Why and How to Account for Sex and Gender in Brain and Behavioral Research.

Long overlooked in neuroscience research, sex and gender are increasingly included as key variables potentially impacting all levels of neurobehavioral analysis. Still, many neuroscientists do not understand the difference between the terms "sex" and "gender," the complexity and nuance of each, or how to best include them as variables in research designs. This TechSights article outlines rationales for considering the influence of sex and gender across taxa, and provides technical guidance for strengthening the rigor and reproducibility of such analyses. This guidance includes the use of appropriate statistical methods for comparing groups as well as controls for key covariates of sex (e.g., total intracranial volume) and gender (e.g., income, caregiver stress, bias). We also recommend approaches for interpreting and communicating sex- and gender-related findings about the brain, which have often been misconstrued by neuroscientists and the lay public alike.

Ambivalent Sexism and Tolerance of Violence Against Women in India.

We examined associations between sexist beliefs and tolerance of violence against women in India using a nationally representative probability sample of adults (n = 133,398). Research consistently indicates that hostile sexism fosters tolerance of violence against women. However, benevolent sexism is sometimes associated with higher tolerance and sometimes with lower tolerance of violence. We proposed that this inconsistency could be resolved by considering the source of violence: Is violence perpetrated by outsiders or intimate partners? Results of a multigroup structural equation model showed that endorsement of hostile sexism was related to greater tolerance of violence regardless of the source. In contrast, endorsement of benevolent sexism was associated with lower tolerance of violence from outsiders but was simultaneously associated with higher tolerance of spousal violence. These opposing processes indicate that although benevolent sexism promises women protection from violence, the very same ideology legitimizes spousal violence, thereby reinforcing men's power within intimate relationships.

Mindful-Gratitude Practice Reduces Prejudice at High Levels of Collective Narcissism.

This research tested the hypothesis that mindful-gratitude practice attenuates the robust association between collective narcissism and prejudice. In Study 1 (a between-subjects study using a nationally representative sample of 569 Polish adults; 313 female), 10 min of mindful-gratitude practice-compared to mindful-attention practice and control-did not decrease prejudice (anti-Semitism), but weakened the positive link between collective narcissism and prejudice. In Study 2 (a preregistered, randomized, controlled-trial study using a convenience sample of 219 Polish adults; 168 female), a 6-week mobile app supported training in daily mindful-gratitude practice decreased prejudice (anti-Semitism, sexism, homophobia, anti-immigrant sentiment) and its link with collective narcissism compared to a wait-list control. The hypothesis-consistent results emphasize the social relevance of mindful-gratitude practice, a time- and cost-effective intervention.

Are Gender Identities and Gender Ideologies Associated with the Variety and Type of Owned Sex Toys? Evidence from a Large Italian Sample of Cisgender Individuals.

Research on the use of sex toys has been primarily performed from a medical perspective, while there is still limited research from a psychosocial perspective. To bridge this gap, in this study we examined whether some psychosocial variables might be linked to sex toy ownership in a sample of 3960 Italian (cisgender men and women) sex toy buyers. More specifically, we investigated the association between gender identities and ideologies and the variety and types of sex toys owned. Based on the data, we detected two dimensions underlying the ownership of sex toys: (1) orientation to owning kinky sex toys and (2) orientation to owning clit-oriented sex toys. Results showed that benevolent sexism and gender system justification were negatively correlated with owning clit-oriented toys. Moreover, strongly gender-identified participants owned a small variety of different toys and preferred toys that were designed to stimulate the vagina or clitoris over less commonly-used toys. No significant correlation between feminist identification and sex toy type owned was found when gender identification was taken into account. These results suggest that the owning of sex toys might be associated with traditional gender ideology and the strength of gender identification.

Uncovering gaps in women's authorship: A big data analysis in academic surgery.

