When I was five years old my forty-two year old father took an overdose of sleeping pills in an attempt to end his life. He survived physically, but our lives were never the same. I grew up wondering what happened to my Dad. Later in life, after I had gone into the health-care field, I learned that he had been irritable and angry for many years, but no one recognized how depressed he was.
Given my family background, it’s not surprising I did my Ph.D. research and dissertation on the differences between male and female depression. Until I had begun my research depression, like other diseases, was seen to be a gender-neutral illness. The same diagnostic scales used to assess depression were given to men and women. Based on the assessments, it was generally accepted that, world-wide, women experienced depression at twice the rate of males. If that were really the case, I wondered why the suicide rate for males was 3 to 18 times higher for men than it was for women.
I suspected that symptoms for depression in men were different than the symptoms of depression in women and that millions of men’s lives could be saved if we used a more gender-specific questionnaire to assess depression. I developed a new instrument that included questions that related to male irritability and anger and found that with a gender-specific assessment of depression more men would be found to be depressed, more could receive treatment, and fewer would feel that suicide was the only way to relieve their emotional pain.
Marianne J. Legato, M.D. is a cardiologist who also found that taking a gender-neutral stance to medicine could be harmful. It was long assumed that heart disease manifested the same in men and women. But it turns out the symptoms of a heart attack may be very different in men than in women. Men may experience the classic symptoms of chest pain that radiates down the left arm. Women often have symptoms including shortness of breath, nausea or vomiting, and back or jaw pain. A gender-neutral approach left many women under-diagnosed and under-treated and as a result many women needlessly died.
To address these issues Dr. Legato founded the Partnership for Gender-Specific Medicine. After a number of years studying these sex and gender differences she concluded, “Everywhere we look, the two sexes are startlingly and unexpectedly different not only in their internal function but in the way they experience illness.”
Dr. Legato’s gender-specific approach to treating illness has found increasing validation and support. According to David C. Page, M.D., professor of biology at the Massachusetts Institute of Technology (MIT), “There are 10 trillion cells in human body and every one of them is sex specific.” We all know that males have an XY chromosome in every cell and females have an XX chromosome, but we haven’t fully understood the implications.
It has been said that our genomes are 99.9% identical from one person to the next. “It turns out that this assertion is correct,” says Dr. Page, “as long as the two individuals being compared are both men. It’s also correct if the two individuals being compared are both women. However, if you compare the genome of a man with the genome of a woman, you’ll find that they are only 98.5% identical. In other words the genetic difference between a man and a woman are 15 times greater than the genetic difference between two men or between two women.” (In other words, a .1% difference vs a 1.5% difference.)
These differences can, and do, make a difference. “Already at my institute,” says Dr. Page, “we have discovered that XX cells and XY cells go about their business, of making proteins for instance, in slightly different ways.” These differences have implications on which diseases we get and how best to treat them. “So all your cells know on a molecular level whether they are XX or XY,” says Dr. Page. “It is true that a great deal of the research going on today which seeks to understand the causes and treatments for disease is failing to account for this most fundamental difference between men and women. The study of disease is flawed.”
My wife Carlin and I often have conflict around memory. I’m forever forgetting where things should be put away. I just can’t seem to remember what pot goes in which cabinet. She on the other hand seems to remember every mistake I’ve ever made in my life.
My wife Carlin and I often have conflict around memory. I’m forever forgetting where things should be put away. I just can’t seem to remember what pot goes in which cabinet. She on the other hand seems to remember every mistake I’ve ever made in my life.
Dr. Legato wrote a book on male/female differences called Why Men Never Remember and Women Never Forget. Recent research has shown that women have a higher rate of blood flow to parts of the brain associated with memory. “This is one of the reasons researchers give for the overwhelming evidence that women have better immediate and delayed recall of the spoken word,” says Dr. Legato. “Women’s higher levels of estrogen also helps with memory. Higher levels of it are associated with improved learning and memory and this may be why women are better at these tasks.”
I’ve found the field of gender-specific medicine has informed my own practice working with men and the families who love them. I suspect we will see an expanded use of these approaches in the larger health system.
Already some of the health data available at Healthy Mendocino is gender-specific. For instance, here’s a look at heart disease and psychological distress through a gender-specific lens. An expanded focus to include sex and gender issues will benefit men, women, and children.
Already some of the health data available at Healthy Mendocino is gender-specific. For instance, here’s a look at heart disease and psychological distress through a gender-specific lens. An expanded focus to include sex and gender issues will benefit men, women, and children.
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Jed Diamond has been a health-care practitioner for more than 40 years and specializes in Gender-Specific Medicine. He has authored 14 books on health including international best-sellers, Male Menopause and The Irritable Male Syndrome. His latest book, The Enlightened Marriage, will be published later this year.
Author:
Jed Diamond, Ph.D
Resource Date:
February 2, 2016
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