DiversityNursing Blog

By Carina Storrs

CNN 

Jenner's story, and others', is indeed bringing gender transitioning, which can involve surgery, hormonal therapy and behavioral changes, into the mainstream. "There's certainly a growing acceptance of gender diversity and understanding of how important [affirming internal gender] is," said Dr. Timothy Cavanaugh, medical director of the Transgender Health Program at Fenway Health.

It is estimated that one in 10,000 people who are born male feel their true identify is female or have a strong desire to be female. There are approximately 100 to 500 genital surgeries every year in the United States as part of gender transition, according to the Encyclopedia of Surgery. But that number could be growing. 

In the older generation, the demographic to which Jenner belongs, "I think many people thought their only option was to hide their internal gender or repress it [because] there wasn't a lot of social support or acceptance," Cavanaugh said. "With growing awareness, people in their 40s, 50s and up are coming to a place where they can do something about it," he added. 

But what does it mean to have gender transition procedures, particularly hormonal therapies and invasive genital and facial surgeries, for this older group, compared with transgender people in their 20s and 30s (which Cavanaugh says is the other common demographic)? Are there health concerns, or benefits, with undergoing physical changes later in life? 

Many transgender people take lifelong hormone therapy, and for transwomen (transitioning from male to female) hormones are estrogens and anti-androgens that block their body's testosterone. Jenner reported undergoing hormone therapy, along with a 10-hour facial feminization surgery and breast augmentation. The Olympic gold medalist and former husband of Kris Kardashian said she has not had genital surgery and it's unclear whether she will.

However, as people age, their bodies become less responsive to hormones, and estrogen's effects. Primarily, breast development and weight redistribution will probably be less dramatic in older transwomen compared with younger, Cavanaugh said. At the same time, doctors tend to prescribe a lower dose of estrogen in older women because of concerns of blood clots, and consequent heart attacks and strokes. 

"It may mean that it takes a little longer, that the feminization is not as vigorous, or the effects may not be as satisfactory in older transwomen," Cavanaugh said. However, physical changes do still occur, and they have clear psychological benefits for these women. (In transmen, or people transitioning from female to male, testosterone therapy is generally viewed as safer than estrogen and more effective, Cavanaugh added.)

Facial surgery can be part of gender transitioning for transwomen who have manly features, such as sagging brows that develop with age, said Dr. David Alessi, facial plastic surgeon and owner and director of the Alessi Institute in Beverly Hills, California. (He added that transwomen who have effeminate faces may not need surgery.)

It is possible to make the face look younger and more feminine at the same time, Alessi said. For example, lifting the brow makes it less saggy and removes wrinkles. But there are limits. "I can make a 60-year-old male look like a 50-year-old woman, but not like a 20-year-old girl," he said. 

The more difficult surgery, for all ages, is genital, and older transgender people have special challenges, Alessi said. In particular, surgeons create a vagina, typically using tissue from the penis. However, that tissue may die in its new location if it does not have good circulation, as is more common in older people, and the surgery would have to be repeated to graft tissue from the colon or mouth, Alessi said. "The goal is to do the genital surgery in one surgery, but more likely it takes two or three surgeries, and that is more likely in older patients," he said. 

There are also general problems with any surgery in people in their 60s and 70s. "Often they develop chronic medical conditions, such as high blood pressure and cardiovascular disease, that makes surgery a little bit more risky" because it could exacerbate these conditions, Cavanaugh said

Gender transitioning does not always involve hormone therapy and surgery, however. Among people in their 20s and 30s, who may have more access to information online and to support groups, "we see a number of younger patients who say, 'I just need my identity affirmed,'" Cavanaugh said. They can sometimes achieve this goal through dress and social behavior and finding groups of like-minded people. 

"[Yet] there are always going to be people who really feel a disconnect between internal gender and anatomy, especially when interacting with the world, that it makes more sense and is really beneficial for them to masculinize or feminize the body," Cavanaugh said.

Halle Tecco

Source: http://rockhealth.com 

Exactly a year ago, we decided to publish the gender data on founders at Rock Health. Despite women being the majority of our team and our board, only 30% of our portfolio companies had a female founder (today, we are at almost 34%). Because we’d like to help our portfolio companies access a diverse talent pool, we began the XX in Health initiative nearly four years ago.

