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[Music]
we are ready to
start um again welcome you to the
session and we start with a interesting
talk by zofi hilner or she told me it's
actually Zara hilner and she will talk
about the discovery of the sex in
medicine please welcome
Sarah thank
you wow thank you very very much for
introducing me and to the curators of
the session thank you for selecting my
talk because I feel very passionate
about it and I hope I can transfer some
of this passion to all of you I am blown
away by how many people are here and
interested in this um since it's a Tech
conference I thought I'd do something
techy uh and I know it is Adventure
capitalized tool but if you want to
participate in parts of this
presentation you can go to mti.com and
insert the code
30363 and
help me with doing a little bit science
on stage I don't know if it will work I
have only done this in English once in
German it usually comes out surprisingly
well but um if you want to
join please do oh I see some people are
joining us they're sending us hearts and
kitty cats that is awesome I going to
you can continue
joining h i going to start with the
story
and it is about an accident father and
son are driving in their car and they're
having
an okay wait this doesn't work so I
going to show you
this so you can actually see what I'm
talking about um father and son are
driving in their car and they are having
an accident both are being picked up by
ambulances the son got injured at his
penis and is being delivered to a
specialist unit in a different hospital
than his father once the sun has been
brought into the operating room the
attending Urological surgeon comes in
and says I cannot operate this is my son
my question now for all of you is how
are the sun and the surgeon
related type in the first thing that
comes into your mind I going to repeat
the story really quickly father and son
have an accident both get injured being
delivered to different hospitals and the
urologist that has to take care of the
injury of the sun says I cannot operate
because it's my
son I would love to show you the results
but it doesn't show on the big
screen which is a Pity but there are
still people joining and answering
questions
[Music]
um and I'm going to give you a minute I
don't know how to I can only describe
then what I can see on the on the slides
and can can put it up later on um insert
is in the in the
presentation
so the biggest word that pops up in a
word bubble that is on this tiny screen
now is the word mother and thank you for
thinking this way because yes that's a
possibility when I do this experiment in
German usually people think of wait a
minute it's the stepfather or a father
of a homosexual relationship or it's the
adoptive father so it's some kind of
male person that is U related to the son
but they do not think about mother
because German is a highly gendered
language when we say surgeon we say
heror and we are used to apply it for
male as for female surgeons but there is
a distinctive word that is hogin which
would be the female
version which brings me to the
point
um
that what I've already mentioned we live
in a gendered world to give you a broad
overview what you can expect in the next
couple of minutes is I going to
determine what we're actually talking
about what is sex what is gender because
both are very very important when it
comes to
Medicine the next thing will be how I am
trying to hack the medical system by
doing the research I'm doing because
that men and women
and other bodies exist is a very very
new idea in
medicine the major terms I'm going to be
discussing uh I will discuss is sex so
the Gen Tils and the genes and the
hormones it's the gender identity which
is also reproduced in society and
different facets it is how we express
our gender whom we are attracted to and
in the end I'm going to give you an
example of the heart attack that is the
best researched version of sex and
gender sensitive medicine so let's talk
about sex when I say sex I do mean the
physical body I am referring to genitals
I am referring to hormones I am
referring to genes the hip shoulder
ratio but there are not only two Sexes
there is the option that We Now call
intersex which has been there for a very
long time it just has been neglected by
medical research for most of the
time and that means when a baby comes
out the first thing people are looking
for is between the legs and can we
identify of what's there if we can't
identify it up until this year they had
7 days to decide if this baby is
supposed to be male or female
and what one surgeon told me was well
you know what Sarah it's easier to drill
a hole than to build a
pole I think you should not cut into any
healthy tissue no matter how old or
young a child is but particularly if
it's a baby and all the exits are
functioning just don't touch it leave it
the baby won't mind and you will
probably save it a lot of trouble once
puberty hits
the hormones kick in and the body will
actually develop into either or or
incisive it's an
option so when you're assigned a sex at
