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Everyone, not just marginalized groups, must fight racism and oppression. Members of privileged groups must learn to be allies. Toronto’s Hospital for Sick Children developed a series of workshops to teach them how.Summary Oppression and racism are pervasive in the health care environment and directly impact patients, physicians, and other health care practitioners. Fostering and promoting allyship skills can increase inclusion in health care and advance systemic change. The Hospital for Sick Children in Toronto developed a foundational allyship workshop to increase awareness and understanding of interpersonal, systemic, and institutional oppression and discrimination in the large pediatric academic center. The workshop emphasizes individual accountability and how to speak up and act against oppression through critical allyship. The authors report promising results around the engagement and desire to practice allyship amongst health care providers.

Discrimination has historically contributed to coercive contraceptive in the United States. We investigated associations between perceived discrimination, or the perception of unequal treatment in everyday life, and contraceptive method use among U.S. women. We analyzed population-based data from a 2013 study of U.S. women who were premenopausal, age 18–50, sexually active with a male partner in the last year and were not attempting pregnancy. Perceived discrimination was measured using the Everyday Discrimination Scale. Contraceptive method use was categorized into five method categories: permanent, highly effective reversible, moderately effective, barrier and no method. We analyzed relationships between perceived discrimination and contraceptive method use with several regression models, controlling for covariates. Among 539 women in our analytic sample, those with high perceived discrimination had lower incomes, less educational attainment and were less likely to be insured. Perceived discrimination was associated with a reduced odds of using any contraceptive method (aOR 0.43, CI 0.21–0.87, p < .001). Contraceptive method users with high perceived discrimination had an increased odds of using highly effective reversible methods versus moderately effective methods (aOR 5.28, CI 1.63–17.07 p = < .001). Women who perceived discrimination were at risk for contraceptive nonuse; however, among contraceptive users, perceived discrimination was associated with the use of more effective reversible methods.

Women's health concerns are generally underrepresented in basic and translational research, but reproductive health in particular has been hampered by a lack of understanding of basic uterine and menstrual physiology. Menstrual health is an integral part of overall health because between menarche and menopause, most women menstruate. Yet for tens of millions of women around the world, menstruation regularly and often catastrophically disrupts their physical, mental, and social well-being. Enhancing our understanding of the underlying phenomena involved in menstruation, abnormal uterine bleeding, and other menstruation-related disorders will move us closer to the goal of personalized care. Furthermore, a deeper mechanistic understanding of menstruation-a fast, scarless healing process in healthy individuals-will likely yield insights into a myriad of other diseases involving regulation of vascular function locally and systemically. We also recognize that many women now delay pregnancy and that there is an increasing desire for fertility and uterine preservation. In September 2018, the Gynecologic Health and Disease Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development convened a 2-day meeting, "Menstruation: Science and Society" with an aim to "identify gaps and opportunities in menstruation science and to raise awareness of the need for more research in this field." Experts in fields ranging from the evolutionary role of menstruation to basic endometrial biology (including omic analysis of the endometrium, stem cells and tissue engineering of the endometrium, endometrial microbiome, and abnormal uterine bleeding and fibroids) and translational medicine (imaging and sampling modalities, patient-focused analysis of menstrual disorders including abnormal uterine bleeding, smart technologies or applications and mobile health platforms) to societal challenges in health literacy and dissemination frameworks across different economic and cultural landscapes shared current state-of-the-art and future vision, incorporating the patient voice at the launch of the meeting. Here, we provide an enhanced meeting report with extensive up-to-date (as of submission) context, capturing the spectrum from how the basic processes of menstruation commence in response to progesterone withdrawal, through the role of tissue-resident and circulating stem and progenitor cells in monthly regeneration-and current gaps in knowledge on how dysregulation leads to abnormal uterine bleeding and other menstruation-related disorders such as adenomyosis, endometriosis, and fibroids-to the clinical challenges in diagnostics, treatment, and patient and societal education. We conclude with an overview of how the global agenda concerning menstruation, and specifically menstrual health and hygiene, are gaining momentum, ranging from increasing investment in addressing menstruation-related barriers facing girls in schools in low- to middle-income countries to the more recent "menstrual equity" and "period poverty" movements spreading across high-income countries.

Le sexe/genre (s/g) doit être pris en compte dans le domaine de la santé au travail, puisque les hommes et les femmes n’occupent pas les mêmes emplois et ne sont pas exposés de la même façon aux risques de santé et sécurité au travail (SST). Cet article propose une réflexion sur les manières de considérer le s/g dans l’intervention ergonomique, en particulier lors des investigations préliminaires. Deux exemples issus d’interventions réalisées en France et au Québec sont présentés. Le premier exemple porte sur l’activité des médecins du travail dans la prévention des troubles musculosquelettiques (TMS). Le second traite du développement et de l’implantation d’une formation portant sur la SST. Dans les deux cas, ces questions portées par les ergonomes chercheuses ont permis de transformer la compréhension des dimensions liées aux parcours de santé, de travail et de vie personnelle pour que la prévention des lésions tienne compte des particularités des hommes et des femmes.

