Sex, gender, and medicine

Mounting evidence shows that biological sex and gender impacts how our bodies and brains work. As our traditional scientific model, heavily influenced by misguided policies and ingrained cultures, is rooted in the belief that males and females are interchangeable outside of our reproductive zones, it’s time for a scientific reboot. Depending upon the context, our chromosomes, hormones, and life experiences effect our lives in ways which are both inconsequential and critically important. To practice up-to-date medicine and optimize our own resiliency, it’s important to understand and openly discuss these very real differences. This introductory chapter is designed as a “sex and gender boot camp” and will review basic definitions, explore clinical and professional examples of sex and gender differences, provide a template for framing differences, and share the author’s personal experiences in discovering this material and using it to become more resilient

The context of child sexual abuse, and points of departure

This chapter sets out the context of child sexual abuse and marks out several points of departure from which the rest of the book proceeds. It first defines the concept of child sexual abuse. Then, it reviews the best literature on the prevalence of child sexual abuse both generally, and in specific contexts, around the world. It reviews other important epidemiological features, referring to evidence about gender, age of onset, the relationship between those who inflict abuse and the child, frequency of offending, factors influencing offending, and theories of offending. It notes the common health and behavioural consequences of child sexual abuse. Significantly, it then reviews literature on the common non-disclosure of child sexual abuse by both girls and boys: a critical feature of this context. The chapter than shows that the gravity of child sexual abuse should be and is recognised in international policy and in most social norms. An appropriately nuanced approach is then urged, in recognition of a spectrum of cases that demand appropriately differentiated responses. Finally, the chapter explains that the book also proceeds on the basis that in any civilised society, individuals, institutions and broader social systems and nation states have a deep ethically-based duty to prevent and identify child sexual abuse, and to respond appropriately to it after it occurs. These ethical duties are consistent with bodies of political and public health theory, the Capabilities Approach, and human dignity informing the book’s entire conceptual approach