History – The Foundation for Gender-Specific Medicine

How did The Foundation for Gender-Specific Medicine begin?

Founded in 1998 as a continuation of the Partnership for Gender-Specific Medicine at Columbia University, The Foundation for Gender-Specific Medicine, Inc (FGSM) is the first organization of its kind: it was established in response to the new interest in the direct investigation of women’s health that began in the early 1990s and which revealed that the differences between men and women were not only completely unexpected but more than had been even imagined they involved every organ in the body. As the first studies were published, it became apparent that men could not be considered normative for the entire human race, but that direct testing of both sexes was necessary for an accurate view of not only normal physiology but of sex-specific experience of the same diseases.

The science of gender-specific medicine emerged and continues to expand. Gender-specific medicine is not the study of women’s health; it is the study of ways in which biological sex and gender impact normal human function and the experience of the same diseases. It is as valuable for men as it is for women; often a difference prompts new investigation about why it exists and how such a difference impacts the risk, incidence and prevention of disability.

Our Mission

The Foundation for Gender-Specific Medicine supports the investigation of how biological sex and gender affect normal human function and the experience of disease. We aim to use the study of gender to foster the development of new sciences and improve healthcare for all patients.

Our Founder: Dr. Marianne Legato

As a traditionally trained molecular biologist, I was taught and I believed that men and women were alike in every way except for their reproductive systems; what we learned from research on men could be applied without separate confirmation/testing to women. I still can’t believe we made such a gigantic mistake.

My life changed one day when a talented medical journalist, Carol Colman, walked into my laboratory and said her mother had died of coronary artery disease—and that she believed it had been an unnecessary death because her mother’s treatment was based on a male model. She believed a woman’s experience of coronary artery disease might be different from that of a man.
-Dr. Marianne Legato

Carol Coleman, Medical Journalist had asked the American Heart Association for the names of 5 cardiologists who might help her investigate this revolutionary idea of a woman’s experience of coronary artery disease might be different from that of a man and four had turned her down. I was the youngest and last on the list. I was intrigued and agreed to help her.

We gathered together all the data we could find and published a book, The Female Heart: The Truth About Women and Coronary Artery Disease, which won the Blakeslsee Award from the American Heart Association for the best book on cardiology for the lay public published that year. It turned out that the diagnosis of coronary artery disease in women was missed and their symptoms often called hysterical or neurotic; one woman (and she was not an exception) was told by her physician that she should ask her husband to take her on a trip and “give her what she needed” – he predicted her symptoms would disappear. She had a major heart attack six weeks later.

My colleagues were initially adamant about entertaining the notion that CAD was any different in men and women; 60 minutes had asked a whole series of cardiologists nationwide to discuss the issue on live television and they all refused to do so. Again, I was definitely a minority of one, but agreed to be interviewed. That program started a flood of reports from ordinary women and their families about how they believed they had not been heard and their symptoms taken seriously. Not surprising: it turned out that the symptoms of a heart attack might be quite different for women than for a man: that nausea and shortness of breath might be the only signs of impending disaster rather than the typical crushing chest pain of which men usually complained. Even less surprising is that the treatment of women who had had heart attacks was less aggressive than that of women; women were thought to be more delicate and less likely to survive invasive strategies to preserve their cardiac function. In brief, women were misdiagnosed and undertreated. And a lack of appreciation of the gender specific nature of the experience of CAD was costing women their lives.

Here’s what followed:

One of the judges T George HARRIS that had reviewed our book for the Blakeslee Award asked me to tea; it turned out he was a consultant for Procter & Gamble on health issues and asked if I would like to be an advisor to that company on matters of women’s health.
1993-1997: In one of those amazing flashes of insight that change one’s life, I said to myself—and to him—that I had a better idea: that my university, Columbia, should form a Partnership with P&G to investigate, develop and promulgate specific products for women’s health.
That began two years of intense negotiations with P&G; my chairman Michael Weisfeldt believed my hypothesis that if the hearts of men and women were different in every respect, it was likely that all the other organs and systems of the body were gender-specific in function as well. Finally, at the end of two years of persuading both P&G’s PhD’s, administrators and my own faculty at Columbia, P&G gave us a four year grant to establish the Partnership for Women’s Health and we were off and running.
1997: My fortunes changed as the director of the new program when my chairman, Doctor Michael Weisfeldt, left Columbia to join the faculty at Johns Hopkins. The man who followed him had little use for the notion that the program or even the hypothesis that there were important differences between men and women. Knowing that there would be no active support for my program within the Department of Medicine at Columbia, I continued it as a private foundation.
1998- present: We are now in our 27th year of existence, with the satisfaction of having gender-specific medicine a firmly established world wide discipline. I was able to retain strong links with Doctor Weisfeldt at Johns Hopkins, and have been deeply involved for years with my colleagues there, Drs. Sabra Klein and Wendy Bennett, who are at the Bloomberg School of Public Health and head an NIH supported program.

The Department of Medicine at Columbia has agreed to harvest the $60,000 a year (the interest on a fund I established while I was there) to support a young fellow investigating some aspect of gender specific medicine, so we continue to collaborate with that group with significant grant support.