867
EDITORIAL Collective Shoulders of Women
“Behind every great man is a great woman.” [1] This has been adopted as a feminist slogan, but I would like to expand this. Behind every great field is a great woman, or at least a woman. Women have carried the weight of the world repeatedly, although often it is the man in front of her who is the figurehead seen. Now do not get me wrong. I am writing this editorial as editorial assistant of The Journal of Sexual Medicine ( JSM). In no way am I the editor of the JSM or involved in making content decisions, so in the case of your journal, I support the editor but definitely stand behind him. I am thinking of 7 years ago when we made the decision to move to San Diego. We had an opportunity to develop a first-ever multidisciplinary practice and a sexual medicine program at a private hospital. So, what was my role? I worked with the hospital vice president responsible for special projects. I worked with a practice management consultant to rent space, outfit it, hire a practice administrator, in other words, to open an office. But this was not just any office. It would have a sex therapist integrated as part of the practice from day 1. It would be 5 years before we brought a physical therapist under our roof. But 7 years ago, I can still remember feeling like the weight of the world was on my shoulders. It may sound odd, but, at the time, I felt like the future of sexual medicine was on my shoulders. The International Society for Sexual Medicine (ISSM), 10 years ago, had already successfully started the first society-owned journal in sexual medicine, and I knew that I was as integral to that success as every other person on the editorial team, but it was a team. This time, in San Diego, I was responsible for finding a space, business negotiations, signing contracts, hiring personnel, basically everything but providing medical care. I knew in my heart that if this practice was not successful, it might be a decade or more before someone had the courage to try this again in sexual medicine. So yes, I felt the weight of the sexual medicine world on my shoulders. We have since moved to a larger space, grown from four of us when we opened our doors to 14 at © 2014 International Society for Sexual Medicine
present. I continue to make business decisions, but fortunately, our practice administrator has long since been replace by a chief financial officer with business acumen, so we can work together, and I no longer worry about whether or not we will be successful. Preceptors train with us regularly to learn not only how to treat men and women with sexual health concerns but how to set up a similar multidisciplinary practice. Our dream has not only become a reality but is being emulated. But I do not want to write just about myself. Those of you who know me know I may brag about my children, but not about myself. Today, I want to write about other women who have also carried the incredible weight of the field of sexual medicine on their shoulders. Several women have carried this load that has been significant for the rest of us in sexual medicine. What is especially exciting for me is that not only do I know the women I cite in this editorial, but they are also good friends. Sharon Parish is an incredible woman. She helped put the International Society for the Study of Women’s Sexual Health (ISSWSH) on the map so to speak by expanding the educational programming of the society. Her commitment to balanced presentations, readable slides, quality speakers, and outreach has meant that education in women’s sexual health is available many times in a year through multiple outlets including ISSWSH, ISSM, National Association of Nurse Practitioners in Women’s Health, and Herman & Wallace Pelvic Rehabilitation Institute. Now, Sharon has stepped down to become the 12th president of ISSWSH. Sharon is the CME editor for your journal, a continuation of her passion for education, giving all of the readers an opportunity to learn from home and earn CME credits. She has cochaired education committees for the ISSM and has a leadership role at the International Consultation for Sexual Medicine. She combines knowledge of sexual medicine with knowledge of educational methodology. She is my counterpart as I am an educator who learned sexual medicine, and Sharon is a physician who learned about education. But J Sex Med 2014;11:867–868
868 Sharon is not your ordinary sexual medicine specialist. She is neither a urologist nor a gynecologist. She is an internist who has made it her business to teach hundreds if not thousands of providers how to properly elicit a sexual health history (who can forget her discussions of openended questions?). She can wax endlessly about the importance of as an internist or primary care physician getting this history. Sharon has focused her career on the importance of sexual health and the multiple providers needed to treat sexual health concerns. We all hope that Sharon’s continued commitment will result in more and more providers traversing the path of sexual medicine whether it be as a focused provider, a primary care physician no longer afraid to ask about sexual health, or an internist understanding the relevance of sexual health to overall health. However you look at it, she is a pioneer. When the early pioneers moved across the plains, whether they were the plains of Nebraska, the Negev, or Siberia, there were men and women traveling together. Although the man may have led the horses or sat behind the wheel, the woman was more often than not the planner, packer, and navigator. You may laugh at the idea of the woman navigating, but mark my words, we have a sense of direction, and it is an unfailing sense that always gets us to where we want and need to be. We are all pioneers traveling in our own forests or deserts or plains, but we do not travel alone. We have followers looking to us to lead them out of the abyss, in this case, their sexual dysfunctions. Currently, the only Food and Drug Administration (FDA)-approved medications for women in our field are for vaginal atrophy and dyspareunia. There is nothing yet for desire, arousal, or orgasm disorders. As I am writing this in January, and this is being published in April, I am hopeful that this is no longer a true statement. You have read from Irwin ad nauseum his distress at the disparity between men’s and women’s sexual health medications, so I will not mention it anymore. The person I want to laud is Cindy Whitehead. She and her husband started a company with a single goal—FDA approval of flibanserin. This company is spearheaded by Cindy. She is unstoppable. She is a woman so she understands women and the importance of an FDA approval. This is not a case of her wanting a return on her investment. This is a matter of breaking that glass ceiling opening the way for the myriad of other investigational products being studied for various sexual dysfunctions in women. J Sex Med 2014;11:867–868
