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Sex Matters: How male-centric medicine endangers women's health and what we can do about it Hardcover – 19 May 2020
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'McGregor is kickass; a respected crusader. If you're a woman, she's definitely the doctor you'd want to see in an emergency or to install as head of medical education' The Times
A clarion call about the dangers of medicine for women, as well as a manual for how women can get the right care for their bodies.
Sex Matters tackles one of the most urgent, yet unspoken issues facing women's health care today: all models of medical research and practice are based on male-centric models that ignore the unique biological and emotional differences between men and women - an omission that endangers women's lives. The facts surrounding how male-centric medicine impacts women's health every day are chilling: in the ER, women are more likely to receive a psychiatric diagnosis with regard to opioid use, while men are more likely to be referred for detoxification; the more vocal women become about their pain, the more likely their providers are to prescribe either inadequate or inappropriate pain relief medication; women often present with nontraditional symptoms of stroke, which causes delays in recognition by both them and their health professionals; and a government accountability study found that 80% of drugs that are withdrawn from the market are due to side effects that happen to women (a result of testing drugs mostly on men).
Leading expert on sex and gender medicine Dr Alyson McGregor focuses on the key areas where these differences are most potentially harmful, addressing:
· Cardiac and stroke diagnosis and treatment in women;
· Prescription and dosing of pharmaceuticals;
· Subjective evaluation of women's symptoms;
· Pain and pain management;
· Hormones and female biochemistry (including prescribed hormones);
· How economic status, race, and gender identity are additional critical factors.
Not only does Dr McGregor explore these disparities in depth, she shares clear, practical suggestions for what we can do. A work of riveting expose, revelatory insights into the medical establishment and actionable guidance for putting this information to use, Sex Matters is an empowering roadmap for reinventing modern medicine - and for self-care.
- Print length272 pages
- LanguageEnglish
- PublisherQuercus Publishing
- Publication date19 May 2020
- Dimensions15.6 x 3 x 23.6 cm
- ISBN-101529405890
- ISBN-13978-1529405897
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Review
Alyson McGregor is a persuasive and intelligent advocate for the unique health care needs of women. The two sexes are significantly different in all the tissues of the body--even to the way the same genes are expressed. An expert in emergency medical care, her deep and informed knowledge of the way disease presents itself in women ensures their prompt and accurate diagnosis and treatment. She is a powerful force in gender-specific health care. ― Marianne J. Legato, MD, PhD (hon. c.), FACP, Emerita Professor of Clinical Medicine, Columbia University
Sex Matters is highly learned, readable, and inspiring. A call to action-we learn exactly how women are understudied and misdiagnosed. We must all insist that medical schools and funding agencies do better. We must all support research in sex and gender medicine so that ultimately your doctor can do right by you! ― Londa Schiebinger, professor of History of Science, Stanford University, and Director of Gendered Innovations in Science, Health & Medicine, Engineering, and Environment
Well-researched, riveting, and insightful, Sex Matters is a triumph for women's health. Dr. McGregor exposes the gender, racial, and economic biases in medicine and puts the spotlight back where it belongs--on the needs of individual patients. ― Wendy S. Klein, MD, MACP, Medical Director, Health Brigade and co-founder, VCU Institute for Women’s Health
Enraging and clearly written, this book is a must-read for all women, who have to deal with ourbiased medical system. A call to arms for those who always suspected that women's pain and symptoms were dismissed and minimized, it also provides practical suggestions for getting better care. ― Maia Szalavitz, New York Times bestselling author of Unbroken Brain
From the frontlines of the medical establishment, McGregor offers a bold indictment of a status quo that's failing women. Ultimately hopeful, Sex Matters combines actionable advice for individual patients navigating a health care system built for men with an urgent call for revolutionary collective change. ― Maya Dusenbery, author of Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick
I learned so much from this new book. I am grateful to Dr. McGregor for her insight and wisdom. We need to spread the word: sex differences are about much more than ovaries and testicles! ― Leonard Sax MD PhD, New York Times bestselling author of Why Gender Matters: What Parents and Teachers Need to Know About the Emerging Science of Sex Differences
Artfully relayed through storytelling, Dr. McGregor brings several familiar stories from the emergency department to your living room, showcasing the many ways men and women are different and why each requires tailored medical care. Her personal experiences of a tortuous path of advocacy are the foundation of action steps to help readers to take charge of their own health and change the future of medicine ― Basmah Safdar, Associate Professor, Yale University, Sex and Gender Medicine Expert
This book is addictive! You will not be able to put it down until you have read it from cover to cover and then want start all over again. The sheer wealth of information is an eye opener for the intelligent lay person and a great source of up to date information for health care workers ― Marek Glezerman, MD, Immediate Past -President, International Society for Gender Medicine
Dr. Alyson McGregor sounds the alarm for the state of women's health in this country. Her excellent, evidence-based book reveals that women's health is still in its infancy and needs significant research to ensure that women are receiving the best possible medical care. The fact that most drugs that were approved in this country did not even have enough women included in the studies that got them approved to know if the effects in women were the same as in men is just one of many concerning findings. Her book shows that there is much work to do in this area (much more even more than we thought) and that we can count on this call to action to spur us onward! This book will be appreciated by medical and lay people alike given its excellent readability. I am thrilled that this book is out there to provide benchmarks and goals so that we can ultimately transform women's health ― Judy Regensteiner, MD, Director of the Center for Women’s Health Research at the University of Colorado
Dr. McGregor makes a clear and compelling case that women, particularly women of color, in the United States time after time receive inadequate or even harmful medical care. Dr. McGregor also explains how cultural stereotypes about women are frequently used by physicians to justify a dismissive approach to women's symptoms even when these symptoms herald conditions with potentially dire outcomes. Taking it one step further, Dr. McGregor provides the reader with suggestions on how to cut through a physician's ability to dismiss her symptoms, encouraging her to find another provider if necessary. ― Molly Carnes, MD.
