(applause) well, i thought i was a well educated, confident physician when i started practice, until i started listening to my patients. and then, what i heard from them,, some of the things they told me didn't really fit with what i had learned in medical school, and it was really confusing. of course, that wasn't the first time i was confused. i was confused because, you know, doctors are really taught to be confident.

we're taught to be confident, we're taught to know everything, and to have answers to every single question, or, at least, pretend we do. you know that, right? and that worked really well for about most of my classmates, most of the people that i hung around with then, but then again, 90% of them were men, at that time, when i was in school. it didn't work so well for me and some of my female classmates. we learned a lot of information that, some of which didn't really resonate with us,

because it didn't resonate with our sense of who we were as women. now, what were we to do? so, we started what many women in the 1970's started: a consciousness raising group. and that's where we felt safe to share what we knew, to ask questions about what we didn't know. and one of the bibles that we turned to was a book that i'm sure you used also in your life at some point, and that was our bodies, ourselves.

(applause) yeah, right? it's still around and it's still extraordinarily useful. that book and what we learned from each other really taught us something which i think is no surprise to any of us: women and men are different. right? but you're telling me, "tell me something i don't know." well, here are some things you might not know, or, perhaps, you knew, but don't remember. one thing is that women and men are different,

but we treat them the same, when it comes to healthcare. women have reproductive chromosomes different from men. you know that. women have xx chromosomes, men have xy. and those chromosomes are not just found in the areas of your body covered by a bikini. they're found in every single cell in your body. that means every cell has a sex. and what that means for you is that, sometimes, medications, even the same medications, may have different effects or side effects

in women and men. it means that sometimes symptoms for the same diseases may be different. it also means some tests to diagnose illnesses, or similar illnesses, may need to be different for women and men. now, i learned lots of information in medical school. some of that information left me with many more questions than answers, and here's an example: 80% of drugs withdrawn from the market are due to side effect in women. 80%!

now, mostly, that's due to the fact that studies were done on men for those drugs, and they were given to women, when they were released to the market, just like they were given to men, although women had never experienced those drugs. and so, they had some side effects up to and including death. now, i know some of the researchers were actually happy that women were excluded from those research studies, because they knew that women's bodies were more complex,

especially hormonally. and, not only that, but the menstrual cycle messed up a lot of their research designed on their lab results. you know, if they could have, they would have asked the question rex harrison asked in my fair lady: "why can't a woman be more like a man?" (laughter) right? it would have made their jobs as researchers so much easier. however, the question that i had in my mind was:

"why can't women be like women? why you figure out how to do a research study that's designed for a woman's body, that would give us information..." right. "... and that would give us information about women's bodies and lives?" there's other things that i learned. i hope you know some of this information, but you probably don't. for example, the symptoms of a heart attack could be different in women and men.

women could experience shortness of breath, profound fatigue, nausea, a sense of anxiety, even. and it's not all in her head. as opposed to those other symptoms, or she may have those same symptoms of crushing chest pain that radiates down to your left arm. those symptoms of a heart attack are different in men and women sometimes, because the areas of the heart,

the areas of the blood vessels in the heart, and the process that causes that disease in a woman is different from men, and sometimes it even requires a different kind of test to diagnose those heart conditions. and i'll bet some of you women in the audience have suffered knee injuries, right? have you? acl? anterior cruciate ligament injuries? and why do i know that? because girls suffer those injuries 2 to 3 times more commonly than boys.

and what i learned in medical school was it was because the ligaments in the tendons were much more stretchy and soft, especially around the time of your menstrual cycle. and so, the treatment was sit on the side line, sit on the bench during gym class, when you're on your period. now, as you might suspect, that did not prevent the injuries. of course, else, it didn't help you gain physical fitness. however, what did help and what does help,

is a different set of techniques for jumping, pivoting, quick starts and stops like you do in soccer, or volleyball, or basketball. those techniques, combined with exercises like strengthening exercises and agility exercises, can decrease knee injuries over 50% in girls. so, coaches need to be teaching those techniques to girls in soccer and volleyball. and that's partly due to the fact

that the muscles in the thigh, in men, contract simultaneously, stabilizing the knee joint, but, in women and girls, they contract at slightly different times, leading to some of those injuries, as one of the causes. now, i'd like you to understand that these are the sex differences, right, the biological differences between women and men. but there are also other differences, and those differences are related to our gender, that is to say our social roles,

how we are thought to be in the proper positions as women and men in society. so, for example, women are usually relegated to the task of cooking in most countries, and some women cook over gas burning stoves, or even open fires in some parts of the world. and that fumes and that smoke actually can cause more lung disease in women than men, not because our lungs are different -- and they are --,

but because we're more exposed to smoke. and men are more prone to accidents and injuries. for example, more men fall off roofs than women, and it's not because they're clumsier.(laughter) ok. so, maybe it's because some men are clumsier, but, in general, it's because of occupational risk exposure. now, i'd like you to fast forward forty years since i was in medical school. those consciousness raising groups have now transitioned into professional organizations

dedicated to doing research on sex and gender, and promoting education in the medical field, on sex and gender specific prevention screening diagnoses and treatment that can benefit not only women, but also men, and it can also reduce healthcare costs. it's taken my colleagues and i forty years to get to this point. it probably will take another twenty or thirty years before this is mainstreamed and can help you. now, you can't wait that long. you don't have that much time.

so, perhaps, if we work together, we can actually speed up this process. my colleagues and i will continue to do the work we're doing, but there are things, perhaps, that you can do. one is [to] be aware of this information. two is to share it with your family and friends. three is to start asking questions; questions, for example, if you're given a prescription, you might ask, "has this medication been studied in both women and men?" "should i expect any differences in effectiveness or side effects?"

if you're asked to have a test for heart disease, you can ask, "is this the best test to diagnose that condition in me?" now, you might have to overcome some of those messages you have on the back of your mind like, "i'm not smart enough. i don't know enough. it's not my place to ask questions." well, let me tell you: it is your place. you are the expert on you. you're the expert on your life. you've lived in your body a long time. you know your medical history.

that information is important. you can partner with your healthcare practitioner. she or he may not even know this information, but together you can find this information and look forward the best sex and gender specific prevention screening diagnoses and treatment options for you. it's the first step in personalized medicine and healthcare. now, you can count on me and my colleagues to do our part. we're counting on you to do yours.