INTRODUCTION: Women are underrepresented in surgical authorship. Using big data analyses, we aimed to investigate women's representation as first and last authors in surgical publications worldwide and identify underlying predictors. METHODS: We retrieved eligible surgical journals using Scimago Journal & Country Rank 2021. We queried articles indexed in PubMed from selected journals published between January 2018 and April 2022. We used the EDirect tool to extract bibliometric data, including first and last authors' names, primary affiliation country, and publication year. Countries and dependent territories were classified following World Bank income levels and regions. Women's representation was predicted from forenames using the Gender-API software. Citations were included if gender accuracy was ≥80%. RESULTS: We analyzed 210,853 citations containing both first and last authors' forenames, representing 158 countries and 14 territories. Women constituted 23.8% (50,161/210,853) of the first and 14.7% (31,069/210,853) of the last authors. High-income economies had more women as first authors than other income categories (p < 0.001), but fewer women as last authors than upper-middle- and lower-middle-income economies (p < 0.001). The odds of the first author being a woman were more than three times higher when the last author was also a woman (OR 3.21, 95% CI 3.13-3.30) and vice versa (OR 3.25, 95% CI 3.16-3.34) after adjusting for income level and publication year. CONCLUSIONS: Women remain globally underrepresented in surgical authorship. Our findings urge concerted global efforts to overcome identified disparities.

The weaponization of professionalism against physicians of color.

Though we have made ample advances in the field of medicine in recent years, our idea of professionalism continues to be based on the standard of how white men dressed in the nineteenth century. Such a standard of professionalism not only perpetuates gender bias, but also aims to remove the culture, traditions, and behaviors of minority groups with the goal of molding these individuals to resemble the majority, preventing 'Afro' heritage from entering medicine. By contextualizing our own experiences in the medical setting as physicians of color in the context of a variety of supporting literature, we provide an overview of professionalism, its role in medicine, the double standard faced by women, and how it continues to be weaponized against physicians of racial, ethnic, and religious minorities. We advocate for minority physicians to embrace their authenticity and for institutions to develop policies that openly, firmly, and enthusiastically welcome physicians of all ethnicities, religions, and genders. Positionality Statement: In the editorial you are about to read, we, the authors, collectively bring a rich tapestry of backgrounds and experiences to our discussion on healthcare disparities. Our team consists of two Hispanic/Latina oncologists, one Middle Eastern oncologist, one Black/Caribbean-American hematologist, and one White pre-medical student with Middle Eastern heritage. Our diverse backgrounds inform our perspectives and enhance our understanding of the complex and multifaceted nature of healthcare. We are united by a shared commitment to justice, equity, and the belief that every patient deserves high-quality care, regardless of their background. This editorial is informed by our professional expertise, personal experiences, and the diverse communities we serve, aiming to highlight the critical need for inclusivity and representation in healthcare. By acknowledging our positionality, we hope to provide a comprehensive and empathetic analysis that not only identifies the challenges but also offers actionable solutions to improve healthcare outcomes for all. We recognize the power of diversity in fostering innovation and driving positive change, and we are dedicated to using our voices and positions to advocate for a more equitable healthcare system.

The effect of Feminist Therapy-Based Group Counseling program on women's psychological empowerment and internalized sexism.

This study aims to develop and examine the effectiveness of a group counseling program based on feminist therapy to empower women and reduce internalized sexism. The program was designed based on the perspective of consciousness-raising groups, which have an essential place in women's movements. A quasi-experimental design with a pretest-posttest control group was used. The participants of the study were 26 young women, with an average age of 22.50±1.10. Data collection tools included the Internalized Sexism Scale, Woman Psychological Power Scale, and Personal Information Form. Analysis of covariance was used for the data analysis. The results suggested a decrease in internalized sexism levels and an increase in psychological power levels among the participants. These results are important for both mental health and gender studies, and may contribute to future practices and research on psychological and educational interventions to reduce sexism among women.

Gender bias of antisocial and borderline personality disorders among psychiatrists.

