Fowler was in fact the first American-born woman to earn a medical degree, and also the first woman to appear before a male medical society.
Two other American-born women have been beatified, the last step before sainthood.
She may also have been the first American-born woman to become a pirate.
Leo Stern was married twice, both times to American-born women.
Like much of Tan's work, this book deals with the relationship between an American-born Chinese woman and her immigrant mother.
"Wherever you go, you don't feel safe," said an American-born woman who has lived in Jerusalem for nearly four decades.
In general, however, the study found that, based on income levels, both foreign-born and American-born Asian women are not subject to discrimination.
American-born women were the least likely to marry a man from the same country (10%).