and women are not equal in our genome and men and women are not equal in the face of disease. Already at my institute we have discovered that XX cells and XY cells go about their business, of making proteins for instance, in slightly different ways.”
Page offers a positive focus for all those who care about the unique health needs of men and women. “We need to build a better tool kit for researchers that is 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.”
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