Medicine is moving in a more personal direction, with targeted treatments and tailored healthcare on the horizon. But in medical research, there is still a startling reality: Many studies fail to take into account the differences between people of different sex and gender. Vital genetic, physical, and social differences could drastically affect a patient’s response to any kind of treatment, so why would any researcher leave these critical factors out of a study? And how can we go about changing this reality?
Londa Schiebinger, PhD, and Mathias Nielsen, PhD, are part of an international team of researchers who are tackling this issue. They recently analyzed 1.5 million research papers published between 2008 and 2015 and found that the more women among the paper’s authors – particularly senior and lead authors – the more likely the research was to take sex and gender into account.
“We would like women to be well-represented in all aspects of research,” said Schiebinger. And, “we want good research. What we have found is that these two things are related, and particularly around the issue of sex and gender in medicine.”
Now, some definitions. Biological sex, the difference caused by chromosomes, hormones, and physical features, impacts the way that a body responds to treatment. People who were born male, for example, often have a larger body mass and require larger doses of medication.
Gender, defined by social roles that could be based on sex or on a person’s individual identification, can change a person’s response to treatment as well. Occupational hazards, for example, can be gender-related, with more masculine people exposed to more heavy lifting. Clothing, for another: People who identify as feminine more often wear high heels, which over time change that person’s gait and bone structure.
Both the National Institutes of Health and the European Commission require studies seeking public funding to account for sex and gender. It may be easier and cheaper to avoid the complications of hormonal cycles and doubling the study’s size (one group of men, another of women), but studies that ignore the reality of a diverse general population are more likely to hit pitfalls later on. Treatments and medications tested mainly on men have later been found responsible for overdoses and cancers in women who were prescribed the same regimen of care.
Based on this research, which was published yesterday in Nature Human Behaviour, Schiebinger said one possible way to encourage more sex and gender analysis in medical research would be to increase the opportunity for women to lead the research teams.
There’s another way, speculates Nielsen: “There’s no clear indication of direction here — if we add more focus on gender and sex analysis, that might draw more women into the research.” The pair think that perhaps the analysis itself is drawing women to particular areas of medical research.
“Our study may be helpful for policy makers in that it demonstrates the mutual benefits of women’s participation in science, and devoting resources to gender and sex analysis in medicine,” Nielsen concluded.
Previously: Stanford Medicine magazine reports on sex, gender and medicine, Stanford professor encourages researchers to take gender into account, Why it’s critical to study the impact of gender differences on diseases and treatments and A look at NIH’s new rules for gender balance in biomedical studies
Photo of Londa Schiebinger by L.A. Cicero