Talking about Gender

Question 1

Sex

• A … construct premised upon biological characteristics enabling sexual …
• Among people, biological sex is variously assigned in relation to … sex-characteristics, gonads, or sex chromosomes; sexual categories include: male, female, … (persons born with both male and female sexual characteristics), and … (persons who undergo surgical and/or hormonal interventions to reassign their sex).

Answer 1

• A biological construct premised upon biological characteristics enabling sexual reproduction.
• Among people, biological sex is variously assigned in relation to secondary sex-characteristics, gonads, or sex chromosomes; sexual categories include: male, female, intersexual (persons born with both male and female sexual characteristics), and transsexual (persons who undergo surgical and/or hormonal interventions to reassign their sex).

Question 2

Sex is a … construct

Answer 2

Sex is a biological construct

Question 3

Sexual categories include:

• ​Male
• Female
• … (persons born with both male and female sexual characteristics)
• … (persons who undergo surgical and/or hormonal interventions to reassign their sex).

Answer 3

• ​Male
• Female
• Intersexual (persons born with both male and female sexual characteristics)
• Transsexual (persons who undergo surgical and/or hormonal interventions to reassign their sex).

Question 4

Intersexual =

Answer 4

persons born with both male and female sexual characteristics

Question 5

Transexual =

Answer 5

persons who undergo surgical and/or hormonal interventions to reassign their sex)

Question 6

Gender refers to a … construct

Answer 6

social

Question 7

Gender refers to a … construct regarding …-bound conventions, roles, and behaviours for, as well as relations between and among, women and men and boys and girls.

Answer 7

Gender refers to a social construct regarding culture-bound conventions, roles, and behaviours for, as well as relations between and among, women and men and boys and girls.

Question 8

Gender roles vary across a continuum and both gender relations and biologic expressions of gender vary within and across …

Answer 8

Gender roles vary across a continuum and both gender relations and biologic expressions of gender vary within and across societies.

Question 9

Sexism, in turn, involves inequitable … relations and refers to institutional and interpersonal practices whereby members of dominant gender groups accrue … by subordinating other gender groups and justify these practices via ideologies of innate S.., difference, or deviance.

Answer 9

Sexism, in turn, involves inequitable gender relations and refers to institutional and interpersonal practices whereby members of dominant gender groups accrue privileges by subordinating other gender groups and justify these practices via ideologies of innate superiority, difference, or deviance.

Question 10

Definitions of Sex/ Gender

Answer 10

Question 11

Why should doctors care about gender socialisation?

Answer 11

• Women in particularly often get delayed diagnosis of conditions e.g. heart attacks
  
  • May be that symptoms are taken less seriously, or how we present these symptoms as a gender

Question 12

Why should doctors care about gender socialisation? (2)

• Gender .. gap

Answer 12

• Gender pay gap (34%) 2017

Question 13

Where does gender come from?

• 4 ideas?

Answer 13

• Genetics?
• Hormones?
• The brain?
• Culture?

Question 14

Intersex =

Answer 14

when the complex processes of sex determination +/- sex differentiation are disrupted/incomplete (? 2-4% of people)

Question 15

What % of people are intersex? (estimated)

Answer 15

2-4% of people

Question 16

David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case

Answer 16

In the mid-1960s, psychologist John Money encouraged the gender reassignment of David Reimer, who was born a biological male but suffered irreparable damage to his penis as an infant. Born in 1965 as Bruce Reimer, his penis was irreparably damaged during infancy due to a failed circumcision. After encouragement from Money, Reimer’s parents decided to raise Reimer as a girl. Reimer underwent surgery as an infant to construct rudimentary female genitals, and was given female hormones during puberty. During childhood, Reimer was never told he was biologically male and regularly visited Money, who tracked the progress of his gender reassignment. Reimer unknowingly acted as an experimental subject in Money’s controversial investigation, which he called the John/Joan case. The case provided results that were used to justify thousands of sex reassignment surgeries for cases of children with reproductive abnormalities. Despite his upbringing, Reimer rejected the female identity as a young teenager and began living as a male. He suffered severe depression throughout his life, which culminated in his suicide at thirty-eight years old. Reimer, and his public statements about the trauma of his transition, brought attention to gender identity and called into question the sex reassignment of infants and children.

Question 17

THE FIVE SEXES. Anne Fausto‐Sterling.