Editorial Cindy wants to stand up and be counted, but she would never claim to be at the front of the line. Instead, she pushes and prods until every woman around her wants to stand up and be counted, fighting the fight for women everywhere. Many people know Cindy for the great dinners and receptions she has been responsible for over the years at our various society meetings, but let me tell you that is just the surface. Cindy knows that she cannot fail because that could mean the field being set back for an indeterminate number of years. Cindy knows she cannot fail because she does not give up. This is not a promotion of flibanserin—this is the case of a great woman behind a whole field because if Cindy can work her magic behind the scenes, raising awareness of both hypoactive sexual desire disorder and the rights of women, we might just open the doors for agencyapproved treatments for women everywhere. So now, let me get off my soapbox. There are women everywhere working in basic science laboratories, hospitals, clinics, and private practices as researchers, providers, therapists, and teachers, making a difference to their patients and their communities every day. The reality is that the weight of the sexual medicine world rests as squarely on their shoulders as on Cindy’s, Sharon’s, and mine. Some days they may feel that pressure and some days they may not, but without women like Annamaria Giraldi and Isbelia Segnini, without women like Lori Brotto and Alessandra Fisher, without women like Anita Clayton and Odile Buisson, where would our field be? These women may not dominate the board of the ISSM, but their work is not only important but necessary to our field for progress and continued success in learning more, treating more, doing more. So hats off to all the women working in our field, whether in academics, private practice, or industry. It is our collective women’s shoulders pushing the boulder uphill, and it is our collective strength that will send that boulder hurtling over the other side! Keep reading your JSM so you can keep up with the women surrounding you. Cite your journal, write, and review for your journal. You too can play a part in the progress of our field. Sue W. Goldstein, BA, IF, CCRC Editorial Assistant References 1 Martin G. The Phrase Finder. 1997. Available at: http:// www.phrases.org.uk/meanings/60500.html (accessed January 19, 2014).
EDITORIAL Collective Shoulders of Women
“Behind every great man is a great woman.” [1] This has been adopted as a feminist slogan, but I would like to expand this. Behind every great field is a great woman, or at least a woman. Women have carried the weight of the world repeatedly, although often it is the man in front of her who is the figurehead seen. Now do not get me wrong. I am writing this editorial as editorial assistant of The Journal of Sexual Medicine ( JSM). In no way am I the editor of the JSM or involved in making content decisions, so in the case of your journal, I support the editor but definitely stand behind him. I am thinking of 7 years ago when we made the decision to move to San Diego. We had an opportunity to develop a first-ever multidisciplinary practice and a sexual medicine program at a private hospital. So, what was my role? I worked with the hospital vice president responsible for special projects. I worked with a practice management consultant to rent space, outfit it, hire a practice administrator, in other words, to open an office. But this was not just any office. It would have a sex therapist integrated as part of the practice from day 1. It would be 5 years before we brought a physical therapist under our roof. But 7 years ago, I can still remember feeling like the weight of the world was on my shoulders. It may sound odd, but, at the time, I felt like the future of sexual medicine was on my shoulders. The International Society for Sexual Medicine (ISSM), 10 years ago, had already successfully started the first society-owned journal in sexual medicine, and I knew that I was as integral to that success as every other person on the editorial team, but it was a team. This time, in San Diego, I was responsible for finding a space, business negotiations, signing contracts, hiring personnel, basically everything but providing medical care. I knew in my heart that if this practice was not successful, it might be a decade or more before someone had the courage to try this again in sexual medicine. So yes, I felt the weight of the sexual medicine world on my shoulders. We have since moved to a larger space, grown from four of us when we opened our doors to 14 at © 2014 International Society for Sexual Medicine
