GenderSexuality by galitdeshe

UGAPREMED A MAGAZINE FOR STUDENTS INTERESTED IN SCIENCE AND HEALTH GRADY COLLEGE OF JOURNALISM

gender and sexuality r o b o ts

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staff Faculty Advisors Dr. Leara Rhodes

Executive Editors Annika Carter Selin Odman Sona Rao Galit Deshe Heather Huynh Jesse Hu Lily Wang Hanna Friedlander Writers Anisha Yagnik Emma Burke Hallie Smith Leah Ginn Nikhil Gangasani Nivedha Balaji Saakya Peechara Sarah Caesar Syeda Nausheen

ANNIKA CARTER Editor-In-Chief

SELIN ODMAN Content Editor

SONA RAO Online Editor

HEATHER HUYNH Operations Editor

JESSE HU Treasurer

GALIT DESHE Design Editor

HANNA FRIEDLANDER Photography Editor

LILY WANG Photography Editor

Designers Wayland Yeung Jonathan Cheaves Photographers Graham Cain

Copy Editors Annika Jonker Christina Najjar Monisha Narayanan Mickey Dao

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a message FROM OUR EDITOR

When I was a child — up until middle school, in fact — I did not have a cell phone. My family owned one desktop computer and one TV. My mother watched my brother and I like a hawk to make sure we weren’t spending too much time (or any time at all, really) using these devices. When I was young, without an iPad or cartoons, I had to entertain myself by building Legos or playing make-believe outside. Now, I have my own personal laptop, a television, an Xbox and an amazing computer that I can hold in the palm of my hand — yes, I’m talking about my smart phone. The immense progress that consumer technology has gained in the past ten years makes me feel old! When I see a two-year-old playing on his own iPhone, I feel like a stereotypical grandparent — “Back in my day we didn’t have cell phones…” Technology has become a necessity. It has revolutionized the way that we learn, the way that we think and the way that we interact with others. The innovation in consumer technology is, no doubt, immense; however, immersed in our cell

phones and computers, many of us have failed to realize the life-changing advances technology has made in the medical field. 100 years ago in 1916, just following World War One, the first successful blood transfusion was completed and the fight for contraceptives for women began. Medicine was still highly experimental and unordered. Surgery consisted of a doctor who had no greater idea of what he was doing than you or I would. In the past century, we have developed vaccines that can stop viruses before we ever feel their symptoms, drugs that are capable of making us feel better in just thirty minutes, machines that can look into our tissues and brains and robots that perform careful surgeries in place of the skilled hands of a doctor. Technology has increased consumer knowledge of medical topics, streamlined doctor-patient interactions and increased the flow of scientific information relating to our health. The list goes on. With this issue, I hope to expose the technological advances that have made the miracles of modern medicine possible. Enjoy.

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con ten ts

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Ahhh to Zika! A Response to the Epidemic Threat Heard Around the World

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THE LEARA SCHOLARSHIP WANNA WIN $500? PreMed Magazine will now be offering a scholarship in each issue. Each scholarship will require a submission from you, our readers. This submission can be a piece of writing, or artwork. In each issue, our scholarship will have a different topic for these submissions.

This month's topic is:

What makes you, you?

To enter, please send an email to ugamedmag@gmail.com by October 31st with the following information: - Your Name - Your Email Address - Your Phone Number - Your Local Address - Your Expected Graduation Date - Your Major - Your Current GPA Please attach to this email a file containing your submission. Preferred files are Microsoft Word documents, .jpgs, or PDFs. Remember, this scholarship is open to ALL majors, not just pre-health students! The recipient of this scholarship will be announced in our December 4th issue. He or she will be rewarded with $500 to be spent on furthering his or her education both on and off campus.

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CONGRATULATIONS

FALL 2016 LEARA SCHOLARSHIP WINNER

CHRISTIAN LAURENT TURN THE PAGE TO READ HIS ENTRY

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Imagine you have just become the proud parent of a newborn. You hear the baby cry just before the doctor whisks your child away for examination. After a few tense moments, the doctor turns around and congratulates you with hesitation. You are told that you baby was born with both female and male genitalia - the diagnosis is intersex.

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Anatomical sex, an issue often taught as being black and white, is a social issue like many others which comes with gray areas. However, scientifically speaking, there are three main types of intersex, which are defined as abnormalities in sexual anatomy that cannot be easily classified as male or female. Those born with true hermaphroditism have male and female internal sex organs, tissue of both the testes and the ovaries, and ambiguous external genitalia. Some people with this condition also have mosaicism of the sex chromosomes, meaning that some cells are

XY (male) while others are XX (female). The second type is gonadal dysgenesis. This type of intersex is characterized by undeveloped sex organs, internal female sex organs, and external genitalia that can fall anywhere on the spectrum from male to female. Sex chromosomes in a person with gonadal dysgenesis can be normal, mosaic, or simply one X chromosome. Finally, pure gonadal dysgenesis is a condition only seen in females. In this variety of intersex, the girls have XY sex chromosomes, female external genitalia, and underdeveloped internal female sex organs. Many of the causes of intersex are genetically linked, resulting from insensitivity to male sex hormones or the dysfunction of enzymes that play a critical role in sex determination. Once it is realized that a child is born with atypical genitalia, doctors try to discover the cause of the condition and help the parents in determining the sex of the child - which has become an extremely controversial issue.