PURPOSE: Antisocial Personality Disorder (ASPD) and Borderline Personality Disorder (BPD) challenge mental health professionals with similar maladaptive behaviors. However, these two disorders differ regarding available evidence-based treatments. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been criticized as being gender-biased diagnostic construct. The present study aimed to determine the gender bias of ASPD and BPD among Turkish psychiatrists. METHODS: Three case vignettes were randomly presented as male or female to the psychiatrists online. The first case was a patient with schizophrenia case to confirm the participant's ability to diagnose. The second case was a patient with ASPD, and the third one was a patient with BPD. RESULTS: Two hundred fifty participants diagnosed the first case correctly (n = 250). The results with statistical significance demonstrated that a female case with ASPD was 5.1 times more likely to get misdiagnosed than a male case with ASPD (p˂0.0001). CONCLUSIONS: Categorical classification of personality disorders in DSM leads to gender bias in in the diagnosis of ASPD and BPD. The present study shows that female cases with ASPD are misdiagnosed as BPD which may result in treatment attempts without evidence.

The perception of gender and the approach taken towards female physicians.

AIM: The aim of this study is to evaluate gender perception among patients in the emergency department (ED) and to examine the effect of gender perception on patients' preference of physician's gender. METHODS: This was a cross-sectional survey study. The survey comprised three sections. The first section collected general information, while the second section inquired about patients' preferences for physicians' gender in the ED, in general examinations, and regarding "sensitive" medical issues. The third section of the survey, entitled the "Perception of Gender Scale," comprised a series of questions designed to assess the participants' perceptions of gender. The scale employed a Likert-type response format, with scores ranging from 25 to 125. Higher scores indicated a more egalitarian gender perception. RESULTS: The number of participants in the study was 431, with 194 males and 237 females. The median age of the participants was 38.5 years (interquartile range [IQR] 28-48). Over half of the participants had completed university education. The study population exhibited a Perception of the Gender Scale (PGS) score of 96 (IQR 78.5-109). With regard to the patient's preference for physicians' gender, in emergency settings (ES) and in general examinations (GE), over three-quarters of the participants indicated that they do not have a preference. However, for sensitive medical issues (SMI), the proportion of participants indicating no preference decreased to 45 %. Among those with the lowest quartile of PGS scores, the percentage of individuals who expressed no gender preference in ES, GE and SMI was 65 %, 60 %, 26 % and who expressed a preference for male physicians was 13 %, 19 %, 43 % respectively. In contrast, of those with the highest quartile of PGS scores, the percentages of those who had no gender preference were 86 %, 90 %, 68 %, while the percentages of those who preferred male physicians were 1.9 %, 1 %, and 4.8 %, respectively. CONCLUSION: In the context of emergency settings and general examinations, approximately three-quarters of the participants indicated no preference regarding the gender of the physician. However, in the case of sensitive medical issues, the proportion of participants with no gender preference was less than half. For patients with a gender preference for their physician, perception of gender is a significant predictor.

Pornography, sexual orientation and ambivalent sexism in young adults in Spain.

BACKGROUND: On line platforms offer access to an almost unlimited variety of pornographic material that shows high levels of sexism. Despite this fact, there are still few studies that assess the effect of pornography on sexism in young adults The aim of this study is to analyze the association of pornography consumption and sexual orientation with benevolent sexism (BS) and hostile sexism (HS) in young men and women. METHODS: We surveyed 2,346 people aged 18-35 years old. Multiple regression models were carried out for BS and HS. The independent variables: current pornography consumption and sexual orientation. Covariates: socio-demographic variables -age, sex, level of education and place of birth-. RESULTS: A) HS: Men who consumed pornography had higher median values of HS than those who did not [ß(95%CI):2.39(0.67;4.10)]. Homosexual/ bisexual men displayed lower values of HS than heterosexual men [ß(95%CI):-2.98(-4.52;-1.45)]. The increase in HS levels associated with pornography consumption was notably greater in homosexual and bisexual women relative to heterosexual women, where that pattern was not observed [ß(95%CI for interaction): 2.27(0.11; 4.43)]. B) BS: Mean values of BS were observed to be lower for both women [ß(95%CI):-2.16(-2.99;-1.32)] and men [ß(95%CI):-4.30(-5.75;-2.86)] who consumed pornography compared to those who did not. Homosexual/bisexual men recorded mean values of BS lower than heterosexual men [ß(95%CI):-3.10(-4.21;-1.99)]. CONCLUSIONS: Pornography consumption is related to sexism and differs according to sex and sexual orientation. As sexism is the substratum of inequality between men and women, it is urgent to launch affective-sexual education programs for young people that take into account the determinants of sexism.

