Why sex really matters | David Page | TEDxBeaconStreet

Why sex really matters | David Page | TEDxBeaconStreet


Translator: Jenny Lam-Chowdhury
Reviewer: Capa Girl I would like to talk with you
about sex and disease, but perhaps not what you’re thinking. So, now that I’ve gotten your attention, I’d like to tell you about
something that’s really fundamental. I’d like to tell you about
a connection between sex and disease that is very critical, but a connection between
sex and disease that has gone largely
unnoticed and unexplored even in within the scientific community. So, to get things under way, let me open with three observations that I think you may find
a little surprising and startling. First of all,
human genome, we have a problem. Second,
men and women are not equal. A pause there — And third,
that the study of disease is flawed. So, let’s explore each
of these in turn. Across the course of time, scientists, no matter
how brilliant they are, have gotten things wrong
in a big way. For a long time,
we thought that the Earth was flat, and we thought that
the sun revolved around the Earth. Well, in this time of
the human genome revolution, it turns out that we’re missing something that is of critical importance. And to understand
what’s that all about, I need to ask you to return
with me to the beginning where each of us began. So, here it is, the moment of conception,
egg meets sperm! All the cells of your body — your lung cells, your liver cells,
your skin cells, all the cells of your body ultimately derived
from this one founding cell, the fertilized egg. So, the fertilized egg divides
to become two cells, those two divide to become four,
and eight, and so on — until your entire body consisting of — on the order of 10 trillion cells
has been assembled, and what is most amazing
is that within the nucleus of each of those 10 trillion cells
that make up your body, within each of those cells, you carry the same
23 pairs of chromosomes. And those 23 pairs of chromosomes, carry all of the DNA, all of the hereditary material, all of the hereditary information with which your cells, and tissues,
and organs in your body execute their functions. So, let’s look at those 23 pairs
of chromosomes in more detail. It turns out, that of the 23 pairs, 22 pairs are absolutely identical and shared between men and women. And here they’re shown — The differences arise in the 23rd pair, which in females is a beautifully matched
pair of X chromosomes, but in males, that 23rd matched pair is replaced by a mismatched pair,
an XY pair. And let’s look in more detail
at that mismatched XY pair — Here they are — to the left, the stately
and grand X chromosome — (Laughter)
Why do you laugh? To its right, the diminutive and demure
Y chromosome, with its head down. Now, if truth be known, I’ve spent the entirety of my career
at Whitehead Institute defending the honor of the Y chromosome —
(Laughter) In the face of innumerable insults to
its character and its future prospect. Even to this day, it is thought by physicians
and most scientists around the world, that the function of the Y chromosome is restricted to the cells
of the reproductive tract. And in fact, this idea that the cells
of the reproductive tract are the only place
where the Y functions, has led, in turn, to the notion that the genomes of men and women are, apart from the reproductive tract, functionally, maybe even morally equivalent. And so, in fact,
it has been said many times that apart from the reproductive tract
and even disregarding that for a moment, it is been said many times, that our genomes are all 99.9% identical, from one person to the next. This idea that we’re 99.9% identical
has gained great traction and for a number of reasons — It’s very appealing to say that
we are all 99.9% identical — It’s so appealing that this idea was seized upon by President Bill Clinton in his 2000 State of the Union address — when he stated that,
“This fall, at the White House… we had a distinguished scientist visiting, an expert in this work
on the human genome, and he said that we are all,
regardless of race, genetically 99.9% the same.” Wow — it turns out that this idea
is even correct — as long as, the two individuals
being compared are both men. It’s also correct, if the two individuals
being compared are both women. However, if you compare
the genome of a man with the genome of a woman, you’ll find that they are actually
only 98.5% identical. In other words, the genetic difference
between a man and a woman is 15 times the genetic difference between two men
or between two women. Let us consider, for example,
the case of Bill and Hillary — (Laughter) So, it turns out that Bill is
as genetically similar to Hillary, as he is to a male chimpanzee.
(Laughter) But, human genome,
we have a problem — In the human genome era
in which we’re living, this fundamental difference
between males and females, has been overlooked. Instead, we have been operating with a unisex vision
of the human genome. And so — in fact, men and women
are not equal in their genomes — as I just explained, and, as I want to go on
to explain now — men and women are also not equal
in the face of disease. Now, what do I mean by that? And what are its consequences and what are the implications
for health care? I will cite a number of examples
to illustrate what I have in mind. We’ll take the case of Rheumatoid Arthritis — For every many with Rheumatoid Arthritis, there are 2 to 3 women
who are affected with this disorder. Now, is Rheumatoid Arthritis
a disease of the reproductive tract? No. Is there any obvious anatomic difference
between men and women to account for this dramatic difference in the incidence of Rheumatoid Arthritis,
its higher incidence in women? There is no simple,
anatomic explanation to be had. Let’s flip the tables now and consider
Autism Spectrum Disorders. For every girl with
an Autism Spectrum Disorder the most recent numbers suggest, that there are about 5 boys
with such a disorder. Why is that the case? Let’s flip the table yet again — Lupus – a long term, autoimmune disorder with devastating consequences
that can result in death, for every man who is suffering from Lupus, there are 6 women
who is suffering from this disorder. And so, for a whole host of disorders that occur outside the reproductive tract we see that the incidence or prevalence in men and women can differ dramatically. And even in the case when a disease occurs in both men and women, that disorder can be much more severe or have more severe consequences in one sex than the other. Let’s consider here
