Invisible Women: the two sexes, unisex and female

Apr 25, 2022

GFPs! I’m back! I missed you! Good GRIEF that was horrific. I finally tested negative on day 15 and felt horrible for every single one of the preceding 14 days.

What a little sh1t this virus is. Also shout out to my deeply unimpressive immune system which pulled out none of the stops to get me through this 😒 felt like it only kicked in on the final two days where I felt worse than I had before...

ANYWAY, I did in fact finally start to feel like I could move again and just in time for the Easter weekend / going to see War on Drugs with the A[merican]B[eefcake] which was AMAZING (although I was very grateful we had gone for seats as I don't think I'd have survived standing for so long so soon after covid otherwise).

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IN OTHER NEWS, during my convalescence I watched the Fran Lebowitz Netflix documentary Pretend It’s A City and holy hell, do I have a MASSIVE CRUSH on this extraordinary woman. I genuinely think she is probably the most amazing default female person to have ever lived and I demand to be her friend, please can someone get that message to her 😭

I mentioned my new-found love to a friend who shall remain nameless, who casually mentioned that she shared a publisher with The Great Fran and maybe she'd fire off an email to her publisher...which got me all excited until she mused that maybe she, as in my so-called-friend, could have dinner with her when she is in NYC this summer...at which point I realised that this emailing would be on HER behalf instead of MY BEHALF. Unbelievable!

GFPs, you mission should you choose to accept it, is to make Fran my friend before my OTHER friend swoops in and steals her right from under my very very sad heartbroken nose. Also, watch Pretend it's a City. It's just utterly fabulous and wonderful and FUNNY and an absolute joy, as is the woman herself. You won't regret it.

Other than that, I'm afraid it's not a vintage edition this week, my dear GFPs, as I think I kind of overdid it the past few days (I was just SO DELIGHTED to have my brain and body back) and I have had to return to bed this weekend, from which I am writing to you. So...you will forgive me [Mr Darcy Face]. Maybe I'll be back to full strength next week???

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Gender data gap of the week

This week CCP says Relax-in. As in the hormone that most famously prepares the female body for pregnancy and birth, but also, it turns out, may be linked to the much higher proportion of ACL injuries suffered by female athletes, who are "between three and eight times more likely to suffer devastating ACL injuries compared to their male counterparts." That's according to 16 years of data from the US National Collegiate Athletics Association (NCAA) Injury Surveillance System.

Sex disparities in sports medicine research may threaten the health and careers of female athletes – Science & research news | Frontiers — blog.frontiersin.org By Emily Parker, University of Iowa Carver College of Medicine Image: leungchopan/Shutterstock.com ‘Hormones’ have long been blamed for anterior cruciate ligament (ACL) injuries in female athletes, but according to a new review paper, one menstrual hormone may be mediating the damage: relaxin. University of Iowa Carver College of Medicine student, Emily Parker, writes to Frontiers…

And the cost of female ACL injuries is huge. Billions of dollars huge, from a combination of immediate and future healthcare costs (ACL injuries can be linked to conditions such as post-traumatic osteoarthritis which sounds fun), not to mention costs to sports tournaments.

But despite this, and despite the fact we've known about the sex disparities in injury rates for years, it has "almost been accepted that these [ACL injuries] are just more prevalent in women.” Which as GFPs everywhere will agree, is an entirely unprecedented reaction to a female healthcare problem.

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archive footage of researchers reacting to female bodies[/caption]

In more unprecedented news, it also turns out that we've known that relaxin is the "likely culprit" for women's disproportionate representation in ACL injuries for TWENTY YEARS.

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GFPs reacting to this unprecedented research situation[/caption]

Is the lack of research into the interplay between relaxin and the musculoskeletal system a result of relaxin having historically just been seen as a lady-pregnancy thing?

University of Iowa gynecologist Dr Michael Haugsdal noted a lack of established information on the musculoskeletal impact of hormones, particularly beyond the context of pregnancy-induced changes.

[...] During his education, Haugsdal said that relaxin was most often mentioned in the context of pregnancy, while [Dr Robert Westermann, head of the Young Adult Hip Preservation Clinic at the University of Iowa] confirmed that it was not a part of orthopedic education.

Incidentally, until 2019 the US National Institutes of Health (NIH) "did not have an R01 grant, the NIH’s original and historically oldest grant mechanism, relating to the influence of sex and gender on health and disease," and there is a national institute within the NIH for every organ system except for the female reproductive tract.

These facts are, I am sure, entirely unrelated.

Anyway, thankfully, some research is now being done, thanks to a female medical student called Emily Parker who noticed the 20 year gap between early relaxin-musculoskeletal studies and literally anything else happening, and decided to take on this particular gendered data gap.

And in her recent write-up of her research, she notes that the representation of relaxin as a "pregnancy" hormone is a category error:

In reality relaxin is a menstrual cycle hormone, peaking just prior to menses, with collagen degradation being a key function. It binds receptors upregulated by the preceding estrogen peak, and activates collagenases also increased in number by the peak of estrogen. Thus, during the menstrual cycle luteal phase, relaxin binds receptors in target tissue, triggering degradation of existing collagen while suppressing synthesis of new collagen.

This mechanism of action is problematic for women because they express receptors beyond the confines of the reproductive system. Prior ACL/relaxin studies confirmed that female ACLs strongly bind relaxin, while male ACLs do not. Later clinical studies showed a significant, positive correlation between high relaxin levels and high ACL injury rates. Importantly, recent studies even bring up potential interventions such as menstrual cycle tracking and hormonal contraceptives.

This is really interesting, because while the "impact of a woman’s hormonal cycle on physical training and recovery for female athletes [...] has received limited scientific attention," available research does suggest that "women in the latter phase of their monthly cycle experience slower recovery rates and higher strain from training when compared with training recovery during the first half of their monthly cycle." Is this all down to the dastardly relaxin? And when relaxin is coursing through out bodies should we just...

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Sorrynot sorry[/caption]

Obviously more research is needed on the subject...final word to Ms Parker:

Prior ACL-relaxin research alone warrants further studies, to replicate the findings and expand upon proposed preventive strategies. Confirmation of a hip-relaxin injury association would only make this work more urgent. Hip and knee injuries are devastating and prevalent among female athletes. If an underlying cause exists for both injuries, which could be mitigated by simple approaches such as menstrual cycle tracking or hormonal contraceptives, then active women deserve a thorough exploration of the matter.

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live action footage of Emily Parker finishing that write-up[/caption]

Default male of the week

Ah yes, the two sexes, unisex and female....

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GFPs fixing it

I love this! All GFPs should do this

George R. Yang @georgeryang

Inspired by @CCriadoPerez’s posts on the issue of researchers defaulting to male, I’ve been defaulting to female nouns in Duolingo and found a mistake in which the app didn’t accept the female form of “guests” for one of its Spanish translations. That’s been fixed now! ☺️

GFP-verse

This update from GFP Tom caught my eye as I was scrolling through the GFP-verse this week....

Hi GFPs,

Oh my goodness UW has a study apparently paying women $40 to remove their own IUD…I simply do not know what to say.

Me neither, Tom, but I do have a non word-based reaction I could help you out with

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live action shot of me reading about this study[/caption]

Looking further, my partner just uncovered that this isn’t even the first study like it. This NIH study was done on 326 women, more than half were willing to try and remove their IUD themselves. Of those only 1 in 5 was successful.