Sex, Space and Environmental Adaptation: A National Workshop on Research Priorities on Sex Differences in Human Responses to Challenging Environments

In April 2001, the Institute of Medicine published a landmark document entitled, ìExploring the Biological Contributions to Human Health, Does Sex Matter?î This report charted the current state of knowledge on the impact on sex and gender on health and disease outcomes in women and men. Additionally, it outlined opportunities for future research, which would explore how disease processes and health are often impacted by sex and gender. The message was clear, namely, that sex and gender do matter to our understanding of diseases related to nearly every major organ system.

With the dawn of the new millennium, the scientific community has completed a tremendous feat in the cloning of the human genome. With this wealth of information, however, there remains yet only limited understanding regarding how many of these genes may be differentially regulated in males and females. Understanding sex differences in gene regulation is critical to our ability to ultimately translate this information for the improvement of the health and quality of life for men and women everywhere.

The existing critical gaps in our basic understanding of sex differences in human health and disease create not only concerns regarding the status of our medical research and health care but also mark a more general social shortcoming in our nation. From the microcosm of space, sex-based differences also have a significant impact on our national mission of space exploration. Women now represent a significant percentage of National Aeronautics and Space Administrationís (NASAís) astronaut corps and will play an important role in the International Space Station program, and in other space exploration activities this century, perhaps even missions to Mars. We currently have little, if any, data relating to long-term health, safety and performance of women in space.

Without a concentrated, integrated focus on the impact of sex on fundamental biology and biomedical science, our nation will remain unable to fulfill fundamental health care goals, maintain an efficient workforce, or meet the demands of harsh environments encountered in space exploration, military deployment or other specialized endeavors of our society.

In order to certify that men and women can live in space, NASA needs to know the physiological changes that occur during space travel. NASA pioneered bedrest studies utilizing healthy humans. Thus far, flying men and women in space has not revealed gender response differences that cause major health concerns. However with longer duration stays in space, it is increasingly important for NASA to be armed with the knowledge needed to ensure the health and safety of all male and female astronauts.

The application of sex based similarities and differences in healthy people are not restricted to space. Nor are these differences inconsequential. Sex-based biomedicine is important to exposures and occupations as extreme as the Antarctic, high altitude, deep sea, and to communities as diverse as the military, international aid workers, emergency and rescue workers, the elderly and children.