There had been a long-standing assumption that females generally vary more in their biological functions due to their complex hormonal interactions in menstrual cycles, reproduction, pregnancy, and even evolutionary effects. Notwithstanding the still existent deficit in sex-based research, there is a growing body of literature that supports meaningful sex and gender differences across many human conditions and systems, particularly the immune system. Among the idiosyncrasies, vagaries and paradoxes (in the book) of the human immune system, the direct and indirect disparities between the male and female systems present the most obvious and arguably perspicacious attributes and mysteries.
Sex is a biological variable that affects immune responses to both self and non-self. The sex of an individual is defined by evolutionary genetics, chromosomal identification, embryology, biology, molecular biology, physiology, and, no less, reproductive organs and sexually related steroid levels. Conversely, sex is distinguished from gender that involves societal influences, cultural behaviors, environmental factors, and activities of a human being. Male and female differences in immunological responses are influenced by both sex and gender. For example, sex contributes to dimorphic physiological, phenotype, and anatomical differences that might influence exposure, recognition, potential transmission, or removal of microorganisms. By contrast, gender relates to organisms’ behaviors that influence exposure to those microorganisms (airborne, contact, etc.), access to healthcare, and medical care that would affect the course of infection. While both sex and gender undeniably influence the immune response, this book’s narrative focuses more on the sex-related biological factors that influence the female immune system. Nonetheless, it also addresses the anthropologic, ecologic, and sociologic “gender” considerations where and when such factors have profound direct or indirect implications in the bioscience and clinical issues being addressed.
The countless distinctions between male and female, called “sexual dimorphism” comprise categories from the biomedical, to the psychosocial, emotional, intellectual, and on and on (colloquially, “Men are from Mars …Women are from Venus” from John Gray’s 1992 book). These differences are based on hard science, foremost evolution, natural, well-reasoned selection, genetics, anatomy, cellular and molecular biology. But also included are anthropologic and ecologic considerations, and varying theories, perspectives and of course, sophistic and romantic viewpoints. Notwithstanding the plethora of good science, valid research, and well reasoned theories, it is generally accepted in the biomedical community that the female immune system is stronger than the male’s, for better or for worse. Such strength, however, also suggests the “sword of Damocles” when comparing female and male immune systems. A powerful immune system can sometimes be a liability. It can promote and generate concomitant negative ramifications (e.g., autoimmune diseases). Such potential, paradoxical, untoward, and even devastating consequences must be examined in depth as well as in conjunction with their clinical implications.
Discussion Questions:
Given the distinction between sex (i.e., biological) and gender (more sociological), which would you consider the greatest influence(s) on the female and male immunological biases: evolution, genetics, molecular biology, anthropologic or ecologic factors
Before we get to our blog on autoimmune diseases, which we all know are greater in females, do you have any thoughts on what might be the most profound cause (not an entirely fair question without the additional discussion scheduled for Blog #19)?
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