The aim of this initiative is to bring women together to network and support one another. The 2,400 members of the group share resources and ideas on LinkedIn and meet regularly across the country. This week we’re hosting a webinar on the topic for both men and women, and next week we’ll host our sixth XX in Health Retreat in NYC.

Today, through this initiative, we are proud to share our third annual report on the state of women in healthcare. Our past reports on this topic have been some of our most popular content, and we encourage you to share this report with your colleagues.

Women are still underrepresented in leadership positions in healthcare.

Despite making up more than half the healthcare workforce, women represent only 21% of executives and 21% of board members at Fortune 500 healthcare companies. Of the 125 women who carry an executive title, only five serve in operating roles as COO or President. And there’s only one woman CEOof a Fortune 500 healthcare company.

Hospital diversity fares slightly better. At Thomson Reuters 100 Top Hospitals, women make up 27% of hospital boards, and 34% of leadership teams. There are 97 women that carry a C-level title at these hospitals and 10 women serve as hospital CEO.

We know from our funding data that women make up only 6% of digital health CEOs funded in the last four years. When we looked at the gender breakdown of the 148 VC firms investing in digital health, we understood why. Women make up only 10% of partners, those responsible for making final investment decisions. In fact, 75 of those firms have ZERO women partners (including Highland Capital, Third Rock, Sequoia, Shasta Ventures). Venture firms with women investment partners are 3X more likely to investin companies with women CEOs. It’s no wonder women CEOs aren’t getting funded.

The problem is real, and the problem matters.

We surveyed over 400 women in the industry to better understand the sentiment around gender discrimination. 96% of the women we surveyed believe gender discrimination still exists. And almost half of them cited gender as one of the biggest hurdles they’ve faced professionally.

Often these are micro-inequities that compound over one’s career. MIT Professor Mary Rowe describes these instances as “apparently small events which are often ephemeral and hard-to-prove, events which are covert, often unintentional, frequently unrecognized by the perpetrator.” But they create work environments which hold women back.

When senior women are scarce in an organization, a vicious cycle of  “second-generation” gender bias kicks in. Researchers describe this bias as barriers that “arise from cultural assumptions and organizational structures, practices, and patterns of interaction that [put] women at a disadvantage.” Fewer women leaders means fewer role models for would-be women leaders. On the flip side, when women who are early in their career see more women in senior leadership positions, it sends the message that they too belong in the C-suite.

The good news is that achieving diverse leadership teams is not just a moral imperative, it’s good for business too.

Having a diverse team creates a positive, virtuous cycle. Companies with women CEOs outperform the stock market, and companies with women on their boards outperform male-only boards by 26 percent. Researchers even estimate that transitioning from a single-gender office to an office evenly split between men and women be associated with a revenue gain of 41%.

Not only do companies with more women in leadership yield better economic returns, recent research also suggests it helps mitigate risk. One study shows that each additional female director reduces the number of a company’s attempted takeover bids by 7.6%. Another study indicates that companies with more women on their board had fewer instances of governance-related scandals such as bribery, corruption, fraud, and shareholder battles.

Let’s get together and support one another.

Empower your colleagues to promote gender equality in the workplace. This month we challenge you to reach out to that mentor, manager, peer, or mentee with whom you’ve been meaning to connect with. Ask her to grab coffee and send us a picture by April 30 so we can share it on the XX in Health website!

Source: www.trocaire.edu/trailblazer-blog

Historically, both men and women have filled the challenging and rewarding role of a nurse. It wasn’t until the Civil War, when nearly 3 million men filled the ranks of two competing American armed forces, that women began to dominate the field.

Today, over 43 million Americans are aged 65 or older – a number that is expected to double over the next 35 years. A larger elderly population means a greater need for long-term health services, and as a result, the healthcare field is one of the fastest-growing industries.

Why does this matter?

 1. The U.S. is already on the verge of a nursing shortage. 

The American Association of Colleges of Nursing reports that the U.S. is experiencing a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows.

