It’s hard to believe that just 32 years ago, the American Food and Drug Administration reversed its exclusionary policy that barred women of reproductive age from being involved in clinical medical trials.
It is well known that medical research has neglected women due to complex hormonal cycles. Researchers even preclude female mice from trials for fear of fluctuating hormones confounding results. Studies that include female species require more participants over longer periods to account for the full duration of the hormonal cycle, and consequently, are more expensive.
One clinical trial for cardiovascular disease treatments found that when controlling for sex, female mice required significantly higher doses for effective treatment. Anatomical differences in the immune system, reproductive system and body-fat composition are primarily responsible for the varied effectiveness in treatment between sexes.
The consequences of this long bias in medical research are entrenched in the medical misogyny women continue to experience today.
This year, the Sydney Morning Herald published a series of testimonies on medical misogyny. These featured horrific, yet unsurprising, incidents of women being dismissed, gaslit, and mistreated by healthcare professionals. One woman was forcibly admitted to a psychiatric ward after she was misdiagnosed with a mental health condition when complaining of noises in her house. Authorities later found food and cameras in her roof. Accounts of 60 women detailed delayed cancer diagnoses, where they had been advised to lose weight, told ‘it’s just menopause,’ or prescribed anti-depressants. Thirteen of these testimonies were provided by loved ones of women whose condition was fatal due to delayed diagnosis.
Like many women, I have a story of medical misogyny.
Nearly two years ago, I was diagnosed with a pituitary adenoma: A non-cancerous tumour that can cause serious hormonal imbalances such as hyperprolactinemia.
In the five years prior to being diagnosed, I experienced chronic headaches, nausea, and fatigue, debilitating mood swings, the loss of my period, and lactation. During this period, I saw several GPs, women’s health specialists, and gynaecologists. I was misdiagnosed, told to meditate and exercise, and prescribed many contraceptive pills, sometimes in tandem with an IUD.
My medical conditions have significantly impacted my quality of life. But what has been equally difficult is clinging to the hope that the next doctor might have a solution. Women are all too familiar with the heartbreak of having another test returned ‘normal’ and the conflicting feelings of relief and disappointment that follow. It is a kind of emotional torture we endure out of desperation, and as a result of sex and gender bias in the healthcare system.
We know women experience significantly poorer health outcomes than men: Women are more likely to suffer chronic health conditions, and more likely to suffer multiple chronic health conditions. Women represent three-quarters of migraine sufferers, two-thirds of dementia sufferers, and almost 80 per cent of people with autoimmune disease.
Women’s poor health outcomes are not just a product of their reproductive systems.
Women experience ‘genderless’ medical conditions at a higher rate and with greater severity than their male counterparts. Women’s predisposition to certain health conditions also isn’t entirely to blame: It’s due to a long history of sex and gender bias in healthcare.
The majority of our medical knowledge has been practiced and tested on men, with women still underrepresented in clinical trials. The most serious adverse effects of approved commercial drugs have disproportionately impacted women. Some of our most commonly used drugs are known to be more effective for men, with research suggesting women experience more side effects when using antidepressants and pain-relieving medications like analgesics.
Our medical curriculum is failing practitioners and patients. Women are more likely to experience ‘atypical’ symptoms when suffering a heart attack, presenting more often without any chest pain at all. Women are also less likely to receive bystander CPR due to fear of being accused of sexual harassment. Across Australian universities, male biology remains the default in textbooks, and only one in four medical students feels adequately trained regarding women’s pain presentations.
The reality is, we are still whispering about health issues that impact women.
We are ignoring the elephant in the room, which is sex and gender bias in healthcare. We are failing to equip future practitioners with comprehensive diagnostic and treatment skills, and we are still compensating for centuries of medical research that has excluded women.
While we fail, women will continue to wear the consequences, resulting in poor quality of life and economic insecurity.