present. I continue to make business decisions, but fortunately, our practice administrator has long since been replace by a chief financial officer with business acumen, so we can work together, and I no longer worry about whether or not we will be successful. Preceptors train with us regularly to learn not only how to treat men and women with sexual health concerns but how to set up a similar multidisciplinary practice. Our dream has not only become a reality but is being emulated. But I do not want to write just about myself. Those of you who know me know I may brag about my children, but not about myself. Today, I want to write about other women who have also carried the incredible weight of the field of sexual medicine on their shoulders. Several women have carried this load that has been significant for the rest of us in sexual medicine. What is especially exciting for me is that not only do I know the women I cite in this editorial, but they are also good friends. Sharon Parish is an incredible woman. She helped put the International Society for the Study of Women’s Sexual Health (ISSWSH) on the map so to speak by expanding the educational programming of the society. Her commitment to balanced presentations, readable slides, quality speakers, and outreach has meant that education in women’s sexual health is available many times in a year through multiple outlets including ISSWSH, ISSM, National Association of Nurse Practitioners in Women’s Health, and Herman & Wallace Pelvic Rehabilitation Institute. Now, Sharon has stepped down to become the 12th president of ISSWSH. Sharon is the CME editor for your journal, a continuation of her passion for education, giving all of the readers an opportunity to learn from home and earn CME credits. She has cochaired education committees for the ISSM and has a leadership role at the International Consultation for Sexual Medicine. She combines knowledge of sexual medicine with knowledge of educational methodology. She is my counterpart as I am an educator who learned sexual medicine, and Sharon is a physician who learned about education. But J Sex Med 2014;11:867–868
868 Sharon is not your ordinary sexual medicine specialist. She is neither a urologist nor a gynecologist. She is an internist who has made it her business to teach hundreds if not thousands of providers how to properly elicit a sexual health history (who can forget her discussions of openended questions?). She can wax endlessly about the importance of as an internist or primary care physician getting this history. Sharon has focused her career on the importance of sexual health and the multiple providers needed to treat sexual health concerns. We all hope that Sharon’s continued commitment will result in more and more providers traversing the path of sexual medicine whether it be as a focused provider, a primary care physician no longer afraid to ask about sexual health, or an internist understanding the relevance of sexual health to overall health. However you look at it, she is a pioneer. When the early pioneers moved across the plains, whether they were the plains of Nebraska, the Negev, or Siberia, there were men and women traveling together. Although the man may have led the horses or sat behind the wheel, the woman was more often than not the planner, packer, and navigator. You may laugh at the idea of the woman navigating, but mark my words, we have a sense of direction, and it is an unfailing sense that always gets us to where we want and need to be. We are all pioneers traveling in our own forests or deserts or plains, but we do not travel alone. We have followers looking to us to lead them out of the abyss, in this case, their sexual dysfunctions. Currently, the only Food and Drug Administration (FDA)-approved medications for women in our field are for vaginal atrophy and dyspareunia. There is nothing yet for desire, arousal, or orgasm disorders. As I am writing this in January, and this is being published in April, I am hopeful that this is no longer a true statement. You have read from Irwin ad nauseum his distress at the disparity between men’s and women’s sexual health medications, so I will not mention it anymore. The person I want to laud is Cindy Whitehead. She and her husband started a company with a single goal—FDA approval of flibanserin. This company is spearheaded by Cindy. She is unstoppable. She is a woman so she understands women and the importance of an FDA approval. This is not a case of her wanting a return on her investment. This is a matter of breaking that glass ceiling opening the way for the myriad of other investigational products being studied for various sexual dysfunctions in women. J Sex Med 2014;11:867–868
Editorial Cindy wants to stand up and be counted, but she would never claim to be at the front of the line. Instead, she pushes and prods until every woman around her wants to stand up and be counted, fighting the fight for women everywhere. Many people know Cindy for the great dinners and receptions she has been responsible for over the years at our various society meetings, but let me tell you that is just the surface. Cindy knows that she cannot fail because that could mean the field being set back for an indeterminate number of years. Cindy knows she cannot fail because she does not give up. This is not a promotion of flibanserin—this is the case of a great woman behind a whole field because if Cindy can work her magic behind the scenes, raising awareness of both hypoactive sexual desire disorder and the rights of women, we might just open the doors for agencyapproved treatments for women everywhere. So now, let me get off my soapbox. There are women everywhere working in basic science laboratories, hospitals, clinics, and private practices as researchers, providers, therapists, and teachers, making a difference to their patients and their communities every day. The reality is that the weight of the sexual medicine world rests as squarely on their shoulders as on Cindy’s, Sharon’s, and mine. Some days they may feel that pressure and some days they may not, but without women like Annamaria Giraldi and Isbelia Segnini, without women like Lori Brotto and Alessandra Fisher, without women like Anita Clayton and Odile Buisson, where would our field be? These women may not dominate the board of the ISSM, but their work is not only important but necessary to our field for progress and continued success in learning more, treating more, doing more. So hats off to all the women working in our field, whether in academics, private practice, or industry. It is our collective women’s shoulders pushing the boulder uphill, and it is our collective strength that will send that boulder hurtling over the other side! Keep reading your JSM so you can keep up with the women surrounding you. Cite your journal, write, and review for your journal. You too can play a part in the progress of our field. Sue W. Goldstein, BA, IF, CCRC Editorial Assistant References 1 Martin G. The Phrase Finder. 1997. Available at: http:// www.phrases.org.uk/meanings/60500.html (accessed January 19, 2014).
