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PubMed2006

Genetic testing for hereditary cancers: the impact of gender on interest, uptake and ethical considerations.

Genetic testing promises earlier intervention and more successful outcomes for individuals at risk for hereditary breast/ovarian and colorectal cancer. Research shows that gender influences health and access to health care services. In this paper, we review theoretical issues of gender, and research outcomes, in relation to genetic testing for hereditary cancers. We argue that integrating a gender analysis into assessment of new technologies and health programs is necessary to improve appropriateness, accessibility and effectiveness. Attention to gender is also critical to developing a deeper understanding of the ethical issues (both benefits and harms) raised by new genetic technologies.

Bioethical Issues↗
PubMedDate not supplied

The primary prevention of heart disease in women through health behavior change promotion in primary care.

PURPOSE: To summarize recent evidence-based recommendations for physical activity promotion, dietary improvement, and tobacco cessation from the U.S. Preventive Services Task Force (USPSTF) and the Task Force on Community Preventive Services (CTF), and examine their applicability to the primary prevention of cardiovascular disease (CVD) in women through primary care interventions. METHODS: For the behaviors cited, USPSTF and CTF recommendations and their associated systematic evidence reviews (SERs) were retrieved. Individual articles from the USPSTF healthy diet and physical activity SERs that met our inclusion criteria were systematically examined to determine the applicability of this research to women. We supplemented findings from these sources with comprehensive federal research summaries and SERs from focused searches of systematic review databases relevant to primary CVD prevention in women through healthy behavior change. MAIN FINDINGS: The USPSTF strongly recommends primary care interventions for tobacco cessation. Strong CTF recommendations for multicomponent systems supports for clinicians, telephone support for quitters, and reduced patient costs for effective cessation therapies guide complementary approaches to assist clinicians. The USPSTF recommends intensive behavioral dietary counseling by specialists for high-risk CVD patients, but found insufficient evidence to recommend for routine healthy diet or physical activity promotion in primary care. The evidence base for these recommendations generally applies to women. Better reporting of gender and minority subgroup outcomes will assist more in-depth understanding of potential differences in either the processes or outcomes of behavior change interventions. CONCLUSIONS: Primary care clinicians, including obstetrician-gynecologists, can contribute to preventing CVD in women through implementing credible evidence-based recommendations for clinical interventions in tobacco and healthy diet. Researchers can further our understanding of gender-specific issues in healthy behavior interventions by reporting process and outcome data for gender and minority subgroups.

Diet↗
PubMed2003

Transgender health.

Transgender persons represent an underserved community in need of sensitive, comprehensive health care. This article presents a literature-based review of the health needs of the transgender patient. Physicians, whether or not they choose to provide hormone therapy, will likely encounter patients with gender identity issues at some point in their practice. A transgender health assessment should involve recognition of possible gender identity disorder, history-taking with respect to prior and current use of hormones or surgical interventions, as well as general physical, mental, and sexual health histories. Physical exam and screening tests need to be based on the organ systems present rather than the perceived gender of the patient. Physicians should be aware of common hormone regimens and their associated risks. Finally, patients best explore transgender issues in a setting of respect and trust in which confidentiality concerns are addressed, and clinic staff are educated about transgender issues.

Female↗
PubMed2003

Tobacco control and gender in south-east Asia. Part II: Singapore and Vietnam.

In the World Health Organization's Western Pacific Region, being born male is the single greatest risk marker for tobacco use. While the literature demonstrates that risks associated with tobacco use may vary according to sex, gender refers to the socially determined roles and responsibilities of men and women, who initiate, continue and quit using tobacco for complex and often different reasons. Cigarette advertising frequently appeals to gender roles. Yet tobacco control policy tends to be gender-blind. Using a broad, gender-sensitivity framework, this contradiction is explored in four Western Pacific countries. Part I of the study presented the rationale, methodology and design of the study, discussed issues surrounding gender and tobacco, and analysed developments in Malaysia and the Philippines (see the previous issue of this journal). Part II deals with Singapore and Vietnam. In all four countries gender was salient for the initiation and maintenance of smoking. Yet, with a few exceptions, gender was largely unrecognized in control policy. Suggestions for overcoming this weakness in order to enhance tobacco control are made.

