american medical women's association position paper on sex- and gender-specific medicine

JOURNAL OF WOMEN’S HEALTHVolume 17, Number 10, 2008© Mary Ann Liebert, Inc.DOI: 10.1089/jwh.2008.1148b

American Medical Women’s Association Position Paper on Sex- and Gender-Specific Medicine

Janice Werbinski, M.D.

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Introduction

SEX- AND GENDER-SPECIFIC HEALTHCARE is an importantwomen’s health issue, and the U.S. healthcare system of-

ten fails to meet women’s health care needs. Statistics gen-erated by the 2001 Institute of Medicine (IOM) report, Ex-ploring the Biological Contributions to Health: Does SexMatter? verify that treatment decisions based on data usedby clinicians and provided in medical education can be verydifferent when analyzed according to sex and gender. Thisholds true across the spectrum of prevention, diagnosis, eval-uation, treatment, and palliation. In some instances, thosetreatment decisions, if not sex- and gender-specific, can bedetrimental to the health of women.

Despite many considered attempts to codify data basedon sex- and gender-specific research and to create women’shealth curricula, recent findings confirm that only a smallpercentage of practicing providers actually incorporate thisknowledge into their clinical practices. In spite of the estab-lishment of the Office of Women’s Health at the National In-stitutes of Health, a 2000 study in the Journal of Women’sHealth shows that even though 80% of research includedwomen, only 25% of outcomes data were analyzed by gen-der, and very few clinical trials report results by gender.

Other research shows that even though 60% of physiciansare aware of the new National Cholesterol Education Pro-gram (NCEP) lipid guidelines for women, only 25% of physi-cians actually implement those guidelines. Additionally, ina managed care database of 9000 women patients, only 12%of high-risk women attained the optimal level of all the lipidsubfractions recommended.

Although 20 Centers of Excellence and 12 Community Cen-ters of Excellence in Women’s Health have been funded by De-partment of Health and Human Services (DHHS) since 1996,in 2007 it was announced that those centers will no longer befunded. The existing Residencies and Fellowships in Women’sHealth have also gradually been subjected to budget cuts.

AMWA’s Position on Sex- and Gender-Specific Medicine

I. AMWA advocates public policy that recognizes thatevery aspect of a citizen’s health is influenced by sex andgender and for policy that ensures that all aspects ofmedical and provider education as well as healthcare de-livery are held to standards that reflect this principle.

II. AMWA advocates public policy that not only ensures

the preservation of the national offices of Women’sHealth already established in the United States (NIHOWH, CDC OWH, DHHS OWH) but promotes devel-opment of other appropriate offices in Women’s Healthat the federal level.

III. AMWA advocates continuing research and research in-stitutions that not only include both genders but also an-alyze and report data according to sex and gender.

IV. AMWA advocates for incorporation of that research intocurricula that are comprehensive, sex- and gender-spe-cific, and evidence-based and will promote sound deci-sion making.

V. AMWA advocates for incorporation of sex- and gender-specific curricula into ALL forms of physician andprovider education, including medical schools, residen-cies, fellowships, midlevel training programs, and con-tinuing medical education venues.

VI. AMWA advocates for a method of certification that al-lows consumers to be assured that their provider hascompleted educational requirements that are specific tosex- and gender-based information.

AMWA’s Position

AMWA believes that healthcare delivered to women, 52%of the American population, should be comprehensive, re-flect the findings of sex- and gender-specific research, andbe available, affordable, and easy to access and use. We sup-port the definition of women’s health put forward by theAmerican College of Women’s Health Physicians: women’shealth is centered on the whole woman in the diverse con-texts of her life and grounded in an interdisciplinary sex-and gender-informed science.

We not only support continued funding of sex- and gen-der-based research and development of appropriate curric-ula reflecting the results of that research but also recognizethe need to translate that information into the practices of allproviders who take care of women.

Address reprint requests to:Janice Werbinski, M.D.

American College of Women’s Health Physicians, Inc.10077 Woodlawn Drive

Portage, MI 49002

E-mail: drwerb@aol.com

American College of Women’s Health Physicians, Inc., Portage, Michigan.