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Last week , three former United States U. Surgeons General called for an end to involuntary medical procedures on intersex babies and children. First, there is insufficient evidence that growing up with atypical genitalia leads to psychosocial distress. Citizenship and Immigration Services adjudicates refugee and asylum applications on the basis of legal guidelines.

A noncitizen can become a refugee by claiming persecution against their lesbian, gay, bisexual, transgender or intersex identity. Full disclosure: I wrote many of these guidelines and furthered a related project during my past life as a government employee. A noncitizen, very often a child, may also gain protection under refugee and asylum law if she is subject to female genital mutilation FGM in her home nation.

Furthermore, the U. In other words, the U.

If the government is willing to protect foreign nationals from such treatment in their countries of origin, then it should also take steps to ensure that its own citizens are not subject to similar harm. It gave us this.

11 years ago ... well, you know.

A hobby popular in Europe, magnet fishing has taken root in America and Jim Walters is among the fishermen leading the way with odd …. Learn More. Mike Gundy made fart noises to let you know exactly what he thinks about Twitter. So, I usually finish it during the evening watching TV man, Only a few female responders reported individual patterns apart from drinking on special occasions. Apart from two respondents, the women reported drinking small amounts of alcohol and usually not on a regular basis.

Besides holidays we drink sometimes during Saturday with lunch, or on any other day when we want to relax, always with dinner. And beer of course during summer, when it is very hot and you want to ease the thirst woman, We gather together I have three [female] friends about once a month to share news, some events, to relax. Three of us finish one bottle of wine during the evening. It became a ritual for us. The difference in drinking patterns was also shown in reports about how the significant other drinks. As a result, women become very busy, have almost no spare time and have fewer occasions to drink.

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These expectations would decrease women's drinking even during traditional drinking occasions. You are the woman and you have to keep your female image, you have to show an example for your children, for your husband, and for others. You have to be clean, you have to do laundry, to cook and to clean, you have to find time to do everything. It does not mean that you should not drink at all but [when there is a drinking occasion] you just sip a bit [from a glass] and put it back. You have to be ideal. If you are a woman you should be a woman. You should not drink every day or without any particular reason or occasion.

You have a family, your household responsibilities man, The other reason given mainly by male respondents was that women have less physical ability to drink. Women get drunk faster than men and if they drink on the same level as men they become drunkards fast. At the same time, the image of a drunken woman was perceived with much more negative attitude than the image of a drunken man by both male and female respondents. If for men maybe it is appropriate to stumble drunkenly, that is understandable.

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But when you see a [drunk] woman it is very unpleasant. No questions about it. If people see a drunken man they can smile. But when a woman is drunk it is a terrible scene. People always judge it. The reasons behind men's drinking were opposite to those of women.


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Hence, men have more time and have more occasions to drink. It is good if he has a summer house and he is busy fixing it, or a car and garage. But if there are no such things there is practically nothing for them to do. Finally, it was mentioned by the majority of participants that current trends between genders are changing, and the younger generation drinks in a different way.

This was linked by participants with changed values, increased advertising and access to alcoholic beverages:. The moral criteria became different. Earlier it was a very rare occasion to see a young girl drinking beer at a bus stop, and people would treat her with a certain [negative] attitude.

But now all you see is beer, beer, beer. I think it is not attractive. And does she not have a home where she can drink this can of beer? It is well documented that cultural norms and customs regulate consumption of alcohol throughout the world. Who, when, where, how and what to drink is regulated in many societies Heath, ; Room, In the case of gender, drinking often becomes a symbol of gender roles, and societies identify and express gender roles through drinking Holmila et al.

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Women traditionally are expected to drink less than men. Women are condemned when they drink and could lose their traditional roles as caretaker and moral agent McDonald, Women's family responsibilities, with their maternal and nursing roles, are not compatible with drinking, and so women have more to lose than to gain from it Room, Our study confirmed previous research findings which have shown large differences in drinking between men and women in Russia.

Women had fewer drinking occasions per year, they had lower amounts of alcohol consumed both annually and weekly, had significantly fewer problems related to alcohol and had significantly fewer occasions of binge drinking. The differences between men and women were not explained, even partly, by controlling for socio-demographic variables.

Qualitative data unveiled what lay behind patterns identified in the epidemiological study in detail. It showed that women were expected to drink and drank much less during mostly cited traditional drinking occasions. The expectations of drinking behaviour also were reflected in attitudes towards drunkenness for men and women. If the appearance of a drunken man in public was tolerated, drunken women were always negatively judged. On the other hand, for male respondents, drinking often large quantities of alcohol was perceived as quite normal.