Did you know only 7 percent of nurses are currently men?   According to the latest National Sample Survey of Registered Nurses conducted by the Health Resources and Services Administration, the percentage of male nurses has more than doubled in the past three decades, but still lingers at 7% today. This number is expected to triple within the next few decades as the need for both male and female healthcare professionals continues to grow.

2. A diverse population needs a diverse nursing staff. 

According to the American Association of Colleges of Nursing (AACN), men are enrolling in nursing programs at a higher rate compared to the past. The IOM report states that there still need to be an emphasis on gender diversification and inclusion in the workforce.

The IOM Report also states that the nursing profession “needs to continue efforts to recruit men; their unique perspectives and skills are important to the profession and will help contribute additional diversity in the workforce.”  The increase in men pursuing a nursing career will help create a more diverse healthcare environment. 

3. Discrimination issues must be overcome.

The idea that men cannot be nurses will never be eradicated until men take to the profession in greater numbers. While nursing is seen as a nontraditional career for men today, the stereotype must change -- nursing is simply too important of a job, and too attractive of a career.

“There are just far too many benefits that come along with nursing, such as a flexible schedule, a secure position, and high pay,” notes the website NursingWithoutBorders.org, “and so it’s therefore difficult for anyone to refuse to pursue a field that only continues to grow.”

Written by David McNamee

Male registered nurses are earning more than female registered nurses across settings, specialties and positions, and this pay gap has not narrowed over time, says a new analysis of salary trends published in JAMA.

Although the salary gap between men and women has narrowed in many occupations since the introduction of the Equal Pay Act 50 years ago, say the study authors, pay inequality persists in medicine and nursing.

Previous studies have found that male registered nurses (RNs) have higher salaries than female registered RNs. In their new study, researchers from the University of California, San Francisco, sought to investigate what employment factors could explain these salary differences using recent data.

The researchers analyzed nationally representative data from the last six quadrennial National Sample Survey of Registered Nurses studies (1988-2008; including 87,903 RNs) and data from the American Community Survey (2001-13; including 205,825 RNs). In both studies, the proportion of men in the sample was 7%.

During every year, both of the studies demonstrated that salaries for male RNs were higher than the salaries of female RNs. What is more, the researchers found no significant changes in this pay gap - which averaged as an overall adjusted earnings difference of $5,148 - over the study period.

In ambulatory care the salary gap was $7,678 and in hospital settings it was $3,873. The smallest pay gap was found in chronic care ($3,792) and the largest was in cardiology ($6,034). The only specialty in which no significant pay gap between men and women RNs was detected was orthopedics. The salary difference was also found to extend across the range of positions, including roles such as middle management and nurse anesthetists.

Employers and physicians 'need to examine pay structures'

"The roles of RNs are expanding with implementation of the Affordable Care Act and emphasis on team-based care delivery," the authors write. 

They conclude:

"A salary gap by gender is especially important in nursing because this profession is the largest in health care and is predominantly female, affecting approximately 2.5 million women. These results may motivate nurse employers, including physicians, to examine their pay structures and act to eliminate inequities."

The results of a 2010 survey looking at the impact of the economic crisis on nursing salaries published in Nursing Management found that a nurse leader's average salary fell by $4,000 between 2007 and 2010. In the same survey, almost 60% of nurse leaders felt that they were not receiving appropriate compensation for their level of organizational responsibility.

However, that survey found no evidence that workload for nurse leaders had increased. The respondents reported that they were still working the same number of hours per week as they had traditionally and were not responsible for more staff members than before the economic crisis.

"If you thought nursing was immune to the downturn, think again. The poor economy is keeping us working longer than we'd anticipated," said Nursing Management editor-in-chief Richard Hader, "and in addition to wage cuts, organizations are freezing or eliminating retirement benefits, further negatively impacting employee morale."

Source: www.medicalnewstoday.com

By JOANN S. LUBLIN

Is there such a thing as a diversity dividend?

A new study of 366 public companies in the U.S., Canada, U.K., Brazil, Mexico and Chile by McKinsey & Co., a major management consultancy, found a statistically significant relationship between companies with women and minorities in their upper ranks and better financial performance as measured by earnings before interest and tax, or EBIT.

