Sex in Medicine: A Q&A with Robin Brehm

Cecilia Galarraga is a new NY Writers Coalition workshop leader. She has just started leading the Imani House workshop at PS 282. For this week’s social justice discussion, Cecilia interviewed Robin Brehm, a medical student at SUNY Downstate, about gender equality in the medical field and the LGBTQ-specific programming of Sex in Medicine Week.

In February, my friend Robin Brehm was looking for papayas in every possible bodega. Though Robin does like a good papaya, these papayas were not for eating. Surprisingly, the papayas were part of an abortion workshop for medical students from SUNY Downstate, where students learned about abortion procedurs and then practiced them on the papayas. Finding the right sized fruit made Robin’s papaya hunt a tricky one.

Robin is a student in the dual MD/MPH program at SUNY Downstate, and this year she headed the organizing committee for Sex in Medicine Week, an umbrella event of which the abortion demonstration was a part. Though Sex and Medicine Week took place in February, I wanted to see what’s coming in the future. Here’s what Robin had to say.

What is Sex in Medicine Week? What’s the goal of the event?

Sex in Medicine Week is a week of workshops and lectures on topics not otherwise taught in medical school. The goal is to address disparities in care and education. It is coordinated by both medical students and masters in public health (MPH) students.

Why did you get involved with Sex in Medicine Week?

I got involved because I care a lot about activism and social justice in medicine. I don’t think we need to be content with the status quo, and I feel like we are ripe for change in medical school education.

Why do you think Sex in Medicine Week is important? What does it provide that medical school education does not?

Downstate is a liberal institution, which is one of the reasons that I decided to go there in the first place. They do a better job than most about addressing health disparities. We talk about how to be equitable in how you give care. We learn how to take a good sexual history and how to talk about sensitive subjects.

However, most medical schools and residencies don’t teach abortion. Though at Downstate we discuss how to talk to trans patients, we don’t learn about health issues specific to trans patients. We don’t learn about how sex might be different if a patient is in a wheelchair.  Even though we have a very diverse patient population, we do not receive training on how our patients’ cultural or religious backgrounds might affect how to work with them. At a basic level, there are questions or topics that might be offensive to members of one group but not to another. Sex in Medicine Week tries to give these topics the time that we think they really need.

I feel most strongly about addressing queer health issues and abortion. LGBTQ patients have worse health outcomes particularly in sexual and reproductive health. And how can we expect people to have access to abortion if we don’t teach doctors how to do it?

Tell me about this year’s discussion focusing on gender equality in medicine. What kind of stories emerged?

Going through my medical school education, a lot remains unsaid about this topic. It is the elephant in the room, not talked about. Things are better in terms of gender equality in medicine, and the stories we heard as part of this event showed that. We received stories from women in medicine in the 1960s, and there was a lot of misogyny. Things are better, but not equal.

I think that many men are really trying. They don’t want to be jerks, but misogyny is really ingrained. One of the most powerful stories was from a male medical student. He tells about training to do a pelvic exam and feeling mistrusted by the female students working alongside him. I think that judgment can operate in reverse so that men feel judged when they do have good intentions. Gender oppression has been around for so long, and I think it influences us in ways we don’t imagine.

What would you like Sex in Medicine Week to address in the future?

We would like it to be more interdisciplinary. Doctors should be learning this stuff, but so should nurses, physical therapists, midwives, on and on. There is no reason we shouldn’t all learn these things together. We would also like to have students from other schools participate.

Every year we do an abortion and contraception demonstration and a workshop on trans health, because we believe really strongly that these things should be covered. We would like to do more about rape and domestic violence. We have tried in the past to have someone come talk about sexual reassignment surgery. The topics really depend on the interests of the medical students and the organizers.

What would you recommend for medical students or other health professionals who want to do similar work? How should they get started?

Start small. The details of funding and space for a big event can be a lot of work, but you can always simply invite a speaker to come and talk about a topic that medical students don’t know much about.

Medical Students for Choice is a national organization that is a great resource. Those of us on the committee are also happy to be a resource. Our research has shown that students want this kind of information, and that their comfort level with these topics is lower than it should be. We would love to see it spread.

Keep an eye out for Sex in Medicine Week 2013. But in the meantime, check out more stories about how gender affects our lives in medicine and the allied health fields — and tell us your own in the comments!