you find a red card on your seat have a
look and raise the card if you agree sex
matter
not everybody seems to be convinced okay
yes sex matters but gender matters to
sex and gender define the way we walk
the way we talk the way we look but also
the way we are looked at the influenced
opportunities we are offered and the
risks we take but today I will be
talking about how sex and gender
mattered to our health I will be talking
both about sex and gender you see sex is
biological gender is social but it is
complicated
HIV is a prime example of the complex
interaction between sex and gender now
some of you are probably too young to
remember the HIV epidemic in the 80s I
was an HIV scientist when I first come I
came to realize how sex and gender
affect people’s lives did you know for
example that young women are twice as
likely to become HIV infected compared
to young men women are a greater risk
for HIV infection and there are both
biological as well as social reasons for
it biologically women are like more
exposed to HIV during sex because of the
larger surface of vagina and cervix
compared to the areas of the male
genital tract where HIV transmission
occurs in addition they’re also exposed
to a larger volume of seminal fluid
during sex
but in addition to these biological sex
differences women there are a number of
gender related socio-economic factors
that make women more vulnerable to HIV
such as sexual violence refusal of their
male partners use condom lack of
economic power or limited education to
know how to prevent HIV but gender
inequality affects men and boys
negatively to
the notion of masculine they can push
men and boys to take unnecessary risks
such as having multiple sexual partners
are not using condom they’re also
expected to be tough and strong making
them reluctant to seek medical care care
resulting in late HIV diagnosis and
treatment but these fundamental sex and
gender-based differences are everywhere
across all diseases to give you a couple
of more examples did you know that women
suffer more of sport injuries and men
women for example are six times more
likely than men who have injury in the
knee ligaments or did you know that men
with anorexia go unnoticed because
having an eating disorder has been
characterized as feminine and seeking
psychological help as unmanly so you see
the entire medicine and the medical
field is gendered so what’s the problem
then the problem is that we have enough
evidence to know that sex and gender
matter to our health but we are doing
very little to understand underlying
reasons for that and respond to these
differences appropriately and we are
facing a myriad of problems as an
illustration we have now discovered that
more women die of heart disease than men
in fact heart disease is the leading
cause of death among women worldwide one
of the reasons is that symptoms for
heart attack was developed based on men
but it shows that women present very
different symptoms so it takes longer
time for them to seek care and when they
do they may go misdiagnosed do not
receive the right treatment at the right
time another widely used example of
widely known example is drug development
in the United States of 10 drugs that
were withdrawn from the market
eight were we thrown because they were
causing more harm to women in another
instance the US Food and Drug
Administration the authority responsible
for approving medicines before they are
introduced to the market reduced said
those of the widely used drug ambien to
half but only for women no changes for
men women metabolize the drug
differently and need only half the dose
for the same effect isn’t that
surprising or isn’t that rather scary
that these fundamental differences are
discovered after drug has been tested
approved introduced to the market
prescribed by doctors and used by us
these are for drugs that half of the
population use why this gender bias well
it appears that in medicine the white
male body has been the point of
reference here we go
meaning that anyone that shows different
symptoms or responds to treat
differently than the average white male
may go misdiagnosed or treated wrongly I
couldn’t understand why it was so
difficult for researchers to really
recognize and acknowledge and examine
these important differences after all
this is a well-known fact already in
1973 in the oldest medical journal the
lancet an article highlights how sex and
gender influences across medicine and
how little we know and today researchers
still fail to think that sex and gender
matter until they stumble upon it so let
me give you a personal anecdote here my
husband is a surgeon more precisely he
operates patients with the cancer of the
esophagus he’s also a researcher I have
been trying since the beginning of time
to convince him to look at the
differences between male and female
patients
and he has persistently claimed that
there are no differences in outcome
until recently he comes from one night
and rather awkwardly says we have found
these findings at my clinic which are
very bizarre I bet you’d be happy to
hear about it well that sounded odd and
then he continues by a mere coincidence
we have now noticed that our female
patients have fewer complications after
an operation are doing better and we
just can’t figure out why Wow I was
really excited I was happy because he
finally admitted that I was right
although he should have known that I’m
always right but imagine imagine if they
do figure out why their female patients
are doing better they could improve the
survival of their maiya patients based
on what they learn from their female
patients examining these differences is
beneficial for everybody but medical
research which is meant to answer a
question if a treatment or a drug work
often doesn’t include enough women to be