The findings could further fuel employers’ efforts to increase the ranks of women and people of color for executive suites and boardrooms — an issue where some progress is being made, albeit slowly.

McKinsey researchers examined the gender, ethnic and racial makeup of top management teams and boards for large concerns across a range of industries as of 2014.  Then, they analyzed the firms’ average earnings before interest and taxes between 2010 and 2013. They collected but didn’t analyze other financial measures such as return on equity.

Businesses with the most gender diverse leadership were 15% more likely to report financial returns above their national industry median, the study showed. An even more striking link turned up at concerns with extensive ethnic diversity. Those best performers were 35% more likely to have financial returns that outpace their industry, according to the analysis. The report did not disclose specific companies.

Highly diverse companies appear to excel financially due to their talent recruitment efforts, strong customer orientation, increased employee satisfaction and improved decision making, the report said.  Those possible factors emerged from prior McKinsey research about diversity.

McKinsey cited “measurable progress” among U.S. companies, where women now represent about 16% of executive teams — compared with 12% for U.K. ones and 6% for Brazilian ones.  But American businesses don’t see a financial payoff from gender diversity “until women constitute at least 22% of a senior executive team,’’ the study noted.  (McKinsey tracked 186 U.S. and Canadian firms.)

The study marks the first time “that the impact of ethnic and gender diversity on financial performance has been looked at for an international sample of companies,’’ said Vivian Hunt, a co-author, in an interview.  Yet “no company is a high performer on both ethnic diversity and on gender,’’ she reported.

And “very few U.S. companies yet have a systematic approach to diversity that is able to consistently achieve a diverse global talent pool,” Ms. Hunt added.

McKinsey has long tracked workplace diversity. A 2007 study, for instance, uncovered a positive relationship between corporate performance and the elevated presence of working women in European countries such as the U.K., France and Germany.

Source: http://blogs.wsj.com

By: Darnell Lattal 

We’ve all heard it preached — in our corporations and beyond — how we should do the right things in the right way and for the right reasons. Even so, it’s often easier, faster and seems more profitable to take actions that fall in a somewhat gray area — what we’ll call a slippery slope.

Here’s what that could look like in an organizational setting: approving products before quality checks, production rate trumping safe practices, questionable sales made for goods not available, creative accounting to justify mergers, suppressing reporting errors, and the many other small ways we individually fail to keep promises or look away when our gut tells us something is amiss.

If one were to break it down by gender, there is no evidence that women are more likely to behave more ethically than men. But gender research does report more verbal sensitivity to the rights and dignity of others among women when compared to men. For instance, women overwhelmingly report that they would not work for a company that will do anything to win. Still, refusal to select such a workplace doesn’t mean that women in the workplace will behave more ethically than men. What people say they will do has very little predictive validity compared to what they actually do.

Nevertheless, gender is an untapped resource in setting the conditions to behave ethically. Consider the oft-cited stereotype that women are known for their inclination as caregivers and men for their conditioning to reach the end goal. Both are important. Caring is of little value if the corporation fails, and end goals are meaningless if people and the public good are harmed. But if each were to bring their strengths to the table when addressing ethical concerns and help keep each other accountable to do the right thing, we might not read about ethical lapses in the news as often.

So, who is in charge of the organizational ethical compass? The ultimate responsibility rests on the shoulders of those who lead, and diversity executives can help leaders to create an ethical workplace culture by starting with the following steps:

• Encourage leaders to surround themselves with men and women who are committed to supporting ethical actions.

• Make sure there’s a set of values that leaders and employees can look to when facing ethical dilemmas. Craft a sophisticated plan of action to ensure ethics is part of everything from sales meetings to production report to community involvement. Translate values into the varied observable actions that represent those values.

• Provide a forum in which errors and near-misses are reported without negative consequences, but are part of the healthy ethical framework the company is striving to create.

• Examine the consequences for saying and doing the wrong thing — subtle and unintended, overt and intended. Leaders must examine themselves and seek evaluative support from others about what they do that’s trending toward or away from what others deem ethical.

• Arrange practices, processes and incentives of the workplace to shape and maintain ethical decisions from the boardroom to the shop floor.