Adolescent↗
PubMed1991

Gender identity conflicts in adolescents as motivation for suicide.

One of the motivational factors for suicide in adolescents is examined in light of gender identity issues and conflicts. It is proposed that difficulties in the formation of a cohesive gender identity are related to the adolescent's motivation to attempt suicide. This paper makes use of Fast's (1984) distinction between "event-centered" and "self-centered" experiences in order to explore problems in the formation of gender identity with reference to regression to earlier stages of psychosexual development. Physiological changes and regressive pull may lead the adolescent to the "event-centered" mode of experience. Thus one minor event may become the focus of the adolescent's gender and self identities. The adolescent may then have regressive omnipotent fantasies of being able to change gender identity through suicidal acts.

Adaptation, Psychological↗
PubMed1996

Woman, M.D.: issues, perceptions and choices.

I would end with some summarizing points and questions. 1. A majority of women identify gender-related issues influencing their career choices and pathways. 2. Women are diverse in their choices and priorities, with varying balances of personal and professional life. 3. Eighty-three percent of the women responding to the survey have married, and 82% of those married have children. They thus are likely to have two sets of seriously competing responsibilities. 4. It is possible to identify especially promising women during residency or fellowship. Exploring their priorities and values with good mentors will be important to avoid short-changing academic medicine of competent women. 5. Men and women need to be SUPERCHOOSERS in making the choices right for that individual, rather than superwomen or supermen. 6. We can question whether the development and potential of women (and some men) in academic medicine could be enhanced by: a. Consideration of guidance or support for child care resources? b. Flexibility in the system (tenure clock, etc.)? c. Identification of limited full-time clinical or research opportunities for faculty with young children or unusual family demands? d. Facilitation of bridging after a period of part-time activity or re-entry after limited participation? e. Consideration of part-time work at home and flexible on-site work hours for periods of special family demands? Finally, a supportive work environment is important for both men and women in medicine and is an essential priority in academic medicine. Medicine is a wonderful field. Academic medicine on my terms, to include family, has been very rewarding. Sometimes there also have been disappointments, in that I have fallen short of some of my aspirations. However, I must accept the responsibility for my choices. I owe a great debt to many of the men and women of the American Clinical and Climatological Association and of Johns Hopkins who are both friends and colleagues and especially to my husband, Dick Johns. After 42 years of marriage, I am still learning about the balance of personal and professional life. May we all be Superchoosers!

Adult↗
PubMed2005

[Gender and HIV/AIDS prevention].

The sociocultural gender norms that interfere with vulnerability to HIV/AIDS in global and Polish context are discussed. The issue of gender related HIV/AIDS vulnerability in Poland is underestimated. Existing data on unemployment rate and average wages seems to indicate that socioeconomic status of women in Poland is rather low and create social suspectibility to HIV infection. Some programmatic and policy recommendations to reduce individual risk and vulnerability of women and men are presented.

Cultural Characteristics↗
PubMedDate not supplied

The dilemma for women of color in clinical trials.

Women in general and women of color in particular have been noticeably absent from clinical research, be it phase I pharmacokinetic drug trials or natural history observational studies. This paper examines several questions about the role of women of color in clinical research: Who participates in clinical trials and why? Do women of color face a particular dilemma in deciding to participate? A biologic construct for race and gender research issues is presented. Given the variations of pharmacokinetics and pharmacodynamics that may be race- or gender-related, certain obstacles must be addressed in order to facilitate responsible research. Those obstacles include the history of abuse of vulnerable populations in the name of clinical research, discrimination in medical care, and the lack of understanding of the combined impact of gender, race, ethnicity, and class on behavior and health.

Black or African American↗
PubMed2006

Social class inequalities in self-rated health and their gender and age group differences in Japan.

