When medicine discovered sex Sarah Hiltner 18-12-2018 To - - PowerPoint PPT Presentation

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When medicine discovered sex Sarah Hiltner 18-12-2018 To - - PowerPoint PPT Presentation

Nov 13, 2023 342 likes •1.23k views

When medicine discovered sex Sarah Hiltner 18-12-2018 To participate join at www.menti.com Insert Code 30 30 63 Father and son are driving in their car. They are having an accident, both are picked up by ambulances. The son got injured

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When medicine discovered sex

Sarah Hiltner 18-12-2018

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  • Father and son are driving in their car. They are having an accident, both

are picked up by ambulances. The son got injured at his penis and is delivered to a specialist unit in a different hospital than his father. Once the son has been brought into the operating room the attending urological surgeon comes in and says:

  • ‘I cannot operate. This is my son.’
  • How are the son and the surgeon related?

Universität Köln (2015) „UeberzeuGENDERe Sprache LeiEaden für eine geschlechtersensible und inklusive Sprache“

To participate join at www.menti.com Insert Code 30 30 63

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We live in a gendered world

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Overview

By Sam Killermann www.itspronouncedmetrosexual.com

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Sex

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:

10.1371/journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900

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Gender

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:

10.1371/journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900

Public Domain, https://commons.wikimedia.org/w/index.php?curid=1685091

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Gender

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:10.1371/ journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900 Public Domain, https://commons.wikimedia.org/w/index.php?curid=1685091 Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858

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A"rac&on

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:10.1371/ journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900 Public Domain, https://commons.wikimedia.org/w/index.php?curid=1685091 Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858 Image: by BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

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Heart attack

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:10.1371/ journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900 Public Domain, https://commons.wikimedia.org/w/index.php?curid=1685091 Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858 Image: by BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

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Sex

By Sam Killermann www.itspronouncedmetrosexual.com

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Sarah as a Genderbread Person

By Sam Killermann www.itspronouncedmetrosexual.com

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Asking about someone's genitalia?

By Sam Killermann www.itspronouncedmetrosexual.com

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Same body

  • Ancient:
  • One sex body
  • Enlightenment:
  • Two sex body
  • Gender medicine
  • Sex and gender

(Laqueur 1990)

"Genga 39" by Bernardino Genga (1620–1690) Anatomia per Uso et Intelligenza del Disegno; public domain

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Same body

  • Ancient:
  • One sex body
  • Enlightenment:
  • Two sex body
  • Gender medicine
  • Sex and gender

(Laqueur 1990)

"Genga 39" by Bernardino Genga (1620–1690) Anatomia per Uso et Intelligenza del Disegno; public domain

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Same body

  • Ancient:
  • One sex body
  • Enlightenment:
  • Two sex body
  • Gender medicine
  • Sex and gender

"Genga 39" by Bernardino Genga (1620–1690) Anatomia per Uso et Intelligenza del Disegno; public domain

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Sex

Parts of human penis. Ilustration from Polish medical handbook - 1905. By Sshirly - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=26225563 By Andreas Bolzer, Gregor Kreth, Irina Solovei, Daniela Koehler, Kaan Saracoglu, Christine Fauth, Stefan Müller, Roland Eils, Christoph Cremer, Michael R. Speicher, Thomas Cremer - Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI: 10.1371/journal.pbio.0030157, Figure 7a, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=1371900

Hormones

  • Pheromones
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Influences of sex

Differences

  • symptoms
  • reactions to pharmaceuticals
  • prevalence of diseases

BUT also a bunch of similari9es

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Research on sex

  • Four core genotype mouse model

Sandberg & Ji 2012 Biology of Sex Differences

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Research on sex

  • Four core genotype mouse model

Sandberg & Ji 2012 Biology of Sex Differences

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Research on sex

  • Genes vs. Hormones

Sandberg & Ji 2012 Biology of Sex Differences

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Research on sex

  • Female gonads but male genes

Sandberg & Ji 2012 Biology of Sex Differences

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Research on sex

  • Male gonads but female genes

Sandberg & Ji 2012 Biology of Sex Differences

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Results from basic research on rodents

McKlintock, Nature RE, 1971

Pheromones (axillary steroids):

  • menstrual cycle synchronization
  • pain perception

Sex of the researcher

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Results from basic research on rodents

Sorge RE, Nat Methods, 2014

“Exposure of mice and rats to male but not female experimenters produces pain inhibition.”