Birth you carry it
along we are used to this tradition and
it actually comes from the old Greek
that they thought the male body is the
ideal and the upper best expression of
how a human being can
be and women just lack a lot of fire to
turn their penis
out that's seriously what they believed
and it's called the one seex body and it
has been predominantly reproduced in
medicine over the time until
Enlightenment struck and
suddenly wo we have two bodes now
everything that um has been looked at
under microscope so they looked at
testicles they looked at ovaries and
thought wh those are different tissues
maybe it's not a penis inside out but
maybe it is something entirely different
and right they
were um but they only thought about it
in the bikini model way which is a term
that Mariana Legato uh originated a
couple of years ago because it refers to
the fact that everything that's covered
by a bikini has been outsourced to
gynecology but the rest of the body of
course is
not there's no difference n it's it's
Aion like okay so when sex and gender
sensitive medicine approached it came
from a long history of women's health
movement so yes the ideology of feminism
and bra burning and angry feminists is
all in there it used to be at least
because now we discovered Wait a
Minute Men are actually discriminated as
well in a lot of diseases we
underestimate the risk for men
depression for example
osteoporosis and many more that we don't
even know
about again sex physical body genitalia
hormones
pheromones all this
influences your
medical Charter so to speak so it has
differences in
symptoms you as a man or as a woman also
when you identify as a non-binary person
your body is still genetically make up
and it has hormones and so it also will
react differently to medication and
pharmaceuticals but also when a disease
will come the prevalence of the disease
for example a heart attack in women is
10 10 years later because they have
estrogens that make the insides of their
blood veins and vessels really smooth so
a clot cannot develop there so there
won't be a heart attack at least not for
another 10 years because men lack this
hormone but there's also a bunch of
similarities our job now is it as a sex
and gender sensitive researchers to
distinguish when does sex matter when
does gender matter but in sex we have a
lot of differences and similarities I've
talked a lot about genes and hormones
and we actually now have a way to
distinguish if the genes have an impact
on health or if it's the
hormones so this four core genotype
Mouse model is a mouthful and I Tred to
explain it as simple as possible but it
is
complicated so you start out with a male
in the female Mouse the male Mouse has
an X Y minus
SRI the Y minus is a natural mutation
that stops this mouse from developing in
testes so it will not have male
genitalia the SRI on the other hand is
then inserted in the mouse to make it
develop genitalia male genitalia and
guts the sexual um reproductive organs
to then recreate or procreate with the
female
Mouse in The Offspring Next Generation
now you have four different
outcomes the female versions have the
X and okay we have two female versions
one is an XY minus and one is an XX the
XX is a just regular female it has a
genetic makeup of a female Mouse and it
has the
hormones the X Y minus Mouse because
it's lacking the
minus it's will turn out to become a
female Mouse on the outside
but
genetically it is still a male
Mouse in this way we can determine and
distinguish if the hormones or the genes
the genes have a different makeup the
other way around is a male mice there we
have an XX Mouse which is a genetic
setup of a female Mouse included the SRI
Gene and that makes it
now uh turn male
so that's one part that you can do in
research and a lot of parts in research
are still done on mice and and and rats
so we use rodents what we underestimated
in the last years is that the
pheromones from the axill steroids
though all the stuff that makes your
axilla
smelly is having an impact on how we
interact with each other and also how
animals interact with us for example uh
um the 70s Barbara mclintoch found out
that the menstrual cycle synchronization
within women that they have their period
at the same time is actually lead to
those or leads back to those
steroids but it also influences how you
perceive pain and how you are willing to
express pain interesting thing is when
someone now comes
in with a
certain steroid acceler
steroid um you will also react
differently to your pain and express it
differently in 2014 there was an
experiment that looked for sex
differences in the researcher and the
effects on the mice and it turned out
that the exposure of mice and rats to
male but not female experimenters
produces pain
inhibition this means male Reser goes
into a lab tries to induce pain and rats
and they will show it at a certain
amount of time when a female researcher
reproduces these experiments the rats
and the
mice they admit earlier that they're in
pain when we can now add one more layer
and this would be when a male researcher
