Defining the Difference

Physiological differences between the sexes create room for discrepancies in health. What one person has to endure, another may not.

Justin Terry-Smith grinded his teeth down on the cotton swab the doctor gave him. His best friend sat in the room with him for moral support.

The test would take about 20 minutes. Twenty minutes from the time the cotton swab left his mouth and went through tests, and then he would find out if he was HIV positive, a human immunodeficiency virus that interferes with the body’s ability to fight off diseases.

When the doctor came back and told Justin that he was, he burst into tears. He and his best friend left after the doctor talked him through what being HIV positive meant and went to the bar. It was happy hour and Justin needed a drink.

This was in 2006, and Justin has been HIV positive for about 11 years now.

According to the Centers for Disease Control and Prevention (CDC), 1.1 million people in the United States are HIV positive, and young gay and bisexual African American men are the most affected. However, women can also get the disease, especially since the vagina is more susceptible to bacteria and viruses.

When it comes to research on health trends and general health, gender is a prime factor in dissecting data. Biological differences in sexes help create a barrier in research to determine male-specific and female-specific diseases and behavioral differences.

Gender goes beyond research for health benefits, though. Birth control, condoms, taxation on pads and tampons, steroids, and muscle supplements are a few other factors in gender-differentiated health.

Gender and HIV Positive

In 2003, Justin came home from the military. He was 23 and in a serious relationship. However, that ended in a rough breakup shortly after he came home.

Justin says he doesn’t do well by himself, preferring to be in a relationship. As a result of being alone, he started dipping into drugs, like cocaine. Excessive drinking and going to bars and clubs almost every night became the norm. This led to intoxicated, unprotected sex with men he didn’t know.

A year after he came home, he started having symptoms.

Sixty-seven percent of those who are diagnosed with HIV are gay and bisexual men, according to the CDC.

Justin woke up one morning with cold sweats, his satin sheets clinging to him, and the need to rush to the bathroom to throw up. He threw up five times. That was when he decided to go to the doctor.  

According to the National Center for Biotechnology Information (NCBI), the biological and behavioral differences between men and women affect the manifestation, epidemiology, and pathophysiology of many different diseases and the health care techniques for those diseases.

The anatomy of a man and a woman is significantly different. According to a chart by the CDC, a woman’s anatomy can put her at a higher risk for an STI—sexually transmitted infections like Chlamydia and Herpes—compared to a man’s anatomy. However, when looking at HIV, which can be transmitted through unprotected sex or through blood transfusions and sharing unsterilized needles, men seem to be at higher risk.

Women are more likely to catch an STI because the moistness of the vagina is a good place for bacteria to grow. However, women are less likely to have common symptoms for STIs than men are.

In 2008, Justin started medication. He also started a blog and YouTube channel called “Justin’s HIV Journal” where he has been documenting his journey every step of the way. Justin searched online for someone in the same demographic he is—a black, gay male—who also had HIV. Justin says that in 2003, it wasn’t a trend to post online about one’s daily journey with a disease like it is today. He thought it was imperative that someone talk about it though, and he wanted to be someone that others in the same demographic could look up to.

Elizabeth Peeler, a health educator in Ball State’s Office of Health, Alcohol and Drug Education, says most STIs do not have symptoms and that is why the CDC recommends those who are sexually active to be tested at least once a year. She says that based on the most current epidemiological data, 1 in 2 sexually active young adults will get an STI by the age of 25.

Justin, now 33, has his Master’s in Public Health and is working on his Doctorate in Public Health. He says it makes sense for not as many women to be HIV positive, and also for women to be less concerned about contracting the disease.

He breaks it down like this: There is a difference between gay men and “men who have sex with men.” Gay men typically don’t have sex with women. He says “men who have sex with men,” or men in the closet, get tested less than openly-gay men might. They also might have a wife or girlfriend at home, and it’s extremely possible they transfer the disease to her by not being open about having sex with men as well. Therefore, they sometimes don’t think to get tested.

Gender and Hygiene

Adrianne Embry sat on her bed scrolling through her Facebook feed and came across another one of the educational, fact-filled videos that she tends to share. This particular one though, led her to feel a surge of pride.

The video was by ATTN: Video, a media/news page on Facebook, and had a tagline stating “Congrats, Florida for ending the tampon tax!” She watched the 49-second video and immediately hit the share button.

The so-called “tampon tax” is the statewide sales tax on feminine hygiene products such as pads and tampons. According to Politifact, there is not a specific “tampon tax” that is pointed directly at feminine hygiene products, but a large majority of U.S. states do not exempt the product from regular state sales tax.