Sex of the researcher

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Osteoporosis

Rieder & Lohff 2008

  • underes2mated in men
  • later incidence
  • higher mortality in

case of fracture

Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

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Gender identity

By Sam Killermann www.itspronouncedmetrosexual.com

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Sarah as a Genderbread Person

By Sam Killermann www.itspronouncedmetrosexual.com

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Gender

By Patrick Whitaker - https://www.flickr.com/photos/126633105@N02/14982651719, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=48995770 https://rosa-hellblau-falle.de/2017/02/goldener-zaunpfahl-die-nominierten/

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Sarah as a Genderbread Person

By Sam Killermann www.itspronouncedmetrosexual.com

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Influences of gender

Assumptions on susceptibility of diseases Examples:

  • erectile disfunction
  • depression

Mansfield et al. 2003, „psychology of men‘s health seeking“ Wallis et al. 2017, „Comparison of postoperative outcomes among patients treated by male and female surgeons…“

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Influences of gender

  • assumptions on susceptibility of diseases
  • interaction with doctors
  • description of symptoms
  • compliance with taking medications
  • reception of patient

Mansfield et al. 2003, „psychology of men‘s health seeking“ Wallis et al. 2017, „Comparison of postoperative outcomes among patients treated by male and female surgeons…“

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Influences of gender

  • assumptions on susceptibility of diseases
  • interaction with doctors
  • description of symptoms
  • compliance with taking medications
  • reception of patient

“NORMS are prescriptions for how men and women should behave, while stereotypes are generalizations about what men and women are like (Pleck, 1981, 1995).” (In: Mansfield – accentuation by Hiltner)

Mansfield et al. 2003, „psychology of men‘s health seeking“ Wallis et al. 2017, „Comparison of postoperaRve outcomes among paRents treated by male and female surgeons…“

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Depression

  • Depression in form of anxiety

– higher in women

  • substance abuse to deal with depression

– higher in men

  • successful suicides – higher rates in men

Mansfield et al. (2003)

Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858

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Depression

  • Scales and measures
  • Responsibilities
  • Gender norms
  • Symptoms vs. solutions

Mansfield et al. 2003

Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858

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A"rac&on

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:10.1371/ journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900 Public Domain, https://commons.wikimedia.org/w/index.php?curid=1685091 Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858 Image: by BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

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Attraction

  • homosexuality
  • bisexuality
  • pansexuality
  • asexuality
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A"rac&on

<a href="https://www.freepik.com/free-photos-vectors/people">People vector created by Freepik</a> <a href='https://www.freepik.com/free-vector/non-traditional-family-icons-set-flat_1538492.htm'>Designed by Macrovector</a> <a href='https://www.freepik.com/free-vector/prohibition-signs_893277.htm'>Designed by Olga_spb</a>

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Sex and Gender – big difference

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:10.1371/ journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900 Public Domain, https://commons.wikimedia.org/w/index.php?curid=1685091 Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858 Image: by BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

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Heart a'ack

By Sam Killermann www.itspronouncedmetrosexual.com By Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI:10.1371/ journal.pbio.0030157, Figure 7a, https://commons.wikimedia.org/w/index.php?curid=1371900 Public Domain, https://commons.wikimedia.org/w/index.php?curid=1685091 Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org 'Suicidal melancholy' after a photograph by H. W. Diamond Lithograph By: W. Baggafter: Hugh Welch DiamondThe Medical Times and Gazette Published: Jan 2 to June 26 1858 Image: by BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

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Part II Hacking the medical system

Sarah Hiltner 18-12-2018

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Exercise break: Breathing exercise

Sarah Hiltner 18-12-2018

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Heart a'ack differences

  • 1. symptoms
  • 2. awareness
  • 3. acknowledgement
  • 4. therapy

Sarah Hiltner 18-12-2018

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Heart attack differences

  • 1. symptoms
  • 2. awareness
  • 3. acknowledgement
  • 4. therapy

Sarah Hiltner 18-12-2018

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Image: by BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons Legato, Marianne J., and John P. Bilezikian. Principles of gender-specific medicine. Vol. 2. Gulf Professional Publishing, 2004.

  • chest pain
  • pain in the left

side of the body

  • cold sweat

Heart attack

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Heart attack in most women

  • weakness
  • shortness of breath
  • back pain
  • nausea

By André Brouillet, died in 1914. - https://farm4.staticflickr.com/3877/14383925682_f732e10d68_o_d.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=3498576

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Heart attack differences

  • 1. symptoms
  • 2. awareness
  • 3. acknowledgement
  • 4. therapy

Sarah Hiltner 18-12-2018

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Cause of death

122916 157996 157 29016 103421 198620 18136 21932 50000 100000 150000 200000 250000 bösartige Neubildungen (Krebs) Krankheiten des Herzkreislaufsystem Brustkrebs Herzinfarkt Männer Frauen

Death by disease in Germany (based on year: 2015)

Sta9s9sches Bundesamt 2017

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Cause of death

122916 157996 157 29016 103421 198620 18136 21932 50000 100000 150000 200000 250000 bösartige Neubildungen (Krebs) Krankheiten des Herzkreislaufsystem Brustkrebs Herzinfarkt Männer Frauen

Death by disease in Germany (based on year: 2015)

Statistisches Bundesamt 2017

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Heart attack differences

  • 1. symptoms
  • 2. awareness
  • 3. acknowledgement
  • 4. therapy

Sarah Hiltner 18-12-2018

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Excercise break: Breathing excercise

Sarah Hiltner 18-12-2018

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Heart attack differences

  • 1. symptoms
  • 2. awareness
  • 3. acknowledgement
  • 4. therapy

Sarah Hiltner 18-12-2018

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Aspirin/ASS: protects men of re-infarction; protects women of strokes

Legato, Marianne J., and John P. Bilezikian. Principles of gender-specific medicine. Vol. 3. Gulf Professional Publishing, 2017.