takes off um his lab code gives it to
the female researcher and she now doing
the same experiment she will get the
same results as the men before so the
male body does not have to be present in
the lab to influence these results it's
sufficient if the pheromones are in the
air this effect only lasts about 30
minutes but I don't know many
researchers that have the time to just
sit in their lab rat to Cal down the
rodents to then experiment on them but
it is not standard to actually say in
published papers with Brent um
experiments which sex the researcher had
but it's proven that it does have an
impact and we should be more aware of
that when I talk about diseases and
differences I want to give you one
example of osteoporosis which is the
loss of density in the bones which means
the bones get brittle and they start
breaking more
easily osteoporosis was long believed to
be a solely female
disease but not quite we just found out
that actually it's underestimated in men
and once they turn
70 they increase the risk of having
osteoporosis as
well what the unfortunate thing is if
they have a fracture in comparison to
women they are more likely to die
because of this fracture so they're
endangered in this this case and when I
look for images and pictures of
osteoporosis the only thing I could find
were ones where women is represented but
I will come back later to that
let's talk about gender
identity gender identity is how you feel
in your head how you identify and how
you experience your gender also based on
how much you align with what your body
is
[Music]
so when
I as a gender person am here I can tell
you I identify as a woman and when we
before talked about sex
sometimes it is interesting to wonder
what someone else has in their pans yes
but it's just to say briefly it's very
impolite to ask sorry to say like just
don't if you wonder maybe they'll tell
you if they're ready but if you don't
intend to have sex with them on a
consensual basis don't ask made that
mistake
so with a gender identity you also don't
know no people will or will not tell you
if they identify with a more women or
with a more
maleness um but they can also identify
as non-binary which means they do not
identify with either or and sometimes
they're even uncomfortable with what
body they
have if someone tells you just respect
that it's awesome that they trust you so
much that they do tell you so also
there um but the gender identity is
highly influenced by Society as well
because there are also expectations from
society to how we are supposed to behave
to
how women have to be kind of softspoken
and timid and pretty and I know I'm here
in a group of very privileged people and
I think it's awesome that we're building
this Utopia here and we're living a
different kind of society that I so hope
will be
mainstreamed but it's not in the main
stream yet and this is
stories to learn to read for boys and
girls I let yourself choose which ones
which and you're not English speaker but
I think it's quite clear the only thing
I do want to point
out
um and just to mention that all the head
chefs and Bakers and all the famous ones
are usually men so I think they made a
mistake right
there when we talk about expression well
look at me I have to carry the
microphone sender at the back of my
dress because well fashion design for
women lacks Pockets yes so please
continue hacking
[Music]
that so the gender expression has a lot
to do with grooming how do I style how
do I carry myself how do I speak how
affectionate and how um do I choose my
mannerisms and also there you can be
you and the Unicorn you are to all the
way women and to all the way male
everything should be okay and we should
not punish anyone for not complying to
that now how does gender
influence our medical records well for
example the Assumption of the ssibility
of diseases susceptibility of diseases
when you're a young man and you suddenly
have erectile dysfunctions you probably
would not have estimated that that is
something
that hit you when we then add a little
bit of depression to the equation it is
also something that men and
depression it's starting to become a
subject it's starting to become a
subject but so far men talk differently
about their symptoms they experience
their body differently and they also
just as women don't think they can have
a heart attack you have a t to your
gender C certain expectations of what
you want no what you think you can have
or develop as a
disease another thing is the interaction
with your doctor so like I mentioned
before how men and women act with other
people how we describe stuff is very
different can be very different on top
of that comes when you're a woman and
you want birth control you have to go to
a gynecologist at one point of your life
and once you're in the system you have
to come back every
year when you're a
man well when you're a child male child
you go to the doctor because your mom
makes you and
then oh wait there was a flu really sick
but managed to get over it and then
maybe with 3540 you have to do the
prostata
thing well till then you didn't have the
