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\"Canadian Women in Medicine is an accessible collection of articles by experienced physicians and researchers exploring how systems, practices, and individuals must change as medicine becomes an increasingly female-dominated profession. As the ratio of practicing physicians' shifts from predominately male to predominately female, issues such as work hours, caregiving, and doctor-patient relationships will all be affected. Canada's medical education is based on a system that has always been designed by and for men; this is also true of our healthcare systems, influencing how women practice, what type of medicine they choose to practice, and how they wish to balance their personal lives with their work. With the intent to open a larger conversation, Canadian Women in Medicine reconsiders medical education, health systems, and expectations, in light of the changing face of medicine. Highlighting the particular experience of women working in the medical profession, editors trace the history of female practitioners, while also providing a perspective on the contemporary struggles women face as they navigate a system that was tailored to the male experience, and is yet to be modified.\"-- Provided by publisher.

Objective: During the past decade, the availability of health information online has increased dramatically. We assessed progress toward the Healthy People 2020 (HP2020) health communication and health information technology objective of increasing the proportion of health information seekers who easily access health information online. Methods: We used data from 4 administrations of the Health Information National Trends Survey (HINTS 2008-2017) (N = 18 103). We conducted multivariable logistic regression analysis to evaluate trends over time in experiences with accessing health information and to examine differences by sociodemographic variables (sex, age, race/ethnicity, education, income, metropolitan status) separately for those who used the internet (vs other information sources) during their most recent search for health information. Results: Among US adults who looked for health information and used the internet for their most recent search, the percentage who reported accessing health information without frustration was stable during the study period (from 37.2% in 2008 to 38.5% in 2017). Accessing information online without frustration was significantly and independently associated with age 35-49 (vs age 18-34) (odds ratio [OR] = 1.34; 95% confidence interval [CI], 1.03 -1.73), non-Hispanic black (vs non-Hispanic white) race/ethnicity (OR = 2.15; 95% CI, 1.55-2.97), and annual household income <$20 000 (vs >$75 000) (OR = 0.66; 95% CI, 0.47-0.93). The percentage of adults who used an information source other than the internet and reported accessing health information online without frustration ranged from 31.3% in 2008 to 42.7% in 2017. Survey year 2017 (vs 2008) (OR = 1.61; 95% CI, 1.09-2.35) and high school graduate education (vs college graduate) (OR = 0.69; 95% CI, 0.49-0.97) were significantly and independently associated with accessing health information without frustration from sources other than the internet. Conclusions: The percentage of online health information seekers reporting easily accessing health information did not meet the HP2020 objective. Continued efforts are needed to enable easy access to online health information among diverse populations.

