This week, I thought I’d address the issue of gender bias in the medical community. In general the “default” subject of study when examining a condition or medication is the white male.
It used to believe that only boys could have dyslexia because only boys were studied. It was nearly the same story with autism, which is why we’re now seeing more and more about how more girls may be on the spectrum but manifest symptoms differently.
Misinformation about things as serious as heart attacks was spread, because only male patients were examined. In reality, the symptoms of a heart attack can be different than they are for men.
Yet, we’ve only been told about the male symptoms for years, for the simple reason females at risk for heart attack weren’t examined quite as ardently over the centuries western medicine has been practiced.
From a historical standpoint, women were excluded to a far greater degree than they are today. Centuries ago, male doctors were not allowed to even look at a naked female in some parts of the western world, even for diagnostic purposes. As a result, medical care for women was substandard in comparison to men. Mental health issues in particular were often brushed off as “hysteria”, or general female weakness.
Today, gender bias in medicine starts all the way back in the classroom. One 2008 Dutch study, cited below, studied text books suggested by at least two Netherlands medical texts in the school years between 2004 and 2006. These books were internationally respected, and the information within them was often used as a basis for diagnostic and therapeutic treatment.
They found that the majority of the texts either lacked differentiation between the genders, separated women’s health into its own chapter, or hid women’s health issues in the notes. Although text books may not be as exclusively relied upon anymore, they do still serve as a fundamental tool for many classes.
Furthermore, the distinction between “gender” and “sex” is rarely made. As a result, intersex and transgender individuals are often left completely out of the conversation. I had a hard time finding studies, but the negative effects aren’t hard to figure out.
This is problematic on psychological, social and physical levels.
The physical aspect is common sense, since individuals who are transitioning with hormonal therapy must be made aware of potential interactions between medication and their unique hormonal levels. Psychologically, misgendering by someone who should be offering care is devastating, which can often result in depression, or worsening of a pre-existing condition. Finally, on a social level, being excluded from non-reproductive medical advances further others an already marginalized population.
These ongoing attitudes have real world consequences on people all over the world, including “advanced” countries such as the US and UK. In the pharmaceutical arena alone, gender bias can result in death, illness and fetal problems.
For example, albuterol, one of the most common emergency medications for asthmatics, has been on the market since the 1960s. Since then, there have only been animal studies, and very few small studies done on asthmatic mothers. In fact, there isn’t any controlled data its effect on human pregnancy, and it’s still unknown if it’s excreted through breast milk. It’s been on the market for over 40 years, yet it hasn’t been extensively studied in pregnant women.
Because it’s known that hormonal levels can effect the way our brains work, one would think it would be common sense to include all genders in clinical studies from the start. As it stands now, that’s still not the case.
In the scope of this blog, this disturbing lack of study on girls and women could result in unpredictable side effects of drugs taken to treat ADHD and some aspects of autism. If we’re to trust our medical establishment, we must demand more equal representation all the way from diagnostic studies to clinical trials.
Dijkstra, Anja F., Verdonk, Petra, Lagro-Janssen, Antoine. “Gender Bias in Medical Textbooks: Examples From Coronary Heart Disease, Depression, Alcohol Abuse and Pharmacology.” Medical Education 42 (2008): 1021-1028
Rinsberg, Gunilla, Hamberg Katarina, Johannson, Eva. “Gender perspective in medicien: a vital part of medical scientific rationality. A useful model for comprehending structures and hierarchies within medical science.” BMC Medicine 4 (2006): 20-25
Albuterol Pregnancy and Breastfeeding Warnings. October. 2014 <http://www.drugs.com/pregnancy/albuterol.html>
Albuterol/ipratropium Pregnancy and Breastfeeding Warnings. October 2014 <http://www.drugs.com/pregnancy/albuterol-ipratropium.html>
Agnvall, Elizabeth. “Am I Having a Heart Attack?” AARP 21 Aug. 2012 <http://www.aarp.org/health/conditions-treatments/info-02-2011/am_i_having_a_heart_attack.1.html>
Kaminski, June. 18th Century Medicine and Women’s Bodies: Sentimentalism Engendered 1998 <http://hygeia-design.com/sentiment.pdf>