Sex Is More Than Skin Deep

NOT LONG AFTER I APPLIED FOR, and was granted, a research position at Brown University, I submitted a proposal for a didactic presentation at the annual meeting of the Society for Academic Emergency Medicine (SAEM). The presentation was titled “Women’s Health and Gender-Specific Research in Emergency Medicine: Yesterday’s Neglect, Tomorrow’s Opportunities.”
I was beyond excited about what I was discovering about women’s bodies and their physiological and biochemical uniqueness, and I couldn’t wait to share this with my peers. Surely, they would be as stunned and galvanized as I was.
Honestly, I was shocked that my proposal was accepted. I was a “newbie,” a mere junior physician, barely out of my residency. Feeling empowered, I rounded up three experts to discuss sex and gender in relationship to emergency medicine. We all prepared our slides and notes and practiced our different roles in the presentation.
We flew out to Chicago for the meeting. I don’t think I’ve ever been so nervous. This was my chance! I was going to start a conversation that would change emergency medicine forever!
Finally, it was time for our presentation. The previous didactic wrapped up, and the room was efficiently changed over. My colleagues and I came in with our notes and slides and set up quietly. The room was empty—but that was okay. People were coming from all over the hotel; it would take them time to arrive.
I fidgeted in my seat, watching the clock. Five minutes to go. Three. Two.
And then, it was time.

I looked out over a sea of empty chairs. The room was set up to hold sixty people, but only two seats were taken—one of them by my colleague and friend were taken—one of them by my colleague and friend Dr. Libby Nestor and the other by my male officemate from Brown who’d stopped in to cheer me on before heading to the airport.
I had no idea what to do. My fellow presenters and I just sat there, staring at each other. Eventually, as if by unspoken consensus, we all stood and started packing our things. Our big idea, it seemed, was dead in the water.
This was such a powerful moment for me. Here was a conversation that could change the face of medicine as we knew it, something that could mean life or death for millions of women around the world—and no one showed up.
I understand now that my fellow physicians didn’t skip my talk because they didn’t care about women’s health issues. They simply didn’t know what they didn’t know. In some respects, I was ahead of my time.
Research, education, and the work of actually providing care to patients are often treated as separate entities in our everyday medical reality. However, the knowledge that researchers gain is incorporated into medical education, which eventually has an effect on bedside care. If I wanted to create real, lasting change within modern medicine on behalf of women and their unique bodies, I would have to address all three of these areas simultaneously. I would have to educate researchers, inspire medical students, and serve my patients in a new, more enlightened way. My Sex and Gender Women’s Health Collaborative has given me momentum to do exactly that, through fellowships, lectures, programs, meetings, and research.
In this chapter, I’ll reveal the many ways in which the current medical establishment isn’t set up to support women’s bodies and how our flawed belief that women’s bodies are equivalent to men’s has negatively impacted women’s outcomes at every level of care. We’ll explore how, in every setting, from pharmaceutical laboratories to hospitals to physicians’ offices, the male-centric model of medicine is ubiquitous and nearly unquestioned—and how understanding the impacts of this male “norm” can mean the difference between life and death for women across America.



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