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.

 

Australian Burden of Disease Study: Illicit Drug Use, Intimate Partner Violence, Unsafe Sex

 Australian Institute of Health and Welfare, Last updated: 

Burden of disease is a measure of the years of healthy life lost from living with, or dying from disease and injury. A portion of this burden is preventable, being due to modifiable risk factors. This report provides information on the deaths and burden of disease due to risk factors included in the Australian Burden of Disease Study 2015. 

New analyses of the key drivers of change over time in the burden of disease due to selected risk factors have recently been added to these data visualisations (August 2020).

The following excerpts may be of interest:

Or you can see all the data here

 

 

Network MindOut webinar: The Impact of Bisexual+ Invisibility on Mental Health

National LGBTI Health Alliance, Recorded 24th March 2020

Bisexual+ people are thought to be the largest group in the LGBTIQ+ population, yet are commonly misunderstood by mainstream society and often invisible in the broader LGBTIQ+ discourse. Although many bisexuals are comfortable with, if not proud of their identity, research from around the world tells us that bisexual+ people are more vulnerable to systemic and individual victimisation than lesbians and gays, and mental health outcomes are particularly poor as a result. This webinar will explore the impacts of bisexual+ invisibility on mental health, and will offer practical tips on how to be more inclusive.

Presenter: Misty Farquhar is a PhD Researcher at the Curtin University Centre for Human Rights Education, where they also teach. Misty’s research explores how people living outside binary ideas of sexuality / gender experience recognition in Australia. Misty is extremely active in community outreach, education, and advocacy efforts and is the founder of Bisexual+ Community Perth.

Snapshot of mental health and suicide prevention statistics for LGBTI people

The National LGBTI Health Alliance (The Alliance), February 2020

Although many lesbian, gay, bisexual, transgender and intersex (LGBTI) Australians live healthy and happy lives, research has demonstrated that a disproportionate number experience poorer mental health outcomes and have higher risk of suicidal behaviours than their peers.

These health outcomes are directly related to experiences of stigma, prejudice, discrimination and abuse on the basis of being LGBTI. This document aims to provide a snapshot of what is known of the current mental health and wellbeing outcomes of LGBTI people in Australia.

Psychosocial mediators of perceived stigma and suicidal ideation among transgender women

Kota, K.K., Salazar, L.F., Culbreth, R.E. et al. Psychosocial mediators of perceived stigma and suicidal ideation among transgender women. BMC Public Health 20125 (2020). https://doi.org/10.1186/s12889-020-8177-z

Abstract

Background

Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

Methods

Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact of gender minority status, and substance use behaviors as potential mediators for the relationship between perceived stigma and suicidal ideation. All models were controlled for age, race, education, and homelessness.

Results

Suicidal ideation was reported by 33% (N = 30) of the study participants. In multivariable analysis, suicidal ideation was associated with sexual abuse (AOR = 3.17, 95% CI = 1.10–9.30), anxiety (AOR = 1.74, 95% CI = 1.10–2.73), family verbal abuse (AOR = 2.99, 95% CI = 1.10–8.40), stranger verbal abuse (AOR = 3.21, 95% CI = 1.02–10.08), and psychosocial impact of gender minority status (AOR = 3.42, 95% CI = 1.81–6.46). Partner support was found to be the protective factor for suicidal ideation (AOR = 0.34, 95% CI = 0.13–0.90). In the mediation analysis, the psychosocial impact of gender minority status mediated the relationship between perceived stigma and suicidal ideation. The estimated conditional indirect effect was 0.46, (95% CI = 0.12–1.11).

Conclusion

Interventions that aim to reduce suicidal behaviors among TGW should address stigma, psychosocial imfamilpact of gender minority status, and different forms of violence and abuse.

Calls for segregated mental health wards to reduce sexual assault risk

ABC (Katherine Gregory on AM), February 2020

Sexual violence against women in mental health wards is going unchecked, despite service providers’ awareness of the problem.

A new report has found women in Victorian mental health wards are vulnerable to sexual assault, harassment and violence from male patients and staff.

It’s calling for stricter separation of male and female patients in mental health wards and an overhaul of how assault complaints are dealt with.

Broadcast: 
Duration: 3min 49sec
Featuring:

– Doctor Juliet Watson, RMIT University
– Charlotte Jones, Victorian Mental Health Legal Centre