time women had to practice the
interaction with doctors so that's also
another
point
when we now switch the way around your
doctor also looks at you and expects a
certain kind of
gender and a certain kind of
behavior and when you have now a
urologist and a Mr floppy situation
going on which might be related to
actually being pressured at work having
the pressure of being the single bread
winner in a family or simply because
you're sad and life sucks
sometimes and you just don't know how to
talk about
it well I don't think a urologist is the
first person that will point that out
some do some are excellent I don't want
to do doctor bashing here but it's all
related to how we move about and what
Society is actually expecting of us and
that brings me to Norms and stereotypes
when we say all men are like this and
all women are like this that's more of a
stereotype but a norm is something that
is being punished by society when you
divert from it so when you suddenly
you're man and you burst out in tears in
the middle of public people will react
in a certain way and I tell you most
times it's unpleasant even as a woman
bursting out in tears ugly crying all
the way public can lead to some
distraction but when you're a man
o that's a tough
one um and that
is something we underestimate as an
effect as well because everybody is
judging that's how we box our worlds and
we try not to I try not to but it's
hard and I talked to about depression
before and it is more common as a form
of anxiety in women and more men are
using substances to deal with the
depression
unfortunately men are really successful
killing themselves when they're
depressed so I was very very happy that
lindorm yesterday made us all stand up
to show if you have experience with
depression and you're willing to talk to
someone that doesn't feel like all glory
Sunshine out of your ass rainbows
awesome thank you because it is a
sens it is a serious
problem and we need to talk about how do
we evaluate depression actually all the
scales and measures we
have are kind of related to being said
and being open of admitting of being
said having sleeping troubles but if you
don't know your not if you don't know
your body that well and don't know how
to talk about it how don't know how to
address it in front of a doctor then
maybe they just miss the
cues they maybe just not used to see a
male version of
depression because it can be the
responsibilities it can be that you have
to work your child is at home and you
hate leaving every morning you would
love to be a stay-at home Dad but you
risk losing your job when you tell your
boss hey I want to stay at
home and that's something that's also
related to the gender norms and once you
taken the little blue pills going back
to erectile dysfunctions you've taken
care of the symptom but not of the cause
which is also something we need to talk
about in medicine that a lot of those
pills take care of the symptoms but not
of the actual cause of
diseases thank
you I think I made it quite clear that
sex and gender are bit different and now
we're going to go to an example of the
heart attack I want to briefly address
that the attraction to
someone uh can also impact your health
because um for example when you're a
lesbian woman and you never had to go to
a gynecologist to get oral contraception
well you kind of not in the system and
the incidences of cervical cancer are
higher in that group because they're not
being screened because they have no
reason to go to a
gynecologist on the other hand when
you're a homosexual men you're banned
for life you Ed to be banned for life
donating blood now you can donate blood
but you have to practice abstinence for
one
year yes good
job okay I need a sip of water I going
to start with the second part of the
presentation soon but before that since
I'm also a physical
therapist we're going to do a little
breathing exercise so please stand up no
no no no don't stand up so sit down
but come lean a bit forward move on your
chair a bit to the
front yes sit up
straight and take a deep breath
in hold it in for a second and
out one more time deep breath in
hold it and all the men breathe
out yes for the women hold on before the
women um the non-binary people can
continue breathing because you're not
mentioned in any of the medical
textbooks anyway so far so just sorry I
tried but the women are still holding
yes
okay H okay 15 seconds fair enough
continue breathing the thing is if you
as a woman would have had a heart attack
it would take about 15 minutes longer to
reach the operating room than a
man but be it used to be 90 minutes it's
progress in the heart attack which is
one of the best researched uh examples
we have by now and probably a lot of you
have already heard of it but I'm not
tired of reusing it because the data is
30 years old and I looked in medical
Tech textbooks from the newest
generation and I have not found a lot of
that data there but when we talk about
heart attack differences in the Sexes we
need to talk about symptoms what I
learned as a physical therapist was that
