SGBH TIMELINE

Expanded Sex & Gender Timeline

Alyson J. McGregor MD MA FACEP, Chantal Tapé, Mary K. Rojek PhD

Updated by SGHC Team

YEAR RESEARCH CLINICAL LEGISLATION, NATIONAL & INTERNATIONAL INITIATIVES EDUCATIONAL

1985 USPHS task force finds exclusion of women from research negatively impacts women’s health

1990 The Society for Women’s Health Research (SWHR) is founded Women’s Health Equity Act passed, establishing the ORWH at NIH Publication of Women’s Health Issues Journal

1991 Women’s Health Initiative (WHI) is funded and launched in 1991 Office of Women’s Health is established at USDHHS

1992 Publication of the first issue of Journal of Women’s Health

1993 NIH Revitalization Act requires that women be included in all research The Advanced Curriculum on Women’s Health is created by the American Medical Women’s Association (AMWA)

1994 Office of Women’s Health is established at the FDA

1995 National Centers of Excellence in Women’s Health are funded The Council on Graduate Medical Education calls for expanded education in women’s health beyond reproductive health

1996 Publication of Women’s Health in the Curriculum: A resource guide for faculty

The American College of Women’s Health Physicians is founded


1998 Publication of Textbook of Women’s Health by Dr. Lila Wallis

1999 Publication of Guide to Preventive Cardiology for Women by Dr. Lori Mosca

2000 NIH ORWH BIRCWH grants program is established for faculty in women’s health and sex differences research National Community Centers of Excellence in Women’s Health are funded Women’s Health Core Competencies are developed by APGO to create women’s health curriculum

Publication of Academic Medicine special issue on sex, gender & women’s health in medical education


2001 IOM report published: “Exploring the Biological Contributions to Human Health: Does Sex Matter?” GAO report: 80% of market withdrawn drugs show adverse effects in women

2002 Women’s Health Initiative study on hormone replacement therapy halted due to breast/cardiac adverse events

2004 Publication of Principles of Gender-Specific Medicine by Dr. Marianne Legato

2005 SGOMSEC concludes that sex differences are essential to the study of toxicology Aspirin is found to decrease risk of stroke but not 1st MI in women

2006 Founding of the Foundation for Gender-Specific Medicine and the Organization for the Study of Sex Differences

2007 Advancing Novel Science in Women’s Health Research grant established National Centers of Excellence in Women’s Health are defunded Laura W. Bush Institute for Women’s Health is established at Texas Tech University Health Sciences Center (TTUHSC)

2010 IOM report finds lack of reporting and analysis of research data by sex Women’s Health Office Act establishes Offices of Women’s Health in 5 federal agencies Publication of Biology of Sex Differences Journal

2011 FDA release guidance on the role of sex difference in determining safety and effectiveness of medical devices Publication of Update: Guidelines for the prevention of cardiovascular disease in women Division of Sex and Gender in Emergency Medicine is established at Warren Alpert Medical School, Brown University

2012 ApoEε4 in Alzheimer’s Disease found to cause changes in brain activity in healthy adult women but not in men

 

The Sex & Gender Women’s Health Collaborative is established

More publications: Sex and Gender Aspects in Clinical Medicine; Handbook of Clinical Gender Medicine; Sex and Gender Differences in Pharmacology

Mayo Clinic conference: Embedding Sex and Gender Health Differences into Medical Curricula


2013 Zolpidem: first drug designated for different dosing in women by the FDA

2014 FDA releases guidelines for sex-specific patient enrollment and reporting for medical device applications Research for All Act introduced in Congress for equity in basic and clinical research

2015 NIH dictates that all federally funded cellular and animal research must include both sexes of cells and animals First Sex and Gender Medical Education Summit held at the Mayo Clinic

2016 Publication of textbook Sex and Gender in Acute Care Medicine

Publication of new journal Gender and the Genome


2017 Publication of 3rd edition of Principles of Gender Specific Medicine by Dr. Legato

2018 First Sex and Gender Interprofessional Health Education Summit held at the University of Utah

Additional information about select items from the above table is presented below.

Research

  • 1977 – The Food and Drug Administration (FDA) bars women of child-bearing potential from participating in most early phase clinical research.
  • 1985 – A U.S. Public Health Service task force finds that the exclusion of women from clinical research has a negative impact on women’s health.
  • 1990 – The Society for Women’s Health Research (SWHR) is founded.
  • 1993 – The Clinical Equity Provision within the NIH Revitalization Act requires that women and minorities be considered as participants in all human subjects research.
  • 2000 – The NIH creates the BIRCWH career development program for junior faculty interested in women’s health and sex differences research.
  • 2001 – The Institute of Medicine (IOM) releases a report entitled, “Exploring the Biological Contributions to Human Health: Does Sex Matter?” It concludes that sex differences affect human health throughout the lifespan. The study of sex differences should be a research agenda priority.
  • 2002 – The Women’s Health Initiative’s large-scale study on hormone replacement therapy is halted 3 years early after participants on estrogen and progestin therapy are found to have an increased risk of heart attack, blood clots, stroke, and breast cancer as compared to placebo.
  • 2006 – The Foundation for Gender-Specific Medicine is founded by Dr. Marianne Legato.
  • 2006 – The Organization for the Study of Sex Differences (OSSD) is founded by member scientists of the Society for Women’s Health Research.
  • 2007 – The NIH Office of Research on Women’s Health creates the Advancing Novel Science in Women’s Health Research (ANSWHR) grant.
  • 2010 – An IOM report finds that despite increasing progress in women’s health research, there are still significant gaps, including in the reporting and analysis of research data by sex.
  • 2011 – The FDA releases a draft guidance on the role of sex difference in determining the safety and effectiveness of medical devices. They recommend not only increased enrollment of women in clinical trials of medical devices but also greater analysis and reporting of study results based on sex.
  • 2012 – A study published in Neuroscience shows that ApoEε4, a common genetic risk factor for Alzheimer’s Disease, has been found to cause changes in brain activity and cerebral spinal fluid in healthy adult women but not in men.[2]
  • 2014 – The FDA provides guidelines for sex-specific patient enrollment, data analysis, and reporting of study information for medical device applications.
  • 2015 – NIH dictates that all federally funded cellular and animal research must include both sexes of cells and animals where appropriate beginning in 2016.

