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Alyson J. McGregor - Sex matters : how male-centric medicine is jeopardizing womens health, and what women can do about it

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Note The information in this book is true and complete to the best of our - photo 1

Note: The information in this book is true and complete to the best of our knowledge. This book is intended only as an informative guide for those wishing to know more about health issues. In no way is this book intended to replace, countermand, or conflict with the advice given to you by your own physician. The ultimate decision concerning care should be made between you and your doctor. We strongly recommend you follow his or her advice. Information in this book is general and is offered with no guarantees on the part of the authors or Hachette Books. The authors and publisher disclaim all liability in connection with the use of this book. The names and identifying details of people associated with events described in this book have been changed. Any similarity to actual persons is coincidental.

Copyright 2020 by Alyson J. McGregor, MD

Jacket design by Amanda Kain

Jacket copyright 2020 Hachette Book Group, Inc.

Hachette Book Group supports the right to free expression and the value of copyright. The purpose of copyright is to encourage writers and artists to produce the creative works that enrich our culture.

The scanning, uploading, and distribution of this book without permission is a theft of the authors intellectual property. If you would like permission to use material from the book (other than for review purposes), please contact permissions@hbgusa.com. Thank you for your support of the authors rights.

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First Edition: May 2020

Published by Hachette Go, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc. The Hachette Go name and logo is a trademark of the Hachette Book Group.

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The publisher is not responsible for websites (or their content) that are not owned by the publisher.

Library of Congress Control Number: 2020933592

ISBNs: 978-0-738-24676-5 (hardcover), 978-0-738-24675-8 (e-book)

LSC-C

E3-20200411-JV-NF-ORI

Praise for
SEX MATTERS

McGregor is to be commended for showing how medicine has long skewed male and harmed women. Especially spot-on are the chapters on implicit bias, treatment of women of color, and issues affecting trans individuals. The author concludes with to-do lists, questions women can ask their providers, and suggestions for advocacy roles to raise awareness of the issues. Good ammunition for mandating sex- and gender-based differences in health professional education, research, and practice.

Kirkus Reviews

This book is addictive! You will not be able to put it down until you have read it from cover to cover and then want to start all over again. The sheer wealth of information is an eye-opener for the intelligent lay person and a great source of up-to-date information for healthcare workers.

Marek Glezerman, MD, Immediate Past-President, International Society for Gender Medicine

Alyson McGregor is a persuasive and intelligent advocate for the unique healthcare needs of women. The two sexes are significantly different in all the tissues of the bodyeven to the way the same genes are expressed. An expert in emergency medical care, her deep and informed knowledge of the way disease presents itself in women ensures their prompt and accurate diagnosis and treatment. She is a powerful force in gender-specific health care.

Marianne J. Legato, MD, PhD (hon. c.), FACP, Emerita Professor of Clinical Medicine, Columbia University

Dr. Alyson McGregor sounds the alarm for the state of womens health in this country. Her excellent, evidence-based book reveals that womens health is still in its infancy and needs significant research to ensure that women are receiving the best possible medical care. The fact that most drugs that were approved in this country did not even have enough women included in the studies that got them approved to know if the effects in women were the same as in men is just one of many concerning findings. Her book shows that there is much work to do in this area (much more even than we thought) and that we can count on this call to action to spur us onward! This book will be appreciated by medical and lay people alike, given its excellent readability. I am thrilled that this book is out there to provide benchmarks and goals so that we can ultimately transform womens health.

Judy Regensteiner, MD, Director of the Center for Womens Health Research at the University of Colorado

Dr. McGregor makes a clear and compelling case that women, particularly women of color, in the United States time after time receive inadequate or even harmful medical care. Dr. McGregor also explains how cultural stereotypes about women are frequently used by physicians to justify a dismissive approach to womens symptoms, even when these symptoms herald conditions with potentially dire outcomes. Taking it one step further, Dr. McGregor provides the reader with suggestions on how to cut through a physicians ability to dismiss her symptoms, encouraging her to find another provider if necessary.

Molly Carnes, MD, MS, Virginia Valian Professor, Departments of Medicine, Psychiatry, and Industrial and Systems Engineering, Director, Center for Womens Health Research, Codirector, Women in Science and Engineering Leadership Institute (WISELI), University of Wisconsin-Madison

I have worked with Dr. Alyson McGregor as a national leader in the area of sex and gender in medicine and health careI commend her on this book.

C. Noel Bairey Merz, MD, Director, Barbra Streisand Womens Heart Center, Cedars-Sinai

THIS BOOK IS DEDICATED TO

All the women I have had the pleasure to care for, who taught me about their illnesses and insight.

All the women whose struggles I have witnessed through our medical system, through everything from lack of understanding, to questioning self-reflection, to endless testing that leaves them feeling dismissed, they have persevered.

AND ALSO TO

My mother and sister, with immense love and gratitude. As I studied medicine, I watched the two of you navigate our medical system from the outside; you helped me see the full circle.

A S AN UNDERGRADUATE in the University of New Hampshires premed program, I took only one elective that wasnt directly related to my major (or, at least, I thought at the time that it wasnt related). That course was womens studies. I loved circling up with other women to talk about the history of women in society and the gender-related issues we faced both individually and collectively. It was illuminating and truly inspiring. When the class ended, and our spirited discussions were replaced in my schedule by yet another biology lab, I felt like a bit of the spark had gone out of my collegiate life.

I didnt know it at the time, but that courseand the questions about sex, gender, and the female experience it sparked in mewould have a profound influence on the trajectory of my career.

When I finished medical school at the Boston University School of Medicine, I applied for a residency at Brown University in my hometown of Providence, Rhode Island. When my residency ended, I wanted to stay on and work there. Because Brown is an academic institution, I needed to choose a research focus in order to apply for a long-term position. When I sat down and thought about it, the only path I wanted to take was one that would improve the lives and health of women. I wanted to know about womens bodies and how those bodies affected (and were affected by) modern medicinein particular, emergency medicine.

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