when someone in front of me has chest
pain pain in the left side of the body
and cold sweat heart attack emergency
call 1112 in Germany and deliver them to
the hospital as soon as
possible when I started working in the
Institute of gender sensitive medicine
I was introduced to new fact well most
women show weakness shortness of breath
back pain and
nausea so we put them on the couch we
send them to an orthopedic and I don't
know U make them rest of
it that's one of the reasons why women
get delivered late to the hospital
another one is the awareness in
themselves so when you ask women what
are you most afraid of dying they say
cancer when you ask men a lot of them
will say heart attack when we look at
the data at the data from 2015 in
Germany then actually cancer on
the what is it for you the left side is
less deadly all major cancers are less
deadly than cardiovascular diseases and
when you look at the cardiovascular
diseases it actually shows that women
the light blue are more in Risk than
dying in dying from a cardiovascular
disease than
men when we now look at breast cancer
and the heart attack it shows that yes
less men die of breast cancer that is
true but there are men that die of
breast
cancer but it's also that less women die
of a heart
attack and less women die of cancer in
comparison to heart attacks and when we
now compare like how many people have
died of a heart attack then it is 43%
were female I know it's not 50
but it's just the awareness of how I
think I how I think I I am susceptible
to a certain disease we need to campaign
for cardiovascular diseases in women we
need to campaign for raising awareness
that the heart attack is a serious
threat for women as well because because
in breast cancer it has worked women are
now sensitized to that so we can move on
to the next one the acknowledgement by
other people the breathing exercise when
I looked at the medical textbooks I
going to refer to later I going to refer
about later you will see that there is a
bias in medicine and this bias leads to
delay delivering to the hospital it
leads to more severe side effects in um
administering
Pharmaceuticals
and one of the examples for is is
aspirin or ass when someone has a heart
attack one of the standard medications
is to give them ass or aspirin and
um that will protect the men for another
heart attack for in reinfarction but in
women it will all only protect them to
have a a
stroke
and we don't know quite why this is but
this is what the data showed so
medications can have different effects
in different Sexes if we know all this
and I said the heart attack is something
we've researched for 30 plus years now
why do we actually need to talk about it
why am I
here because there's a bias in medical
textbooks that I've looked
into and one is androcentrism which
means the medicine is centered around a
male body so I looked at a lot of
textbooks I read a lot of chapters and I
brought you some
pictures I don't know if you can see a
pattern this is a selection they are not
all when I showed all I was critiqued in
practicing this talk it's just too long
people will get the point trust
me so all those pictures and medical
textbooks only in the chapters about a
heart attack that 43% I know
representation of women in pictures
we're not talking about like
photographs it's painted pictures not
one
woman gender insensitivity is something
when you research in on one sex and then
transfer it on the other without
checking if it's actually
applicable so in this book it said in
German special patient groups underneath
it's the subgroups are older patients
women patients with renal insufficiency
diabetes and
anemia congratulations women we all
belong into the category of chronic
diseases oh but um although we're so
special in the bottom line it says well
generally you should still take the same
approach as with
men wait so we're really special and
we're
atypical but we are being treated the
same great brings me to the last buyers
is it's the double standard same
situation for the same for different
Sexes but they are treated
differently in this case I translated a
quote from a book which says in case of
a heart attack immobilize the patient
and remove restricting clothes TI shirt
color neck
tie well I think you know what I mean
it's um and then in in in German you
have usually in books this this one
quote like because it's easier to read
we only going to use the male version of
this word of like
patient and women are implicitly meant
as
well well but we ignore them
explicitly one book was really honest
they say well RSS is good for
preventing H it's just for women we have
insufficient data for a general
recommendation so congratulations dear
medical students trying to figure out
out with
them I've talked a lot about now about
in um the differences between the Sexes
but there are also a lot of
similarities and this is the big
differentiation we need to make because
the interex differences and the intrasex
differences need to be
regarded I made an image here just one
side is supposed to be the male
population the other one the female