Answer 17

Question 18

Debunking gender

Answer 18

Question 19

Does gender exist?
The biological effects of the social world

Answer 19

• There are biological associations
• Narrowed over the years - what is changing?

Question 20

Trans

• Transgender people have a gender identity that does not match …, which is generally based on … observation.
• …% of transgender youth will attempt suicide before their 20th birthday
• Transition may or may not involve …/… treatment
• Gender …. — having one’s gender identity acknowledged and accepted in social, legal, and other settings
• Beyond … accessibility, discrimination is associated with increased stress, anxiety, depressive symptoms, post-traumatic stress disorder, substance abuse, and suicide. It is also associated with increased risk of bullying, verbal harassment, sexual assault, and nonsexual violence, as well as decreased health care utilization.

Answer 20

• Transgender people have a gender identity that does not match their sex assigned at birth, which is generally based on anatomical observation.
• 50% of transgender youth will attempt suicide before their 20th birthday
• Transition may or may not involve hormone/surgical treatment
• Gender affirmation — having one’s gender identity acknowledged and accepted in social, legal, and other settings
• Beyond bathroom accessibility, discrimination is associated with increased stress, anxiety, depressive symptoms, post-traumatic stress disorder, substance abuse, and suicide. It is also associated with increased risk of bullying, verbal harassment, sexual assault, and nonsexual violence, as well as decreased health care utilization.

Question 21

Epicene (Gender Neutral) Pronouns

• Names and pronouns should match … … If in doubt:

Answer 21

Names and pronouns should match gender presentation. If in doubt:

“Clinicians can ask patients which pronouns to use when referring to them and how to conduct a physical exam in a manner that will be most comfortable for them.”

Question 22

Definitions of Selected Gender Identity Terms

Answer 22

Question 23

Guidelines for the care of Trans Patients in Primary Care

Answer 23

Question 24

What is Gender Dysphoria?

Answer 24

Question 25

_Your role as the GP - Guidelines for the care of Trans Patients_

Answer 25

Question 26

_Primary Care of Trans\* populations_ * You may be the first person they tell off their gender dissonance * Open non-... approach * It is unhelpful to delay treatment at a Gender Identity Service; high incidence of ... and .... abuse in untreated Trans\* population * Refer to Regional Gender Service (+/- via CAMHS), even if they are not completely sure that they are transgender * Signpost to ... groups * ... to mental health problems * Self ... with hormones * ...: may still need cervical, breast, prostate and AAA ... (and transmen should check for ...) * Avoid misattributing commonplace health problems to gender

Answer 26

* You may be the first person they tell off their gender dissonance * Open non-**judgemental** approach * It is unhelpful to delay treatment at a Gender Identity Service; high incidence of **suicide** and **substance** abuse in untreated Trans\* population * Refer to Regional Gender Service (+/- via CAMHS), even if they are not completely sure that they are transgender * Signpost to **support** groups * **Vulnerable** to mental health problems * Self **medication** with hormones * **Screening**: may still need cervical, breast, prostate and AAA **screening** (and transmen should check for **lumps**) * Avoid misattributing commonplace health problems to gender

Question 27

_'Gender' awareness is good for health_ * A physician who knows a patient is a transgender man or transgender woman will know exactly what ... tests that patient needs to stay healthy. * A physician encountering a lesbian patient will not assume she “got that way” because she was ... ... * A gay couple bringing their sick child to the ER will be treated with the same respect and care as a straight couple. * And adults who were born with relatively unusual forms of sex development will already know their medical histories, and their doctors will understand them. * Children who are variant in terms of their sex or gender identities will encounter doctors who recognize their real needs and their strengths, and will know how to encourage their families to do the same * The needs of patients will come before other social ...

Answer 27

* A physician who knows a patient is a transgender man or transgender woman will know exactly what **screening** tests that patient needs to stay healthy. * A physician encountering a lesbian patient will not assume she “got that way” because she was **sexually** **abused**. * A gay couple bringing their sick child to the ER will be treated with the same respect and care as a straight couple. * And adults who were born with relatively unusual forms of sex development will already know their medical histories, and their doctors will understand them. * Children who are variant in terms of their sex or gender identities will encounter doctors who recognize their real needs and their strengths, and will know how to encourage their families to do the same * The needs of patients will come before other social **norms**.