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Sex, Gender, and Medicine

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Burnout in Women Physicians
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Abstract

Mounting evidence shows that biological sex and gender impacts how our bodies and brains work. As our traditional scientific model, heavily influenced by misguided policies and ingrained cultures, is rooted in the belief that males and females are interchangeable outside of our reproductive zones, it’s time for a scientific reboot. Depending upon the context, our chromosomes, hormones, and life experiences effect our lives in ways which are both inconsequential and critically important. To practice up-to-date medicine and optimize our own resiliency, it’s important to understand and openly discuss these very real differences. This introductory chapter is designed as a “sex and gender boot camp” and will review basic definitions, explore clinical and professional examples of sex and gender differences, provide a template for framing differences, and share the author’s personal experiences in discovering this material and using it to become more resilient.

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References

  1. Annis A. Same words, different language. London: Piatkus Books; 2003.

    Google Scholar 

  2. Sax L. Why gender matters: what parents and teachers need to know about the emerging science of sex differences. Double Day. 2005.

    Google Scholar 

  3. Weston PSJ, Hunter MD, Sokhi DS, Wilkinson ID, Woodruff PWR. NeuroImage discrimination of voice gender in the human auditory cortex. NeuroImage. 2015;105:208–14. https://doi.org/10.1016/j.neuroimage.2014.10.056.

    Article  PubMed  Google Scholar 

  4. Hoffman HJ, Dobie RA, Losonczy KG, Themann CL, Flamme GA. Declining prevalence of hearing loss in US adults aged 20 to 69 years. JAMA Otolaryngol Head Neck Surg. 2017;143(3):274–85. https://doi.org/10.1001/jamaoto.2016.3527.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Homans NC, Metselaar RM, Dingemanse JG, Van Der Schroeff MP, Brocaar MP, Wieringa MH, et al. Prevalence of age-related hearing loss, including sex differences, in older adults in a large Cohort study. Larygnoscope. 2017;127:725–30. https://doi.org/10.1002/lary.26150.

    Article  Google Scholar 

  6. West JS, Low JCM, Stankovic KM. Revealing hearing loss: a survey of how people verbally disclose their hearing loss. Ear Hear. 2016;37:194–205.

    Article  Google Scholar 

  7. Oliveira-Pinto AV, Santos RM, Coutinho RA, Oliveira LM, Santos GB, et al. Sexual dimorphism in the human olfactory bulb: females have more neurons and glial cells than males. PLoS One. 2014;9(11):e111733. https://doi.org/10.1371/journal.pone.0111733.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Dalton P, Doolittle N, Breslin PAS. Gender-specific induction of enhanced sensitivity to odors. Nat Neurosci. 2002;5:199. Retrieved from https://doi.org/10.1038/nn803

    Article  CAS  Google Scholar 

  9. Tomova L, von Dawans B, Heinrichs M, Silani G, Lamm C. Is stress affecting our ability to tune into others? Evidence for gender differences in the effects of stress on self-other distinction. Psychoneuroendocrinology. 2014;43:95–104. https://doi.org/10.1016/j.psyneuen.2014.02.006.

    Article  CAS  PubMed  Google Scholar 

  10. Mather M, Lighthall NR, Nga L, Gorlick MA. Sex differences in how stress affects brain activity during face viewing. Neuroreport. 2010;21(14):933–7. https://doi.org/10.1097/WNR.0b013e32833ddd92.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Koski SE. Behavior: warriors shaking hands. Curr Biol. 2016;26(16):R760–2. https://doi.org/10.1016/j.cub.2016.06.058.

    Article  CAS  PubMed  Google Scholar 

  12. Dorrough AR. A cross-national analysis of sex differences in prisoner’ s dilemma games and Andreas Gl o. Br J Soc Psychol. 2019;58:225–40. https://doi.org/10.1111/bjso.12287.

    Article  PubMed  Google Scholar 

  13. Legato M. Principles of gender-specific medicine. Gender in the genomic era. 3rd ed. Amsterdam: Academic; 2017.

    Google Scholar 

  14. Dr. Marianne J Legato. Accessed 7 Mar 2019. https://gendermed.org/dr-legato/.

  15. Madsen T, Bourjeily G, Hasnain M, et al. Sex- and gender-based medicine: the need for precise terminology 1 2. Gender Genome. 2017;1(3):122–8. https://doi.org/10.1089/gg.2017.0005.

    Article  Google Scholar 

  16. Hassett JM, Siebert ER, Wallen K. Sex differences in rhesus monkey toy preferences parallel those of children. Horm Behav. 2008 Aug;54(3):359–64. https://doi.org/10.1016/j.yhbeh.2008.03.008. Epub 2008 Mar 25.

  17. Wolfe J (host). Influence of testosterone and cortisol on decision making with Dr. John Coates. Sex and Why podcast August 8, 2018. https://www.sexandwhy.com/sex-why-episode-8-influence-of-testosterone-and-cortisol-on-decision-making/. Accessed 10 Mar 2019.

  18. Page L, Coates J. Winner and loser effects in human competitions. Evidence from equally matched tennis players. Evol Hum Behav. 2017;38:530. https://doi.org/10.1016/j.evolhumbehav.2017.02.003.

    Article  Google Scholar 

  19. Coates JM, Herbert J. Endogenous steroids and financial risk taking on a London trading floor. Proc Natl Acad Sci U S A. 2008;105(16):6167–72. https://doi.org/10.1073/pnas.0704025105.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Coates J, Gurnell M. Combining field work and laboratory work in the study of financial risk-taking. Horm Behav. 2017;92:13–9. https://doi.org/10.1016/j.yhbeh.2017.01.008.