the case of Dilated Cardiomyopathy. Dilated Cardiomyopathy is a condition where the wall of the heart thins, and the heart balloons dangerously — and sometimes, with
devastating consequences. What I’m going to show you here
is the survival curve, the death curve, if you will, for women who have
Dilated Cardiomyopathy due to a very specific genetic defect — It turns out that men can also get
Dilated Cardiomyopathy as a result of this same
specific genetic defect, but if they do, they tend to die
at a much younger age. Why is this the case? Well, so I asked my colleagues — When I travel around, I ask my colleagues
in biomedical research — Why is it, that for so many disorders, the incidence of disease
or the severity of disease differs so dramatically
between men and women? Why is this the case? And the answer,
that I almost invariably get is — “I don’t have a clue.” Now, this is a big question — this is a big, big question — Whenever I press harder
on my colleagues and say, What do you think might be going on? The answer that I receive,
most frequently is, “Well, maybe it’s the sex hormones.” How could it be that we are
in such a place in the research world, in this human genetics era, when the answers are so shallow? Well, it turns out that
the human genetics revolution has delivered us,
has provided us with a set of tools with which we can ask the question — Why is one man at a higher or
a lower risk than another man of suffering from a particular disease? Similarly, we have the tools
with which to ask the question — Why is one woman at a higher or
a lower risk than another woman of suffering from a particular disease? But, as unbelievable as it may seem, we have no genetic toolkit
to ask the question, Why are men, as a group,
at a higher or lower risk of [suffering from] a particular disease,
than women, as a group? This is a big, big question and to this point,
we have had no answers, no systematic way of proceeding. But perhaps, just perhaps — the answer has been staring at us
in the face all along. Because, of course, the individuals
who are prone to Autism, and who tend to suffer more
severely at an early age from Dilated Cardiomyopathy, those individuals are men
and they are XY. And those individuals who disproportionately suffer from Lups and Rheumatoid Arthritis,
and a host of other diseases, are women and they are XX. Of course, being XY versus XX
is the most fundamental difference, between males and females. But, the whole biomedical research enterprise has been operating for decades
under the assumption that the Y chromosome is operating only within the cells of the reproductive tract or, to frame it another way, that the Y chromosome matters
only in our nether parts. And, as an extension, the notion has been held firm throughout the biomedical research enterprise
for decades, that all the differences between the sexes outside the reproductive tract, including differences in disease susceptibility outside the reproductive tract, the notion has been that all such differences must stem from sex hormones that are produced
by the reproductive organs. But it turns out that in recent years, my laboratory at the Whitehead Institute
has discovered that the Y chromosome is functioning not just in the reproductive organs but actually, throughout the body. So that all the cells of your body — the skin cells, the cells of your liver, and of your heart, and even of your ear, those cells know,
at a fundamental molecular level, whether they are XX or XY. And the question that
I want to put before you is, “Does this matter?” Does it matter outside
the reproductive tract? And I would like to suggest
that it does matter, and it suggests a path forward
towards a better health care. But how serious is the problem?
Am I making this up? Is the research enterprise
really unaware of this reality? Well, if I go to visit my research colleagues
around the world working in universities, in medical centers,
in pharmaceutical companies — If I got to ask colleagues around the world who are studying human cells, as shown here — If I ask them, “Are you studying
XX cells or XY cells?” The answer I get, almost always is —
“I don’t know.” Well, if you don’t know whether
if you’re studying XX or XY cells — How could you possibly be taking account
of this most fundamental difference between male and female cells,
tissues, organs and bodies? And so — it is the case that a great deal
of the researchs being conducted today with an eye towards
understanding the cause of disease, and identifying possible cures and
treatments for disease, is failing to account for this
most fundamental difference between men and women. And it is for this reason that I said,
somewhat provocatively, at the beginning of this talk with you, that the study of disease is flawed. Well — what to do?
What can be done? How can we think about this differently? How can we think about
reconnecting and reconsidering the link between sex and disease? Well, here is what I think — First of all, XX and XY cells
do their business differently, at the level of cells and all the higher levels
of organization that follow. So, we need to take account, as researchers across the world, that there are, in fact,
fundamental differences, not just in the reproductive tract, but throughout the body, between XX and XY cells. We need to discover
what those differences are. Already, in my laboratory
at Whitehead Institute, we are pursuing this question, and already, we’ve discovered that XX and XY cells go about the business, for example, of making proteins,
in slightly different ways. Second, we need to build a better toolkit for the scientists and the clinicians who are pursuing cures
and treatments for disease. We need to build a toolkit that is
XX and XY informed, rather than the present unisex toolkit. We need a toolkit that takes full recognition of the fundamental differences between XX and XY cells,
tissues, organs and bodies. And I believe that if we do this, and I believe that we can, that we will arrive at
a fundamentally new paradigm for understanding and
treating human disease, so that, in the future, if you go to seek the help of a health care professional, that it will in fact matter, if you’re a male or a female — the treatment that you receive, and not just, if you’re going to see your gynecologist or your urologist. So, in the future, this will transform the way we encounter the health care system, and I think that it will —
for you, and for me, and for our children,
and our grandchildren, transform the experience of healthcare. Thank you very much.
(Applause)