population the two dashes at the top
they are representing one how big the
differences between the sexes in the um
in a general comparison are when you
look at the broader picture of the
actual intra sex differences so in the
group of women what are the differences
there and in the group of men what are
the differences there they are a lot
bigger the problem is we don't even look
for the Sexes separately so the first
step is to look and separate Research
into men and women and again I'm very
very sorry not to include binary
non-binary persons to be in the binary
because medicine is discovering this
binary as we speak so it will be a very
slow process to go to gender as a
spectrum to sex as a spectrum but we
need to start somewhere and we need to
start looking for those two groups to
then actually dissect these groups in
comparison to each other why is it not
mainstream yet
I have interviewed a lot of um gender
medicine
experts and I brought a quote from a
Nobel Prize
winner and Mr Tim hun said 2015 3 years
ago 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 criticize them they
Cry 3 years ago but there's no no bias
in in medicine in science um some
experiences of the resistance of the
pioneers of gender medicine one said
well they just did not see the problem
they thought I was the problem shooting
the messenger works everywhere I guess
another one was well if you're a
cardiologist for 25 years you have to
learn now that you may have done things
wrong with many female patients it's not
nice to
accept and I agree when you're a medical
doctor and you have been practicing for
a long time with knowledge your thought
is accurate it's part of your identity
and it's hard to digest it's a bitter
pill to swallow to suddenly realize
maybe you have overdosed maybe you have
even killed someone so I know that this
kind of resistance is is there and we
need to address it nevertheless we need
to change the system we don't come
around it
one last thing is there's also
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 am 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 so we as gender sensitive
researchers are met with a lot of
hostility within our own research
environment
environment um and gender is being very
like G like maybe over there maybe the
social sciences can take care
of well we try I'm a sociologist working
in a Medical Faculty trying to improve
it but it's difficult because there are
two
different um
cultures we're coming now to a new
problem that I've just encountered doing
my current research
algorithms when we are now entering the
new decade of computer assisted
Diagnostics when we knew when we want to
help doctors making the right decisions
we need to feed them
data all the book examples I showed you
were books published in 28 to
2012 so they were the most recent
editions of those books and they were
available in onethird of all medical
libraries in Germany at least in oneir
one of the books was actually in every
Library and if now this kind of
knowledge is being fed to algorithms
that then have to computer assist we
don't get rid of the
bias and I know there's a lot of
research about it out there but I would
also like to um invite you on the one
hand to a conference that is happening
at the redart University in Nan on bias
in artificial intelligence and
Neuroscience um the call for papers is
still open if you have something if you
know something please contribute it will
be very
interesting and I would also like to
give you the opportunity to go back to M
and help with any ideas you have I will
read through those if I can manage to
switch the
slide yes there we
go okay I I I would love to show you I
can't um I don't know why it's not
working but the first one was get rid of
AI I like
that well I hope I could Enlighten you a
little bit I thank you very much for
listening and participating in my
presentation and please reach out on uh
Twitter uh or contact me via email if
you have any questions or ideas that we
cannot um address in the Q&A that's now
following um but yeah Q&A starts now I
guess
a
[Applause]
thank
you thank
you thank you ah thank you Sarah for
wonderful talk and the paper the talk is
open for discussion and open for
questions are there any
questions
I see no urg ENT one so I will start
with one or is somebody running to
microphone too okay it's your question
yeah I have ju I microphone too hello I
have just a very brief question um those
quotes from women who are identified
with names of colors I was wondering did
you gather those as part of your
research were they anonymized can you
tell me the story behind that study yeah
uh it was my master thesis and I
interviewed uh 20 Experts of sex and
gender sensitive medicine in Europe and
um I asked them about how and if they
have managed to implement it at their
respective universities and that's why I
uh I interviewed them all myself and
transcribed it and then um analyzed it
why we have so much resistance and why
it's not moving on because it is such a
broad subject that it's actually going
cross all the Specialties in medicine
