Medical systems discriminate against women, leaving them misunderstood, mistreated and misdiagnosed.
There are biological sex differences in every organ and system of the body that mean there are significant sex differences in the health issues men and women face, the causes of their different health problems and the effectiveness of the treatments we might use to tackle these problems.
But these differences have been ignored in medical education, research and diagnoses on the front line meaning that countless women have suffered and died unnecessarily because of gender-data gaps all the way through the medical profession.
This is according to Caroline Criado Perez (2019) in ‘Invisible Women: Exposing Data Bias in World Designed for Men’, and below I summarise her chapter on gender bias in the medical professions.
Gender bias in medical education
Medical education is focused on ‘the male norm’ such that there is a male-default bias, with women in general being seen as abnormal.
This bias against women goes back to the Ancient Greeks: Aristotle saw the female body as a mutilated male body, the female was viewed as the male turned outside in and Ovaries were female testicle, not given their own name until the seventeenth century.
Representation of the male body as the norm persists in modern medical textbooks: A 2008 analysis of over 16000 textbooks revealed that the male body was used three times more than the female body to represent ‘neutral’ body parts; and the results of clinical trials were written up as relevant to both men and women even when women had been excluded from the trials.
Gender data gaps also exist in curricula, with gender related health issues rarely taught in medical degrees, and where they are, there are only a few courses in a few universities.
Health differences between men and women
There are significant biological differences between male and female bodies
There are sex differences in lung capacity such that women who smoke the same number of cigarettes to men are between 20-70% more likely to develop lung cancer.
Women are three times more likely than men to develop Autoimmune diseases, they make up 80% of those with these diseases.
There are sex differences in our cells and our proteins, in biological markers for autism and significant differences in how males and females respond to stress.
Research on heart attacks which focus mainly on men have found that chances of survival are higher if someone has a heart attack during the day, this is reliable research which has been repeated many times. However a 2016 study found a lower chance of survival for daytime heart attacks – the difference being that this study was done on female (mice).
Research bias in health studies
Women have largely been excluded from medical research.
Since the landmark discovery of the Y chromosome in 1990 as the ‘sex determining region’, most research has focused on testes development, it is only since 2010 that we started researching the active process of ovarian determination.
In 31 landmark trials of congestive heart failure between 1987 and 2012 females made up only 25% of participants.
Women make up 55% of people who are HIV positive in the developing world and yet less than 40% of people in vaccination studies were women and less than 20% were women in studies aiming to find a cure.
Pregnant women are routinely excluded from clinical trials to the extent that we lack solid data on how to treat them for practically anything. For example during the 2002-4 SARS outbreak in China pregnant women’s health outcomes were not systematically tracked, thus we have no information on how to treat them come the next pandemic.
Women are 70% more likely to suffer depression than men but animal studies on brain disorders are five times more likely to be done on male animals.
When female viagra was found to react negatively with alcohol in 2015 the manufacturer decided to run a trial – on 23 men and two women, and they did not sex-disaggregate their findings.
A 2001 audit of FDA records found that a third of documents didn’t sex-disaggregate their data and 40% didn’t even specify the sex of the respondents.
A 2014 op-ed in the journal Scientific American complained that including both men and women in experiments was a waste of resources.
The lack of sex-specific data prevents us from giving appropriate advice to women.
For example in 2011 the World Cancer Fund complained that only 50% of studies into the impact of diet on cancer specified differences between men and women so it is difficult to give sex-specific guidance for diets for women to reduce cancer risks.
CRT-D devices are used to correct delays in electrical signals in the heart. The frequency these are set to matters, they can save lives, and for men the correct frequency is 150 milliseconds, the default setting for both men and women. However when you sex-disaggregate the data you find that a setting of 130-149 MS reduced female deaths by 76%.
Even something as basic as advice on exercise is gender biased against women: trials have found that resistance training is bad if you have high blood pressure, again the standard advice for both sexes, but more recent research has found that it might actually benefit women with high blood pressure.
Women have been dying in greater numbers than they have to be, especially because they ingest 80% of pharmaceuticals in the U.S.
The whole of the medical profession is complicit in this and things need to change to save women’s lives!
Signposting and Sources
This material shows us that there are gender biases in healthcare, based on gender biases in medical research, and it reminds us of the continued importance of Feminism today.
Source: Caroline Criado Perez (2019) Invisible Women: Exposing Data Bias in World Designed for Men.
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