Sex and gender: modifiers of health, disease, and medicine

The Lancet, Volume 396, Issue 10250, 22–28 August 2020, Pages 565-582
Mauvais-Jarvis, F., et al

Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men’s and women’s health.

 

Pride in Prevention: A guide to primary prevention of family violence experienced by LGBTIQ communities.

Pride in Prevention Evidence Guide

Produced by Rainbow Health Victoria for the LGBTIQ Family Violence Prevention Project 2019–202, launched 30 Jun 2020

Authors: Marina Carman, Jackson Fairchild, Matthew Parsons, Claire Farrugia, Jennifer Power and Adam Bourne.

The Pride in Prevention Evidence Guide  is now available to download.

This project forges new ground in the primary prevention of family violence experienced by LGBTIQ communities, seeking to address critical evidence gaps, strengthen understanding of the drivers of violence, and build expertise for both LGBTIQ organisations and family violence primary prevention organisations to effectively deliver evidence-based programs.

COVID-19: A Gender Lens – sexual & reproductive health and gender inequality

UN Population Fund (UNFPA), March 2020

Disease outbreaks affect women and men differently, and pandemics make existing inequalities for women and girls and discrimination of other marginalized groups such as persons with disabilities and those in extreme poverty, worse. This needs to be considered, given the different impacts surrounding detection and access to treatment for women and men.

Women represent 70 percent of the health and social sector workforce globally and special attention should be given to how their work environment may expose them to discrimination, as well as thinking about their sexual and reproductive health and psychosocial needs as frontline health workers

The sex lives of young women marked by frustration, stress, guilt and embarrassment

Monash University, 24 Feb 2020

Professor Susan Davis, a leading Monash University expert on women’s health, admits it was a highly ambitious project: minutely studying the sexual wellbeing of 7000 young Australian women with particular focus on complicated, intimate ideas such as desire, arousal, orgasm, responsiveness and self-esteem.

Now that it’s done (and published this week in the international journal Fertility and Sterility), she’s “very concerned.” The main finding is that half of the women studied experience personal “distress” related to sex. One in five has at least one sexual dysfunction. “Young” means aged 18 to 39. The concern, she says, is because “sexual wellbeing is recognised as a fundamental human right”.

“This is a wake-up call to the community,” she says. “This is what we [society] are doing to people. We expected to find that a meaningful number of young women had sexual issues, but we were not expecting to find half were distressed sexually.”

Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia

Ziersch, A., Due, C. & Walsh, M. Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia. BMC Public Health 20108 (2020). https://doi.org/10.1186/s12889-019-8068-3

Abstract

Background

Research has shown that discrimination is harmful to health, but there is relatively little known about discrimination experienced by people from refugee and asylum-seeking backgrounds in resettlement countries and associated health effects. This qualitative-focused mixed methods paper reports on discrimination experienced by refugees and asylum seekers, responses to discrimination, and impacts on health.

Methods

As part of a broader study of housing, social inclusion and health, surveys were completed by 423 adult refugees and asylum seekers living in South Australia who had been in Australia for up to 7 years. The survey included questions on discrimination based on skin colour, ethnicity and religion, as well as questions on hope, trust, belonging, sense of control and health (including the SF-8). Semi-structured interviews were conducted with 65 survey participants, purposively sampled by visa status, continent and gender, further exploring experiences of discrimination. These and survey open-ended responses were analysed thematically.

Results

Twenty-two percent of survey participants reported experiences of discrimination since arriving in Australia (14% in the last year), and 90% of these felt that discrimination had harmed their health. Key settings of discrimination were public transport, within the neighbourhood, and in relation to employment. Those who reported discrimination had significantly worse mental health (p < .000) but not physical health. Discrimination was also associated with less sense of belonging (p = .001), lower levels of trust (p = .038), reduced sense of control (p = .012) and less hope (p = .006). Incidents described in interviews and the open-ended survey responses included incivility, physical assault, and denial of services, experienced across intersecting characteristics of race/ethnicity, religion, gender and visa status. Responses to discrimination spanned affective, cognitive and behavioural dimensions, ranging across types of experience, participant characteristics and context, with most individuals reporting multiple response types. While some of the responses were reported by participants as protective of health, participants’ reflections indicated significant negative impacts on mental health in particular.

Conclusion

Discrimination featured in the resettlement experiences of a significant number of refugees and asylum seekers, with participants reporting clear negative impacts on mental health. Addressing discrimination is a key resettlement and health issue requiring urgent action.

New ‘Trans @ School’ resource

 LGBTI Legal Service, Legal Aid Queensland and the Queensland Human Rights Commission, in consultation with the Queensland Children’s Gender Service, 2020

This resource has been developed in consultation with the Queensland Children’s Gender Service, young people, parents and educators.
School is an important part of life for children and young people. Schools not only have an ethical duty, but a legal responsibility to provide a safe and supportive environment that protects all students, including trans and gender diverse students. As such, schools need to know how to support trans or gender diverse students, and understand that each will have specific needs.
This guide is for trans and gender diverse students, and aims to help them navigate the complex issues that can arise at school.