able to examine these differences my
team and I looked at a sample of HIV
drug clinical trials clinical trials of
drugs are designed to answer the
question if a drug is safe and effective
compared to placebo in our sample of
over 95,000 patients that were included
in these trials only about a quarter
where women more surprisingly of about
500 scientific articles that reported
the results of these clinical trials
only 17% mentioned sex or gender at that
time I was started thinking about what
could I do about this gender bias at a
time I was an editor of an medical
journal of an HIV Journal medical
journals are important because research
findings are
communicated to the great their medical
community and public through publication
of scientific articles as a medical
editor I have an opportunity to make a
difference so I decided to introduce a
gender policy I decided to ask my
authors to mention how many men how many
women and if included in their study how
many transgender person participated in
their research and also describe if they
looked at any differences among these
groups and if not explained why it’s
quite simple right but for any idea to
enable a profound change it needs to be
replicated so I approached a few other
editors of other HIV journals and
suddenly we were a handful of journals
acknowledging I’m embracing the
importance of sex and gender in HIV
research as I grew more and more
interested in this topic I came across
really fascinating example about how sex
and gender affect us and affect our
lives and health beyond medicine and I’d
love to share a couple of these with you
some of them are really eye-opening I
came across this study that looked at
whiplash injuries
now whiplash is an injury to the neck
caused by rapid forceful back and move
back and forth movement in car accidents
this study showed that women suffer 2 to
3 times more a whiplash than men and
they take longer to recover do you know
why isn’t this they found out that the
crash test dummies used by car
manufacturers to test the safety safety
of the cars its features were based on
white male models even that fascinating
how not thinking about the differences
between women and men’s anatomy can have
come at a very huge cost to women and
society now I would like to take you to
study about hurricanes now you probably
wonder what have hurricanes have to do
with sex and gender right
well you all have heard about Hurricane
Katrina hurricane Mathieu hurricane Irma
and the damages that they caused well
this study looked at strong hurricanes
of same intensity and showed that
hurricanes with male with female names
tend to be deadlier than hurricanes from
male names the authors conclude that
individuals simply underestimate the
strength of the hurricane and their
vulnerability to it if the hurricane has
a more feminine name compared to when it
has a more masculine name isn’t that
just fascinating how we are
subconsciously affected by the gender
roles and expectations that we have
created in our society well as I came
across these examples our even more
convinced that we had to do things
differently we had to change minds so I
started thinking so why not think big
why not try to encourage all scientific
journals across disciplines beyond
medicine to introduce a gender policy so
I set up a gender policy committee
I brought together a group of
like-minded committed driven researchers
doctors editors science communicators
under the umbrella of European
Association of science editors together
we embarked on a journey we were all
volunteering on top of our daily jobs we
were using our spare time and our own
resources and it took us over two years
to develop a set of guidelines which we
called sex and gender equity in research
this sager guidelines we thought it was
an appropriate name we had to be Sager
in the way we did research and reported
it the Sager guidelines provide a set of
clear and simple instructions to authors
and researchers we provide a set of
recommendations but the three main
points are always mentioned the sex or
gender of your subject in your research
if you’re using animals cells or tissues
you need to mention the sex if you’re
developing an app or a technology you
need to mention if it’s gonna be
applying on both men and women to always
disaggregate your data by sex
meaning that presents your data
separately for men and women and if
included in your study transgender
persons and finally and most importantly
analyze your data with the gender lens
look at differences look at biological
differences if you’re in a medicine look
at gender-based differences and if you
do not look up any differences between
the sexes and the genders you better
have a good excuse and we want to hear
that the sager guidelines were launched
in 2016 and it has received a lot of
attention more and more journals are
endorsing it or translating it into
other languages but we have a long way
to go there is still a lot of resistance
to change but now I’m confident I’m
confident that the change is possible
and it’s happening there is increasing
number of researchers doctors patients
who are aware of these important
differences and demanding a change and I
want to invite you to join this movement
you can make a difference while you may
choose different career paths we all
have something in common we all have a
sex and we all have a gender we are all
patients and consumers protecting our
health and that of our loved ones so
demand evidence question current
practice drive a change let’s together
put on our gender lens and make sure
health care and our society is based on
evidence and benefit all today we know
that every cell is sexed today we know
that everybody is gendered this is no
longer a question today we know that sex
gender matter thank you
[Applause]