Sales tax can get pricey—the average statewide sales tax is 6.25 percent, but in some cities like Chicago the sales tax can be as high as 10.25 percent.

Adrianne feels strongly about this topic—she believes that tampons and pads are a necessity and should be treated like food in the eyes of the government. They should not be taxed.

Her first thoughts on the video were: Go Florida. I can’t wait for this to hit Indiana.

She feels similarly about birth control. A pack of birth control pills at Planned Parenthood ranges from $19-$28 without insurance. Not only does birth control help with stopping pregnancies, it can also help monthly period cramps and balance out hormones so women can have a regular menstrual cycle.

Adrianne says she would like to experience not having her menstrual cycle. She wonders what it would be like to be a man who didn’t bleed every time their period kicked in—hers is completely irregular and happens randomly about every three months.

Unlike other forms of contraception, clinics give out condoms for free. On college campuses like Ball State University, condoms can be found at the health center. In Adrianne’s eyes though, condoms only help with men’s pleasure. They are only used for sex, whereas birth control can help with other things, some of which are involuntary.

According to Peeler, condoms are easier to distribute than birth control. Unlike birth control, condoms do not require a prescription and there are external and internal condoms available at most clinics. Also, under the Affordable Care Act, or Obamacare, birth control is covered for free by insurance.

But that doesn’t help 20-year-olds who don’t have health insurance like Adrianne.

Gender and Health Supplements

Andrew Cobb starts most of his days with a concoction of apple cider vinegar, water, and lemon juice. He then takes one probiotic and starts to make a healthy breakfast.

This has been his almost-constant routine, aside from his cheat days on the weekends, since the beginning of 2017.  

Last year, he noticed that he had gained some weight since getting married and having two children. In high school, gaining weight wasn’t a concern for him. He played football, basketball, and lifted weights almost every other day of the week. Now, at 37, with a family and a full-time job at FedEx, working out had become an afterthought. He wasn’t happy.

So he started looking into ways to combat this, in order to feel more comfortable with himself. Through his research, Andrew found that taking supplements was an option to help him lose weight when he wasn’t exercising.

Most of the time, men think they’re supposed to fit into a certain image of what a man should be. When they don’t, they might become unhappy with their appearance.

Andrew doesn’t see it as “the supplements are making him lose weight.” Instead, he views the supplements as something he may have been lacking in his body—vitamins that his body isn’t producing and protein that he doesn’t intake through his normal meals.

However, Peeler points out that health supplements are not regulated by the Food and Drug Administration (FDA).

For Andrew, getting in shape wasn’t a New Year’s Resolution. He had visited the doctor before the new year and they had told him his height and weight—he was 5’9’’ and weighed 260 pounds. Two weeks later when he weighed himself again at home, he was 263 pounds. He could feel himself getting bigger.

Andrew says he watched a bunch of videos online on how to get in the right mindset to lose weight. One video in particular told him that whatever he wanted to do, he had to write it down and do it.

So he did.

He told himself he had until he was 40 to be in the best shape of his life.

Andrew decided to take Garcinia Cambogia pills as well as change his diet and workout routine. This pill is allegedly able to cut weight down, even if a person isn’t actively working toward that goal. He pays close to $15 for a big bottle of the pills that he buys online through Amazon.

Although Andrew takes Garcinia Cambogia and has lost 37 pounds since starting his diet, a study by The Journal of the American Medical Association reported that Garcinia Cambogia failed to produce weight loss in the 135 randomized men and women who were tested over 12 weeks.

According to the Council for Responsible Nutrition, 67 percent of adults younger than 50 take dietary supplements.

At first, Andrew’s wife joined his diet. She attended the gym and worked out, ate healthier meals like he did, and took the special supplements and home remedy cleanses like the apple cider vinegar concoction Andrew was taking. After a couple months, though, she stopped. She now will only take the probiotics with him.  

Andrew found out about probiotics through a Facebook infomercial. It lasted about a minute, but he was convinced that probiotics were what he needed to “clean out his filter before it started shutting him down.”  

Andrew sets the treadmill at an incline of five at the gym. He’s recently just started getting up the courage to workout at a gym rather than at home. Mondays and Wednesdays are gym days, and once he gets his mile in on the treadmill, he puts in about a half hour of strength training. After his workout, he chugs a Corey Lee chocolate protein shake.

Andrew researches as much as he can about the health habits he is going to pick up. Most of the videos he watches feature men who are in “good” shape and who he would like his body to look like.