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IGH is the only organization in the world with a mandate to fund research on gender, sex and health. The mission of IGH is to foster research excellence regarding the influence of gender and sex on the health of women and men throughout life, and to apply these research findings to identify and address pressing health challenges. The production of What a Difference Sex and Gender Make would not have been possible without the immense contributions of many in all stages of the process, including:.

It is with great pride that we present this gender, sex and health research casebook, What a Difference Sex and Gender Make. For over 10 years we have supported research that fills critical knowledge gaps related to the health of women, men, girls, boys and that advances the science of gender, sex and health — some of this stellar work appears in the s that follow.

We can no longer assume that drugs, devices, interventions and policies are equally appropriate for men and women. In Canada, men die younger than women, while women experience a heavier burden of chronic illness. There are numerous differences in how men and women behave with regards to their health, their use of the health system and their responses to therapies.

There is also great diversity within populations of women Free pussy in Canada n c of men, as well as important similarities between men and women that need to be considered in prevention and treatment. Our purpose in developing this casebook is to showcase the difference that ing for sex and gender makes in health research. The casebook is a resource of concrete examples — from across the gamut of health disciplines and topics — of how gender and sex considerations are being incorporated in health research and why this is important. It is the position of IGH that all health research should consider the influence of gender and sex in any phenomena of study.

If our research des do not take sex and gender intothe evidence we generate may be incomplete or simply incorrect; we risk not only doing harm such as extrapolating findings based on male samples to femalesbut also missing critical opportunities to improve health for example, not detecting the benefits of an intervention in a subgroup of men.

We recognize that there are research questions where sex and gender are not relevant — but irrelevance should be determined by scientific rationale, not oversight. This casebook will serve as a guide for health researchers looking to incorporate gender and sex into their work. We hope that this casebook will circulate far and wide in support of research to improve the health of everybody. In this collection, you will find examples from a diversity of disciplines and health foci where ing for sex and gender in health research has advanced what we know, improved how we do research and made the products of health research more useful.

This is the difference that sex and gender make. What this casebook demonstrates is that this difference is ificant; there is much to be gained from the routine integration of gender and sex across the health research spectrum. Each of the 12 chapters in this volume illustrates how health research processes and outcomes can look different when the influences of sex and gender are considered. Questions to consider are included to encourage readers to explore ways that sex and gender can benefit their own work.

What a Difference Sex and Gender Make will be of interest to a range of audiences. For trainees and newcomers to gender, sex and health research, this casebook offers a reference point to begin a foray into the field. For researchers contemplating taking up sex and gender in their studies, this collection offers examples of how this can be done.

For the wider gender, sex and health research community, this casebook aims to spark new ideas and approaches to drive the field forward. We hope that this resource will be shared with colleagues and the next generation of gender, sex and health researchers.

Gender Free pussy in Canada n c generally viewed as a social concept. There are no universally accepted definitions or easy separation of these terms. We acknowledge that definitions of sex and gender are evolving as the science changes.

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This casebook is organized into three parts that focus on the difference that sex and gender make in terms of: 1 shifting the health research landscape, 2 strengthening science, and 3 translating research into action.

While we have situated chapters within this three-part thematic, we note that many speak across these foci — and rightfully so; knowledge creation, research methods and knowledge translation are all part of the iterative process that we call research. We begin in Part I with examples of where integrating gender and sex has created new knowledge about health and illness. We have gleaned new insights about the mechanisms underlying disease, shifted paradigms of knowledge based solely on evidence derived from a single sex and improved the applicability of findings. In chapter 1Mendrek chronicles her path to developing a program of research on gender and sex differences in schizophrenia.

She plots her own practical and political challenges in considering gender and sex in mental health research as a student and newer researcher against a turn in some areas of the field to recognize influences of sex and gender.

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Mendrek illustrates how a sex-blind approach risks generating erroneous findings. In chapter 2Simard, Boucher and Tremblay describe how considering sex in their biomedical research on lung development led to better understandings of the health risks associated with premature birth for both boys and girls. Taking a historical view, in chapter 3 Juster and Lupien document how gender and sex changed the course of stress research. They demonstrate how stress is a case in point where the intersections of gender social stressors and sex biological reactions matter in determining the trajectories of stress-related conditions.