Arrière-plan Les organismes de financement de la recherche en santé et les rédacteurs de revues scientifiques ont récemment intensifié leurs efforts pour accroître la prise en compte des questions de sexe et de genre dans la conception, la conduite et la communication des études afin de garantir que les résultats de la recherche s’appliquent à tous. Cependant, l’examen de la littérature sur la recherche sur la mise en œuvre révèle que l’attention portée au sexe et au genre n’a pas encore infiltré les méthodes de recherche dans ce domaine. Discussion Les raisons pour lesquelles le sexe et le genre sont systématiquement pris en compte dans la recherche sur la mise en œuvre sont multiples. Le sexe et le genre sont importants dans la prise de décision, la communication, l’engagement des parties prenantes et les préférences pour l’adoption des interventions. Les rôles de genre, l’identité de genre, les relations de genre et le genre institutionnalisé influencent la manière dont une stratégie de mise en œuvre fonctionne, pour qui, dans quelles circonstances et pourquoi. De nouvelles preuves montrent que les théories des programmes peuvent fonctionner différemment au sein et entre les sexes, les genres et d’autres caractéristiques intersectionnelles dans diverses circonstances. En outre, sans une étude appropriée, les stratégies de mise en œuvre peuvent exploiter ou ignorer par inadvertance, plutôt que de transformer la réflexion sur le sexe et les facteurs liés au genre. Des techniques sont décrites pour mesurer et analyser le sexe et le genre dans la recherche sur la mise en œuvre en utilisant des méthodes à la fois quantitatives et qualitatives. Résumé Le présent article décrit l’application de méthodes d’intégration du sexe et du genre dans la recherche sur la mise en œuvre. Poser systématiquement des questions critiques sur le sexe et le genre conduira probablement à la découverte de résultats positifs, ainsi que de conséquences imprévues. Le résultat a le potentiel de renforcer à la fois la pratique et la science de la mise en œuvre, d’améliorer les résultats en matière de santé et de réduire les inégalités entre les sexes.

The research reported in this article sought to shed light on the North, Central and South American indigenous moon time teachings related to the menstrual cycle of women. The historical institutionalization, medicalization and colonization of indigenous women's practices have devalued and almost destroyed this knowledge. This study explored the question of whether or not lost indigenous knowledge of women's power can be reclaimed for women's health and well-being. A qualitative participatory research methodology was adopted, based on an indigenous paradigm and scholarly rigour and including protocols acceptable to an Ojibwe grandmother, Isabelle Meawasige, who shared her knowledge and experience. The experiential knowledge gained and the meanings expressed by female participants in a circle sharing facilitated by the principal author are presented and discussed. The results of this research reveal optimistic possibilities to co-create health and well-being for the participants, grounded in what is both visible and invisible within indigenous women's culture.

Informed by intersectionality theory, a tradition that theorizes intersecting power relations of racism, patriarchy, classism and heterosexism, this paper investigates the degree to which race, gender, class and sexuality manifest distinct and interconnected associations with self-reported hypertension in nationally-representative survey data from Canada. Binary logistic regression is used to model the main effects of, and interactions between, race, gender, education, household income and sexual orientation on hypertension, controlling for age, using data from the 2003 Canadian Community Health Survey (n = 90,310). From a main effects (‘additive’) perspective, Black respondents, respondents with less than high school and poorer respondents were significantly more likely than White respondents, university-educated Canadians and wealthier Canadians, respectively, to report hypertension. However, the interactive models indicate that the additive models were poor predictors of hypertension for wealthy Black men, wealthy South Asian women, women with less than a high school diploma and wealthy bisexual respondents, who were more likely than expected to report hypertension, and for poor Black men, poor South Asian women, poor South Asian men and women with a university degree, who were less likely than expected to report hypertension. It appears that, with regard to blood pressure at least, Canadians experience the health effects of education differently by their genders and the health effects of income differently by their identities defined at the intersection of race and gender. This study provides empirical support for the intersectional approach to cardiovascular health inequalities by demonstrating that race, gender, class and sexuality cannot be disentangled from one another as predictors of hypertension.