look and raise the card if you agree sex
matter
not everybody seems to be convinced okay
yes sex matters but gender matters to
sex and gender define the way we walk
the way we talk the way we look but also
the way we are looked at the influenced
opportunities we are offered and the
risks we take but today I will be
talking about how sex and gender
mattered to our health I will be talking
both about sex and gender you see sex is
biological gender is social but it is
complicated
HIV is a prime example of the complex
interaction between sex and gender now
some of you are probably too young to
remember the HIV epidemic in the 80s I
was an HIV scientist when I first come I
came to realize how sex and gender
affect people’s lives did you know for
example that young women are twice as
likely to become HIV infected compared
to young men women are a greater risk
for HIV infection and there are both
biological as well as social reasons for
it biologically women are like more
exposed to HIV during sex because of the
larger surface of vagina and cervix
compared to the areas of the male
genital tract where HIV transmission
occurs in addition they’re also exposed
to a larger volume of seminal fluid
during sex
but in addition to these biological sex
differences women there are a number of
gender related socio-economic factors
that make women more vulnerable to HIV
such as sexual violence refusal of their
male partners use condom lack of
economic power or limited education to
know how to prevent HIV but gender
inequality affects men and boys
negatively to
the notion of masculine they can push
men and boys to take unnecessary risks
such as having multiple sexual partners
are not using condom they’re also
expected to be tough and strong making
them reluctant to seek medical care care
resulting in late HIV diagnosis and
treatment but these fundamental sex and
gender-based differences are everywhere
across all diseases to give you a couple
of more examples did you know that women
suffer more of sport injuries and men
women for example are six times more
likely than men who have injury in the
knee ligaments or did you know that men
with anorexia go unnoticed because
having an eating disorder has been
characterized as feminine and seeking
psychological help as unmanly so you see
the entire medicine and the medical
field is gendered so what’s the problem
then the problem is that we have enough
evidence to know that sex and gender
matter to our health but we are doing
very little to understand underlying
reasons for that and respond to these
differences appropriately and we are
facing a myriad of problems as an
illustration we have now discovered that
more women die of heart disease than men
in fact heart disease is the leading
cause of death among women worldwide one
of the reasons is that symptoms for
heart attack was developed based on men
but it shows that women present very
different symptoms so it takes longer
time for them to seek care and when they
do they may go misdiagnosed do not
receive the right treatment at the right
time another widely used example of
widely known example is drug development
in the United States of 10 drugs that
were withdrawn from the market
eight were we thrown because they were
causing more harm to women in another
instance the US Food and Drug
Administration the authority responsible
for approving medicines before they are
introduced to the market reduced said
those of the widely used drug ambien to
half but only for women no changes for
men women metabolize the drug
differently and need only half the dose
for the same effect isn’t that
surprising or isn’t that rather scary
that these fundamental differences are
discovered after drug has been tested
approved introduced to the market
prescribed by doctors and used by us
these are for drugs that half of the
population use why this gender bias well
it appears that in medicine the white
male body has been the point of
reference here we go
meaning that anyone that shows different
symptoms or responds to treat
differently than the average white male
may go misdiagnosed or treated wrongly I
couldn’t understand why it was so
difficult for researchers to really
recognize and acknowledge and examine
these important differences after all
this is a well-known fact already in
1973 in the oldest medical journal the
lancet an article highlights how sex and
gender influences across medicine and
how little we know and today researchers
still fail to think that sex and gender
matter until they stumble upon it so let
me give you a personal anecdote here my
husband is a surgeon more precisely he
operates patients with the cancer of the
esophagus he’s also a researcher I have
been trying since the beginning of time
to convince him to look at the
differences between male and female
patients
and he has persistently claimed that
there are no differences in outcome
until recently he comes from one night
and rather awkwardly says we have found
these findings at my clinic which are
very bizarre I bet you’d be happy to
hear about it well that sounded odd and
then he continues by a mere coincidence
we have now noticed that our female
patients have fewer complications after
an operation are doing better and we
just can’t figure out why Wow I was
really excited I was happy because he
finally admitted that I was right
although he should have known that I’m
always right but imagine imagine if they
do figure out why their female patients
are doing better they could improve the
survival of their maiya patients based
on what they learn from their female
patients examining these differences is
beneficial for everybody but medical
research which is meant to answer a
question if a treatment or a drug work
often doesn’t include enough women to be
able to examine these differences my