Systematic reviews are syntheses of multiple research studies on a given topic that are regarded as one of the most authoritative sources of scientific evidence. It is evident in these chapters that incorporating sex and gender in health research can reconfigure the knowledge status quo. Part II brings together cases that exemplify how taking sex and gender into contributes to more robust methods and analytic frameworks.

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Our study des frame the possibilities for what we can know and what we can do with our research evidence; including gender and sex expands the scope of those possibilities and provides a frontier for innovation. In chapter 6Messing, Stock and Tissot draw on their research about the effects of prolonged workplace standing to illustrate why stratifying by gender in multivariate statistical analyses reveals links between exposure and effect that may otherwise remain hidden.

Savary, in chapter 7shares analytic lessons learned about the importance of considering gender in assessing the implementation of a safety protocol in a male-dominated industry. Savary demonstrates how making gender an explicit factor in her research enabled her to uncover flaws in the safety plan that could not be explained by her initial approach.

Closing this section, Bauer illustrates how the treatment of sex and gender in survey de can lead to the exclusion of transgender study participants. Bauer shows how sex and gender in survey question de can be addressed to be more inclusive of populations. These chapters present some of the myriad ways that gender and sex considerations contribute to more scientifically sound. The third and final section of this casebook focuses on moving research into action, also known as knowledge translation KT.

KT involves the translation of research evidence into domains such as policy and practice where it can be applied to improve health and health care. The chapters in this section demonstrate how integrating sex and gender into strategies for KT can lead to more streamlined utilization of research evidence and more tailored interventions. Banister and Begoray, in chapter 10explore how gender influenced the development and success of a sexual health literacy program for Indigenous female adolescents. Diaz-Granados and Stewart, in chapter 11report how a sex- and gender-based analysis led to health-related policy changes at a national level in multiple countries; their work underscores the potential of using a sex and gender lens for generating wide-ranging impacts.

Finally, Oliffe, Bottorff and Sarbit recount their development of the first-ever men-centred resource for reducing and quitting smoking. Their work illustrates how gender can be a catalyst Free pussy in Canada n c bridge the gap between knowledge and health behaviour change.

By creating an intervention that tapped into masculine ideals, the team effectively packaged health messaging to be meaningful for men who smoked. The diversity of examples contained herein underscores the transversal relevance of gender and sex to the study of health. As a collection, these cases paint a compelling picture of the difference that sex and gender make in health research. About Knowledge Translation. ificant epidemiological and clinical data has amassed over the years indicating important differences between women and men in the prevalence, course and expression of various mental health problems.

As an undergraduate student in the Psychology Honours Program at Concordia University I became interested in gender research. The first major project that I deed assessed the relationship between masculinity and femininity as measured by the Bem Sex Role Inventory and self-esteem.

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Consistent with existing reports in this area, I found positive correlations between masculinity and self-esteem measures, and negative correlations between femininity and self-esteem. The following year, for my honours thesis project, I asked my potential supervisor, an expert in the behavioural neurobiology of drug addiction, if I could investigate sex differences in the rewarding properties of amphetamine in rats. Still, during my graduate and postdoctoral training, while continuing research on the neurobiology of motivated behaviour, and later while studying brain function in schizophrenia patients, it was difficult to convince my supervisors to invest in examining sex and gender differences by testing sufficient s of males and females.

There were numerous practical obstacles to doing this type of research — above all the fact that including both female and male rats in studies is more expensive and produces more variable. Female rats have an estrous cycle — the equivalent of human menstrual cycle — that contributes to this variability. I stopped insisting on studying both male and female subjects. I was not certain anymore if studying sex and gender differences was a worthwhile endeavour. I convinced myself partly because of my socio-cultural background and bias, and partly because of the lack of evidence to convince me otherwise that the neurobiological sex differences were so negligible that they could be ignored in neuroanatomical and neurofunctional research.

However, with time, science proved me wrong: new evidence started emerging that pointed to undeniable differences between male and female organisms that were no longer restricted to reproductive organs and behaviour, but encompassed cognitive strategies, emotion processing, responses to stressful situations, and so on. Thus, when I finally established myself as an independent researcher, I decided to re-visit my initial research passion and examine potential sex and gender differences in severe psychiatric disorders.