Much has been written in the past two decades about women in academic science careers, but this literature is contradictory. Many analyses have revealed a level playing field, with men and women faring equally, whereas other analyses have suggested numerous areas in which the playing field is not level. The only widely-agreed-upon conclusion is that women are underrepresented in college majors, graduate school programs, and the professoriate in those fields that are the most mathematically intensive, such as geoscience, engineering, economics, mathematics/computer science, and the physical sciences. In other scientific fields (psychology, life science, social science), women are found in much higher percentages. In this monograph, we undertake extensive life-course analyses comparing the trajectories of women and men in math-intensive fields with those of their counterparts in non-math-intensive fields in which women are close to parity with or even exceed the number of men. We begin by examining early-childhood differences in spatial processing and follow this through quantitative performance in middle childhood and adolescence, including high school coursework. We then focus on the transition of the sexes from high school to college major, then to graduate school, and, finally, to careers in academic science. The results of our myriad analyses reveal that early sex differences in spatial and mathematical reasoning need not stem from biological bases, that the gap between average female and male math ability is narrowing (suggesting strong environmental influences), and that sex differences in math ability at the right tail show variation over time and across nationalities, ethnicities, and other factors, indicating that the ratio of males to females at the right tail can and does change. We find that gender differences in attitudes toward and expectations about math careers and ability (controlling for actual ability) are evident by kindergarten and increase thereafter, leading to lower female propensities to major in math-intensive subjects in college but higher female propensities to major in non-math-intensive sciences, with overall science, technology, engineering, and mathematics (STEM) majors at 50% female for more than a decade. Post-college, although men with majors in math-intensive subjects have historically chosen and completed PhDs in these fields more often than women, the gap has recently narrowed by two thirds; among non-math-intensive STEM majors, women are more likely than men to go into health and other people-related occupations instead of pursuing PhDs. Importantly, of those who obtain doctorates in math-intensive fields, men and women entering the professoriate have equivalent access to tenure-track academic jobs in science, and they persist and are remunerated at comparable rates—with some caveats that we discuss. The transition from graduate programs to assistant professorships shows more pipeline leakage in the fields in which women are already very prevalent (psychology, life science, social science) than in the math-intensive fields in which they are underrepresented but in which the number of females holding assistant professorships is at least commensurate with (if not greater than) that of males. That is, invitations to interview for tenure-track positions in math-intensive fields—as well as actual employment offers—reveal that female PhD applicants fare at least as well as their male counterparts in math-intensive fields. Along these same lines, our analyses reveal that manuscript reviewing and grant funding are gender neutral: Male and female authors and principal investigators are equally likely to have their manuscripts accepted by journal editors and their grants funded, with only very occasional exceptions. There are no compelling sex differences in hours worked or average citations per publication, but there is an overall male advantage in productivity. We attempt to reconcile these results amid the disparate claims made regarding their causes, examining sex differences in citations, hours worked, and interests. We conclude by suggesting that although in the past, gender discrimination was an important cause of women's underrepresentation in scientific academic careers, this claim has continued to be invoked after it has ceased being a valid cause of women's underrepresentation in math-intensive fields. Consequently, current barriers to women's full participation in mathematically intensive academic science fields are rooted in pre-college factors and the subsequent likelihood of majoring in these fields, and future research should focus on these barriers rather than misdirecting attention toward historical barriers that no longer account for women's underrepresentation in academic science.

Two cohorts of intellectually talented 13-year-olds were identified in the 1970s (1972–1974 and 1976–1978) as being in the top 1% of mathematical reasoning ability (1,037 males, 613 females). About four decades later, data on their careers, accomplishments, psychological well-being, families, and life preferences and priorities were collected. Their accomplishments far exceeded base-rate expectations: Across the two cohorts, 4.1% had earned tenure at a major research university, 2.3% were top executives at \"name brand\" or Fortune 500 companies, and 2.4% were attorneys at major firms or organizations; participants had published 85 books and 7,572 refereed articles, secured 681 patents, and amassed $358 million in grants. For both males and females, mathematical precocity early in life predicts later creative contributions and leadership in critical occupational roles. On average, males had incomes much greater than their spouses', whereas females had incomes slightly lower than their spouses'. Salient sex differences that paralleled the differential career outcomes of the male and female participants were found in lifestyle preferences and priorities and in time allocation.

The transition from medical school to residency is a critical step in the careers of physicians. Because of the standardized application process-wherein schools submit summative Medical Student Performance Evaluations (MSPE's)-it also represents a unique opportunity to assess the possible prevalence of racial and gender disparities, as shown elsewhere in medicine. The authors conducted textual analysis of MSPE's from 6,000 US students applying to 16 residency programs at a single institution in 2014-15. They used custom software to extract demographic data and keyword frequency from each MSPE. The main outcome measure was the proportion of applicants described using 24 pre-determined words from four thematic categories (\"standout traits\", \"ability\", \"grindstone habits\", and \"compassion\"). The data showed significant differences based on race and gender. White applicants were more likely to be described using \"standout\" or \"ability\" keywords (including \"exceptional\", \"best\", and \"outstanding\") while Black applicants were more likely to be described as \"competent\". These differences remained significant after controlling for United States Medical Licensing Examination Step 1 scores. Female applicants were more frequently described as \"caring\", \"compassionate\", and \"empathic\" or \"empathetic\". Women were also more frequently described as \"bright\" and \"organized\". While the MSPE is intended to reflect an objective, summative assessment of students' qualifications, these data demonstrate for the first time systematic differences in how candidates are described based on racial/ethnic and gender group membership. Recognizing possible implicit biases and their potential impact is important for faculty who strive to create a more egalitarian medical community.