Clinical

  • 2001 – A report released by the U.S. Government Accountability Office reveals that 8 of the 10 drugs withdrawn from the market since 1997 are more likely to cause adverse effects in women than in men.
  • 2005 – A large-scale randomized trial of low-dose aspirin use in women finds that aspirin decreases the risk of ischemic stroke in women, while having little to no effect on the risk of heart attack in women under age 65.
  • 2013 – The recommended dosage for sleep medications containing Zolpidem is changed by the FDA after studies show that the previously recommended dose may be too high, particularly in women. Women are found to metabolize the drug more slowly, putting them at greater risk for next-day impairment.

Legislation and National and International Initiatives

  • 1990 – The Congressional Caucus on Women’s Issues introduces the Women’s Health Equity Act, which contains 20 separate bills that seek to improve women’s health outcomes and advance scientific research. Although the bill does not pass, it prompts the NIH to create the Office of Research on Women’s Health (ORWH) that same year.
  • 1994 – The United Nations International Conference on Population and Development is held in Cairo. The conference affirms the role of women’s education and empowerment in improving health outcomes and quality of life.
  • 1995 – DHHS allocates funding for National Centers of Excellence in Women’s Health across the country. These centers are established to provide comprehensive health care for women, advance women’s health research, integrate women’s health content into medical education, and advance women in academic medicine.
  • 2000 – DHHS allocates funding for National Community Centers of Excellence in Women’s Health
  • 2007 – National Centers of Excellence in Women’s Health are defunded.
  • 2010 – The Women’s Health Office Act (WHOA) becomes law. This act makes permanent the Offices of Women’s Health in 5 federal agencies, including the CDC and the FDA.
  • 2014 – Research for All Act introduced in Congress for equity in basic and clinical research. Resubmitted in Congress in 2015.

Educational

  • 1915 – The American Medical Women’s Association (AMWA) is founded to address the unequal representation of women in medicine.
  • 1970 – Our Bodies, Ourselves is published by The Boston Women’s Health Book Collective.
  • 1990 – The first issue of the Women’s Health Issues Journal is published.
  • 1992 – The first issue of the Journal of Women’s Health is published.
  • 1993 – The Advanced Curriculum on Women’s Health is created by AMWA.
  • 1995 – The Council on Graduate Medical Education (ACGME) calls for expanded education in women’s health.
  • 1996 – NAWHME publishes Women’s Health in the Curriculum: A resource guide for faculty.
  • 1996 – The American College of Women’s Health Physicians is founded with the goal of advancing the art and science of women’s health.
  • 1998 – Dr. Lila Wallis publishes her comprehensive work, the Textbook of Women’s Health.
  • 2000 – Women’s Health Core Competencies are created by the Association of Professors of Gynecology and Obstetrics (APGO) to address women’s health gaps in medical school curricula.
  • 2000 – The journal, Academic Medicine publishes a special issue on sex, gender, and women’s health in medical education. (November)
  • 2004 – Dr. Marianne Legato’s ground-breaking reference book, Principles of Gender-Specific Medicine, is published.
  • 2005 – The Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC) holds a workshop on Gender Differences and Human and Ecological Risk. The group concludes that sex differences are essential to the study of toxicology.
  • 2011 – Division of Sex and Gender in Emergency Medicine founded, first division in emergency medicine dedicated to advancing clinical care through sex and gender specific research, education, and advocacy.
  • 2012 – The Sex & Gender Women’s Health Collaborative (SGWHC) is established.
  • 2012 – The volume Sex and Gender Aspects in Clinical Medicine is published. (edited by Sabine Oertelt-Prigione and Vera Regitz-Zagrosek)
  • 2012 – Handbook of Clinical Gender Medicine is published. (edited by Karin Schenck-Gustafsson, Paula R. DeCola, Donald W. Pfaff, David S. Pisetsky)
  • 2012 – Sex and Gender Differences in Pharmacology is published. (edited by Vera Regitz-Zagrosek)
  • 2012 – Experts from US medical schools, schools of public health, NIH, HRSA OWH, and ORWH convene at the Mayo Clinic for 2 days to address the need for curricular change re: Sex and Gender Medical Education
  • 2015 – Sex and Gender Medical Education Summit is held at the Mayo Clinic, Rochester MN
  • 2016 – Sex and Gender in Acute Care Medicine is published (edited by Alyson J McGregor, Esther K Choo, Bruce M Becker)
  • 2018 – Sex and Gender Health Education Summit is held at University of Utah Sciences, Salt Lake City UT

² Werbinski J, Rojek MK, Cabral MD. 2019. “The need to integrate sex and gender differences into pediatric pedagogy.” Advances in Pediatrics. (in press).


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