Therapy and Prevention

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If we know all this – why do we need to talk about it?

Sarah Hiltner 18-12-2018

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Bias in medical textbooks

  • 1. androcentrism
  • 2. gender insensitivity
  • 3. double standard

Sarah Hiltner 18-12-2018

Eichler, Fuchs & Maschwesky-Schneider. Richtlinien zur Vermeidung von Gender Bias in der Gesundheitsforschung. Z f Gesundheitswiss., 8 Jg. 2000 H 4

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Bias in medical textbooks

  • 1. androcentrism
  • 2. gender insensitivity
  • 3. double standard

Sarah Hiltner 18-12-2018

Eichler, Fuchs & Maschwesky-Schneider. Richtlinien zur Vermeidung von Gender Bias in der Gesundheitsforschung. Z f Gesundheitswiss., 8 Jg. 2000 H 4

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Replication

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Pictures

Mathes (2012) S. 86

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Pictures

Lederhuber, Lange & Deisenhofer (2010) S. 146

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Pictures

Steffel & Lüscher (2011) S. 48

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Pictures

Mathes (2012) S. 79

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Pictures

Stierle & Hartmann (2008) S. 179

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Pictures

Mathes (2012) S. 121

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Pictures

Lederhuber, Lange & Deisenhofer (2010) S. 43

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Pictures

Mathes (2012) S. 124

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Pictures

Mathes (2012) S. 137

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Pictures

Lederhuber, Lange & Deisenhofer (2010) S. 144

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Bias in medical textbooks

  • 1. androcentrism
  • 2. gender insensitivity
  • 3. double standard

Sarah Hiltner 18-12-2018

Eichler, Fuchs & Maschwesky-Schneider. Richtlinien zur Vermeidung von Gender Bias in der Gesundheitsforschung. Z f Gesundheitswiss., 8 Jg. 2000 H 4

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Results

Spes 2011, S. 13

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Bias in medical textbooks

  • 1. androcentrism
  • 2. gender insensi6vity
  • 3. double standard

Sarah Hiltner 18-12-2018

Eichler, Fuchs & Maschwesky-Schneider. Richtlinien zur Vermeidung von Gender Bias in der Gesundheitsforschung. Z f Gesundheitswiss., 8 Jg. 2000 H 4

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Results

Mathes (2012) S. 257

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Lederhuber 2010

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Results

Stierle (2008) S. 12

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Bias in medical textbooks

  • 1. androcentrism
  • 2. gender insensitivity
  • 3. double standard

Sarah Hiltner 18-12-2018

Eichler, Fuchs & Maschwesky-Schneider. Richtlinien zur Vermeidung von Gender Bias in der Gesundheitsforschung. Z f Gesundheitswiss., 8 Jg. 2000 H 4

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Women were special, atypical

  • r not men2oned at all

Sarah Hiltner 18-12-2018

Hiltner S, Oertelt-Prigione S (2017) Gender and the Genome

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IntER sex differences vs. IntRA sex differences

Sarah Hiltner 18-12-2018

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Inter

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Intra

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Why is it not mainstream yet?

Sarah Hiltner 18-12-2018

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Discrimination

Sarah Hiltner 18-12-2018

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“Let me tell you about my trouble with girls ... three things happen when they are in the lab ... You fall in love with them, they fall in love with you and when you criticise them, they cry.” Tim Hunt, 2015, Nobel Prize Winner for Physiology or Medicine 2001

h"ps://www.theguardian.com/uk-news/2015/jun/10/nobel-scien>st->m-hunt-female-scien>sts-cause-trouble-for-men-in-labs

Discrimination of women

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Experiences of resistance by gender medicine pioneers

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Results

“They did not see the problem – they thought I was the problem!” (Frau Magenta)

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Results

“[I]f you are a cardiologist for twenty-five years - you have to learn now that you may have done things wrong with many female patients, it's not nice to accept!” (Frau Magenta)

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Results

“[T]here is a resistance, because sometimes gender will be associated with an ideology of feminism. And I say, well, of course I'm a feminist, I really am a feminist, but what I'm doing now is based on the theory and not ideology of feminism, but I will implement it into just practical proposals for education and daily practice.” (Frau Lavendel)

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New problem: Algorithms

Sarah Hiltner 18-12-2018

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Bias in AI and Neuroscience Transdisciplinary conference 17-19th June 2019 Radboud University Nijmegen

Sarah Hiltner 18-12-2018

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Thank you!

Sarah Hiltner, Sociologist MA & Physical therapist

sarah.hiltner@radboudumc.nl Twitter: @SophieHiltner