BACKGROUND: Few studies have examined social inequalities in self-rated health in Japan, and the issue of gender differences related to social inequalities in self-rated health remains inconclusive. METHODS: The data derived from interviews with 2987 randomly selected Japanese adults in four prefectures in Japan who completed the cross-national World Mental Health survey from 2002 through 2005. We calculated odds ratios (ORs) of having poor self-rated physical and mental health by two social class indicators independently with multivariate logistic regression models, adjusted for age, gender, marital status, and area. Stratified analyses by gender and age group were also conducted. RESULTS: The adjusted ORs of the lowest educational attainment category having poor self-rated physical and mental health were 1.42 (95% confidence interval [CI]: 1.15-1.76) and 1.37 (95% CI: 1.10-1.70), respectively. Among females, educational attainment had significant linear associations with self-rated physical and mental health. Adjusted household income was also significantly associated with self-rated physical health among female respondents. No associations were found among males. While educational attainment was associated with self-rated health among the young age group, adjusted household income was associated with self-rated physical health in the middle and old age group. CONCLUSION: These results indicated social inequalities in self-rated health and prominent social inequalities in self-rated health among females in Japan. Social inequalities in self-rated health seemed to exist across age groups. However, the mechanism of social inequalities in self-rated health could be different depending on the age group.

Adult↗
PubMedDate not supplied

Gender differences in depression: perspectives from neuropsychology.

Although there has been much productive research in neuropsychology on the topic of depression, rarely has the issue of gender differences been taken into consideration. It is not uncommon for researchers investigating the neuropsychological concomitants of depression to test only women, or far more women than men, making it impossible to examine the prospect that there might be differences between these two groups. This article is an attempt to integrate research from two areas of neuropsychology: (1) gender differences in neuropsychological functions and (2) neuropsychological functions in depression. Since so few studies have examined gender differences in depression and their relation to neuropsychological patterns, there will be few firm conclusions to be drawn. However, some speculations will be offered, and some suggestions outlined for potentially fruitful future research.

Bipolar Disorder↗
PubMed1994

Engendering psychology.

Engendering psychology refers to cultivating a psychology that is sensitive to issues of gender and diversity. The increase in the number of female psychologists does not guarantee that the discipline will be responsive to those issues. This article reviews the progress made in engendering psychology by examining undergraduate textbooks and classroom instruction and looking at gender bias in both research and practice. By engendering psychology, it becomes a stronger science and profession and better serves the public interest.

Adult↗
PubMed2005

Gender differences in social reactions to abuse disclosures, post-abuse coping, and PTSD of child sexual abuse survivors.

OBJECTIVE: This research examines the understudied issue of gender differences in disclosure, social reactions, post-abuse coping, and PTSD of adult survivors of child sexual abuse (CSA). METHOD: Data were collected on a cross-sectional convenience sample of 733 college students completing a confidential survey about their demographic characteristics, sexual abuse experiences, disclosure characteristics, post-abuse coping, and social reactions from others. RESULTS: Female students reported greater prevalence and severity of CSA, more distress and self-blame immediately post-assault, and greater reliance on coping strategies of withdrawal and trying to forget than male students. Women were more likely to have disclosed their abuse to others, to have received positive reactions, and to report greater PTSD symptom severity, but were no more likely to receive negative reactions upon disclosure than men. Women delaying disclosure had greater PTSD symptom severity, whereas men's symptoms did not vary by timing of disclosure. Additional regression analyses examined predictors of PTSD symptom severity and negative and positive social reactions to abuse disclosures. CONCLUSIONS: Several gender differences were observed in this sample of college students in terms of sexual abuse experiences, psychological symptoms, coping, PTSD, and some aspects of disclosure and social reactions from others.

Adaptation, Psychological↗
PubMed2006

Implications of gender differences for human health risk assessment and toxicology.

This paper from The Human Health working group of SGOMSEC 16 examines a broad range of issues on gender effects in toxicology. Gender differences in toxicology begin at the gamete and embryo stage, continuing through development and maturation and into old age. Sex influences exposure, toxicokinetics, and toxicodynamics. The effects of sex have often been overlooked in both epidemiology and toxicology. In addition to the obvious modifying effects of the sex hormones and conditions affecting the male and female reproductive organs and sex roles, both genetic and hormonal effects influence many aspects of life and toxic responses. All aspects of toxicology should consider gender-balanced designs so that a more comprehensive understanding of differences and similarities can be obtained. Differential gene expression is a new frontier in toxicology. Risk assessment should account for gender and life cycle differences. The biological basis for altered sex ratios observed in several populations should be sought in animal models, and expanded to other compounds that might exert sex-selective effects. Wherever possible and feasible, toxicologic and environmental epidemiological studies should be designed and have sufficient statistical power to quantify differential gender-based exposures and outcomes.