Gender-based violence and harassment at work and health and occupational outcomes. A systematic review of prospective studies.

BACKGROUND: Many people experience forms of gender-based violence and harassment (GBVH) in the context of their work. This includes a wide range of experiences, from subtle expressions of hostility to physical assault, that can also be of a sexual nature (e.g., sexual harassment or assault). This systematic review aimed to summarize findings about the prospective associations of work-related GBVH with people's health and occupational situation. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Scopus, Web of Science, MEDLINE and PsycINFO were searched for prospective studies in English from 1990 to May 24, 2023. Studies were included if they concerned a working population, exposure to any form of GBVH in the work context, and a health outcome or manifest occupational outcome. Quality was assessed with a modified version of the Cochrane 'Tool to Assess Risk of Bias in Cohort Studies', and studies assessed as low quality were excluded from the narrative synthesis. For the narrative synthesis, we grouped the results by similar exposures and outcomes and reported the strength and statistical significance of the associations. RESULTS: Of the 1 937 screened records, 29 studies were included in the narrative synthesis. Studies were mainly conducted in the USA and northern Europe and investigated exposure to sexual violence or harassment (SVH). Only two included studies investigated non-sexual kinds of GBVH. Consistently, studies showed associations of work-related SVH with poor mental health and there were indications of an association with hazardous substance use. There was no consistent evidence for an association of SVH with subsequent sickness absence, and there were too few studies concerning physical health and occupational outcomes to synthesize the results. CONCLUSIONS: There is consistent evidence of work-related SVH as a risk factor for subsequent poor mental health. There is no indication that the health consequences of SVH differ between women and men, although women are more often affected. There is a need for conceptual consistency, the consideration of non-sexual behaviors and prospective studies that test clear hypotheses about the temporal sequence of events.

Understanding the interplay between organisational injustice and the health and wellbeing of female police officers: a meta-ethnography.

BACKGROUND: Female police officers are reported to encounter more bias, discriminatory practices, and inadequate support than their male counterparts and experience poorer health outcomes. This meta-ethnographic review looks beyond individual responsibilities to consider which aspects of policing impact the health and well-being of female police officers. METHODS: Primary qualitative and mixed method studies published between 2000 and 2024 were included. ProQuest (all databases) and Ovid (Medline and Embase) were searched using terms related to health, wellbeing, females, police, and qualitative research. This was a cross-jurisdictional review, with no limit on country of study. In total, twenty-one papers met the inclusion criteria. A seven-phase inductive and interpretative meta-ethnographic technique was employed to synthesise, analyse, and interpret the data. RESULTS: The data analysis revealed a distinct outcome that demonstrated a strong relationship and substantial impacts of organisational injustice on the health and well-being of female police officers. Our findings showed that organisational injustice, encompassing procedural, relational, distributive, and gendered injustice, significantly influences the health and well-being of female officers. Impacts on mental health were commonly discussed, followed by aspects influencing social health, workplace wellbeing, and physical health. Moreover, the effects of these four forms of organisational injustice and the associated cultural, systemic, and structural risk factors extend beyond the immediate health and wellbeing impacts on the individual female officer through impeding other aspects of their work life, such as career progression and work-life balance, that can further impact long-term health and well-being. CONCLUSION: This review highlights the importance of addressing organisational injustice and the cultural, systemic, and structural risk factors within policing to promote healthier and more inclusive workforces for female officers. Policymakers and practitioners should critically examine policies and practices that may appear gender neutral but disproportionately impact women, affecting the health and well-being of female police officers. By addressing these issues, transformative action can be taken to create safer, more supportive, and healthier working environments for female police officers.

Weight stigma is uniquely tied to maladaptive eating across different racial, ethnic, and gender groups.

