Medicine’s Gender Revolution: How Women Stopped Being Treated As ‘Small Men’
Deb Colville, 10 Aug 17
       

For a long time, medication dosages were adjusted for patient size and women were simply ‘small men’. Shutterstock/The Conversation

Men and women respond differently to diseases and treatments for biological, social and psychological reasons. This is the first article in our series on Gender Medicine, where experts explore these differences and the importance of approaching treatment and diagnosis through a gender lens.


Until the turn of this century, there was little sense in Western medicine that gender mattered. Outside the niche of female reproductive medicine, the male body was the universal model for anatomy studies.

Clinical trials mainly involved males and the results became the evidence base for the diagnosis and treatment of both genders. Medication dosages were typically adjusted for patient size and women were simply “small men”.

Medical academia has also been male-centred, with teachers, professors and researchers being mostly male. Twenty-five years ago, most college boards representing medical specialities around the world were almost exclusively male.

But in the last 20 years, mainstream medical research has begun to seriously explore gender differences and bias in academic and clinical medicine. This explicit recognition of gender — along with factors such as ethnicity and socioeconomic status — helped determine how healthy all people’s lives are likely to be.

And so, the discipline of “gender medicine” (also called sex-specific medicine) was born. Gender medicine centres opened in the early 2000s, textbooks followed and gender modules were introduced into some medical training and curricula.

In 2008, the World Health Organisation issued guidelines on “teaching gender competence”. This is the capacity for health professionals to identify where gender-based differences are significant, and how to ensure more equitable outcomes.

Gendered medicine is not only about women. It is about identifying differences in clinical care and ensuring the best health care is provided for all. It is also about ensuring equity of health care access, and about gender equity in the composition and roles in the profession.

Does gender matter?

Gender is not the same as sex, which is about biological and physical male-female differences. Gender relates to the social and cultural behaviours we attach to the biological aspects of sex; it is not binary and exists on a spectrum.

In medicine, gender impacts how, when and why a person accesses medical care, and the outcomes of that access. For instance, women seeing their doctor for chronic pain often don’t feel adequately listened to or supported.

In the area of heart health, women are less likely to seek help for a heart attack as their symptoms make it harder to identify. Studies have also found they don’t receive potentially beneficial treatments for heart disease in the same way men do, and have lower survival rates.

Women are less likely to seek help for a heart attack than men. from shutterstock.com

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