Bone and Bones↗
PubMed1985

Development, dependence, and gender inequality in the Third World.

While there has been much recent empirical investigation of the relationship between economic development, dependence, and income inequality, the issue of gender inequality has received less systematic attention. This exploratory study is a cross-sectional investigation of the effects of industrialization and investment, debt, and export dependency on levels of female education, and on rates of female economic participation, both absolutely and relative to male rates in 60 less developed countries. Although some of the macroeconomic indicators emerge as significant predictors of gender inequality in several of the regression equations, the most important explanatory variable is cultural region. These findings fail to lend strong empirical support to either the modernization or the dependency/world system theoretical perspective. The concluding discussion speculates on the interpretation of the research findings, offers some observations on the conceptual distinctions between class and gender stratification, and suggestions some directions for future research.

Agriculture↗
PubMed2003

Tobacco control and gender in Southeast Asia. Part I: Malaysia and the Philippines.

In the World Health Organization's Western Pacific Region, being born male is the single greatest risk marker for tobacco use. While the literature demonstrates that risks associated with tobacco use may vary according to sex, gender refers to the socially determined roles and responsibilities of men and women, who initiate, continue and quit using tobacco for complex and often different reasons. Cigarette advertising frequently appeals to gender roles. Yet tobacco control policy tends to be gender-blind. Using a broad gender-sensitivity framework, this contradiction is explored in four Western Pacific countries. Part I of the study discusses issues surrounding gender and tobacco, and analyses developments in Malaysia and the Philippines. Part II deals with Singapore and Vietnam. In all four countries, gender was salient for the initiation and maintenance of smoking, and in Malaysia and the Philippines was highly significant in cigarette promotion. Yet, with a few exceptions, gender was largely unrecognized in control policy. Suggestions for overcoming this weakness in order to enhance tobacco control are made in Part II.

Adolescent↗
PubMed2005

Multiethnic perspectives on elder mistreatment.

PURPOSE: We conducted this study to understand the interpretations of elder mistreatment (EM) in multiethnic older adults. DESIGN AND METHODS: Focus group sessions were held with three ethnically homogenous groups (n = 18) and a group of elder care professionals (n = 6) eliciting responses to vignettes depicting various types of elder mistreatment. Qualitative analysis of focus group transcripts was performed to define EM occurrence, its severity, and to identify the perpetrator and victim. RESULTS: Four main categories emerged: social expectations, caregiver expectations, victim characteristics, and characteristics of the interaction. Themes included issues of gender roles, filial obligations, martial commitments, and ageism as features of the vignette discussions. Professional and lay caregiver issues were features of the caregiver expectations. Mental capacity, physical dependency, physical attributes, and complicity were the victim characteristics discussed. The characteristics of the interaction that were identified included resistance to care, retaliation, habitual occurrence, and perpetrator intent. IMPLICATIONS: Older adults identify multiple factors influencing the interpretation of elder mistreatment. These factors may determine strategies for future EM intervention.

Journal Article↗
PubMed2004

Anorexia nervosa and gender identity disorder in biologic males: a report of two cases.

UNLABELLED: Gender identity disorder is a rare disorder of uncertain etiology. The emphasis on body shape in this disorder suggests that there may be an association with anorexia nervosa. METHOD: We report two cases of anorexia nervosa and gender identity disorder in biologic males who presented to an eating disorders service. RESULTS: One was treated successfully as an outpatient and subsequently underwent gender reassignment surgery. The other patient required admission and prolonged psychotherapy. DISCUSSION: Differences between the two cases are discussed. Issues of gender identity should be considered in the assessment of male patients presenting with anorexia nervosa.

Adult↗
PubMed1992

Treatment issues and treatment configurations for mentally ill homeless women.

This article reviews and discusses various issues pertinent to effective delivery of treatment services to mentally ill homeless women. The central emphasis is upon the gender-specific issues unique to this population and includes attention to distinctive features of effective case management, utilization of group therapy techniques, and greater integration of the psychiatrist into the treatment team. The article concludes with a discussion of the future issues relevant to community based services to homeless mentally ill women.

Female↗