a systematic attack on women and the feminine that at some points particularly targeted women who were healers and named them as witches.
Witches lost their central place in theorizing during the 18th century, when natural philosophy was radically reconstituted. Natural theology (which required divine intervention in the order of things) was replaced by rational theology in which God was held to be omniscient and prescient rather than interventionist in a daily sense. With rational theology came rational science, a science based on observation and an understanding of the ordered nature of nature, a ‘mechanical’ view of nature that has prevailed since. The witch burnings, then, could be considered part of the process of science cleansing itself of magic, part of the triumph of mechanistic thinking ushered in by Descartes. The witch burnings were the backdrop to the fierce competition among medical paradigms - Galenist, Paracelsian, iatrochemical, mechanistic - that was part of the scientific revolution of the early modern age.
Rational thought became the science on which modern medicine is based, and it contains within it a horror of magic, nature, chaos, intuition, and the feminine. The medical profession was developed in part to distinguish itself from the activities of others who claimed to heal, at a time when women and the feminine had been tortured into silence. That modern science, and with it modern medicine, were deeply implicated in the reification of the masculine, and rose from the ashes of the witches’ pyre, makes the relationship between the feminine and medicine highly problematic. Distrust and fear of the feminine remains deeply embedded in medicine as an inadequately identified legacy with hidden consequences that this book’s authors are opening to scrutiny. It is essential to come to grips with this engendering of medical knowledge if we are to understand how gender and medicine interact.
Gender, of course, includes all sexes and sexual identities and is not code for women; however women are the missing majority. This is the right time to grapple with the idea that gender, and possibly sex, are not binary phenomena and that they are described as such in scientific literature as the result of acts of power that have made sexual and gender variability sources of hostility and invisibility. The need to ensure that sex is dichotomous is not universal, and many Asian and traditional cultures have spaces for people who identify as neither exclusively female nor male. Sex and gender may be better considered as a fluid continuum along which people can position themselves variously during their lives.
In one Australian Indigenous culture, boys and girls can choose their gender roles and change them during their lifetime, and there is no such thing as sexual ambiguity because you are who you are. This is a radically transformative thought. It has the power to break apart the dichotomous thinking that underpins the power systems that are in place now. The work of gender and medicine has this power to transform science and clinical care.
The philosophy of Plato that created dichotomous thought was the means by which Western systems created binary categories to help order a disordered universe, including male and female. These categories extended beyond the sexual divide to include foundational concepts such as good and bad, mind and emotion, science and nature, knowledge and opinion, and soul and body. The technical consequences of dualism are the science and digital revolution we are living through today. The political consequences were that all of the good, mind, science, knowledge, and soul categories were joined together in a slippery move that aligned them with male and left female embedded within all that was unknowable and mysterious.
The Christian Bible then compounded the divide by commanding man to have dominion over all other living things, including women and nature and ‘every creeping thing’. If we are to survive as a species, this dualistic and power-over thinking must change. Now that we know that we have to do things differently, the obvious place to begin is by embracing what men and women have to offer collaboratively and unpacking the ways of the feminine with reverence instead of horror.
What can we know when we include the feminine? Einstein wrote that no problem can be solved from the same level of consciousness that created it. The possibilities that have been held in the unconscious for thousands of years are re-emerging in the science of gender and medicine.
One example is the exciting concept of biomimicry, which takes inspiration from nature to solve human problems. It is based on the realization that instead of dominion over nature we need to understand her if we are to survive as a species. Nature has been problem-solving for billions of years, and every life form in existence today is the product of those billions of years of experimental research. It is an example of the power of paradigm shifts in thinking, one that coincides with the emergence of the feminine.
It has taken thousands of years to create the thought systems that we know now. It will take just decades to build on this accumulated wisdom with the new tools that come with understanding the clinical implications of sex and gender. That is the work that is described in this textbook. Within a decade, the scientists and clinicians of the Western world will ask, ‘how could we have missed that?’.
In their rigorous pursuit of knowledge, scientists and doctors will join with social scientists to gain the benefits of hybrid vigor. Gender is a concept of the social sciences and it takes the epistemologies and methodologies of the social sciences to unpick the meaning to improve clinical care. The creative insights that are released when the two thought forms are employed together will astound with their discoveries.
Jo Wainer, AM, PhD
Eastern Health Clinical School
Faculty of Medicine, Nursing and Health Sciences
Monash University
Wellington Road
Clayton, VIC 3800 (Australia)
Tel. +61 3 9094 9573, E-Mail [email protected]
Introduction
Schenck-Gustafsson K, DeCola PR, Pfaff DW, Pisetsky DS (eds): Handbook of Clinical Gender Medicine.
Basel, Karger, 2012, pp 5–7
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Biological Sex and the Genome: What Makes Us Ourselves?
Marianne J. Legato
Partnership for Gender-Specific Medicine, Columbia University, New York, N.Y., USA
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Abstract
The last three decades have witnessed a revolution in our concept of the importance of biological sex in determining phenotype. More and more we are successfully meeting the challenge of studying females directly at all levels of research rather than making males normative for the entire population. As a consequence, we have discovered fascinating and completely unanticipated differences between the sexes.Those differences exist not only at the macroscopic level and in the organism as a whole, but also at the molecular level: for example, we now know that the same genes are expressed differently as a function of gender. Gender-specific biomedical investigation has helped us formulate questions about normal function and the pathophysiology of disease we never would have otherwise asked and has deeply enriched and expanded our notion of precisely what makes us ourselves.
Copyright © 2012 S. Karger AG, Basel
Heraclitus, the philosopher of change, pointed out that the only thing of which we can be completely certain is that everything in the world around us is in flux and that nothing endures but change itself [