Although searching for an “answer” to a baby’s gender may seem ridiculous, this need stems from a parent’s wish for their baby to live a normal life. Therefore, parents are willing to follow a protocol determined by doctors. This includes inspection of the external and internal sex organs, determination of future fertility, and karyotyping to determine the genetic sex. In most cases, doctors and parents evaluate the testing results to determine what sex the baby will be assigned and raised as. However, there are some patients who are not diagnosed as intersex until puberty or even until they die. In these cases, patients have less severe external presentation of symptoms. They do not realize that something is amiss until they have issues related to infertility or an abnormal progression of events in puberty. While surgery is an option for those born with ambiguous genitalia, the Intersex Society of North America recommends that babies born as intersex are raised as whatever gender the child wants -allowing for him or her to decide at an appropriate age what gender and genitalia to have. However, in some cases, surgery on internal sex organs must be done sooner, forcing the sex of the individual to be determined by doctors. For example, sex organ tumors are common in intersex patients. In these situations, the organs containing the tumor are removed and hormone therapy is implemented. No matter which treatment is chosen for the patient, therapy through counseling and honesty from family members are widely accepted as ways to help intersex patients have the best possible quality of life.

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CHALLENGES FOR SEXUAL AND GENDER MINORITY MEMBERS

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As the number of individuals identifying as members of the LGBT community is growing, understanding and fulfilling their health needs should be of major importance to those who work in healthcare. They share all of the same physical and mental issues as any other group of society, but many of their problems arise from different origins. Many struggle with hiding their sexuality, living marginalized lives and finding physicians that have the mindset, expertise and skills required to understand their bodies. The insecurity that sexual and gender minorities tend to have bring about challenges to the medical community. Hesitancy to divulge sexual or gender identity when receiving care doesn’t allow the doctor to provide the best care for the patient. Along with the routine checks that must be performed, transgender individuals should follow up with their natal sex issues, such as prostate or breast cancer checks. Prevention services are almost culturally inappropriate, for medical personnel may not always know how to be sensitive to an LGBT member’s feelings. However, many healthcare providers are not proficient in dealing with LGBT concerns. The lack of data and resources covering minority health makes it difficult for physicians to learn about their patients who are members of the LGBT community. Also, many transgender individuals choose to use exogenous hormones. If a doctor is unaware of this, they may not be able to correctly diagnose a patient’s condition.

Financial barriers also prevent minority members from receiving appropriate care. Health insurance limits a minority member’s ability to have transitional therapies, appropriate medication to aid in the transition, or even have the surgery performed. Many insurers refuse to cover these operations or resources because they are not necessary for one to have a healthy body. On top of physical issues that LGBT members may have, they might acquire a mental health disorder, such as depression or anxiety. This could be brought about by verbal, emotional or physical abuse from family or community members. Even further, these issues could cause more disorders that negatively affect health. The LGBT population is disproportionately overweight or obese. This unhealthy lifestyle could cause cardiovascular disease, lipid abnormalities or glucose intolerance. While some rely on food as comfort, others turn to substance abuse. Recreational drug use can lead to detrimental choices like unsafe sexual practices or suicide. These threats to the LGBT community are a fact of life. The medical community can help by providing education for physicians and giving minority members a comfortable experience in the office. All members of society should be cognizant of the physical and emotional struggle that LGBT members have or are going through.

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UNDERMINING THE POTENTIAL OF WOMEN IN MEDICINE Over the last quarter century, women’s representation, in otherwise male dominated professions such as medicine, has increased significantly. Today, women are entering medical school at roughly the same rate as their male counterparts, yet women encounter a rather subjective medical school experience. Often times, women are criticized and judged for their outward appearances rather than their skills and work ethic. Allyson Herbst, a current resident in internal medicine at Emory University, recalls the time in medical school a resident physician disclaimed “You’re not wearing make-up today. Maybe you should rethink that choice” (Washington Post). Women in the medical field are judged by and held to different standards in comparison to males. During performance evaluations, women are more likely to receive feedback that asks them to “smile more” and “be more approachable” rather than constructive criticism. Female medical students must confront such demeaning comments and sexist banter on a daily basis. Sexism is awfully pervasive and entrenched in the field of medicine, which causes women’s opinion and insight to be considered secondary. Female medical students must also deal with discrimination by the faculty members of medical schools. Women are usually encouraged by faculty members to pursue medical opportunities based solely on an easier, smaller workday so that they can give time to their family. Yet, males are rarely ever advised to pursue a field due to lower number of working hours. While such recommendations are not ill intentioned, they have the potential to

