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“When women are in charge of research teams, the teams publish more often on the topic of gender differences”

Prof. Dr. Gertraud (Turu) Stadler

Prof. Dr. Gertraud (Turu) Stadler
Image Credit: Bert Queiros

Prof. Gertraud (Turu) Stadler holds the professorship for gender-sensitive prevention research at Charité – Universitätsmedizin, where she is in charge of the Gender Research in Medicine unit. We caught up with her to talk about her research and her goals in the areas of equal rights, participation, and equal opportunity. 

Professor Stadler, can you tell us a little about your field, gender-sensitive prevention research? 

Prevention research is my main topic. I study how we stay as healthy as possible and prevent chronic disease and health conditions. The earlier in life we start to support healthy behaviors and environments, the more healthy life years we can gain. For example, our team of researchers is active at over 30 schools in Berlin, where we do gender-sensitive smoking prevention with students of all genders. Kids can gain up to ten healthy life years by staying smoke-free, and our goal with the program is to help with that. The idea is to reach boys, girls, and nonbinary kids alike. And that requires personalized measures tailored to different needs. 

Why are these kinds of personalized approaches important? 

When it comes to health behavior, there are big and observable gender differences. Some boys and men think it’s not masculine to eat a salad or vegetables. Images of toxic masculinity like the cool “Marlboro Man” are still really prevalent in people’s minds. Women are much more likely to be diagnosed with depression and anxiety, but suicide is three times more common in men. Men are also more likely to be overweight and less likely to keep up with routine health screenings. Men die an average of five years earlier than women – not because that’s just their fate, but because there are gender differences in health behavior and living conditions. On the flip side, women face health disadvantages when it comes to things like treating a heart attack. Diagnosis and care are geared toward the average patient, who is older and male. Women have different symptoms, and the event takes a different course. We need to take factors like that better into account in medical research and healthcare. 

How do your findings make their way into medical practice to establish sensitivity to gender and diversity in healthcare? 

Research on these topics is still in its infancy in both Germany and Europe as a whole. This is a cross-cutting subject that can’t be dealt with just by specialized institutions and initiatives working in isolation. We need contributions from everyone who studies health. The best way to do that is by systematically considering gender and diversity across all our studies. That’s already how it’s done in Canada, for example. For all projects that receive public funding, the findings are listed separately by gender in the final report. That makes it easy to see where there are differences – and where there aren’t. If we want to offer personalized medicine, we need better data. That’s also why at Charité, we’re also studying how to actually measure and gather data on diversity and developing methods of analyzing large volumes of data effectively. And finally, we’re working on incorporating what we already know into teaching as well, across a full range of disciplines. 

What other factors should we consider aside from gender when we think about diversity in medicine? 

We had that same question in the Berlin University Alliance, so right at the start, we carried out a joint project with over 50 experts from Berlin and international areas. One traditional factor is age, which is routinely recorded in medicine and healthcare research. But that’s also as far as it goes. There are so many other important parameters, like social situation, meaning a person’s education, finances, and material resources. We know that these social factors have a really big impact on health, but there have hardly been any systematic surveys. And then you have comorbidities – meaning coexisting mental and physical illnesses and conditions – and other health limitations and disabilities. Often, not enough information is collected about those, either. Care work is another factor, for example when women don’t engage with rehab because they have small children or other family members to take care of. Sexual orientation, ethnicity, religion, and beliefs are also important diversity domains that haven’t received much attention so far. All of this affects how you provide someone with appropriate medical care, whether a medication works well, and whether important information reaches the patient. At the end of our project, we put together what we call the minimum set of diversity items (DiMIS, for the German name “DiversitätsMinimalItemSatz”), which is a suggested minimal questionnaire on gender and diversity, so future studies can take these aspects systematically into account. 

You’re not only a professor at Charité, but also a member of the steering committee on the cross-cutting topic of diversity and gender equality at the BUA. What are the concrete goals of your work in this role? 

The committee is made up of members from all four BUA partners. There are researchers working in the field of diversity and gender studies and also the central equal opportunity officers, who are highly familiar with practical measures to increase equality of opportunity. We maintain excellent and productive dialogue, and within the network of excellence, we advance both research on these topics and the conditions in the integrated research space so that everyone can explore and develop their talents to the fullest. One example is that when women are in charge of research teams, the teams publish more often on the topic of gender differences. The composition of teams of researchers plays a role in what questions are studied. People with lived experiences of marginalization are more sensitive to these topics. 

How far along are we in Berlin toward the goal of equal opportunity in research? 

Female students have made up about 50 percent of all medical students in Berlin since the 1990s. About 40 percent of the city’s population has an immigrant background. Berlin is diverse and multicultural. You might say the whole world is right at home here. But the people who could directly embody important topics like global health and diversity right here are still underrepresented in our institutions. We know from international data that we have a “leaky pipeline” in science and the research sector, meaning that a lot of talent gets lost along the way between the different levels of the hierarchy. Talented members of underrepresented groups have a harder time reaching positions of leadership.  

What kinds of talent and potential is the research sector losing as a result? 

We can learn from the experiences these people bring with them. That includes things like how the health systems work in other countries. One good example is Kerala, in the south of India. Life expectancy there is similar to that in highly industrialized countries, but they don’t have the same high-performance medical capabilities. Thinking in terms of reverse innovation, our healthcare sector could benefit from some of the well-functioning and less capital-intensive solutions developed there. We can also learn a lot from researchers who come from countries with a lot of pandemic experience. The BUA can initiate important developments and provide impetus for tapping into these forms of potential. For our third grand challenge, for example, we introduced the idea that applications for research funding should prompt people to consider whether gender and diversity are factors in the research questions. That often goes overlooked otherwise. Our mentoring program for women on their way to a professorship – ProFil – now also includes an English-language line so we can also reach and support those who don’t come from German-speaking countries. Excellence in research is international, and we need to better equip ourselves to advance that internationalization.