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I ventured into the literature and was surprised by what I discovered: Despite a wealth of research that established that some of the most prevalent psychiatric problems, including depression and anxiety disorders, are diagnosed more frequently and often have a more serious clinical course in women than in men, considering gender and sex in mental health research and clinical practice was still quite rare. For example, the lifetime prevalence of major depressive disorder MDD in women is approximately twice that of men. Free pussy in Canada n c has been proposed to be an important player in this sex difference because: 1 the rates of MDD are similar in girls and boys before puberty and among elderly people; and 2 mood often appears to fluctuate with changes in hormones, such as the low-estrogen premenstrual and postpartum periods when women are at increased risk for mood disorders Freeman et al.

Gender-related psychosocial factors have been identified as potential contributors to the differential prevalence of MDD in men and women. The picture is further complicated by a clinical bias to diagnose depression in women more readily than in men. When it comes to addictive, compulsive and obsessive behaviours, large discrepancies between the sexes have also been observed. It is important however to point out that despite lower rates of drug abuse in women than in men, the of women using and abusing prescription and illegal drugs is increasing.

Following initiation, women tend to increase their rate of consumption and become addicted to alcohol, marijuana, opiates and cocaine more rapidly than do men. The underlying mechanisms of these sex differences remain unclear, but a few factors have been studied including the hormones estrogen and progesterone.

When I revisited the field I was primarily interested in schizophrenia and related psychoses and realized that very little research had focused on sex and gender differences in this complex and devastating condition. It typically begins during late adolescence or early adulthood, often le to a social and economic impoverishment and to great distress for patients and their families.

It is characterized by a heterogeneous clinical presentation with symptoms ranging from hallucinations and delusions so-called positive symptomsthrough to disorganized behaviour, to social withdrawal, poverty of speech and lack of motivation referred to as negative symptoms. There is still controversy as to whether there are sex differences in the lifetime risk of developing schizophrenia, but researchers and clinicians agree that in the younger population the risk is higher in men, while over the age of 40 the risk is higher in women.

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Although these differences have been well documented, we still know very little about their underlying mechanisms. Consequently men and women with schizophrenia tend to receive similar psychopharmacological drugs and psychosocial interventions group homes, occupational therapysometimes with suboptimal. An example is the prescription of similar antipsychotic dosages resulting in more serious side effects in women who typically require smaller doses Seeman, All of this has motivated me to establish a research program devoted to examining neurofunctional, hormonal and psychosocial factors implicated in sex and gender differences in psychoses.

Specifically, in one study we asked participants to perform a classic mental rotation task where participants are presented with pairs of rotated or unrotated figures and have to determine if the figures are identical or if they are mirror images. During this task, participants are scanned with functional magnetic resonance imaging fMRI imaging that shows how the brain works.

This task normally elicits better performance and greater brain activations in men than in women in the general population. What is critical to note is that we would not have been able to detect this effect if we had included only one sex in our study. Figure Brain activations during mental rotation in schizophrenia patients and in healthy comparison patients. Unfortunately, an overwhelming majority of functional neuroimaging studies in schizophrenia consist of exclusively or predominantly male samples.

Even if the samples are mixed, there is usually an insufficient of women to allow for comparison between the sexes. In fact, had we only included men in our study, our conclusions would be only partly true. A male-only sample would have led us to argue that patients with schizophrenia were characterized by deficits in visuo-spatial processing at the behavioural and neurofunctional level when, in fact, it was only male patients who presented with a dramatic deficit; this deficit was not presented by female patients. Our suggest that women and men with schizophrenia may be characterized by different cognitive and neural anomalies.

This is important because neurocognitive deficits represent a hallmark problem in schizophrenia and some cognitive remediation techniques have been developed recently to help patients in their daily activities. Characterization of differences in cognitive function and underlying brain circuitry could help in applying unique approaches appropriate for each sex.

More generally, this research may contribute to developing better models and theories of schizophrenia, Free pussy in Canada n c would take sex and gender into consideration. It is possible that the factors contributing to the development of psychoses are different in men and women. Larry Cahill has been exploring sex and gender differences in emotional memory over the past 10 years with some striking. In closing, the following by Cahill is an important methodological point:.

The striking quantity and diversity of sex-related influences on nervous system function argue that the burden of proof regarding the issue has shifted from those examining the issue in their investigations generally having to justify why, to those not doing so having to justify why not. Cahill,p. Becker, J. Sex differences in drug abuse. Frontiers in Neuroendocrinology, 2936— Cahill, L. Sex influences on brain and emotional memory: The burden of proof has shifted.

Progress in Brain Research,29—

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What a Difference Sex and Gender Make: A Gender, Sex and Health Research Casebook