The aging population: Imperative to uncouple sex and gender to establish “gender equal” health care

Bachmann, Gloria; Mussman, Brianna

doi:10.1016/j.maturitas.2015.01.009

Cited by 14 publications

(12 citation statements)

References 19 publications

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“…Quite a number of articles (14.5%: Supplementary Table S3 ) endorse the DSM-5 work group's claims that the new diagnostic criterion serves to depathologize gender nonconformity. These ranged from ambitious claims, such as “DSM-5 also recognizes gender identity in individuals as an option and not a stigmatized mental illness,” 46 (p. 422) to lesser but no less problematic assertions, such as “the term ‘gender dysphoria’ has replaced gender identity disorder and this change in terminology removes the ‘pathology’ from being transgender, which is not a mental health condition.” 47 (p. 792) In addition, this and 5.7% ( Supplementary Table S4 ) of other articles highlight that transgender identities are no longer considered a sign of pathology, but an aspect of human diversity. Semantically this may be true; however, they offer no indication of how or why the change in name removes pathology from being transgender.…”

Section: Distress and Diagnosesmentioning

confidence: 99%

What Is Gender Dysphoria? A Critical Systematic Narrative Review

Davy

Toze

2018

Transgender Health

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In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association has changed the diagnosis of gender identity disorder to gender dysphoria (GD). In this critical narrative review we ask: What is gender dysphoria? We report on some of the inconsistencies in the articles that foreground distress while obfuscating the fact that not all trans and intersex people suffer stress or impaired functioning, and the inappropriate referencing to intersex people in the diagnostic criterion, claims about the GD diagnosis contributing to the depathologization of and reducing stigma surrounding trans people, the conceptualizations of “gender dysphoric” research subjects, and finally we question the etiological approaches using GD as a conceptual framework. We further suggest that there are a number of methodological issues that need to be resolved to be able to claim that the GD diagnosis can be validated. To shed light on these paradoxes and methodological issues in the DSM-5, we report on the content validity of GD by reviewing research articles postdiagnostic inception. These findings will contribute to the debate about the validity of GD as a diagnosis for the 21st century for those people who need to live a different gender to that assigned at birth.

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Section: Distress and Diagnosesmentioning

confidence: 99%

What Is Gender Dysphoria? A Critical Systematic Narrative Review

Davy

Toze

2018

Transgender Health

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“…Although all cells have a sex, designated by the presence and dosage of X or Y chromosomes, which in most cases will be XX (female) or XY (male), gender is a designated societal determinant and therefore traditionally described only in humans (Bachmann and Mussman, 2015). Of particular importance for this discussion, rodents do not have a gender.…”

Section: Defining Sex and Gendermentioning

confidence: 99%

Sex as a Biological Variable: Who, What, When, Why, and How

Bale

Epperson

2016

Neuropsychopharmacol

120

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The inclusion of sex as a biological variable in research is absolutely essential for improving our understanding of disease mechanisms contributing to risk and resilience. Studies focusing on examining sex differences have demonstrated across many levels of analyses and stages of brain development and maturation that males and females can differ significantly. This review will discuss examples of animal models and clinical studies to provide guidance and reference for the inclusion of sex as an important biological variable relevant to a Neuropsychopharmacology audience.

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“…For the purposes of our discussion, one’s sex is determined by the presence and dosage of X or Y chromosomes, which in most cases will be XX (female) and XY (male). When we refer to gender, we are referencing the individual’s sense of themselves as being a man or woman, which is typically based upon the social and cultural constructs of their community [10, 11]. While progress in the consideration of sex and gender differences in health among cis-gender/cis-sex individuals has been slow, a focus on sex and gender in regard to the health of the transgender/transex community is non-existent and an area of growing importance.…”

Section: Introductionmentioning

confidence: 99%

Inclusion of sex and gender in biomedical research: survey of clinical research proposed at the University of Pennsylvania

et al. 2017

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BackgroundThe 2015 National Institutes of Health (NIH) policy that sex be considered as a biological variable (SABV) is now a critical part of the peer-review process for NIH funding as well as publication in several high-impact scientific journals. We sought to determine the degree to which biomedical researchers at the University of Pennsylvania already consider SABV or gender in their research.MethodsWe reviewed 240 research protocols approved by the University of Pennsylvania Investigational Review Board (IRB) consecutively submitted between January and July 2016. Each protocol was searched for the terms sex, gender, male, female, man, and woman and justifications related to the population under study. A PubMed search was conducted to determine the current state of knowledge regarding potential sex and/or gender differences with respect to protocol topic. Data were summarized using descriptive statistics.ResultsOf the 165 (68.8%) protocols that included one of the search terms, only 24 (14.5%) provided justification for the choice of the sex/gender of the population studied. Sixty-three percent (n = 151) of the protocols focused on topics for which the extant literature supports at least a moderate degree of sex/gender differences in some aspect of the disorder/condition being studied. Of these, only three (2.0%) indicated that the investigator would consider sex or gender impact on their primary outcomes.ConclusionsReview of a subset of IRB protocols submitted at a major research institution suggests that very few investigators are considering sex or gender as important variables in their clinical research at the stage of protocol development. IRBs are in an excellent position to encourage investigators to consider SABV and gender in order to enhance the rigor of research design, maximize the importance of the resulting knowledge, and ensure that subject selection is equitable. These findings serve as the basis for developing an intervention at the level of IRB protocol development and submission that will promote consideration of SABV and/or gender, factors with critical import to patient safety and efficacy of interventions.

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The aging population: Imperative to uncouple sex and gender to establish “gender equal” health care

Cited by 14 publications

References 19 publications

What Is Gender Dysphoria? A Critical Systematic Narrative Review

What Is Gender Dysphoria? A Critical Systematic Narrative Review

Sex as a Biological Variable: Who, What, When, Why, and How

Inclusion of sex and gender in biomedical research: survey of clinical research proposed at the University of Pennsylvania

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