    Article  PubMed  Google Scholar 

  21. Annual testosterone drug revenue in the US in 2013 (in billion UA dollars). https://www.statista.com/statistics/320301/predicted-annual-testosterone-drug-revenues-in-the-us/. Accessed 12 Marfv 2019.

  22. Kandasamy N, Hardy B, Page L, et al. Cortisol shifts financial risk preferences. Proc Natl Acad Sci U S A. 2014;111(9):3608–13. https://doi.org/10.1073/pnas.1317908111.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Ferree NK, Kamat R, Cahill L. Influences of menstrual cycle position and sex hormone levels on spontaneous intrusive recollections following emotional stimuli. Conscious Cogn. 2011;20(4):1154–62.

    Article  Google Scholar 

  24. Huded CP, Johnson M, Kravitz K, et al. 4-step protocol for disparities in STEMI care and outcomes in women. JACC. 2018;71(19). https://doi.org/10.1016/j.jacc.2018.02.039.

  25. Mehta LS, Beckie TM, Devon HA, et al. Acute myocardial infarction in women a scientific statement from the American Heart Association. Circulation. 2016;133(9):916. https://doi.org/10.1161/CIR.0000000000000351.

    Article  CAS  PubMed  Google Scholar 

  26. Wolfe J (host). Sex differences in heart disease with Dr. Basmah Safdar. Sex and Why Podcast. https://www.sexandwhy.com/episode-4-sex-differences-in-heart-disease/.

  27. Mueller AS, Jenkins TM, Osborne M, Dayal A, O’Connor DM, Arora VM. Gender differences in attending physicians’ feedback to residents: a qualitative analysis. J Grad Med Educ. 2017;9(5):577–85. https://doi.org/10.4300/JGME-D-17-00126.1.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Witteman HO, Hendricks M, Straus S, Tannenbaum C. Articles are gender gaps due to evaluations of the applicant or the science? A natural experiment at a national funding agency. Lancet. 2019;393(10171):531–40. https://doi.org/10.1016/S0140-6736(18)32611-4.

    Article  PubMed  Google Scholar 

  29. Handley IM, Brown ER, Moss-Racusin CA, Smith JL. Quality of evidence revealing subtle gender biases in science is in the eye of the beholder. Proc Natl Acad Sci U S A. 2015;112(43):13201–6. https://doi.org/10.1073/pnas.1510649112.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Kaplan JT, Gimbel SI, Harris S, Ahluwalia R, Jacks JZ, Devine PG, et al. Neural correlates of maintaining one’s political beliefs in the face of counterevidence. Sci Rep. 2016;6:39589. https://doi.org/10.1038/srep39589.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Joel D, Berman Z, Tavor I, Wexler N, Gaber O, Stein Y, et al. Sex beyond the genitalia: the human brain mosaic submission PDF. Proc Natl Acad Sci U S A. 2015;112:15468. https://doi.org/10.1073/pnas.1509654112.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Joel D, Fine C. Can we finally stop talking about “Male” and “Female” Brains? Dec 3, 2018 NY Times. https://www.nytimes.com/2018/12/03/opinion/male-female-brains-mosaic.html. Accessed 10 Mar 2019.

  33. Hill T. Academic activists send a published paper down the memory whole. Sept 7, 2018 Quillette. https://quillette.com/2018/09/07/academic-activists-send-a-published-paper-down-the-memory-hole/. Accessed 10 Mar 2019.

  34. Wolfe J (host). New Rules for Women with Dr. Anne Litwin. Sex and Why Podcast Feb 21, 2018. https://www.sexandwhy.com/episode-6-new-rules-for-women/. Accessed 10 Mar 2019.

  35. Shah ASV, Griffiths M, Lee KK, Mcallister DA, Hunter AL, Ferry AV, et al. High sensitivity cardiac troponin and the under-diagnosis of myocardial infarction in women: prospective cohort study. BMJ. 2015;350:g7873. https://doi.org/10.1136/bmj.g7873.

    Article  PubMed  PubMed Central  Google Scholar 

  36. McCarthy MM, Arnold AP, Ball GF, Blaustein JD, De Vries GJ. Sex differences in the brain: the not so inconvenient truth. J Neurosci. 2012;32:2241–7.

    Article  Google Scholar 

  37. Spataro BM, Tilstra SA, Rubio DM, Mcneil MA. The toxicity of self-blame: sex differences in burnout and coping. J Women’s Health. 2016;25(11):1147–52. https://doi.org/10.1089/jwh.2015.5604.

    Article  Google Scholar 

  38. Seo D, Ahluwalia A, Potenza MN, Sinha R. Gender differences in neural correlates of stress-induced anxiety. J Neurosci Res. 2017;125:115–25. https://doi.org/10.1002/jnr.23926.

    Article  CAS  Google Scholar 

  39. Ali A, Subhi Y, Ringsted C, Konge L. Gender differences in the acquisition of surgical skills: a systematic review. Surg Endosc. 2015;29(11):3065–73. https://doi.org/10.1007/s00464-015-4092-2.

    Article  PubMed  Google Scholar 

  40. Sherman GD, Rice LK, Jin ES, Jones AC, Josephs RA. Sex differences in cortisol’s regulation of affiliative behavior. Horm Behav. 2017;92:20–8. https://doi.org/10.1016/j.yhbeh.2016.12.005.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Jeannette Wolfe .

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Wolfe, J. (2020). Sex, Gender, and Medicine. In: Stonnington, C., Files, J. (eds) Burnout in Women Physicians. Springer, Cham. https://doi.org/10.1007/978-3-030-44459-4_1

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  • DOI: https://doi.org/10.1007/978-3-030-44459-4_1

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