Video Transcript – What a Difference Sex and Gender Make in Health Research

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Dr. Joy Johnson, Scientific Director, CIHR Institute of Gender and Health:

Gender and sex make a difference in health research. Indeed, gender and sex make a difference to the health of everybody.

Gender has to do with our social roles, our identities and what society expects from men and women. Sex, on the other hand, has to do with our biological make-up, our chromosomes, our hormones, our sexual organs.

The CIHR Institute of Gender and Health has a mission to foster research excellence that focuses on the health of men and women and to encourage considerations of sex and gender.

Researchers, however, often struggle with how to apply the concepts of sex and gender in their own research, and so we've developed a casebook with 12 excellent examples that can help demonstrate how to apply and utilize the concepts of sex and gender in health research.

Dr. Randy Fransoo, University of Manitoba:

My name is Randy Fransoo and I'm with my mom, Angèle, who's the inspiration for this story.

I'm a Research Scientist at the Manitoba Centre for Health Policy at the University of Manitoba. I used to think that gender was just a politically correct term for "sex" but I've learned the difference and you can too by reading this casebook.

In health research, producing separate results by sex and/or gender lets you see the whole story in your data. Unless you do that, you can be misled by averages that may mask underlying differences. So, if you don't check, you'll never know.

My chapter starts with a personal story about my parents and how their experiences affected our study of sex differences in cardiac care.

Our research shows that accounting for age and sex were both critical. Our initial results mirrored the findings of previous studies that showed that men get more cardiac treatments than women.

But here's the gold nugget: When you separate the results by sex and age, you see that it is not that males get more treatments than females, it's that younger patients get more treatments than older patients, and because men are younger when they experience their heart attacks, it looks like there's a sex bias when, in fact, there isn't. Men and women in each age group were equally likely to receive these treatments.

These findings are important because they show that the historical sex bias in cardiac care has been overcome. Women now experiencing heart attacks are as likely as their same-aged male counterparts to receive these key cardiac interventions.

Dr. Yves Tremblay, Laval University:

My name is Yves Tremblay. I am currently Professor in the Obstetrics and Gynecology Department at Laval University.

I am also currently a scientist at the CHUL Research Centre and, as a part of my scientific activity, I am the Director for the Health Respiratory Network of the Fonds de Recherche - Québec en Santé.

In this chapter, we provide our example of how, by introducing the fetal lung tissue from females in our experimental design first with the normal idea that female tissue will serve as a negative control, we have discovered, for both male and female, the fetal lung can synthetize androgen and, therefore, unexpectedly, a new role for male sex steroids essential for normal lung development in both females and males was discovered.

So androgen synthesis by fetal lung tissue in both sexes in correlation with critical processes during lung maturation is a novel concept that introduces a new perspective on the role of androgen in the fetal lung and makes much more complex our approach to control the action of androgen with regard to respiratory distress syndrome in neonates.

This discovery has shifted our paradigm on the control of androgen action during fetal lung development and how to look at its control with respect to some neonatal diseases and lung maturation.

Coexistence of physiologic and pathologic effects of androgen on fetal lung is novel and is now considered as essential to approaching neonatal lung complications.

In summary, from our experience, we demonstrate why and how integration of each sex in our approach has bonified our discovery.

The second benefit is also how, by integrating sex, we were invited to go further in this paradigm of the sex- and gender-based approach by integrating more human science related to premature birth and the consequence of being born prematurely. Thank you.

Dr. Johanne Saint-Charles, University of Quebec at Montreal:

Our chapter is a collective work. It is based upon research done in interdisciplinary research projects using ecosystem approaches to health.

These projects aim at understanding and, hopefully, finding solutions to problems related to health and the environment.

Ms. Marie Eve Rioux-Pelletier, University of Quebec at Montreal:

We have tried to better understand the role of sex and gender in the diffusion of information and in the adoption of practices that promote better health.

Among other things, we have looked at exchange and discussion networks within communities concerned by the issues.

Dr. Pierre Mongeau, University of Quebec at Montreal:

Our main conclusion is that the process of diffusion is often different for women and men.

Therefore, to favour equity, we should take the following into account: Men and women are often seen as having to have areas of specialization leading to the fact that some topics will be more discussed by either men or women.

This leads to distinct exchange and diffusion networks. For example, in our studies in the Amazon, health and food were mostly discussed by women while fishing and agriculture were mostly addressed by men.

Ms. Marie Eve Rioux-Pelletier:

Another lesson in our chapter is that these differences vary depending on the social context, and it is important not to hold stereotypical views on which topics belong to which gender.

Dr. Johanne Saint-Charles:

Finally, to conclude this overview of our chapter, I will say that since there are distinct paths of diffusion between men and women, it is also important to find places of connection between their networks so that knowledge and practices can circulate.

I hope you will enjoy your reading.

Dr. Joy Johnson:

This casebook demonstrates why it's important to consider gender and sex in health research and what we stand to gain from this practice.

Our work at the CIHR Institute of Gender and Health seeks to foster the routine integration of gender and sex considerations into all domains of health research.

If our research designs do not take sex and gender into account, the evidence that we generate may be incomplete or simply incorrect. We risk not only doing harm but also missing critical opportunities to improve the health of men of women.

For health researchers contemplating taking up sex and gender in their studies, this collection offers examples of how this can be done.

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