I have worked with Dr. Alyson McGregor as a national leader in the area of sex and gender in medicine and healthcare-I commend her on this book ― C. Noel Bairey Merz, MD, Director, Barbara Streisand Women’s Heart Center, Cedars-Sinai
[McGregor's] book is unashamedly activist; a how-to guide for obtaining better treatment... the core content is hair-raising and potentially life-saving ― The Times
Picking up the hardback book, one could be tempted to ask, "how bad could it really be?" Within a chapter, the answer is clear: much worse than you ever imagined ― Irish Independent
Her seminal work on the urgency of acknowledging sex differences comes at a time when political leaders across the globe are being compelled to state that sex does not exist ― The Critic
Such an important book ― BookRiot
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Product details
- Publisher : Quercus Publishing (19 May 2020)
- Language : English
- Hardcover : 272 pages
- ISBN-10 : 1529405890
- ISBN-13 : 978-1529405897
- Dimensions : 15.6 x 3 x 23.6 cm
- Best Sellers Rank: 742,370 in Books (See Top 100 in Books)
- 1,556 in Public Health & Preventive Medicine
- 2,547 in Basic Medical Science (Books)
- 7,760 in General Medical Issues Guides
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It is really worrying to what extent women are neglected in medical and pharmaceutical research.
I've known about women being excluded from clinical trials for more than a decade and hoped this book would bring things up to date. It kind of does - but with so much padding, it could be half the length.
The first half of the book has lots of "in this chapter I'm going to tell you" and then you get told....and then you get a summary at the end. Yeah, I got the message the first time.
Plus, for anyone from the UK, the book is written for America so it's hard to relate to drug names like Ambien, which we don't use.
I almost removed a star for page 148 (trans). Sex is not ASSIGNED at birth. It is OBSERVED. And can be observed when in utero. Quit with the imprecise language. And stop using Cis women. We are just WOMEN.
I'd suggest googling the topic and reading some of the papers and press stories online.
Top reviews from other countries
5.0 out of 5 stars Essential read
5.0 out of 5 stars Essential read on women's health
At the very least, this book can save you or the women in your family and community plenty of grief.
Dr Alyson McGregor, an emergency physician at Brown University, is at the forefront of a growing movement to understand differences in how men and women manifest illness, communicate problems, and respond to treatment, and to close disparities that subject women to inferior medical care and health outcomes. She has written a lucid, sober, science-based guide that is also a compassionate work of advocacy on behalf of women’s health care.
Women’s health, Dr McGregor points out, is conventionally restricted to female reproductive organs. She calls for a much broader holistic approach to female physical and mental wellness.
She goes on to document how a male-centered view has dominated medical research and care for
centuries; and how positioning men as the default for diagnosis, prevention, treatment, medical research, medication studies, clinical practice and caregiver attitudes has damaged women’s wellbeing.
Because of chromosomal and hormonal differences from men, women present symptoms and respond to treatments in a panoply of ways that are different from men. Caregivers and patients alike need to learn the particular manifestations that major killers such as cardiac failure and stroke present in women. They need to understand how women metabolize both prescription and over-the-counter drugs, and the importance of appropriate pharmaceutical dosing. They must be
sensitive to how women experience pain and respond to pain medications. They must recognize the influences of hormonal cycles as well as synthetic hormones (e.g., birth control pills or hormone regimens for individuals undergoing sex transition) and incorporate this knowledge into treatment protocols.
Medical providers and patients also must be alert to the social and cultural environment of care as well as the many individual factors – race, religion, ethnicity and national origin – that shape everything from diagnosis and treatment to clinical conventions and bedside manner. She takes apart the readiness of medical professionals to tell women that problems are “all in your mind” and to diagnose sometimes severe physical problems as “anxiety” or other psychic afflictions.
