Male/Female Is Not Enough: Adding Measures of Masculinity and Femininity to General Population Surveys

Survey research and sociological theory each provide insights into how and why people and groups act, think, and feel. Sociological theories identify what concepts are important for understanding and representing the social world. That is, sociological theories inform what to measure in surveys, and, to a certain extent, how to measure it. Survey research permits sociologists to carefully specify what is to be measured vis a vis sociological theory, setting surveys apart as a social research tool. It is this level of specification of concepts and measures that allow surveys to provide continued value at a time when “big data” proliferate. High quality survey measurement and estimation is necessary for sociologists to evaluate sociological theory among generalizable samples with well-developed questions, leading to further refinement and improvement of the theory and improved understanding of the social world. High quality surveys also provide insights into where sociological theories fail and where they must be adjusted for different subgroups, as well as basic insights into the prevalence of outcomes of interest. Together, sociological theory and survey methods produce insights about society that can inform decision-making and social policy. This mutually reinforcing relationship between sociological theory and survey methods requires sociological theory to evolve from insights obtained using survey methods and survey measurement to evolve with advances in in sociological theory. The measurement of sex and gender in surveys is one area where the development of survey measures has not kept pace with sociological theory and empirical, largely qualitative, findings. Contemporary gender theory sees sex and gender as separate concepts, both of which are important for understanding behaviors and outcomes. Yet, virtually all contemporary surveys measure sex as a binary “male” versus “female” categorization and fail to measure gender, ignoring important heterogeneity in gender identification that may exist within sex categories and any overlap that may occur across categories. Both gender scholars and survey researchers are potentially affected by this shortcoming of modern survey measurement. Gender scholars lose an important tool for assessing gender theories, especially on generalizable samples, risking conclusions that are specific to a small group of individuals rather than the population at large. Survey researchers risk producing theoretically obsolete data, limiting the utility of the data or potentially generating misleading conclusions. Survey data that fail to capture and reflect modern and complex understandings of our social realities also face increased risk of being replaced by “big data” such as administrative and social media data. Survey data that do reflect modern and complex understandings can bring value not available in administrative or other data and are therefore unlikely to be replaced. This paper is part of a growing chorus advocating for updates to how modern surveys measure sex and gender. We argue that the reliance on a single binary measure of sex (male or female) is out of step with current sociological understandings of sex and gender. In response, we propose and test a new theoretically-informed gradational measure of gender identification in a nationally representative mail survey. We evaluate whether respondents answer the gender measure and examine the reliability and predictive validity of the measure. In particular, we examine whether measuring gender gradationally adds explanatory value beyond sex on important social outcomes such as sexuality, childcare, grocery shopping, housework, working for pay, and military service. We also examine whether sex moderates the effect of gender identification in the ways that sociological theory would suggest on these outcomes

The neurogenic bladder: medical treatment

Neurogenic bladder sphincter dysfunction (NBSD) can cause severe and irreversible renal damage and bladder-wall destruction years before incontinence becomes an issue. Therefore, the first step in adequate management is to recognize early the bladder at risk for upper- and lower-tract deterioration and to start adequate medical treatment proactively. Clean intermittent catheterization combined with anticholinergics (oral or intravesical) is the standard therapy for NBSD. Early institution of such treatment can prevent both renal damage and secondary bladder-wall changes, thereby potentially improving long-term outcomes. In children with severe side effects or with insufficient suppression of detrusor overactivity despite maximal dosage of oral oxybutynin, intravesical instillation is an effective alternative. Intravesical instillation eliminates systemic side effects by reducing the first-pass metabolism and, compared with oral oxybutynin, intravesical oxybutynin is a more potent and long-acting detrusor suppressor. There is growing evidence that with early adequate treatment, kidneys are saved and normal bladder growth can be achieved in children so they will no longer need surgical bladder augmentation to achieve safe urinary continence in adolescence and adulthood

The COVID-19 Pandemic: Crisis Management for Plastic Surgeons.

The worldwide outbreak of coronavirus disease 2019 (COVID-19) has forced health care systems across the United States to undertake broad restructuring to address the ongoing crisis. The framework of crisis management can assist plastic surgeons navigate the dynamic environment of the COVID-19 pandemic. This article outlines crisis management tools at a number of different levels, from hospital-wide to plastic surgeon-specific, and it offers a practical discussion of the coronavirus situation as it affects plastic surgeons. Although there are innumerable ways that this virus is currently changing plastic surgeons\u27 practices, it is crucial to remember that these changes are temporary, and they will be best met by being confronted head-on