team and I looked at a sample of HIV
drug clinical trials clinical trials of
drugs are designed to answer the
question if a drug is safe and effective
compared to placebo in our sample of
over 95,000 patients that were included
in these trials only about a quarter
where women more surprisingly of about
500 scientific articles that reported
the results of these clinical trials
only 17% mentioned sex or gender at that
time I was started thinking about what
could I do about this gender bias at a
time I was an editor of an medical
journal of an HIV Journal medical
journals are important because research
findings are
communicated to the great their medical
community and public through publication
of scientific articles as a medical
editor I have an opportunity to make a
difference so I decided to introduce a
gender policy I decided to ask my
authors to mention how many men how many
women and if included in their study how
many transgender person participated in
their research and also describe if they
looked at any differences among these
groups and if not explained why it’s
quite simple right but for any idea to
enable a profound change it needs to be
replicated so I approached a few other
editors of other HIV journals and
suddenly we were a handful of journals
acknowledging I’m embracing the
importance of sex and gender in HIV
research as I grew more and more
interested in this topic I came across
really fascinating example about how sex
and gender affect us and affect our
lives and health beyond medicine and I’d
love to share a couple of these with you
some of them are really eye-opening I
came across this study that looked at
whiplash injuries
now whiplash is an injury to the neck
caused by rapid forceful back and move
back and forth movement in car accidents
this study showed that women suffer 2 to
3 times more a whiplash than men and
they take longer to recover do you know
why isn’t this they found out that the
crash test dummies used by car
manufacturers to test the safety safety
of the cars its features were based on
white male models even that fascinating
how not thinking about the differences
between women and men’s anatomy can have
come at a very huge cost to women and
society now I would like to take you to
study about hurricanes now you probably
wonder what have hurricanes have to do
with sex and gender right
well you all have heard about Hurricane
Katrina hurricane Mathieu hurricane Irma
and the damages that they caused well
this study looked at strong hurricanes
of same intensity and showed that
hurricanes with male with female names
tend to be deadlier than hurricanes from
male names the authors conclude that
individuals simply underestimate the
strength of the hurricane and their
vulnerability to it if the hurricane has
a more feminine name compared to when it
has a more masculine name isn’t that
just fascinating how we are
subconsciously affected by the gender
roles and expectations that we have
created in our society well as I came
across these examples our even more
convinced that we had to do things
differently we had to change minds so I
started thinking so why not think big
why not try to encourage all scientific
journals across disciplines beyond
medicine to introduce a gender policy so
I set up a gender policy committee
I brought together a group of
like-minded committed driven researchers
doctors editors science communicators
under the umbrella of European
Association of science editors together
we embarked on a journey we were all
volunteering on top of our daily jobs we
were using our spare time and our own
resources and it took us over two years
to develop a set of guidelines which we
called sex and gender equity in research
this sager guidelines we thought it was
an appropriate name we had to be Sager
in the way we did research and reported
it the Sager guidelines provide a set of
clear and simple instructions to authors
and researchers we provide a set of
recommendations but the three main
points are always mentioned the sex or
gender of your subject in your research
if you’re using animals cells or tissues
you need to mention the sex if you’re
developing an app or a technology you
need to mention if it’s gonna be
applying on both men and women to always
disaggregate your data by sex
meaning that presents your data
separately for men and women and if
included in your study transgender
persons and finally and most importantly
analyze your data with the gender lens
look at differences look at biological
differences if you’re in a medicine look
at gender-based differences and if you
do not look up any differences between
the sexes and the genders you better
have a good excuse and we want to hear
that the sager guidelines were launched
in 2016 and it has received a lot of
attention more and more journals are
endorsing it or translating it into
other languages but we have a long way
to go there is still a lot of resistance
to change but now I’m confident I’m
confident that the change is possible
and it’s happening there is increasing
number of researchers doctors patients
who are aware of these important
differences and demanding a change and I
want to invite you to join this movement
you can make a difference while you may
choose different career paths we all
have something in common we all have a
sex and we all have a gender we are all
patients and consumers protecting our
health and that of our loved ones so
demand evidence question current
practice drive a change let’s together
put on our gender lens and make sure
health care and our society is based on
evidence and benefit all today we know
that every cell is sexed today we know
that everybody is gendered this is no
longer a question today we know that sex
gender matter thank you
[Applause]
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