but now it's established as like a site
specialty which is conflicting as well
but it's it's work in progress I mean
the discipline of sex and gender
sensitive medicine is like 20 years old
so we're talking about Cutting Edge new
medicine I know 20 years is a long time
for you and your experience is the work
Fields but in medicine everything turns
a lot slower thank you thank you for the
question oh we continue with the
microphone too young hi um so as a woman
this was the the first time that I heard
that there's a difference between you
know heart attacks for men and women in
terms of symptoms um and I'm not asking
you to list all the different symptoms
and other things but are there any other
major things that we should be aware of
that where there are known differences
well metabolization of um medication is
a big big um influence and um usually
women need less
medicine um but more often
so the amount but it's something you
need to discuss with your doctor and I
was quite surprised that most of the
medications that are handed out are not
weight adapted at least because usually
women are also a little bit lighter in
weight um but I'm so sorry to say I'm
also not a medical doctor I'm a
sociologist so I'm trying to um cover it
but ask your ask your doctor about it
make them do the research because they
are the experts and they should come
back to you with an
answer
we continue with the microphone too um
you also talked about um intersex people
yes did you come across any research um
where it's yeah where where diseases in
intersex people are dealt with or like
how the male and female uh thingy is
coming you know it's kind of connected
to that I personally have not and I
think the research in that area is very
very marginal it's because there are
still a lot of doctors that are experts
in that area and that do misgendering
that address the people with the wrong
pronouns and it's uh I think they I'm
very sorry to say but trans and intersex
people have the longest way to go and
ahead of them but it's it's
just I yeah we need to do it ourselves
otherwise nobody will actually take care
of it I gu yes sorry to
say okay I see a question at microphone
4 or are you guys just standing
there no question no I have a question
okay thank you um yeah thank you for the
talk um I'm a doctor so I'm very
interested in your opinion um
towards uh the development considering
why we are all here so considering the
digital transformation of health and do
you have the impression from a
sociologist perspective that it's
getting better or the just young white
man now replace the old white man and um
all the apps out there are very very
gender insensitive and stuff than uh
second part yes all the apps out there
are still very very gender insensitive
because the knowledge that needs to be
inserted is still being
researched um I fear the old white men
are not replaced by old all by young
white men but also by young white women
that act like white old men
um we're talking about medicine it's as
a sociologist it's one of the most
hierarchical and most traditional uh
cultures within our system so there it
is moving really slowly and those power
relations are replaced very very slowly
so I don't think I got going to benefit
from my research to be honest so sorry
but that's also a burden I have to live
with but I still do my job for you and
your children
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so okay microphone one please hello
thank you for your talk um can we lift
our hopes in seeing that um most well
not most but about 60% of medical
students uh nowadays are female
it does bring forth
change um but slowly but I do have to
say I have a lot of Hope for the younger
generation in general like with each
younger generation we do have people
that are energized that are more open
that have lived with serieses like I
don't know Sid with representations of
people of color with trans people with
intersex people that have been more in
touch with it so it feels more natural
to them so there's less resistance which
is a good thing um and that will bring
change as well because you can't
underestimate the influence of Pop
Culture so um I I wouldn't say it's the
hope that more women are coming in the
research um but it's that that General
we as a society get more open and more
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aware microphone 2
please hi um thank you very much was
very interesting um my question is if uh
we could see AI as a chance rather than
a threat um because I'm I'm also working
in field related to Medical it and I
think most efforts go into analyzing a
lot of data from patients with the
attributes where sex is one attribute
and not in learning textb knowledge
which just repeats the
bias I I totally agree I think actually
Ai and the new uh way of of analyzing
data and and compiling data is very very
interesting and important to to feed
that but we still have to consider and
be aware that there might be a gender
bias in the Assumption and that's my my
research is on um finding out how we can
operationalize gender and make that one