Weight stigma, racism, and sexism (social devaluation due to body weight, race or ethnicity, and sex or gender), have been linked to increased maladaptive eating behaviors; however, no research has investigated the unique associations between different forms of stigma and eating concurrently. We analyzed within-group (by race/ethnicity and sex) effects of different forms of stigma on maladaptive eating behaviors to test whether there is some unique relationship between weight stigma and maladaptive eating across identities. Additionally, we explored differences by racial/ethnic group and sex, as well as BMI category, in levels of reported weight stigma, racism, sexism, and maladaptive eating. Participants (N = 1051) were recruited so that there were approximately even numbers of participants identifying as Black (33.3%), Hispanic or Latino (32.8%), and White (33.9%). Overall, participants reported similar amounts of weight stigma by race/ethnicity and sex, but different levels of racism and sexism. Weight stigma, but not racism or sexism consistently predicted binge eating and eating to cope across groups, controlling for education, income, BMI, and age. Restricted dieting, however, was only predicted by weight stigma for Hispanic/Latino and Black men. These findings suggest that weight stigma is a unique predictor of maladaptive eating, even when considering the effects of racism and sexism. This study provides evidence of a more focused model of weight stigma and eating outcomes, rather than a more general model of the effect of stigma on eating outcomes due to overall stress. Future research should investigate when and why weight stigma drives restricted dieting, since this relationship seems strongest in men, going against many common inclinations about weight stigma.

Structural Sexism and Breastfeeding in the United States, 2016-2021.

INTRODUCTION: Recent studies demonstrate that structural sexism erodes women's health and impedes access to healthcare. This study extends this research to examine the relationship between structural sexism and breastfeeding initiation and duration in the United States. METHOD: A multifaceted state-level structural sexism index was constructed and merged with responses from the 2016-2021 National Survey of Children's Health by state and child's birth year. For children ages six months to 5 years, the prevalence of being ever breastfed and breastfed for at least six months was measured across levels of structural sexism. Multivariable logistic regression analyzed the association of structural sexism with breastfeeding outcomes, net of individual and family characteristics. RESULTS: Higher levels of structural sexism were associated with lower odds of breastfeeding initiation and lower odds of breastfeeding for at least six months net of family and child characteristics. In addition, sensitivity analyses show that variations in state breastfeeding laws did not explain these differences. DISCUSSION: This study highlights structural sexism's role in limiting breastfeeding initiation and duration. Breastfeeding promotions and guidelines should consider the broader context of structural sexism.

Hegemonic masculinity predicts 2016 and 2020 voting and candidate evaluations.

This work examined whether the endorsement of the culturally idealized form of masculinity-hegemonic masculinity (HM)-accounted for unique variance in men's and women's support for Donald Trump across seven studies (n = 2,007). Consistent with our theoretical backdrop, in the days (Studies 1 and 2) and months (Studies 3 through 6) following the 2016 American presidential election, women's and men's endorsement of HM predicted voting for and evaluations of Trump, over and above political party affiliation, gender, race, and education. These effects held when controlling for respondents' trust in the government, in contrast to a populist explanation of support for Trump. In addition, as conceptualized, HM was associated with less trust in the government (Study 3), more sexism (Study 4), more racism (Study 5), and more xenophobia (Study 6) but continued to predict unique variance in evaluations of Trump when controlling for each of these factors. Whereas HM predicted evaluations of Trump, across studies, social and prejudiced attitudes predicted evaluations of his democratic challengers: Clinton in 2016 and Biden in 2020. We replicate the findings of Studies 1 through 6 using a nationally representative sample of the United States (Study 7) 50 days prior to the 2020 presidential election. The findings highlight the importance of psychological examinations of masculinity as a cultural ideology to understand how men's and women's endorsement of HM legitimizes patriarchal dominance and reinforces gender, race, and class-based hierarchies via candidate support.

Pride & prejudice: A scoping review of LGBTQ + medical trainee experiences.

