Stress and resilience: why sex and gender matter

For a guy who studies other people's stress for a living, Robert-Paul Juster certainly seems to handle it well himself.

The Université de Montréal neuroscientist is busy on many fronts, researching stress among the lesbian, gay, bisexual, and transgender (LGBT) community, stress in the workplace, stress and aging, and stress among psychiatric patients.

So how does he feel about being able to take things to the next level, thanks to a prestigious grant from the Canada Foundation for Innovation's John R. Evans Leaders Fund?

Doesn't stress him out a bit.

"This partnership means we can establish a new cutting-edge laboratory and go into even more depth," said Juster, 35, an assistant research professor in UdeM's Department of Psychiatry and Addictology. "Not only is it something positive for me and my team, it's a real privilege."

CESAR, for short

Robert-Paul Juster

Credit: Amélie Philibert

The new lab will be called the Centre d'études sur le sexe*genre, l'allostasie, et la résilience - CESAR, for short. CESAR is based at the Centre de recherche de l'Institut universitaire en santé mentale de Montréal. Unique in Canada, CESAR will use neuroscientific methods to study stress and resilience as it relates to sex and gender.

"Most researchers who study stress from a sociological, psychological, gender or feminist angle do so without considering the biological aspects," Juster explained.

"But my research is transdisciplinary. What I do is integrate biological, psychological, and sociological traditions into the process - a kind of methodological triangulation - and that strengthens the research."

With undergraduate training in psychology at Concordia University and graduate training in neuroscience from McGill University as well as three years of postdoctoral research in psychiatry at Columbia University in New York, Juster returned home to Montreal last year to continue his work at UdeM. That includes studying how stress relates to accelerated aging by focusing on the health needs of LGBT older adults. In addition, CESAR will soon begin looking at the transgender community, which Juster believes has not received sufficient attention in health research. Beyond the LGBT community, Juster is also looking at burnout and emotional exhaustion in the workplace and stress physiology among psychiatric patients seeking emergency services.

'Wear and tear'

But his work on gender and sex are what's catching people's attention now.

Juster believes that studying sex and gender factors - things like hormones, gender roles, sexual orientation and gender identity - will provide greater insights into something called allostatic load (AL), the physiological 'wear and tear' that people go through when they suffer chronic stress. It will also give a better picture of the trajectories of sex-specific diseases over time.

"Every cell is sexed, every person is gendered, and every organism is stressed," explained Juster.

"Biological sex refers to male/female differences shaped by genes, anatomy, gonads, and hormones. Socio-cultural gender refers to diverse roles, orientations, and identities that influence health.

"Over time, chronic stress induces allostatic load that is indexed using a battery of biomarkers. These biomarkers represent neuroendocrine, immune, metabolic, and cardiovascular functioning of the individual. AL predicts many conditions like cardiovascular disease and psychiatric problems that affect men and women differently.

"To better depict profiles of risk and resilience to AL, my research program examines the interplay between sex*gender factors in relation to AL and mental health. This has been achieved by assessing how individual differences in sex hormones, gender-roles, and sexual orientation uniquely relate to AL."

More dynamic approaches

"We usually index AL with an average of 20 biomarkers, but this needs to be improved with more dynamic approaches and with new technologies that allow for a more comprehensive assessment of emergent biomarkers," said Juster.

"With the CFI's support, we'll be able to modernize stress reactivity paradigms in our laboratory, incorporate psychophysiological equipment to better capture cardiovascular functioning, and upgrade biochemical lab technologies to maximize efficiency.

"In the end, by refining AL measurement with prospective designs, we will be a lot better at preventing disease. Gender medicine is the future: we'll someday be able to tailor medical interventions to all people in a better way."

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