I (Mary) recently attended a Wilderness First Responder Recertification course set in a winter environment replete with participants heavily clad in winter gear, ranging in age from their early twenties to late fifties. These courses provide one venue for acquiring and updating wilderness medical knowledge, and train wilderness guides and instructors in managing risk and medical issues in a backcountry setting. The courses are theory and scenario-based, including numerous simulations. During the debrief of one first aid scenario, the instructor asked for help in recalling if the patient was a woman and a male student responded, ‘Well, that’s debatable!’ While everyone except a few of us laughed, the instructor meekly whispered ‘Hey now’ in response. Further into the course, I found myself treating a female patient who reluctantly announced ‘birth control’ when I inquired about any medications that she was assigned to say she was taking. I later asked this woman, who was a lesbian and in her mid-twenties, about how she felt about being assigned a birth control medication by the course instructor. I was curious about her response to the first scenario and she simply shrugged her shoulders, stating, ‘I guess I am just used to it.’ Later that day, I heard a student advise another course participant who was complaining about the cold, ‘Geez, buddy, man up!’ I left the course wondering if these comments occurred because of the less formal environment. I imagined that in a formal school, such instances would not go unaddressed.