of the variables in the equation um to
see if that has an influence as
well okay number four
please I uh thanks for your talk we you
had some very good examples in there
there's just one example where I'm not
sure it's the menstrual synchrony thing
I'm pretty sure this is not
state-ofthe-art anymore to say there's
menstral synchrony in women sorry I
didn't understand that the menstrual
synchrony thing yeah okay I'm pretty
sure that science doesn't say that
anymore okay well um then I'm going to
do my research on that thank you for the
for the for the input okay number
two hi um I was wondering if in some
questions it could be useful to skip the
gender question and just go to genes
right away because um medicine is
getting very complex with genes which
are factors going into the equation so
maybe this could be easier for many
questions do sociologists think about
that I can't say I have but maybe if you
have time that sounds very interesting
to to talk more elaborate more on
that yeah just uh like neuroscience you
have um you know you have the genes uh
in the brain and depending on which Gene
you have you are more susceptible to uh
like uh nicotine addiction smoking which
is a factor which leads to heart attack
and stuff as well so uh this is as well
as the sex um you have this influence
but you have the genes as well so this
is very interesting too and maybe at
some points sex is just one factor which
goes into that but it's not uh the only
one no no of course it's not the only
one but we have to start looking for it
because so far it hasn't it's not
systematically integrated in research
like when sudden sometimes they um
um uh sometimes they they do have a
group of male and female mice rats
humans um and then they kind of divide
those groups but sometimes they even
miss that step so it's not
systematically integrated yet as a
variable in the the research
and I think I I don't I want to Advocate
to do that like it
is yes that like we need to start with
that actually acknowledging that we have
to look for sex differences and if there
are none awesome then we can move to
look for other differences but we need
to
know yeah microphone four please uh
thank you thank you for the talk um I
really like the part where you showed
that the researches itself is gender
influence with the ni and the lab code
um thinking to the issue about data for
intersex people
um is there is there some research in
how often we actually do have data for
interex people in the samples we do for
the research or are they is there enough
data for interex people to be
represented or do we need other ways of
researching this issue I think most um
trials will
ask for um male or female and if you're
interx you can participate it will be an
exclusion criteria because the sample
group would be too small so you'd have
to kick them out anyway for statistical
reasons
sorry um I guess there is one more
question at number
two so as far I uh understand there is a
huge gap in time when it comes to uh
pain so women most likely will uh wait
longer for treatment when it comes to
pain so my question is do you have uh
any ideas how we could address
that well that's a complex issue and the
research I've read about is that um
women are trained to do their care and
put their care work first so I just have
to finish the dishes or wait I need to
pick up the kids or I know those are
also kind of stereotypes I'm I'm now
referring to and they're oldfashioned
but they're still present and they're
still harming people because when you're
trained to do this all your life you are
less likely to actually take care of
yourself and take yourself
seriously number four please um I had a
question about the heart attack rates in
women mhm so with this 43% do women
actually have less often heart attacks
or can it still be the case that the
cause of death death is not recognized
as a heart attack that's an excellent
question well it's hard to to to know um
but we need to to look more for that and
it's also that men can have this female
version of a heart attack which can then
be misdiagnosed and and not not be um
the life cannot be saved because people
just don't react on on those Triggers on
those symptoms um but we need to we need
to look into it
why people have died of course but an
autopsy you wouldn't do when someone is
old and it
looks like something so I guess there
are a couple Miss yes
thanks number two please hi thank you I
was wondering if you've come across any
examples of perhaps people doing
Quantified Self stuff uh contributing to
um these issues or perhaps providing
data or research uh that traditional
medicine hasn't been doing I'm sorry to
say I have not no but also good to look
into maybe someone in the in the
audience that would be interested yes
please reach out let me
know if you
do okay I think there are no more
questions so thank thanks to you for the
for the discussion and the questions but
most of all of course thanks Sarah for
the wonderful
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talk
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