The National Academies Press

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1 Introduction
Pages 13-27

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From page 13... ... , the committee defines biology, for the purposes of this report, to include the genetic, molecular, biochemical, hormonal, cellular, physiological, behavioral, and psychosocial aspects of life. 2The committee defines sex as the classification of living things, generally as male or female according to their reproductive organs and functions assigned by the chromosomal complement, and gender as a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation. Read the entire page →
From page 14... ... formed the Committee on Understanding the Biology of Sex and Gender Differences in response to combined requests from a consortium of public and private sponsors.3 In general, the sponsors asked that the IOM committee evaluate and consider the current understanding of sex differences and determinants at the biological level. Specifically, the sponsors asked the committee to address the follow. Read the entire page →
From page 15... ... Focusing the Analysis on Biology Across the Life Span After critical review of the task and a discussion with the study sponsors at the first meeting, the committee acknowledged the potentially broad scope that a comprehensive analysis of sex and gender differences in health would have. This is evidenced by the expansive National Institutes of Health (NIH) Read the entire page →
From page 16... ... Low social status, absence of freedoms, limited or no access to health care including family planning and hormone treatments, and poor quality of care are particularly important issues for the health of women in certain cultures and may have a greater impact on their overall health than biology. As the focus of this report is the health consequences of biologicallybased differences between the sexes, these issues are not addressed here. Read the entire page →
From page 17... ... An individual may display characteristics considered more typical of the opposite sex, and a person's sense of gender may change over the course of a lifetime. Gender identity and gender role affect individual activities, exposures, and access to care, all of which can affect health and all of which vary widely across cultures. Read the entire page →
From page 18... ... Although such definitions are helpful, two committee members argued that they imply that the idea of biological difference suggests a predominance of physiology, with a subsequent fine-tuning by environment.4 Moreover, the two committee members were concerned that dividing biological and environmental events into separate spheres could make researchers less likely to ask solid mechanistic questions about, for example, how diet and mechanical stress affect bone development. To illustrate, a variety of factors, including behavioral habits, hormones, genetics, and environmental influences, affect the development of bone mass. Read the entire page →
From page 19... ... In this example, when more is understood about the mechanism of bone formation including how the many factors interact to either promote or impede bone development researchers and clinicians can begin to formulate an arsenal of new approaches to increase bone mass well before menopause. This example illustrates how biological questions that are posed as a result of an approach that examines how factors outside the body are translated into differences between male and female bodies will break new scientific ground. Read the entire page →
From page 20... ... In addition, small differences between the sexes may be informative in providing an understanding of the underlying mechanisms of normal and pathological functions. Sex Variability Biologists study variability as part of life, and many biological variables, for example, age and family history, affect health. Read the entire page →
From page 21... ... EVOLVING RESEARCH POLICY In recent years, considerable attention has been given to the differences and similarities between females and males (1) at the societal level by researchers evaluating how individual behaviors, lifestyles, and surroundings affect one's biological development and health and (2) Read the entire page →
From page 22... ... As a result, the medical community lacks useful, comparable data on conditions that occur disproportionately, that manifest dif Read the entire page →
From page 23... ... EDUCE ferently' or that require different approaches to diagnosis and treatment in males and females. For many years it was assumed Mat males' parUcularly Caucasian males' provided We ~norm" or 'standard and Mere was a tendency to view females as being deviant or problematic even in studying diseases that affect both sexes" Onsthute of Medicine' 1994' p. Read the entire page →
From page 24... ... Thus, although the thalidomide and DES incidents were not related to the participation of women in clinical trials, they fostered an aversion to involving women who were or who could become pregnant in any drug-related research (Institute of Medicine, 1994~. (Although both thalidomide and DES were successfully tested in clinical trials, the side effects were not apparent until the approved drugs were used widely by pregnant women, who were not part of the clinical trial population.) Read the entire page →
From page 25... ... Ironically, even as it was acknowledged that the female hormonal cycle is a significant confounding variable and test substances might respond unpredictably to hormonal fluctuations, it was nonetheless widely believed that men and women were similar enough that it was acceptable to then treat women with therapies developed solely on the basis of the results of studies performed with men as research subjects (Haseltine and Jacobson, 1997~. The policy of exclusion continued into the mid-1980s, when, in 1985, the U.S. Read the entire page →
From page 26... ... Despite the progress made in focusing on women's health research and including women in clinical trials, such research will have limited value unless the underlying implications that is, the actual differences between males and females that make such research so critical are systematically studied and elucidated. Such research can enhance the basis for interpreting the results of separate studies with males and females, helping to clarify findings of no essential sex differences, and suggesting mechanisms to be pursued when sex differences are found. Read the entire page →
From page 27... ... and cellular research models of human conditions appear throughout the report, generally in conjunction with a particular example. Finally, Chapter 6 addresses overarching barriers to valid and productive research on sex and gender differences as they relate to health and discusses the challenges and opportunities that lie ahead in this emerging field of research. Read the entire page →

From page 13...

... , the committee defines biology, for the purposes of this report, to include the genetic, molecular, biochemical, hormonal, cellular, physiological, behavioral, and psychosocial aspects of life. 2The committee defines sex as the classification of living things, generally as male or female according to their reproductive organs and functions assigned by the chromosomal complement, and gender as a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation.

1 Introduction Pages 13-27

1 Introduction
Pages 13-27