Les nouvelles technologies de communication, et notamment Internet, ont transformé à la fois les stratégies relationnelles et la transmission et le partage des informations dans toutes les sphères de la vie, incluant le domaine de la santé. Pour les minorités sexuelles qui sont confrontées à de multiples formes de discrimination et de marginalisation, Internet est devenu un puissant moyen de s’organiser, d’informer et d’intervenir dans le champ de la santé. Les associations et organismes communautaires ciblant ces populations proposent aujourd’hui un ensemble de sites et de stratégies de soutien et d’intervention. Ces outils synchrones et asynchrones disponibles en ligne visent l’amélioration de la santé mentale et physique, des relations interpersonnelles et la prévention des ITSS et du VIH/sida. Par contre, les usages qui varient en fonction des populations LGBT peuvent aussi concourir à la prise de risques et à des formes de dépendance. Afin de mieux comprendre les enjeux entourant les usages d’Internet et la santé, cet ouvrage, réalisé grâce à l’appui de l’équipe pancanadienne Sexualités et genres ;: vulnérabilité et résilience (SVR), regroupe les contributions de chercheurs de l’équipe qui ont effectué des travaux sur Internet et la santé ainsi que d’intervenants impliqués dans des organismes communautaires, qui utilisent des sites Internet à des fins de réseautage, de transfert d’informations et d’interventions en ligne dans les contextes québécois et canadien.

The author discusses issues pertaining to transgender women and girls. Women identifying as male or transitioning to becoming male are often ignored in the scientific and lay literature on transgender people. The many newer terms for transgender women and girls are discussed, as well as new ways for transgender girls to express their identities. The importance of family and community supports is discussed, and common issues that young transgender people bring into mental health treatment are elucidated.

Résumé Le Canada et le Québec, sociétés pluriethniques, possèdent des politiques et des programmes de promotion et de prévention pour contrer les violences faites aux femmes, mais reconnaissent que le défi est de taille dans le contexte migratoire. Les immigrantes, confrontées à la violence conjugale, ne disposent souvent pas d’accessibilité culturelle aux services sociaux et de santé ou n’obtiennent pas de réponse adéquate à leurs besoins. Toutefois, certains organismes ont des projets pour leur venir en aide mais ils ne sont pas systématiques. L’article présente les résultats d’une recherche exploratoire, avec approche ethnologique, qui documente la perception de 10 intervenants d’organismes communautaires et institutionnels concernant leurs activités dans le domaine et leur préoccupation pour la promotion et la prévention primaire, même si leurs pratiques concrètes sont surtout centrées sur la prévention secondaire. Maints empêchements les limitent, mais leurs perceptions des réponses promotionnelles et préventives mettent en lumière l’impact de la violence structurelle et de la violence conjugale et orientent les perspectives de renouvellement des pratiques d’intervention sociosanitaire en matière de violence conjugale.

Purpose: This qualitative research aimed to elicit experiences and beliefs of recent South Asian immigrant women about their major health concerns after immigration. Methods: Four focus groups were conducted with 24 Hindi-speaking women who had lived less than five years in Canada. The audiotaped data were transcribed, translated, and analyzed by identification of themes and subcategories. Results: Mental health (MH) emerged as an overarching health concern with three major themes, i.e., appraisal of the mental burden (extent and general susceptibility), stress-inducing factors, and coping strategies. Many participants agreed that MH did not become a concern to them until after immigration. Women discussed their compromised MH using verbal and symptomatic expressions. The stress-inducing factors identified by participants included loss of social support, economic uncertainties, downward social mobility, mechanistic lifestyle, barriers in accessing health services, and climatic and food changes. Women's major coping strategies included increased efforts to socialize, use of preventative health practices and self-awareness. Conclusion: Although participant women discussed a number of ways to deal with post-immigration stressors, the women's perceived compromised mental health reflects the inadequacy of their coping strategies and the available resources. Despite access to healthcare providers, women failed to identify healthcare encounters as opportunities to seek help and discuss their mental health concerns. Health and social care programs need to actively address the compromised mental health perceived by the studied group.

L’excision et l’infibulation sont parties intégrantes des traditions de nombreuses sociétés africaines issues majoritairement de la région subsaharienne. En contexte canadien, aucune information statistique n’est présentement disponible sur la prédominance de cette pratique, malgré le fait que de nombreux intervenants soupçonnent que plusieurs immigrant(e)s en provenance de ces pays sont susceptibles de faire subir ces pratiques à leurs fillettes. Cette étude qualitative explore les valeurs et les croyances des immigrant(e)s par rapport à ces pratiques traditionnelles, tout en cernant les défis de leur processus d’intégration au Canada et leur recours aux services de santé.

Woman is a fascinating, fact-filled guide that covers everything from organs to orgasms, hormones to hysterectomies. With her characteristic clarity, insight, and sheer exuberance of language, bestselling author Natalie Angier cuts through the still-prevalent myths and misinformation surrounding the female body, that most enigmatic of evolutionary masterpieces. With a witty and assured narrative, and a reader-friendly dose of science, Woman is an essential and engaging resource for all time.