Dr. Mark was the first Senior Medical Advisor to the Office on Women’s Health within the Department of Health and Human Services. She has published and delivered over 600 lectures, and is a frequent health media expert. While providing scientific and strategic direction and community outreach for agencies, academia, industry, professional societies and non-governmental organizations around the globe, Dr. Mark has received numerous awards including an honorary Doctor of Laws degree for her contributions to medicine, sex/gender-based health and emerging technologies.
MOGUL was honored to have recently had the opportunity to speak with Dr. Mark about her fascinating career path, as well as her exciting new initiative iGIANT, which is a series of national roundtables, symposia and innovation prizes to focus on the “Impact of Gender/Sex on Innovation and Novel Technologies”.
Dr. Saralyn Mark: The White House is a champion for innovation and technology, as well as promoting gender equity in issues ranging from workplace opportunity to the delivery of health care. I had a golden opportunity to weave these important elements into a program that could promote an enhanced understanding and dialogue about the role of gender and sex in all aspects of our lives.
I see gender and sex playing a critical role, which often we ignore or take for granted. For example, during an iGIANT roundtable at the Department of Health and Human Services in July 2015, a participant commented that when a child is born, the first question one asks is, “Is it a boy or is it a girl?”
Thus, understanding the impact of gender/sex on innovation and novel technologies needs to be further explored by diverse stakeholders across many sectors of our lives including health, information technology, transportation and retail. Humans are very adaptable, but it is now time that we can precisely design elements such as programs, protocols, policies and products to improve not only work efficiency, but also the quality of life for men and women. I describe in more detail these points in my blog.
Mogul: What were the key takeaways from the first health iGIANT roundtable in DC?
Dr. Mark: There was significant discussion about terminology and the lexicon for gender and sex. Sometimes, there seems to be confusion within communities on how to use these terms.
I think it’s important that we have a common lexicon so that academia can speak to industry, industry can speak to agencies, and agencies can speak to advocacy and professional societies. We need to understand each other. Definitions have become more confusing because of the interplay between the environment and genome.
There were some participants that want to keep it simple and just use "gender". Others, especially the scientific community, are very adamant that we needed to be clear about defining "sex" and "gender". They saw this as an opportunity to teach - a learning opportunity.
MOGUL: Is there anything you can relay to the public about next steps for iGIANT, or any news that the public should be aware of?
Dr. Mark: Stanford University will host an IT iGIANT roundtable in September 2015 and the National Space and Biomedical Research Institute will co-host with the Laura W. Bush Institute/Texas Tech University a retail iGIANT roundtable in November 2015; and J and B Medical will host a transportation iGIANT roundtable in October 2015 in Detroit. Additional institutions and organizations have offered to host future iGIANT roundtables. Information from these sessions is available at www.solamedsolutions.com and https://genderedinnovations.stanford.edu.
In 2016, there will be a symposium with participants from the roundtables. During this event, best practices from all the sectors will be highlighted to further advance the dissemination of expertise and knowledge and partnership formation. There will also be an announcement of iGIANT prizes for outstanding innovation to be awarded at the next symposium in 2017. The iGIANT roundtables, symposia and prizes will promote and accelerate the development of gender/sex-based design elements, which may improve work efficiency and the safety and quality of life for men and women.
MOGUL: In this day and age, there still seems to be a certain stigma around women’s health, surely one built upon the idea that for a woman to acknowledge any suffering, she is admitting flaws in herself. How can we combat this stigma and change stereotypes around women to be more aware of the health struggles they might face?
Dr. Mark: In the women's health community, we've been working passionately to advance the women’s health agenda for several decades, and I think we’ve made significant progress. Discussing women's health from a sex/gender perspective may help to eliminate some of the stigma and shame; we’re not talking about who’s better, faster, or smarter. It’s really not a competitive process between men and women, or to be used as a tool to discriminate.
It's important to own our health care issues and needs. When you talk about what some of your concerns are, you're actually empowering yourself to get the help that you need. You can also help, not only yourself, but those around you: family, friends, colleagues. By taking an empowered and active role in your health care, you serve as a role model for others to take the same act of personal responsibility.
Dr. Mark: Stellar Medicine: A Journey Through the Universe of Women’s Health is a part-memoir, part-guide book on controversial health issues. I focused on the psycho-social and political environment which shape our decisions, and I wove in many of my experiences, in order to share narratives that I think people can relate to and understand.
There is a chapter in the book on medical myths. We call them, by the way, “old wives’ tales”. Some of these “myths” often have an element of truth, which makes it difficult to discern what is real and what is a fallacy. I think it’s important that when one reads articles, when one hears somebody talk, to take a moment and think about what they’re saying; to take time and investigate. Is there evidence backing up what is being suggested? When you do that, you come away with a more educated, balanced perspective.