• Leaders should be open to critique of business strategies and tactics — in some instances it’s acknowledging that the worker in the boiler room may know better than leaders about what is really going on that is ethical or not.

• Encourage use of a scorecard of ethical elements to evaluate how well leaders and employees are doing, jot down what “slippery slopes” they faced and how they might better respond to it going forward.

• Share learning in an active way. Review short-term effects against uncertain but possible longer-term effects. Calibrate and change course where needed.

Source: Diversity Executive 

Are women more ethical than men? What do you think? Let us know with your comments below.

The Nontraditional Career Resource Center encourages students to look beyond gender when choosing a career.

At a middle school in Brick Township, N.J., two eighth-graders developed a presentation that expressed the joys and hardships of their lives in immigrant families. At a high school in Marlboro, N.J., a young woman started a project to help kids in India whose parents are incarcerated. And at a school in Bergen County, N.J., a student started an intramural club for classmates who weren’t on any sports teams.  

Three projects. Three distinct visions of compassion and social justice. One common source: the Nontraditional Career Resource Center at Rutgers University.

The center, a state-funded program and part of the School of Management and Labor Relations, worked directly with those students, and others, to help them develop social-action projects.

Located in the Center for Women and Work, the NCRC’s principal mission is to raise awareness about career paths that are considered nontraditional—those jobs in which one gender comprises 25 percent of the workforce or less. The center employs a range of outreach efforts—guest speakers, workshops, partnerships with employers and educators, and programs for students in grades 7 through 12—that allows it to reach many different audiences.

“What we want people to understand is that at the heart of it all, choosing a career should not be based on your gender,” said Glenda Gracia-Rivera, associate director. “Girls may not be encouraged to go into the sciences or building trades because those are defined as male jobs. Boys may not be encouraged to become nurses or teachers because they are not considered nurturing enough.”

One of the center’s hallmark programs, the Career Summer Institute, began July 11 and brings 90 high-school students to Cook Campus at Rutgers for an intensive, one-week residential program that will focus on how to go about choosing a career. Students will learn about various careers, participate in workshops, and receive leadership training, all geared to developing their decision-making abilities. And like their predecessors, they’ll be encouraged to develop social-action projects so they can take the values they learn during the week back to their communities. The projects, which are called Step Up!, aim at addressing inequities in the students’ schools or towns.

“The kids come out super energized,” Gracia-Rivera said. “So we help them come up with an issue. We tell them, ‘you don’t have to change the world, you just have to address something at the local level.”’

Indra Murti, who attended the institute two years ago and is now a Rutgers undergraduate student, came up with a project that went far beyond the local level. During a visit to India in the summer of 2008, she became aware of a residential school for children of parents in jail or deceased. After visiting and volunteering at the school, Murti said she was moved to do more for the kids, who are supported entirely by the nuns who run the school.

Returning to Marlboro High School, she formed a student club devoted to maintaining a relationship with the school in India. The American students and the Indian students became pen pals.

“When I saw the kids (in India), and I felt their enthusiasm, it made me really want to help them,” Murti said.

Two eighth-graders in Brick Township, meanwhile, who attended the center’s program for younger students, The Academy of Leadership and Equity, came up with an idea that inspired everyone in their school. The students, one of Indian descent and the other of Mexican origin, worked with their ESL teacher, Theresa Ryan-Botello, to develop an oral presentation that expressed their hopes and fears as immigrants in America.

“They felt they were misunderstood by teachers,” Ryan-Botello said. “So our approach was: ‘Instead of complaining, let’s do something positive.’”

The presentation, “Many Worlds into One World,” told of the students’ ethnic background, examined the demographic changes in the middle school, and offered gentle tips on how to foster respect and greater communication within the school.

“They spoke from their heart, and that was really touching,” Ryan-Botello said. “Many of the teachers were in tears.”
 
All told, 10 students attending programs at the NCRC completed social-action projects, prompting the center’s staff to hold an awards dinner for the kids and their families last spring at the Labor Education Center. The students received certificates and other prizes.  

“Here are young people doing amazing things,” Gracia-Rivera said. “I felt like they needed to be honored and recognized for their efforts.”

Reprinted from Rutgers Today – RutgersToday.rutgers.edu.