report from Dr. Hava Bugajer, President WIZO Austria

The annual meeting of the Austrian Society for Gender Specific Medicine was held on 17 April 2015 in the premises of the Medical Association in Vienna. The main theme of this year’s meeting was “Sex and gender – in the past, present and future”. Professor Dr. Alexandra Kautzky-Willer, President of the Society, opened the meeting followed by greetings by Mag. Ines Stilling of the Ministry for Women’s Affairs and by Prof. Dr. Thomas Szekeres, President of the General Medical Council. Dr. Hava Bugajer, President of WIZO and a founding member of the society, pointed out that reproductive rights, free access to contraceptives and sexual education for boys and girls are still subject for discussions and conflicts at UN committees. Contraception yesterday, today and tomorrow was theme of the keynote lectures. Ass. Professor Dr. Harun Fajkovic from the Medical University Vienna (MUV) approached the subject from the point of view of men that should, he argued, in future be more included in family planning and contraception than up to now. 90% of responsibility for family planning is still left in the hands of women. In light of a rapidly growing world population (2,5 billion people in 1950 and a forecast of 9.1 billion for the year 2050), family planning is an essential subject when planning the future of mankind on our planet. Statistics shows that out of 1 million of reported pregnancies, 500,000 were not planned, 150,000 end in an interruption of the pregnancy and 500 end in the death of the woman. Various contraception methods were discussed, pointing out that using a condom, one of the oldest known methods, protect against HIV but not against HBV infection and in 4% of cases ends in an unwanted pregnancy. The contraceptive pill, which is in wide use since the 60s of the 20th century, also puts all responsibility in hands of women. The speaker considers vasectomy (sterilization of the men) as an effective method to include men in family planning in the future and to share risks between both partners. The sterilization of women, often in use, requires far more severe surgery than sterilization of men, a minimal surgical manipulation. The only disadvantage of these two surgical procedures is that they are not always reversible. Attempts to invent a pill for men, parallel to the contraceptive pill for women, has failed up to now. Since pregnancy and contraception all happen to women, and they are the ones who have to live with the consequences, their education and relation to their bodies is of great importance, says Prof. MMag. DDr. Barbara Maier of Hanusch Hospital, who spoke about contraception for women. Sexual autonomy and satisfaction are a major factor for wellbeing and satisfaction with one’s body. A future perspective is the separation between sexuality and reproduction. This process began with the invention of the contraceptive pill and will continue with the possibility to freeze egg cells. This method is not medically but socially indicated. It will remove from women the stress of “running out of time”. The final question asked was whether it will become a tool for further empowerment of women or cause them more stress by growing pressures in the workplace. Gender dysphoria is the terminology used for transsexuality, transgender and all other existing forms of sexual identity, reported Dr. Ulrike Kaufmann from the MUV. It refers to persons who do not feel well with the sexual identity assigned to their body, they do not feel happy “within” their body and behave “differently”. The result is gender non-conformity, people that show a different behavior than expected for their gender. Transitional forms, occurring occasionally during childhood and disappearing later, are not a subject for treatment. Sustainable forms must be treated before causing severe personality damage. Usually those persons are helped to reach the gender that they feel to belong to by hormone therapy and occasionally by surgery. The legal base for change of gender exists in most of countries. A life “in between sexes” is not accepted yet. PD Dr. Markus Margreiter from the MUV explained future surgery methods that might be helpful for sex change and Prof. Mag. Dr. Sabine Völkl-Kernstock from the MUV, about psychological aspects of gender inconformity in childhood and adolescence. The ratio between girls and boys observed for gender atypical behavior is 4:1 (4 times more girls), although there is gender equality 1:1 in occurrence of real gender inconformity in behavior. The assumption is that gender atypical behavior of boys is more accepted. Gender related sexual disturbances in diabetes, coronary heart disease, oncology and psychiatric disease were subjects of further reports. An animation film to support sexual education in high schools was the subject of a panel discussion chaired by Prof. Dr. Beate Wimmer-Puchinger. The importance of sexual education for young boys and girls was pointed out. Questions arising at approaching adolescence, informing about the needs and how to respect the partner of the other sex while also making them aware of one’s own needs were handled in this animation. It also initiated tolerance and respect by showing other forms of sexuality, like homosexuality. It was pointed out in the discussion that sexual education should be longitudinal, beginning at earlier age and advancing step by step to point out problems arising at later age. Education should also include discussion of contraception, age adjusted. This education will support young persons in their desire to achieve a satisfactory sexual life for themselves and their partners.

This vivid discussion closed the conference.