She also illuminates the extra burdens faced by women of color and by transgender men and women, who are even more vulnerable than white women to being dismissed, misdiagnosed, or given flawed treatment.
Without sensationalizing, relying instead on solid scientific evidence along with humanizing stories to illustrate her sometimes shocking revelations, McGregor shows how medical research and practice have failed women in the past, and how more inclusive approaches will better serve everyone. She offers clear, workable guidelines for improvements in medical science and clinical practice, as well as practical guidance for individuals negotiating the healthcare system.
This book is highly recommended – as a resource for you and anyone else who gives or seeks care, and as a gift to anyone you care about.
5.0 out of 5 stars EXCELLENT!!
4.0 out of 5 stars A (sort of) introduction to the topic
Gender is a social construct to fit people into boxes according to their sex. Of course, considering gender is made up, from there you can make up as many genders as you like, however this luckily stuck to transgender rather than gender ideology. Unfortunately, it mistakes transsexuals for transgenderism, and near the end of the chapter which speaks of trans issues, speaks of transwomen but not of transmen. My biggest issue was not the mention of trans per se, but the fact that current science shows affirming a person's gender identity while they are depressed, self harming or suicidal augments the risks of them committing suicide after transition. Further, the very fact such a human experimentation was ever allowed in medicine breaks all the rules and all ethical standards regardless of any ideology behind it or correlating to it.
Trans people require psychiatric and psychological care *before* any decision to transition can even occur, and untreated trauma and other emotional and mental problems only highten the complications during and post transition. While it is necessary to speak of the health of trans individuals, they are by and large the least marginalised group of individuals statistically, and less than 0.1% of the population(the rise being due to ROGD through social contagion and peer pressure). The effects of hormones listed in trans patients aren't a change of sex, they are a normal reaction to heightened and lowered doses of hormones, as proven by individuals on hormones for other medical reasons who are not trans. I think speaking of the health of trans people was a good addition, but all the information was in the wrong direction and, aside from it being important to tell your healthcare provider you are trans, the information in question(that one should do surgery when suicidal) is not backed by any new medical and scientific studies. Thus the addition of having a medical report at the end inclusive of trans is as useful as having it for every single condition that exists. One must be sympathetic and compassionate towards trans people, but not confuse gender identity with sexed reality, so for a book on sex differences, it was surprising and disappointing.
As for the mention of pain tolerance in men and women, while the study of putting your hands in cold water did show women reacted faster to pain, another said the opposite, so those are inconclusive and perhaps based on which nerves are being stimulated and individual pain tolerance threshold rather than sexed based, though studies on the topic are intriguing.
It is true women have more nerves than men, however there is currently no study proving those nerves are nociceptive(pain receptors), and considering women also have heightened senses in all departments(hearing, smell, taste, touch and see more colour than men) it may be in part thanks to multiple nerves. Though in the case of smell, it has been noted that even women with no olfactory bulbs, those women were still able to smell and thus olfactory bulbs in women may not actually be the source of olfaction as they are in men. So perhaps it's not just a question of nerves afterall, but more research is needed. In peripheral nerves, women have more nerves not just in the genitalia tract, but also in the hands and cranium which I hope will not be left out of future medical textbooks. All in all, the book was good and I would've given it 5 stars were it not for a political bias, though I am not speaking of feminism nor do I know whether she is left wing, right wing or neither, and it is possible she hasn't come across the research in question, when I read medical and scientific books from fellow medics and scientists, I expect more of what the summary promises. That is not to say the book was not good. Everything including a kind look toward trans people seems written with good intentions and is well configured, but good intentions don't always lead to good outcomes when going from false starts. As, ironically, this book starts off pointing out! It is well known that there are more detransitioners than people happy to have transitioned, the study from the 80s frequently referenced by trans rights activists to prove the number is few having been an incomplete study that was done in a time where over 40 year old autogynephiles were principally the transitioners, as opposed to today where the majority are under 25 year old girls, many of whom are dealing with multiple stress factors. While a difference is said to exist differentiating autogynephiles from true transsexuals, the political movement has skewed definitions and perceptions by changing the definition of the term trans into an umbrella term hence when carrying out scientific and medical research studies, it is even more important to stick to easily definable words and their meanings. Even more so when the book is destined to people with no medical background.
This was as stated in the book a non exhaustive look at sex differences and as I know plenty on heart health, it personally left me wanting more but I do recommend this book for anyone new to the subject, bar the aforementioned which I advise you to tread with caution. (I give the benefit of the doubt that it was a question of not enough information on the subject and thus hold no contempt, whether it is actually the case that she doesn't know is unknown to me but if patient healthcare truly is her priority, I have no doubt she would do her best if aware and I salute her work, not just on this book, but on healthcare for women in general). If you plan on buying this book, I wish you a happy reading! Enjoy.




