Examining how biology and society impact patient care

Jacqueline Hay (Vanier Scholar 2017), Applied Health Sciences Ph.D. candidate, was awarded the Netherlands Organization for Health Research and Development (ZonMw) Gender in Research Fellowship in 2022. The international fellowship supports 20 Ph.D. students and post-doctoral researchers around the world in advancing health research. The ZonMw Gender and Health Knowledge Program supports young scholars revolutionizing health care and research.

This past August, Hay joined the next class of fellows to take the Gender and Health course and participate in the Gender in Research workshops as part of the Erasmus Summer Programme in Rotterdam, Netherlands.

UM Today recently spoke with Jacqueline about her research and experience.

Can you describe what your current research at UM is about?

I am interested in exploring how biology (sex) and society (gender identity, roles, relations, and institutionalized gender) impact cardiovascular outcomes. As a Canadian Society for Exercise Physiology Clinical Exercise Physiologist, I have a specific interest in understanding physical activity patterns before and after cardiac surgery and the feasibility of assessing cardiac rehabilitation referrals and outcomes.

What were some of the experiences/knowledge that you feel has been most valuable from the fellowship?

Travelling to the Netherlands allowed me to engage with diverse scholars from around the world to build my network and invigorated my desire to learn more and support others in pursuing sex and gender-based research. I learned that sex and gender are understudied modifiers of health. Although research and medicine are shifting towards personalized and intersectional approaches that consider sex, gender, and power – we still have much work to do!

Can you speak to the importance of sex and gender research in health care and clinical research?

Although often used interchangeably, sex (biology) and gender (society) are different constructs, and a failure to consider either and how they interact may have significant unintended consequences. For instance, drugs developed and tested primarily in males more often result in overdoses in females due to biological differences in how the drug is absorbed, distributed, metabolized and eliminated. Gender differences in how someone perceives themselves or how others perceive them may delay diagnosis. For example, heart disease has long been considered a man’s disease. Often, women are unaware of their risk, delay seeking help and communicate additional symptoms differently, leading to delayed diagnosis and poorer prognoses.

Treating people as individuals is also crucial to precision medicine. A greater understanding of sex and gender diversity is needed to develop safe, effective, and patient-centred care. We must move beyond the binary of sex (female/male) and gender (man/woman) and the assumptions that an individual’s sex aligns with their gender.

Is there any advice you would suggest to students interested in getting involved in this type of research (whether that’s health and/or gender research)?

For one, I want to highlight a common misconception. Sex and gender factors are not just isolated to health research. I want to challenge students of all disciplines to explore how they can advance their fields of interest by considering sex and gender. Gendered innovations is an excellent resource and provide students with general terminology, links to policies, and methodologies. You can also explore case studies about health, medicine, cells, textbooks, facial recognition, and even crash test dummies.

If you are primarily interested in health research, the Canadian Institutes of Health Research Institute of Gender and Health has developed free training modules. The information covered in these modules is key for those pursuing Master’s or Doctoral level funding. I advise students to keep seeking new knowledge, challenge the status quo, and support others to grow our collective capacity to understand the complexity of sex and gender better. Be open to new ideas, and do not fear knowing! Chasing uncertainty is what drives innovation and change. I know I have so much more to learn and grow.

Francesca Espiritu