Our qualitative findings also have shown that besides a reported physical ability for men to drink more, gender roles and strong traditional culture around women's drinking affected drinking behaviour in this sample.

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It appears, therefore, that to combat cultural permissiveness or encouragement of male drinking, it will be necessary either for society to undergo a radical shift across a wide range of mores which seems unlikely in the near future or that public health campaigns will need to focus on dissociating alcohol from these cultural expectations and values. This will require an extended and concerted effort and considerable resources, but given the damage that male alcohol consumption is doing to the Russian economy as well as to the health and wellbeing of its population, such expenditure would probably be more than repaid.

Several limitations of our study should be considered when interpreting the results. First, the present study investigated a relatively restricted age range, focusing on middle-aged and older participants. In most populations, drinking and particularly problem drinking tends to decrease with age. Thus, the differences in drinking found in this study may not apply to younger persons.

The emergence of beer and light alcoholic beverages markets and consumer hedonistic culture among young people are likely to decrease the gender gap in drinking in Russia, an area that is yet to be studied. Moreover, most of the participants were brought up and spent most of their adult life during the Soviet era, which is culturally quite different from post-Soviet times; that might correspond to different gender expressions and gender identities and related drinking behaviour. For example, one study has shown that young women in post-Soviet Russia perceive the social environment as more permissive of alcohol consumption than during the Soviet era, and could be more involved in drinking behaviour to exercise their personal freedoms in new modern times Hinote et al.

Second, drinking is typically under-reported in surveys and that is likely to be the case here.

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The absolute levels of means and proportions estimated in our study may, therefore, be underestimated. In addition, there is some evidence that in Russia, women tend to under-report their alcohol intake to a larger extent then men Laatikainen et al. However, the differences between men and women were so large that it is extremely unlikely that they could be explained by differential under-reporting. The validity of the quantitative findings view is supported by analyses of serum gamma-glutamyl transferase, which show a gender difference consistent with self-reported alcohol intake Nikitin et al.

Third, the qualitative study can only access the perceptions of participants, and it may be that there are important influences operating that are outside their awareness. For example, it has been shown in a number of populations that price plays a major role in consumption Wagenaar et al. Finally, the quantitative data were collected in — and patterns may have changed since then. This is unlikely, however, as the qualitative data were collected during re-examination of the cohort, and the self-reported drinking showed a reasonable stability over time. Our study has shown a large gap in drinking in Novosibirsk between genders.

Drinking large amounts and being drunk were more tolerated amongst men. Gender roles were the main reason behind drinking practices and in some cases, very heavy drinking by men was balanced by near abstinence among women as someone had to take care of the family. Moreover, our study detected a variety of individual patterns which, to our knowledge, have not previously been adequately documented. We thank the staff of the Institute of Internal Medicine in Novosibirsk for their great support and all study participants for their contribution. National Center for Biotechnology Information , U.

Alcohol Alcohol. Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract Aims: The study investigated gender differences in drinking patterns and the reasons behind them among men and women in the Russian city of Novosibirsk. Drinking measures To describe alcohol consumption patterns including problem alcohol intake, we used the graduated frequency questionnaire GF; Greenfield, ; Rehm, Negative consequences of drinking We used the CAGE questionnaire Ewing, ; people with two or more positive answers to each questionnaire were considered as problem drinkers.

Covariates Several other variables were used in the analyses. Statistical analysis First, we compared the crude available measures of drinking between men and women. Qualitative interviews Interviews were conducted on several occasions between May and November Open in a separate window. Men Women Men vs. Qualitative study We interviewed 20 women and 24 men aged from 48 to 63, selected from the quantitative study described above.

Traditional drinking pattern Both men and women reported that they drank on holidays and special occasions, many of which were ritualized; the so-called traditional drinking pattern. Individual drinking patterns Although the majority of the responders reported traditional drinking pattern on special occasions, almost every man but only few women reported different individual patterns as well.

So, I usually finish it during the evening watching TV man, 69 Only a few female responders reported individual patterns apart from drinking on special occasions. And beer of course during summer, when it is very hot and you want to ease the thirst woman, 54 We gather together I have three [female] friends about once a month to share news, some events, to relax. You have a family, your household responsibilities man, 65 The other reason given mainly by male respondents was that women have less physical ability to drink. This was linked by participants with changed values, increased advertising and access to alcoholic beverages: The moral criteria became different.

Limitations Several limitations of our study should be considered when interpreting the results.