Gender Medicine Explained

By Giorgia Esposito, Doctor of Pharmacy, specialized in Gender Medicine

Words are important. 

They shape our thoughts and, consequently, our actions.

In the context of gender, it's important to emphasize language and definitions to provide visibility, create social reassurance among and for people, and to write laws that protect those who otherwise wouldn't exist. Everything we don't name is as if it doesn't exist. 

Sex is not the same as gender

Let's start by understanding what gender is. First of all, gender is not the same as biological sex, which refers to the physical and chromosomal characteristics we are born with, and which does not necessarily coincide with gender. Gender, in fact, concerns who we are: our individual sense of belonging to a particular gender.

Gender expression is still different; it's the way we communicate our gender to others through clothing, behavior, voice, or gestures. Also connected to these concepts are gender stereotypes, which are preconceived ideas about how we "should" be, while gender roles represent the actual social expectations linked to each gender.

Furthermore, when defining gender, it's important to consider that gender binarism, or the idea that only two genders exist (either female or male), is contrary to gender diversity.

But when did the discussion of gender in medicine begin?

It started in the 1960s with American doctors R. Stoller and J. Money of the Johns Hopkins Hospital in Baltimore, who distinguished a person's psychosexual orientation (gender) from their anatomical sex (sex). Against this backdrop, feminist movements for women's health emerged, which, in the 1960s and 70s, demanded control over reproductive rights and denounced the power of the paternalistic medical community, which manifested in the denial of access to abortion and contraceptives, in the judgmental and stereotypical view of prostitution and pornography, in gender-based violence, and in the standards of the beauty industry.

The first studies on the link between gender and health

Crucial in conceptualizing gender as a determinant of health inequalities was the book Sex, Gender & Society by Ann Oakley, which explains how gender determines social discrimination, and the manual Women and their bodies by the Boston Women’s Health Collective, whose publishing profits were donated to the feminist collective itself.

World conferences on women's issues, starting in 1975 in Mexico City, moving through Copenhagen (1980) and Nairobi (1985), up to the fourth in Beijing in 1995, also helped bring to light gender equality, women's empowerment within society, and the neutralization of sexed identity. From that moment on, gender lent itself to being understood as a neutral concept, neither feminine nor masculine.

From pathologization to recognition

From that moment on, the depathologization of all gender identities and sexualities that did not conform to cis-heterosexual norms began. Medical knowledge was poised to cease being the sole authority on these subjectivities, which until then had been considered cases requiring pharmacological and psychiatric treatment. We would have to wait until 2014 for the first appearance of the word "dysphoria" in the Diagnostic and Statistical Manual of Mental Disorders (DSM), no longer considered a treatable illness (DSM-5). Until then, terms like transvestism and homosexuality were discussed, considered "sexual deviations" and classified as "sociopathic personality disorders."

The Importance of Language in Medicine

This highlights how crucial it is, even in medicine, for language to constantly expand, transform, and reinvent itself to create healthcare pathways that consider health holistically and without prejudice.

Technical-scientific terminology should not foster the creation of cages and ghettos, prejudices and distances. Instead, it should guide us towards an openness of perspectives and knowledge, fostering exchange and acceptance. It is not true that it cannot be modified; on the contrary, its rigidity benefits neither society nor science itself and could become extremely dangerous.

So, what exactly is gender medicine, and who is it for?

Gender medicine (GM), or more precisely, gender-specific medicine, is defined by the World Health Organization (WHO) as the study of how biological differences (defined by sex) and socio-economic and cultural differences (defined by gender) influence the health and disease status of every individual.

It is, therefore, a medicine that concerns everyone: not "women's medicine" or "transgender people's medicine," but a medicine for all people, capable of recognizing and valuing diversity as a fundamental element of care and equity.

The Intersectional Approach

The intersectional approach offers a more ethical and realistic perspective: inequalities are not solely the result of personal characteristics, but rather the complex interplay of systemic oppressions, ranging from sexism to racism, classism to transphobia. 

Despite well-known differences between men and women in terms of body composition, genetics, metabolism, hormonal status, and immune system, women are still treated today with protocols and medications designed for men, without considering identities that extend beyond the gender binary.

‍Medicine That Evolves with Society

Just like language, medicine is a tool for fostering better community living, and as such, it must constantly expand, transform, and reinvent itself. Science is not diminished by change but by stagnation; integrating gender studies into medicine makes it healthier, more equitable, and more attentive to individual needs.

The Value of the Feminine in Healthcare

The "feminine" in healthcare — understood as a greater consideration of the female sex in research and clinical practice, rather than the imposition of female standards or a reduction to only women's experiences — thus becomes an act of recognition and representation for all individuals who, regardless of their sexual orientation, identity, or gender expression, have the right to be included in scientific studies and care pathways.

Gender medicine is, therefore, medicine for those who identify as male, female, or outside these categories.

Towards More Inclusive Medicine

Science and public health have a social responsibility in health education. Therefore, they must educate themselves, embrace new, less stigmatizing and pathologizing perspectives, and steer the culture of care towards an increasingly inclusive, welcoming, and difference-respecting model.

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