When you're reading an article that may be a bit controversial, look and see who sponsored the research, who sponsored the webpage. Do they have an inherent bias? Do they have some connection for financial gain? Is there a potential conflict of interest? I think you have to probe a little deeper and ask appropriate questions to people that you trust, in order to help you get the right information for you.
MOGUL: As a Senior Medical Advisor to NASA, I’m sure you’re aware of how much the human body changes upon entering space. How does a woman’s body change specifically, and what strides in women’s health can help a female astronaut cope with these changes?
Dr. Mark: The Journal of Women’s Health published NASA's decadal review exploring the impact of sex/gender on how the body adapts to space. Over 50 scientists participated in this comprehensive review. The journal articles are outstanding and available for the public to read.
We looked at six areas of the human body: cardiovascular, musculoskeletal, reproductive, neurosensory, behavioral, and immunological. The body functions as an integrated system, but I think it’s useful, at times, to separate function to fully investigate and understand the individual role of each system for maintaining health and well-being.
Everyone adapts to space. It’s important to examine sex and gender differences so that we can provide appropriate care as needed. We see that what happens in the body in space can often reflect what we consider to be a model for accelerated aging on Earth. It's very exciting that some of these changes can be slowed down and potentially even reversed by some of our countermeasures that we use in space, or extensive rehabilitation programs that we use upon return to Earth.
In every system of the body, there are changes. When we go into space, there is cephalad distribution of blood flow. Blood is flowing to the head because of the lack of gravity.
There is a syndrome called “Visual Impairment Intracranial Pressure”. What that means is that eyesight can be impacted by increased fluid into the brain, creating increased pressure in the brain and eventually the eye. Interestingly, we see more significant changes and symptoms in men versus our female astronauts, and we are not sure why this is happening.
In space, the body adapts quickly and dramatically so we can appreciate small differences between men and women. We find both men and women adapt pretty much equally well to space.
MOGUL: What set you on the path to championing women’s health, and what is your advice to young women today who are looking to follow in your footsteps?
Dr. Mark: First, you have to follow in your own footsteps because everyone’s path is going to be different; our experiences shape what we believe. I think you can have role models and people who can guide and help you, and champion what you are doing. I do think it’s important to accept that your path is going to be unique. So, try not to compare yourself to others -- honor your unique journey.
It's essential to believe in what you are doing in your career - to be passionate and committed to your vision, since there may be hurdles along the way. I conduct leadership workshops called "The Power of 3". At the start of the workshop, I encourage participants to define their three core values upon which they can use to chart their lives and careers. For me, it includes loyalty, fortitude and flexibility; they have always guided me in the right direction. I've had to create my career path and positions, since I was often charting new territory. Fortunately, I've found mentors and then champions later in my career who have provided support and advice.
When I was in training, I realized that we were using a unidimensional approach to take care of our male and female patients and, intuitively, that did not make sense to me.
We looked at women from a reproductive focus or at the end of their life. The whole middle part of life was negated or ignored. I felt that we needed to take more of an integrated view. I reached out to several medical disciplines to inquire if I could work with them clinically and to conduct research. At the end of the day, I realized that I had created what was considered now to be a women’s health fellowship. It was the first women's health fellowship in the United States. Fortunately, there are now several residency and fellowship programs which are transforming the landscape in women's health research and health care.
For example, I felt that we needed to have a more integrated and coordinated system of health care. Because women would have to go to multiple providers, and before there was an electronic health record, information would get lost or not shared. While at the Department of Health and Human Services, I helped design the National Centers of Excellence in Women's Health to change this scenario. We wanted to move beyond what I consider a "bikini medicine" model of health care, which is a focus on breast and reproductive tissue, and everything else is forgotten.
Overall regarding career opportunities, I would like for people to not lose faith. If they find they’re having challenges to meet their goals, maybe there’s just a different way to do it. In just about every program that I’ve ever established or created, there’s often been some roadblocks. At the end of the day, they’ve actually been an advantage because they helped me refine my vision, goals and strategies.
MOGUL: Is there anything you’d like to add in terms of iGIANT, in order to share with our international community?
Dr. Mark: I want the iGIANT program to transform the way we look and use our environment. Take a moment to consider whether the technology and innovation which surround your life are designed to truly meet your needs as a woman or a man. For example, are your athletic gear and shoes, your computer or phone, your car seat, and most importantly, your medications and medical devices really designed for the way your body moves, metabolizes or interacts?
Once we start looking critically at how gender/sex impact innovation and novel technologies, the world will never look the same again. Once we start to see the world through this gender/sex lens, we can change and improve how we interact with all our environments on Earth and in space, which can change the quality of all our lives. It's time to begin this iGIANT journey together!