Why Sex Matters: How the New Science of Gender Medicine Can Save Men’s Lives

Long before anyone had heard of the field of “gender medicine” I was on a search to find answers to the question, “why do men die sooner and live sicker?”  I was five years old when my father tried to commit suicide.  He had, what I was told was, a “nervous breakdown.”   I didn’t know what that was, but I knew he was having trouble finding work in a down economy and he had become increasingly irritable, angry, and withdrawn.  Although he didn’t die our lives were never the same.  The year before, the father of one of my friends had killed himself.

Men were supposed to be the “top dogs,” strong, silent, and invincible.  The T.V. programs of the era told us that “father knows best” and the women and children should follow his lead and learn.  But in our family, and in the families of many of my friends, there was something clearly wrong with father.  My mother had her own problems, but she seemed to be aware of them and talk with her girlfriends about them.  But my father was on top of the world….until,  it became crystal clear that, he wasn’t.   I grew up with a hunger to find answers and a terror that if I didn’t find them I would end up facing suicide in my own life.

My first inklings of an answer came in 1976 when I read, The Hazards of Being Male Male by psychologist, Herb Goldberg.  He said, “The male has paid a heavy price for his masculine ‘privilege’ and power.  He is out of touch with his emotions and his body. He is playing by the rules of the male game plan and with lemming-like purpose he is destroying himself—emotionally, psychologically, and physically.”  It was the first public recognition that all was not right with men.

In graduate school I learned everything I could about mental health and illness and I got my master’s degree in social work in 1968.  The next year our son, Jemal, was born.  I made a vow to him that I would be a different kind of father than my father was able to be to me and I would do everything I could to create a world that helped men live well so they, and their families, could enjoy a full and productive life.

The Emergence of Gender-Specific Medicine to Improve the Lives of Women and Men 

While I was working on my master’s degree between 1965 and 1968, Marianne Legato, M.D. was a visiting fellow in cardiology at the Columbia University College of Physicians and Surgeons.  She and her colleagues made a remarkable and disturbing discovery.  They found that cardiologists were treating the complaints of men and women very differently:  doctors were twice as likely to ascribe a woman’s symptoms to hysteria or emotion as those of a man.  Thus, women were under-diagnosed for coronary artery disease (CAD) and under-treated.  As a result women were dying who could have been saved.

Since then our understanding of heart disease has changed dramatically and we now recognize that we must take gender and sex differences into account in diagnosing and treating heart disease, as well as other illnesses.  In her groundbreaking book, Eve’s Rib:  The New Science of Gender-Specific Medicine and How It Can Save Your Life, she says that her research is not just about women’s health, but about the health of both sexes.  “Until now we’ve acted as though men and women were essentially identical except for the differences in their reproductive function.  In fact, information we’ve been gathering over the past ten years tells us that this is anything but true, and that everywhere we look, the two sexes are startlingly and unexpectedly different not only in their normal function but in the ways they experience illness.”

Legato established The Foundation for Gender Specific-Medicine to support the investigation of the ways in which biological sex and gender affect normal human function and the experience of disease.  Investigations on a genetic, cellular, and biological level have improved health and prolonged life for both sexes.  “The evolution of gender-specific medicine is similar to the emergence of pediatrics,” says Dr. Legato, “which evolved because of an increasing awareness of the fact that children were not simply small adults. Their physiology, diseases, and treatment are age specific.”

 Gender Medicine and the Future of Men’s Health

We know that men live sicker and die sooner than women.  According to researcher Dr. Will Courtenay, author of the landmark book, Dying to Be Men, “For nearly all 15 leading causes of death [except Alzheimer’s], men and boys have high age-adjusted death rates than women and girls.  This remains true in every age group throughout the life span.”

Although gender-based medicine and health care are receiving increasing attention among health-care professionals, most of the attention has focused on women’s health.  Dr. Legato has a personal, as well as a professional interest in seeing that we pay equal attention to the health needs of men.

Dr. Legato begins her book, Why Men Die First:  How to Lengthen Your Lifespan, with a sad memory.  “My physician father illustrated many of the biological and societal hazards of being male.  My mother outlived him by a decade mourning his absence every day.”  Her dad was similar to many men who didn’t take care of themselves and were taught it was their duty to sacrifice themselves on behalf of others.

“My father’s lifestyle was not conducive to a long and healthy life.  He had what I came to consider the quintessentially male nature:  He worked with an amazing tenacity at his vocation and he never asked anyone for help or complained about the burdens it placed on him.  He took risks that were unnecessary, asked no one for advice or counsel, smoked three packs of Philip Morris cigarettes a day, ate huge amounts of pasta, oiled vegetables, and rich Italian pastries, and frequently finished his long day with a generous helping of Scotch on the rocks in one of the beautifully faceted crystal glasses he favored.”

 The Truth Shall Set Us Free 

Before we can begin to save men’s lives, we have to open our eyes to the facts.  When Marianne Legato turned her attention from women to men, what she discovered shocked and appalled her:

  • 6 percent of the boys who die before age 10 are murdered.
  • For men between the ages of 15 and 34, suicide and homicide are the leading causes of death after what are called “unintentional injuries.”
  • Heart disease begins to claim men when they are only 35 years old.

More recent research at the Foundation for Gender Specific Medicine shows the following:

  • Men have less vigorous immune systems and are less able to fight some types of infection.
  • The part of the brain that moderates impulsive behavior is not yet fully developed in adolescent males, but it is in females. As a result, teenage boys often exhibit risky behavior that makes them prone to accidents.
  • It is untrue that women are the “weaker sex.” Evidence shows that men are more vulnerable in the womb and throughout their lives. 240 males are conceived for every 100 females. Yet, the ratio of actual birth is 1.05 boys to 1 girl. Men live a much more fragile existence throughout their lives and, on average, die six years earlier than women.

Too many men and women, including health-care professionals, have come to accept the reality that men must die sooner and live sicker.  It’s just what we have to accept about being men.  Women and children will just have to prepare to take care of us as we get sick and mourn our passing when we die too soon.

But those in the emerging field of Gender Medicine, like Dr. Legato, don’t accept that reality.  When I think of my own father and Dr. Legato’s father, I cry at the loss.  I want a better life for myself, my children, and grandchildren.  For more than 40 years I have been helping men, and the women who love them, to live well.  I believe Gender Medicine can help us all.  How about you?  Let me know what you think by sharing a comment below.

I’d also like to invite you to join me on Twitter for an ongoing dialogue: @MenAliveNow

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