PURPOSE: LGBTQ + medical trainees experience significant discrimination. These individuals are stigmatized within a hetero- and cis-normative system, resulting in poorer outcomes in mental health and increased stress regarding career trajectory compared with their hetero- and cis-identifying counterparts. However, literature on the barriers experienced during medical training in this marginalized group is limited to small heterogeneous studies. This scoping review collates and explores prominent themes in existing literature on the personal and professional outcomes of LGBTQ + medical trainees. METHODS: We searched five library databases (SCOPUS, Ovid-Medline, ERIC, PsycINFO and EMBASE) for studies that investigated LGBTQ + medical trainees' academic, personal, or professional outcomes. Screening and full text review were performed in duplicate, and all authors participated in thematic analysis to determine emerging themes, which were iteratively reviewed to consensus. RESULTS: From 1809 records, 45 met inclusion criteria (κ = 0.57). Major themes that emerged in the literature included the prevalence of discrimination and mistreatment faced by LGBTQ + medical trainees from colleagues and superiors, concerns regarding disclosure of sexual and/or gender minority identity, and overall negative impacts on mental health including higher rates of depression, substance use, and suicidal ideation. There was a noted lack of inclusivity in medical education and having an LGBTQ + identity had a large impact on career trajectory. Community with peers and mentors was an important determinant of success and belonging. There was a noteworthy lack of research on intersectionality or positive interventions that improved outcomes for this population. CONCLUSION: This scoping review highlighted important barriers facing LGBTQ + medical trainees, identifying substantial gaps in the existing literature. Research on supportive interventions and predictors of training success is lacking and will be important to foster an inclusive education system. These findings provide critical insights for education leaders and researchers to help create and evaluate inclusive and empowering environments for trainees.

Is the link between the Dark Tetrad and the acceptance of sexual violence mediated by sexual machismo?

Previous studies have established relationships between the Dark Tetrad traits and sexual violence and its acceptance through myths about this type of violence. Sexual violence is positively associated with machismo, with sexist beliefs having been found to be linked with the Dark Tetrad and with the acceptance of sexual violence. Using a community sample comprising 362 adults between the ages of 18 and 70 (M = 35.6, SD = 14.3) and three self-report measures, this cross-sectional study aimed to explore the mediating role of sexual machismo in the relationship between each of the Dark Tetrad traits and the acceptance of sexual violence, both in the overall sample and by gender, as well as whether a significant variance in this acceptance is explained by the "dark" traits, sexual machismo, and gender. In the regression, sexual machismo (the male) gender, and only Machiavellianism were uniquely associated with the acceptance of sexual violence, and sexual machismo partially mediated the associations between the Dark Tetrad and the acceptance of sexual violence. These findings indicate that being male and higher in sexism is more closely linked with the acceptance of sexual violence than most Dark Tetrad traits. Moreover, the associations between the Dark Tetrad, sexual machismo, and the acceptance of sexual violence were stronger in men, consistent with the notion that these traits facilitate a "male" exploitive mating strategy, which likely also extends to victim-blaming and positive attitudes about sexual violence more broadly. Lastly, the results emphasize the pervasiveness of beliefs about male superiority over women and its relationship with victim-blaming even in women.

A small shift, a major leap: Changing gender-role attitudes among adolescents across two ethnic groups.

INTRODUCTION: The current study examined a growth mindset intervention designed to promote egalitarian gender role attitudes among adolescents during a pivotal stage of their development, as these attitudes may have important implications for their identity development, well-being, and future life decisions. METHODS: A sample of 181 eighth-grade students (61% female, Mage = 13.14, SD = 0.42) from six Israeli schools participated in the study. The sample consisted of 49% Jewish and 51% Arab adolescents, including both Muslims and Christians. Adolescents engaged in a two-session intervention that included videos and reflective writing tasks. Pre-and postintervention, they completed self-administered questionnaires assessing their gender-role mindsets, attitudes toward women, and sexism. The data collection and intervention process took place from late 2021 to early 2023. RESULTS: After the intervention, there was an increase in growth mindsets and egalitarian attitudes towards women among adolescents, and a reduction in benevolent sexism and fixed gender-role mindsets. Hostile sexism, however, remained unchanged. No significant sex or ethnic differences were found in the effectiveness of the intervention. Gender-role mindsets mediated the association between the intervention and egalitarian attitudes, but not the association between the intervention and benevolent sexism. CONCLUSIONS: The findings demonstrate the potential of brief and targeted growth mindset interventions in promoting favorable changes adolescents' attitudes towards gender roles. According to this study, despite prolonged gender-role socialization, adolescents from diverse ethnic backgrounds can move towards more egalitarian attitudes and flexibility in gender roles through a rather targeted process. This finding is promising especially in adolescence, when stereotypes are often intensified.