100 thoughts on “Why sex really matters | David Page | TEDxBeaconStreet

  1. Did you hear that, next generation researchers? You already have job security. Lol. All the research that was done that hasn't identified if they are working on a "y" or an "x" chromosome cell will need to be done over again. Clean slate. Scrub. Do-over. Any gems of understanding hiding in this field of research will remain hidden until someone goes back to redo all this work. That's what I'm hearing. Is that what you are hearing?

  2. I stop watching this video as soon as he said men and women are not equal. That goes against my personal beliefs.

  3. 20 minutes of ego and whitehead….this man sez nothing and then proclaims how his wh lab is going to profoundly affect health care.,.dudes full of himself….waste of time

  4. Am I going nuts? I can't exact the time, but around 13.59, he actually does a time glitch! Nope, I can't be serious! Hey? Somebody please tell me that this glitch is not only for my eyes! Wow!

  5. I mean is he just going to ignore the fact that we have known for a very long time that color blindness is related to the x chromosome, which is why men are far more likely to be color blind. Basically we have known for a very long time that the x and y chromosomes affect things outside of the genitals

  6. How can gender role behavioural differences be ruled out, as a reason for different mortality rates and variable rates of disease between men and women?

  7. Autism is a terrible example: women present differently and are better at hiding it, so it just goes without a diagnosis.

  8. Thank you transgenders for making the medical field much more challenging.

    It's about time we up the game for the doctors that don't have anything better to do.

  9. Ooops, you really mean to say that men and women aren't the same, NOT that they aren't "equal". Everyone knows and has always known that men and women aren't the same. Equal means the same in value, not the same in every way! You are using incorrect terminology.

  10. What he is implying is that men and women that are diagnosed with the same disease, could get different treatment or medication. However, despite what we know, there is not a single situation where a prescription medication proven to work, only helps one gender and not the other.

  11. A more relevant title like why gender and illness are important probably would've garnered a lot more views.

  12. xy vs xx makes a difference as to what therapy to prescribe. What about blood grouping? Does the difference of blood type make a difference to how we should be treated for disease?

  13. Only people blinded by fundamentally flawed philosophy (liberals) ever considered "the assumption that male and female cells are equal and interchangeable". The wonder is, that it has taken them this long to acknowledge it. Meanwhile, the societal damage that they inflicted and continue to inflict in inestimable. Now let's talk about boys who think they are girls, and vice versa. When will the left recognize reality here?

  14. Wow, he's pedantic. 4 minutes in and he hasn't offered any new information at all. I'm back in middle school biology class.

  15. This is fascinating. It makes me curious about the effects of hormone treatments in people that are transitioning in relation to their biological xx or xy chromosomes.

  16. I get that the knowledge leading to only a suggestion was accumulated through decades of research however someone at least tell him, presenting is not writing.

  17. If the difference between man and women genetics are the same as a man and monkey. Is it possible for person to have " monkey kid" together???

  18. I am amazed that scientist study cells without knowing whether the cells are male or female. That should be the first thing in the label when the cells are collected.

  19. There is a lot of bad science here and things being pushed under the rug.
    I don’t doubt that he is a good scientist, but the kind of “pop science” he is selling his audience is problematic.
    You cannot just use “The genome of xy is z% the same” just like that, you have to define how you determine something being different – genes are not just a 1:1 deal, they usually code for multiple proteins and the different exons can be put in so many different forms that such a blanket statement as the one above is misleading and just there for shock value, not truth seeking.
    Secondly he is completely ignoring that differences in diagnosis between sexes do not automatically mean differences in incidence between sexes. He talked about autism spectrum disorder which is massively underdianosed in girls because their symptoms are a little different.
    So I agree with his thesis, I do not agree with the little nuance he makes.

