Medical science improves our lives by developing treatments for illnesses. But if a treatment is going to work for everyone, research and testing must be done on a varied population. The challenges of science often lead to just the opposite situation. One way to test if a drug is actually having the hypothesized effect is to give it to several people who are otherwise as similar as possible.
Medical treatments may therefore be developed without sufficient testing on both men and women. In a letter to The Lancet, I joined my genSET colleagues in noting that “medical treatments for women are less evidence-based than for men. Pain research demonstrates this point well: 79% of animal studies published in the journal Pain over the past 10 years included males only, with a mere 8% of studies on females only, and another 4% explicitly designed to test for sex differences (the rest did not specify).”
The Gendered Innovations website illustrates the quality-enhancing effect of carefully considering sex and gender in research. Many of the examples there are cases where women have been left out of the process, but it also includes cases where men suffer from skewed testing.
A classic example of leaving women out of the picture comes from the research on heart disease, which according to WHO is the number one killer of women in the U.S. and Europe. Research on heart disease is so skewed towards men that women are often mis- and under-diagnosed.
Analyzing sex and gender in heart disease has required formulating new research questions about disease definitions, symptoms, diagnosis, prevention strategies, and treatments. Once sex and gender were factored into the equation, knowledge about heart disease increased dramatically. As is often the case, including women subjects—of diverse social and ethnic backgrounds—in research has led to a better understanding of disease in both women and men.
The study of osteoporosis shows that men also are sometimes inappropriately excluded from the research. They are present in the statistics: men account for one-third of hip fractures resulting from osteoporosis. But the treatments are based on research on women. Again, Gendered Innovations presents a methodological solution and a case study.
In the case of osteoporosis, diagnostic models have been developed for women, using bone mineral density (BMD) norms of healthy young, white women, and criteria to identify risk in men are not well established. Researchers are improving these reference models and opening new areas of research by considering disease progression in both women and men, and by evaluating risk using sex-specific reference models.
Researchers have identified medical conditions and treatments which correlate with osteoporotic fracture, especially in men. New diagnostics … improve diagnosis in both women and men.
Perhaps medicine is the field in which it is easiest to identify examples where a more balanced inclusion of sex and gender factors in research would improve healthcare for everyone. But gendering research is important in other areas, too. Browse the Gendered Innovations site to see more examples.
The challenge for scientific leadership is this: What can universities and funding organizations do to increase acknowledgement of gender and sex in research questions?
If gendered research questions give scientific results of higher quality, we need to invest in making gendered research the norm. How should we do that? Would it make sense in your field? Why or why not?
Photo courtesy of chrisevans
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