Dr. Teresa Woodruff and Dr. Melina Kibbe of the Women's Health Research Institute's Leadership Council were featured recently on WTTW Chicago Tonight. They discussed their activism for the inclusion of males and females in pre-clinical research studies. The recent shift by the NIH to include both genders in NIH-funded basic research, will help minimize gender biases in devises and medications once studies reach the clinical phase. Dr. Woodruff and Dr. Kibbe laud the NIH for this shift and also share their insights on this important issue. Watch the full WTTW interview today!
Surfacing research proves the Sub-Saharan African traditions of Female Genital Mutilation and Female Genital Cutting (FGM/FGC) lead to long-term health consequences. Such health problems are found to impact the delivery and health of newborns. Researchers and anthropologists from the Autonomus University of Barcelona collected data from 588 females in The Gambia. Data were carefully gathered through questionnaires and physical examinations of the female patients, and analyzed with 95% confidence intervals. The results showed that 75.6% of the women had undergone FGM or FGC, and these women had a significantly higher prevalence of health problems including dysmenorrhea, vulvar or vaginal pain, fibrosis, keloid, synechia, and sexual dysfunction. Furthermore, research showed these women were four times more likely to experience delivery complications such as perineal tear, obstructed labor, episiotomy, cesarean-necessitated delivery, and stillbirth.
The Foundation for Research on Women’s Health reported that seven of The Gambia’s nine ethnic groups practice FGM or FGC on girls between the ages of 10 and 15. Female Genital Mutilation and Cutting occurs in four types. Type I is a partial clitoridectomy, Type II is a full removal of the clitoris, Type III is a partial or full excision of the external genitalia, and Type IV is vaginal sealing. While FGM and FGC are not common in many parts of the world, The Gambia sees these practices as rooted in customs and traditions dependent upon ethnic, religious, and cultural foundations. Culturally, these practices are seen as “rites of passage” into womanhood, and guarantee a woman’s sexual purity, as pleasure is removed from the woman’s body.
Alternatively, FGM and FGC have been internationally recognized as violations of women’s rights and cruel discriminations against women. Furthermore, since these practices are almost always carried out on minors, sometimes without parental consent, issues of children’s rights also come into play. The World Health Organization characterized these practices as violating “a person’s rights to health, security, and physical integrity” as well as “the right to be free from torture and cruel, inhuman or degrading treatment” especially when these practices frequently lead to death or long-term health problems.
While it is difficult to impose regulations on cultural traditions so foreign to the Western world, it is important to document the surfacing research that points to the long-term hazards that accompany these practices. The next steps should be educational outreaches informing the women of The Gambia of the dangers involved with FGM and FGC. This way, they may best make decisions to protect their reproductive health while preserving and respecting their cultural identity.
Yesterday morning we awoke to a political landscape that seems jarred by the process of democracy, but ready to move forward as a nation. Three issues defined the outcome: the percent of women who chose democratic principles; the resounding losses by candidates who are antiquated in their thinking about pregnancy, in particular; and, the need to hold all of us accountable as citizens in the care of each other starting at the research bench to the bedside. I’m a reproductive scientist and direct the Women’s Health Research Institute at Northwestern University, so these issues are my issues and it is now time to look forward and identify actionable steps that moves our field forward.
I’ll start with the women. I believe the 55% to 43% differential in the women’s vote for Obama was not just a vote for a person, but for a platform. It is a vote that recognizes that sexuality is not something that can be regulated by the state. It is a vote that states emphatically that the fact of rape is never legitimate. It says that the consequences of forced intercourse are never ‘god’s will’. Women ‘got’ the vote in 1920 and today their votes say that the politicians must begin to understand that women’s concerns are important and legitimate.
How we move forward to ensure that women’s bodies and their health are not political footballs or pincushions (depending on your gender-identified metaphor) is critical. Here are some suggestions:
- We can no longer allow basic research and new drug development be done solely in male models (cell, animal or human) —this practice loses the ‘bang for our buck’ when we discover sex differences further down the research pipeline.
- We must report sex differences (or no difference) in study findings and include them in our scientific publications.
- We must redistribute more federal dollars to fund important reproductive health studies that include the ovary, uterus, testis, egg, and sperm that impact the next generation of Americans. (The Reproductive Science Branch of the National Institute of Child Health allocates only .022% of $30 billion to address reproductive health issues)
- And we must invest in tomorrow’s generation of innovators who might now be high school students or graduate students by funding innovative education programs and traditional training grants today that include a respect for sex and gender differences in all aspects of health and well-being.
I’ve gone from the very broadest issue of our day – the election and women’s issues and women’s votes – to the very granular issues of funding the next generation of research. Bill O’Reilly, speaking on Fox News election night said that 50% of the population voted for Obama because they want ‘stuff’. I think the ‘stuff’ we want is the right to speak our mind and be heard on issues that concern our health and the health of our families. We want our bodies to be respected by politicians, scientists, and everyone in between. The ‘stuff’ we want is assurances that the biomedical community is including male and female animals and patients in all of the scientific studies that we, women, fund through our taxes. The ‘stuff’ we want is to make sure that there is a way forward for research in an area that without question, touches each and every one of us. Our vote suggests that that ‘stuff’ is important and on this ‘morning after’ we are looking forward to the next four years.
Author: Teresa K. Woodruff, PhD, Thomas J. Watkins Professor of Obstetrics and Gynecology