534 Women’s Health Psychology
Nezu (1987) found that level of masculinity, not biological
sex, predicted distress levels and effective use of problem-
solving coping skills in undergraduate students and that cop-
ing skills may mediate the relationship between sex roles and
distress. Similarly, Friedman, Nezu, Nezu, Trunzo, & Graf
(1999) found problem-solving skills and masculinity, regard-
less of biological sex, to be signi“cant predictors of psycho-
logical distress in persons with cancer, whereas femininity was
not predictive of these factors. Results such as these suggest
that social roles or sex roles may better explain differences in
coping style, thoughts, and behaviors because studies examin-
ing biological sex differences in coping have been inconclu-
sive (Dunkel-Schetter, Feinstein, Taylor, & Falke, 1992).
These results have implications for women in both re-
search and clinical settings. With respect to social context,
women are stereotypically categorized as being high in femi-
ninity and expected to model the traditional female sex role.
Those in the “eld of medicine and mental health must remain
cautious of classifying patients according to their biological
sex exclusively. By considering the sex role orientation of the
individual (rather than making assumptions based on biolog-
ical sex), researchers and mental health and health care
professionals can reduce clinical biases that can potentially
hamper treatment, among other variables.
CONCLUSIONS AND FUTURE DIRECTIONS
IN WOMEN’S HEALTH
This chapter addresses several of the physical and psycholog-
ical health problems faced by women, as well as social fac-
tors that may contribute to women•s health problems. Despite
advances in the “eld, women•s health remains an area de-
serving increased attention. It is important for clinicians and
researchers who work in the “eld of women•s health to con-
tinue to serve as ambassadors for increased research funding,
health education, and outreach to women from all ethnic-
racial and cultural groups, and for the achievement of equal
status for women in academia. Those working in the “eld of
women•s health must look at past achievements and suc-
cesses as a guide for future goals, opportunities, and contin-
ued progress. This section provides a summary of the current
status of women•s health, as well as some possible challenges
and opportunities we may confront in the future.
Health Care
Historically, health care has been a male-dominated profes-
sion, with men serving as the primary providers and adminis-
trators in the “eld. This has changed signi“cantly as the
13.4% of women graduating from medical school in 1975 in-
creased to 40% in 1997 (Bertakis, 1998). Despite this signif-
icant increase in women•s medical school enrollment, more
women drop out of medical school than men, with attrition
rates for women steadily increasing over time (Fitzpatrick &
Wright, 1995). Future research must examine not only rates
of attrition, but also potential factors contributing to higher
medical school drop-out for women across the nation (e.g.,
“nancial burden, role strain) and possible solutions.
As a result of women entering and graduating from med-
ical school in greater numbers, more women currently serve
as faculty members in academic medicine than ever before.
This is positive in terms of the interaction between female
physicians and female medical students with respect to men-
torship, the availability of female physicians for training both
male and female medical students, and possible augmented
exposure to women•s health issues, as well as greater research
and clinical opportunities available in the area of women•s
health because of increased numbers of women in the “eld.
However, while great strides have been made in the number
of women entering academic medicine, the rate of women
faculty who are awarded tenure and achieve senior ranks
or high administrative ranks has not advanced at the rate
expected given the in”ux of women in academia (Morahan
et al., 2001). In a review of the literature, Carnes et al. (2001)
reported that lack of role models and mentors, feelings of iso-
lation, gender discrimination, and lack of support for family-
related responsibilities that most commonly fall on women
serve as potential reasons women do not achieve academic
leadership positions. Traditionally, such positions are ob-
tained through research and the acquisition of grant funding,
areas in which improvement for women is needed. In the
future, women•s health is an area of research that may allow
female psychologists, physicians, and scientists to advance to
academic positions, at the same time promoting the clinical
and research knowledge of women•s health.PsychologyThe entrance and advancement of women in the “eld of psy-
chology has been dramatic as women earned 66% of the PhD
degrees in psychology awarded in 1999. The rate of women
earning PhD degrees has increased 8% since 1990, at which
time 58% of new PhD degrees were awarded to women.
The majority of these degrees were awarded to European
American women (84%), followed by Hispanic women
(6%), African American women (5%), Asian women (4%),
and women of Native American descent (1%). Over the past
decade, the percentage of PhD degrees awarded to women
of color increased from 12% to 17%, indicating increasing