contribute to stereotype threat in which negative stereotypes heighten doubt and anxiety within the student. A growing number of research studies show that constant pressure to conform to certain expectations interferes with individuals’ intellectual performance. Also, some areas of medicine, such as surgery, has a hostile and unfavorable environment for women. Surgery is a field in medicine in which women are stereotyped to be “the weaker sex [who] are unable to withstand the emotional and physical stressors” (Julia Haskin) that accompany an operating room. This type of mentality is unreasonable and irrational as female medical students undergo the same schooling, training and examinations as male medical students. Therefore, women in the healthcare system are capable of providing equal quality of care as men. In addition to menial treatment, female physicians are often times mistaken for other roles such as nurses. While this mistake is innocuous, it reveals how deeply ingrained the idea that doctors are males is in society. The #ILookLikeASurgeon movement, started by Heather Logghe a surgery resident, works to “shatter the traditional image of a surgeon” (AWS). And in doing so, it celebrates and highlights that idea that a healthcare professional can be from any gender, race, ethnicity, religion and lifestyle.

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GENDER PAY INEQUALITY IN THE HEALTHCARE INDUSTRY Given that women comprise nearly half of the total U.S. labor force, it seems absurdly anachronistic to talk about the existence of a gender pay gap in this day and age. However, despite the enactment of legislation like the Equal Pay Act in 1963 and the Lily Ledbetter Fair Pay Act of 2009 which both prohibit employment discrimination, the disheartening reality still shows women as victims of income inequality in the workforce. In fact, recent reports released by the U.S Congress indicate that American working women typically earn only 79 percent of what men in similar jobs earn. Female physicians, in particular, are dramatically affected by gender pay inequality and often get paid on average $50,000 less annually than their male counterparts when numerous factors, such as number of patients seen, education and experience, have all been taken into account. Dr. Vineet M. Arora, a professor of medicine at University of Chicago and a strong advocate of equal pay for equal work, has spent several years researching the factors that possibly lead to this gender gap. Her research findings indicate that, first and foremost, the main cause of this gender pay disparity is blatant gender discrimination against women, with employers more likely to underpay women than men. Dr. Arora and her fellow researchers found that certain industries and even specific sectors within the healthcare industry, such as radiology, have been successful at adhering to the Equal Pay Act of 1963. They believe that identifying the factors that contribute to successful incorporation of equal pay in these settings could help remedy the problem in fields that undergo the largest pay gaps between genders. What Dr. Arora and her colleagues discovered was that female physicians were often less likely to negotiate for a higher salary due to the stigma women face for making such requests. Hence, they

advocate establishing programs and workshops that empower women and teach them to negotiate more successfully, in the hopes that this will help promote pay transparency and better salary practices. Numerous organizations, such as the National Committee on Pay Equity (NCPE) and the National Organization for Women, have been created to shed light on the various ways we can reach the goal of pay equity. Equal Pay Day, created by the NCPE, is celebrated on April 12th each year to symbolize “how far into the year women must work to earn what men earned in the previous year.” Although the road to gender pay equality is expected to be bridged only by the year 2050, pay equality advocates like Dr. Arora continue to fervently fight for this cause and hope to make some drastic changes even earlier. Even former President Barak Obama addressed the issue previously in his State of the Union speech, saying, “Today, women make up about half our workforce. But they still make 77 cents for every dollar a man earns. That is wrong. And in 2014, it’s an embarrassment. Women deserve equal pay for equal work.” And it is still an embarrassment here in 2017. While it’s great to see even lead political figures like Obama stand up for income equality, it should be noted that much hard work and dedication will be required on the people’s part to fight the long-held beliefs and misconceptions associated with the causes of this gap. With the dawn of a new era in politics, President-elect Donald Trump and policymakers should continue funding causes that aim to combat gender inequality in the nation-- ideally before 2050.