  20. Sogi made me quit teaching, this video is illegal according to bill C-16 thanks NANCY WILSON RAYBOLT, same lady who was "harassed" by liberals to make a decision aka do her job… fudge me

  21. UBC executives are at odds with this reality
    Its the opposite of what they teach
    Damn thats sad
    Vancouver is a place of dead mind

  22. As a physician I agree, receptors and its reaction to stimuli is gender dependent, take pain as example

  23. It seems kind of obvious that the XY chromosomes would make a difference to the entire person, especially when you consider the things that go wrong in people with XXX and XXY and other mutations of the XY set. I'm amazed they haven't thought about this before now.

  24. It sounds as if the medical researchers have been waddling down the same old investigative route devoid of any curiosity. If the cops were that slapdash in their work, proceeded with the same insignificant levels of curiosity then hardly a single crime would be solved.

  25. It’s a simple answer.
    It’s politically incorrect to broach the subject, and if you do…you risk being ostracized, called a sexist and potentially denied funding…perhaps even lose your job.

    What this researcher is discussing is so patently obvious, it beggars belief it’s not considered. There is the real subject to study. How politics and social constructs can force science to admit the world I’d flat and the Earth is the center of the universe.

  26. Im not a specialist, so couldn’t know. But the ‘reproductive tract’ is responsible for hormones, so it can just be the case that these diseases come from these hormonal differences. However, seems best to study all possibilities.

  27. David Page is not convincing at all. He did not present a single bit of result, just exposed a question and qualified all other researchers to be shallow. The sample with Hillary and Monkey is disgustingly asymmetric. If his motivation would be scientific, he could demonstrate the very same in top of Hillary, and pair Bill with the monkey, or demonstrate both variations. Just for the record, I am not a political correctness believer, I do believe, that people’s rights are equal, and not the people themself, indeed they are definitely different.

  28. We have to also consider how culture impacts the differences between men and women when it comes to disease. If men are acting like idiots because they are not being held accountable as much by their society they may be more likely to get certain diseases. Also hormones may be a valid answer for some diseases.

  29. XX Vs. XY…?! It makes me wonder about some of our current contemporary social movements… It has been postulated in some scientific communities that the ingestion of certain cannabis products may have a detrimental effect on chromosomal structures in our genes… 'Nutherwords… do we have such advocates for lunacy as Bruce Jenner and Chastity Bono in our midst because of their misguided hippy parent's and grandparent's desire to escape reality…??? And… could that be a result of massive logistical increases of international contraband distribution through Viet Nam and Cuba during the late 1960's at the hands of Castro brothers and their oriental allies in their crimes against humanity…?

  30. Genetically, what does that mean… 99.9% the same, if I change a gene and 3X the mass, the two individuals will be 99.99 % the same genetically, but one will be 3X larger, like Andre the Giant vs a normal guy, they are not close the same…

  31. The difference between the sexes was designed by God to be analogous to the relationship between Christ and His Bride. Outside of that, there is no rhyme or reason anyone can arrive at. Since, without God, no meaning or purpose can be logically and rationally, therefore intelligently, posited.
    Therefore,
    the failure of man to follow simple Reality Theory, many benefits are sacrificed.

    Professing themselves to be wise, they became fools.

  32. Not sure why but after watching (mostly listening) i feel so much calmer…
    But i love it how this person asks certain questions and is not laughed at. like most people that try to better the life or the knowledge about the universe.

  33. 99.9% identical, how we tell you to listen to us, how we take your identity and special away. Its how we trick you. Diffrent is not wrong or bad. Its the best most beautiful thing that should give us a right sense of all humans as special. Which we all are. There we are.

  34. Opposites don't attract, like attracts like. Male an female attract because they are two parts of the same One that we are! Just as proton and electron attract because they are two parts of the same Atom. The reason we separated was because we were lonely.

  35. I'm interested in the percentage of the genome similarity between Hilary and the chimp as well. That would've been as interesting as it would be explanatory of the way in which the statistics incompletely describes of what the similarity between genomes really consists of.

  36. This has been truly fascinating, to know what research is currently being conducted, and on what basis. Without your very valuable input, we would never have known – So thank you very much for educating us! The Indian Ayurvedic system of medicine treats people according to the 4 elements, in terms of our body types, what we prefer to eat, and have even mapped out very accurate personality profiles according to each element – air, fire, water and earth. It's also so inspiring when Eastern and Western health experts share their expertise, and knowledge that's often 1000's of years in the making!

  37. The us health care system seems to beas bad as the education system. I am happy to live in europe: all the things he says, esp. in the begining of the talk – are common knowlege to everyone (!) here.

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