Gender myths are a threat to health

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in 2013, The US Food and Drug Administration has made an unprecedented recommendation that women should take a lower dose of the insomnia drug zolpidem than men, reasoning that the drug has a longer effect in women, which could pose a safety issue.

However, in 2019, research conducted at Tufts University concluded that the drug’s differential effects had nothing to do with sex. Rather, researchers found that a person’s body size determined the rate at which the drug exited their system. The report concluded that lower doses prescribed to women may actually lead to lower doses and failure to effectively treat insomnia. “They were using sex for body size because we collect data about sex; we don’t collect data about body size,” says Angela Saini, author of the study. The Patriarchs: How Men Began to Rule“This is sometimes a perverse way of doing medicine: You make your diagnosis based on the data you have rather than the data you need.”

In fact, Saini argues that many of the differences in health outcomes between men and women have nothing to do with biological sex. “It can be very tempting for scientists to look at a difference and find a simple biological explanation for it, but those simple explanations often don’t exist when it comes to gender and health,” he said.

Of course, gender differences exist in aspects of health such as reproductive health and physiology. However, research shows that, in most cases, health differences between men and women – from disease symptoms to medication effectiveness – are actually quite modest. “The differences that do exist are due to gender,” says Saini. “Differences in the way we treat and think about people and the perceptions we have about them.” According to Saini, this is what explains many of the failures in terms of women’s health.

For example, consider the common misconception that women show different, atypical heart attack symptoms from men. This prevalent myth was debunked by a 2019 study funded by the British Heart Foundation at the University of Edinburgh. The research, which included nearly 2,000 patients, showed that in fact, 93 percent of both sexes reported chest pain — the most common symptom — while the same percentage of men and women (around 50 percent) also felt pain down their left arm. “The problem of women being underdiagnosed is because health professionals and even women who have had heart attacks themselves believe that heart attacks mostly happen to men,” says Saini. Estimates suggest that differences in care for women have led to about 8,200 deaths due to heart attacks in England and Wales since 2014

“It’s not about men discriminating against women; it’s often about women not being listened to — sometimes by other women,” she says. Another example that clearly demonstrates how gender can affect health outcomes comes from a 2016 Canadian study of patients hospitalized with acute coronary syndrome. The research showed that patients who had higher rates of recurrence were those who played stereotypical gender roles associated with women — such as doing more housework and not being the main breadwinner at home — regardless of whether they were men or women. “This was because people who played female social roles were more likely to be anxious,” Saini says.

If these inequalities are due to the way patients are viewed and treated, for Saini the solution is clear: “We must be careful to diagnose the problem where it is, not where we imagine it is.” She highlights the successful work of Jenny Joseph, a British midwife who founded the Commonsense Childbirth School of Midwifery in Orlando, Florida, in 2009 to help women without access to maternal health care. Research has shown that black mothers in both the US and the UK are three times more likely to die from childbirth than white women.

“Joseph reduced maternal mortality by improving the quality of care for minority women, listening to their concerns, and responding when they’re in pain,” says Saini. “We don’t need technology to solve this issue. We simply cannot allow our biases and prejudices to get in the way.”

This article is published in the July/August 2024 issue Wired UK Magazine.

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