“Does Sex Matter”: A “New Frontier” for Healthcare

Blog: “Does Sex Matter”: A “New Frontier” for Healthcare

“Does sex matter?” Well, from my perspective, I guess it always has... I am a clinician of the oral cavity but… in my previous “life” I was a reproductive endocrinologist of fish. Sex did matter, especially if I was going to get my PhD dissertation completed, and I did. I forgot about this “sex” thing from a personal perspective until I became a Dentist of oral and maxillofacial diseases. As I traveled further down the academic road, and, now as both Section Head for the Department of Oral and Maxillofacial Surgery at the University of Utah School of Dentistry and co-director of WiHMS, this dilemma has been reincarnated within my ability to both take care of patients and train our future legacy.

 I was asked to be on the scientific planning committee of the 2018 Summit on Sex and Gender in Health Education and never realized the commonality of this dilemma across all specialties of healthcare. This summit was the 2nd of a series that originated at the Mayo Clinic in 2015 in order to create a roadmap for integrating sex and gender scientific evidence into medical practice. In order to understand the roadmap, you have to understand the definitions of sex and gender.

  1. SEX: the biologic construct segregating male and female based upon reproductive organs and chromosome complement.
  2. GENDER: refers to a person’s self -representation and behavior as man or woman within the context of social structure and culture: LGBTQ12*
  3. Sex and Gender-based medicine (SGBM): the practice of medicine based on the understanding that biology and social factors have important implications for screening, diagnosis, treatment, and prevention
  1. The medical/health community must be aware how a person’s sex can affect their body’s responsiveness to disease identification and TX. There are still large gaps about how men and women experience certain medical conditions differently: Remember the Framingham Heart Study: Male model of health Dr. Marjorie Jenkins of the Laura Bush Institute and leader of this endeavor along with Drs. Allyson MacGregor and Dr. Eliza Chin states“We are seeing diseases…” which mask identification of the same disease that presents itself differently in woman and men. Diseases do not work the same between men and women.

The 2018 Summit was convened here at the University of Utah that served as a host to over 250 participants from not only medicine but Dentistry, Nursing, Pharmacy and Allied health professions :> 170 US and international institutions. Co-sponsors were The Laura Bush Institute/AMWA/Mayo Clinic /Unic Utah School of Dentistry/Texas Tech pp/The goal was to create a network of health professionals who will forge a curricular integration of scientific evidence demonstrating the influence that sex as a biologic variable and gender on specific disease processes and the need to teach this strategy to their health students using an interprofessional approach.

  1. Why do we need to know the difference /examples: Examples of diseases that are identified differently based upon sex as a biologic variable and gender are?
    1. Cardiovascular Disease which presents itself differently in males and females
    2. Diabetes
    3. Pain management strategies: Chronic pain/addiction/Temporomandibular Disorders (TMD) /Inflammation/Osteoporosis
    4. Cancer
    5. Substance abuse: Alcohol/Tobacco/Recreational drugs
    6. Medication prescribing; i.e. Ambien /Opioids
    7. Autoimmune diseases
    8. Obesity
  1. The biologic variable of sex and gender impacts clinical outcomes and research approaches which leads to greater needs for curricula that supports sex and gender-specific medicine
    1. Comprehensive sex and gender curricula across disciplines.
    2. There is already a database being developed as a case-based approach through the Laura Bush Institute for Women’s health: Texas Tech
    3. sexandgenderhealth.org
    4. The NIH states that SGBM needs to be considered in the design, analysis, and reporting of study outcomes.
    5. An Interprofessional Collaborative will apply curricula that crosses all health disciplines in order to develop a comprehensive sex and gender educational paradigm for a Precision medicine approach for patient-centered care.

And so………. Does Sex matter”????? Yes, it does. Our collaborative approach will instill a comprehensive sex and gender educational paradigm for person-centered care

Because our role as healthcare providers require that health be a universal right to all regardless of sex and gender.

 

Leslie R. Halpern, MD, DDS, PhD, MPH, FACS

Co-Director of WiHMS