What is Gender Medicine? - The Genders

Presentation by Prof. Dr. med. Alexandra Kautzky-Willer

Part 1: What is gender medicine?

Gender medicine – often also referred to as “gender-specific medicine” – has its roots in the feminist movement. For a long time, not only the general view of the world was male-dominated, but in medicine, too, the male served as the prototype of human beings. The medical knowledge regarding clinical pictures, diagnosis, and therapy was based on this one model.  “35 years old, 80 kg, white, male”, explains Univ. Prof. Dr. Alexandra Kautzky-Willer, Professor of Gender Medicine, in a lecture. Blind spots were thus systemic.

Only with the rise of the feminist movement did the topic of women’s health also come into focus. The first reports on female health were produced which in turn inspired specific male health reports. From the endeavor to consider humans in a more differentiated manner, gender medicine developed. It is the first and most important step towards patient-centered, individualized medicine.

Gender medicine is individualized medicine

When we speak today of “precision medicine”, of a medicine that treats the patient with a view to individual circumstances, gender also always plays a role. Gender medicine therefore always deals with both – with men and women. Thus, differences, but also similarities can be found.

Kautzky-Willer: “This is important: It does not always have to be different. The important thing is to check and see if symptoms, diagnosis and choice of therapy differ for certain clinical pictures. If they turn out to be identical: great! Otherwise, however, you need to take this into account.”

Differences between men and women span the entire medical spectrum – from health-related behaviors and prevention through symptoms, disease, and diagnosis to therapy and rehabilitation. The indications are likewise manifold. As a holistic approach, gender medicine deals with all organs and disease patterns, not only with “female-specific” (e.g. breast, uterus) or with “male-specific” (e.g. prostate) ones. 

The World Health Organization (WHO) puts it briefly: „Being a man or a woman has a significant impact on health“. One of the WHO’s health-related goals is therefore gender equality (i.e. equality of chances between genders). 

Gender and/or sex

Anyone who wants to understand this “significant impact on health” has to deal with two components:

• sex (biological) and
• gender (social)

Either interacts with the other throughout live, influencing, up into old age, how diseases arise and how we experience them.

Gender was described as early as in 1949 by the French author Simone de Beauvoir: “One is not born, but rather becomes, a woman.” De Beauvoir (and later also gender medicine) thus refers to social influences, to education, and to the individual life situations of women. How is power distributed? Who has the resources? Many studies show the health-related effects of education and pay. Equal opportunities as defined by the WHO Health Objective therefore mean reduction of social inequalities. Experiences of violence also affect women more strongly than men.

Gender manifests in social norms. This is evident, among other things, when looking at women’s and men’s magazines. Food-related articles for men focus – to put it in a very clichéd manner – around the topics of barbecues and beer, male health articles refer to potency, and in the fitness magazine, men can read about the fastest way to get a six-pack. Women’s magazines meanwhile subscribe to the “optimal nutritional plan for her”; it is all about dieting, healthy recipes, and fitness plans in order to achieve a bikini-perfect figure.

XX and XY and other sexes

The second mainstay of gender medicine, “sex”, deals with the role of biology, especially of the sex chromosomes. Women have the sex chromosome configuration XX, men XY.

The X chromosome carries the majority of genes for heart, brain, and immune system. This affects many areas: Women have a stronger immune system than men do; they are less at risk for infectious diseases; and they have better antibody production after vaccination. The other side of the coin is that women are more often affected by autoimmune diseases. These include, among others, hyper- or hypothyroidism, multiple sclerosis and rheumatic diseases.

The Y chromosome mainly contains genes that are related to sexual function.

Latest research even suggests a third sex. This refers to persons who cannot be classified in the binary “male or female” system. Here, although sex is determined, there is a deviating but healthy gender identity, a sexual differentiation disorder, or a gender identity disorder. These findings must also be considered in gender research.

Sex hormones

The following applies to all genders: The sex hormones play an important role in health. Almost all organs have receptors (docking points) for sex hormones and are influenced by them. They influence whether and when (and which) diseases occur.

+++ Read in Part 2: What are the physical differences between men and women? +++

The author, Prof. Dr. med. Alexandra Kautzky-Willer, Medical University of Vienna (MedUni Vienna), is the scientific director of the Institute for Gender Medicine in Gars am Kamp, a healthcare facility of VAMED in cooperation with MedUni Vienna.

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+ "Part 3 - What is Gender Medicine? - Cardiology, body weight, cancer, depression & medications" - from Univ. Prof. Dr. Alexandra Kautzky-Willer
+ "Lose weight in a healthy and sustainable way" - from Dr. univ. med. Alex Witasek