Verdonk Petra, Benschop Yvonne W M, de Haes Hanneke C J M, Lagro-Janssen Toine L M
Department of Social Medicine, Faculty of Health Medicine and Life Sciences, University Maastricht, Maastricht, The Netherlands.
Adv Health Sci Educ Theory Pract. 2009 Mar;14(1):135-52. doi: 10.1007/s10459-008-9100-z. Epub 2008 Feb 15.
Gender is an essential determinant of health and illness. Gender awareness in doctors contributes to equity and equality in health and aims towards better health for men and women. Nevertheless, gender has largely been ignored in medicine. First, it is stated that medicine was 'gender blind' by not considering gender whenever relevant. Secondly, medicine is said to be 'male biased' because the largest body of knowledge on health and illness is about men and their health. Thirdly, gender role ideology negatively influences treatment and health outcomes. Finally, gender inequality has been overlooked as a determinant of health and illness. The uptake of gender issues in medical education brings about specific challenges for several reasons. For instance, the political-ideological connotations of gender issues create resistance especially in traditionalists in medical schools. Secondly, it is necessary to clarify which gender issues must be integrated in which domains. Also, some are interdisciplinary issues and as such more difficult to integrate. Finally, schools need assistance with implementation. The integration of psychosocial issues along with biomedical ones in clinical cases, the dissemination of literature and education material, staff education, and efforts towards structural embedding of gender in curricula are determining factors for successful implementation. Gender equity is not a spontaneous process. Medical education provides specific opportunities that may contribute to transformation for medical schools educate future doctors for future patients in future settings. Consequently, future benefits legitimize the integration of gender as a qualitative investment in medical education.
性别是健康与疾病的一个重要决定因素。医生的性别意识有助于实现医疗卫生领域的公平和平等，目标是让男性和女性都能享有更健康的生活。然而，性别在医学中很大程度上被忽视了。首先，有人指出医学是“性别盲视”的，因为在相关情况下不考虑性别因素。其次，医学被认为是“男性偏向”的，因为关于健康与疾病的最大知识体系是围绕男性及其健康的。第三，性别角色意识形态对治疗和健康结果产生负面影响。最后，性别不平等作为健康与疾病的一个决定因素一直被忽视。医学教育中对性别问题的接纳带来了一些特殊挑战，原因如下。例如，性别问题的政治意识形态内涵引发了抵触情绪，尤其是在医学院的传统主义者中。其次，有必要厘清哪些性别问题必须融入哪些领域。此外，有些是跨学科问题，因此更难融入。最后，学校在实施方面需要得到帮助。将社会心理问题与生物医学问题整合到临床案例中、传播文献和教育材料、开展员工培训以及努力将性别观念结构性地融入课程，这些都是成功实施的决定性因素。性别平等不是一个自发的过程。医学教育提供了一些特殊机会，可能有助于推动变革，因为医学院为未来环境中的未来患者培养未来的医生。因此，未来的益处使将性别观念融入医学教育成为一项有价值的质性投资。