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behave

AS INSTRUCTED

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It begins from the moment we are born. “Congrats, It’s a Girl!” balloons are sold exclusively in delicate pastel pinks; baby boys’ bedrooms are painted in light blues. At a young age, little boys are given trucks to crash together during playtime; girls are given Barbie’s instead. Phrases like, “you run like a girl,” and “real men don’t cry,” are thrown around elementary school playgrounds. As puberty blossoms, young boys are taught being assertive is seen as strength, young girls will be instructed not to be too bossy. Young boys will be told they aren’t manly if they express their emotions; young ladies

are encouraged to share their feelings. As college arrives, women learn they aren’t taken seriously as competent math and science majors and men learn that being a male art major only invites ridicule. This polarization of genders begins early in life and only increases in consequence as a child grows older. Gender polarization is a concept in sociology by American psychologist Sandra Bem, which states, “societies tend to define femininity and masculinity as polar opposite genders, such that male-acceptable behaviors and attitudes are WWW.PREMEDMAG.ORG

not seen as appropriate for women, and vice versa”. Society has taken upon itself the task of putting men and women into different boxes, designating what it believes to be proper behavior and lifestyle choices for each respective gender. The task of raising children is put into one box, responsibility of supporting the family financially put into the other. The delegation of roles and attributes to specific genders is not only harmful, but an antiquated practice. The tired notion that men and women are so fundamentally different is offensive - not only because of the division it creates, but because of its consequences on societal expectations. These expectations are imprinted on virtually every aspect of human existence, including models of dress, social roles, and emotional expression. The stereotypes and polarization of genders is equally harmful in the medical field. Previous research shows that women are far less likely to seek immediate emergency medical treatment than men for similar afflictions, such as heart attacks. In fact, women are far more likely to die from delay of medical treatment for heart attacks. Further investigation reveals a startling truth, women are afraid they we be told they are ‘over-reacting.’ The toxic figment that women are dramatic or over emotional extends to patient care as well. Masses of women tell tales of inadequate medical care because their concerns were not taken seriously. In these instances, women report their doctors minimizing their reported symptoms, even going as far to say it’s all in their heads. This discrepancy is largely disproportional in the treatment of pain. According to a National Pain Report survey, 90% of women coping with chronic pain felt the healthcare system discriminates against them. Furthermore, found that medical professionals are more likely to tell women that their symptoms are psychosomatic, a term defined as “a physical disorder that is caused by or notably influenced by emotional factors.”

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Men are affected by gender polarization and societal standards as well. Some studies have found that psychiatrists are less likely to diagnose and medicate men as compared to women for depression, even when they score similarly on standardized diagnostic tests. Researchers hypothesize this results in part from the subconsciously ingrained ideal that men are emotionally hardier than their female counterparts. Statistics show women are more likely to seek medical treatment for mental illness. This has been thought to contribute to a disproportionate suicide rate for men. According to a similar study, women are 48% more likely to be prescribed psychotropic drugs. Obviously, men face a disadvantage in mental health treatment. All of these disparities are blanketed by the looming shadow of gender polarization. The problem arises when these expectations alter the course of an individual’s life. Polarization and gender specific expectations mold a person to view and experience the world differently. Men grow more likely to be self-centered and career oriented as they are passively molded by societal influence. Similarly, women are subtly instructed to behave more timidly and put family and household above herself. Imagine that each young girl is treated with the respect and expectation to thrive just as boys are. Would this ease the disproportionate rate of poverty, in which 70% of the poor are women? Could the abolition of polarization empower more men to come forward after domestic violence and seek mental health treatment? In all likelihood, the dissolution of gender roles and polarization would have significant positive impacts on society and forward progress.

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A RISING CONCERN AND HOW TO DODGE IT

S T I

Sexually Transmitted Infections (STIs) affect individuals of all ages. However, the fact that half of the 20 million people diagnosed with new infections each year, comes from the 15-24 age group is frightening. STIs can be transferred from one individual to another through any means of sexual contact. STIs sometimes also referred to as Sexually Transmitted Diseases (STDs) can rise from bacterial, viral or parasitical pathogens. The most common STI is Human papillomavirus (HPV) with over 14.1 million new infections each year followed by Chlamydia with about 2.9 million cases each year. Some other common infections include Gonorrhea, Genital Herpes and Syphilis. STIs are a larger concern among women than men since women have harsher repercussions and health consequences than men. Maltreated syphilis in pregnant women can lead to infantile death. Untreated Chlamydia and gonorrhea can increase the risk of chronic pelvic pain and ectopic pregnancy, which is an abnormal pregnancy where the fertilized egg settles in places other than the uterus. Additionally, STIs can cause infertility in women. STIs can lead to organ damage, certain types of cancer and death. STIs are common among young women since they are biologically more susceptible to the infections, men who have sexual relationships with other men and young individuals with multiple sex partners. Many STIs have little to no symptoms so it is essential that certain precautions are taken to decrease the number of infections and deaths due to STIs. Vaccinations can help prevent HPV and hepatitis B, the practice of monogamy or reducing the number of sex partners can reduce the chances of encountering infected individuals, disclosure of infections with partners, increased access to prevention services and increased screening can help decrease the high numbers of youth STIs. The use of condoms is also highly effective in reducing the transmission of STIs because they can serve as a barrier that covers any infected parts. That being said, the most dependable way to dodge this bullet would be practicing abstinence and choose a sexual partner who has also practiced abstinence.

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