An authoritative, state-of-the-art collection that brings togetherkey experts toprovide an overviewof the field. This new paperbackedition includes 3 new chapters on human resources and health, end-of-life care and complementary and alternative medicine as well as thorough updates to the introduction and conclusion.

Management of intersex disorders

A critical step in developing sexual assault prevention and treatment is identifying groups at high risk for sexual assault. We explored the independent and interaction effects of sexual identity, gender identity, and race/ethnicity on past-year sexual assault among college students. From 2011 to 2013, 71,421 undergraduate students from 120 US post-secondary education institutions completed cross-sectional surveys. We fit multilevel logistic regression models to examine differences in past-year sexual assault. Compared to cisgender (i.e., non-transgender) men, cisgender women (adjusted odds ratios [AOR] = 2.47; 95% confidence interval [CI] 2.29, 2.68) and transgender people (AOR = 3.93; 95% CI 2.68, 5.76) had higher odds of sexual assault. Among cisgender people, gays/lesbians had higher odds of sexual assault than heterosexuals for men (AOR = 3.50; 95% CI 2.81, 4.35) but not for women (AOR = 1.13; 95% CI 0.87, 1.46). People unsure of their sexual identity had higher odds of sexual assault than heterosexuals, but effects were larger among cisgender men (AOR = 2.92; 95% CI 2.10, 4.08) than cisgender women (AOR = 1.68; 95% CI 1.40, 2.02). Bisexuals had higher odds of sexual assault than heterosexuals with similar magnitude among cisgender men (AOR = 3.19; 95% CI 2.37, 4.27) and women (AOR = 2.31; 95% CI 2.05, 2.60). Among transgender people, Blacks had higher odds of sexual assault than Whites (AOR = 8.26; 95% CI 1.09, 62.82). Predicted probabilities of sexual assault ranged from 2.6 (API cisgender men) to 57.7% (Black transgender people). Epidemiologic research and interventions should consider intersections of gender identity, sexual identity, and race/ethnicity to better tailor sexual assault prevention and treatment for college students.

Background Sex- and gender-based medicine (SGBM) addresses differences between males/men and females/women with regard to clinical manifestation, diagnostics, treatment and outcomes of diseases. The implementation of SGBM in the medical curriculum varies, and data on the knowledge of lecturers and students about SGBM is scarce. This study aims to evaluate the perceived importance and knowledge of SGBM among lecturers and students. Methods This cross-sectional observational survey was conducted using a questionnaire, including ranked with a Likert Scale. Statistical analysis was performed with the Chi-squared test. All lecturers and students at the Bern University Medical School in Switzerland were invited to voluntarily participate. Results 114 (34.1%) lecturers and 903 (41.4%) students participated in the survey. Women perceived education of SGBM to be of greater importance than men in lecturer and student subgroups respectively (lecturers women vs. men median 6.0 vs. 5.0, P  = 0.011; students 6.0 vs. 5.0, P  < 0.001 ) . No significant differences between genders of self-reported knowledge of SGBM were found (lecturers women vs. men median 4.0 vs. 4.0, P  = 0.624; students 3.0 vs. 4.0, P  = 0.562). There were significant differences in the perception of the SGBM being actively addressed in lectures between lecturers and students (59.4% vs. 28.8%, P  < 0.001) and whether the curriculum should include SGBM (strongly agree 28.9% vs. 51.3%, P  < 0.001). Conclusion Women lecturers and students consider teaching of SGBM during medical studies to be more important than men. Lecturers perceived the amount of SGBM already included in the lectures to be greater compared to students.

Over its history, the Journal circulated ideas about innate sex differences that facilitated essentialization of women to their reproductive roles and exclusion of women from medicine, among other ills.