The effects of gender discrimination on medical students' choice of specialty for their (junior) residency - a survey among medical students in Germany.

BACKGROUND: Gender discrimination is known to affect societies in many different settings. Medical education is no exception. This study focusses on the consequences, gender discrimination can have on medical students and their choice of (junior) residency specialty. METHODS: An online questionnaire was developed and distributed among the 40 medical faculties in Germany. The study population contained medical students in their fifth and sixth academic year. RESULTS: The survey's participants consisted of 759 students from 31 universities. Female medical students experienced significantly more gender discrimination compared to their male colleagues (f = 487, 87.9% vs. m = 76, 45.8%, p < 0.0001). The specialties with the most reported gender discrimination were family medicine (f = 180, 42.9% vs. m = 15, 23.8%, p < 0.05), followed by surgery (f = 369, 87.4% vs. m = 44, 69.8%, p < 0.05), internal medicine (f = 282, 67.3% vs. m = 37, 58.7%, ns), orthopaedics/casualty surgery (f = 270, 65.1% vs. m = 32, 50.8%, p < 0.05), and gynaecology (women (f = 142, 34.1% vs. m = 34, 54.0%, p < 0.05). Gynaecology was the only specialty, men experienced more discrimination compared to women. Among the students that ever changed their specialty of choice (f = 346 (73.3%) m = 95 (72%)), significantly more women than men claimed gender discrimination to be one of the main three reasons for their specialty choice (f = 42, 12.1% vs. m = 1, 1.1%, p < 0.05). In addition, 53 students (f = 50 (10.6%) m = 3 (2.3%)) stated to rule out a specialty from the beginning due to gender discrimination. CONCLUSION: Gender discrimination is frequently experienced by medical students in Germany. It influences their choice of medical specialty directly. Our data suggest a fundamental problem that proposes and implicates certain specialties to be attractive for only one gender.

Impact of Gender-Role Attitudes and Mental Health on Hostile Sexism and Acceptance of Cosmetic Surgery.

BACKGROUND: Each year, tens of thousands of people worldwide choose to undergo cosmetic surgery in order to alter their appearance. In recent years, young people have gradually emerged to comprise the main driving force behind the increasing demand for cosmetic surgery. Previous studies have found that sexism may motivate young people to undergo such surgeries. However, few studies have been conducted to determine if this psychological mechanism influences the acceptance of cosmetic surgery among Chinese university students. METHODS: A total of 579 Chinese university students (280 girls and 299 boys, 17-20 years) volunteered to participate in the online survey. They completed a questionnaire containing the Ambivalent Sexism Inventory, the 12-item General Health Questionnaire, the Gender-Role Attitudes Questionnaire and the Acceptance of Cosmetic Surgery Scale. We firstly evaluated the underlying factor structure of the Acceptance of Cosmetic Surgery Scale using exploratory and confirmatory factor analyses, and exploring pattern of associations between the constructs was analyzed via path analysis. RESULTS: According to the findings, hostile sexism was associated with greater levels of acceptance toward cosmetic surgery. Moreover, gender-role attitudes mediated the link between hostile sexism and the acceptance of cosmetic surgery, and this mediation was positively influenced by general mental health. CONCLUSION: Our study contributes to a deeper understanding of Chinese university students' attitudes toward cosmetic surgery, hostile sexism may contribute to normalizing traditional gender stereotypes and encourage cosmetic surgery acceptability among Chinese university students. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .