Well, if weight is used as a proxy for gender, then larger women would need a higher dose; smaller people would need a lower dose. So why not use body weight to gauge the dose a person should receive? This will be a more efficient way to make decisions. But because we collect data along some lines and not others, the guidelines are written along some lines and not others.
As another example, sometimes the pain women feel when coming forward is not fully recognized. Statistically, women are more likely to see a doctor when they have pain than men. But then common myths and assumptions start to emerge: “It wasn’t that serious.” “She was hysterical.”
So there’s a lot to distinguish here. This is a pick we don’t usually care about. We just see the difference and attribute it to something without really knowing what the root cause is.
So how can we better distinguish between sex differences and sexism to close the gender health gap?
For me, it’s about taking medicine to a new level of research, the level of the social determinants of health. Many of the things that kill most of us have huge social or environmental components. Things like diet, stress, the way society treats us.
Only recently has the impact of sexism and racism on health, along with the impact of other social factors, been studied. The work you do and whether you are married can also have an impact on health.
So all these little details need to be worked on, and it’s an ongoing project. That’s not to say you’d only do one study on the health effects of being married or being a stay-at-home mom. Because those social factors are always changing.
Sex and gender are an aspect of this social story. But it’s important to understand where to call it appropriately. Sometimes gender is relevant, sometimes not. Sometimes sex is important, sometimes not.
What’s stopping things from getting better?
Well, research funding agencies are more interested in looking inside our bodies to explain why things are the way they are. The outside world is more difficult to study because social circumstances are always changing. Things can vary significantly between families and even within families. Collecting data on the social environment is much more difficult.
But we’re at a stage where we can learn a lot from people’s phones tracking their activities. Data is being collected on people’s diet, exercise, and activity levels. Eventually, we will be able to build personalized pictures of people, no longer generalizing about people in a group and assuming they are typical of that group, but understanding them as a complex individual.
Who is making progress in understanding and closing gender health gaps?
Sarah Richardson’s team at Harvard University (she directs the Gender Science Laboratory) has done incredible work analyzing the causes of gender health disparities. They make medical researchers think very carefully about the context of the conditions they are investigating.
The team has done a fantastic job during the pandemic. In the beginning, there were a lot of really crazy claims about gender differences in the virus, like that women were protected because on average they had stronger immune systems. They show that if you look at the data, the claim doesn’t hold up. They help dispel the very pseudoscientific assumption that the virus is hitting all populations evenly and help end the neglect of population patterns as factors in COVID-19, the types of jobs people hold, frontline workers, and so on.
As Richardson notes, this work around sexual situationism is a very compelling model for how to think about sex and gender in research.
Hear Angela Saini speak at the Wired Health magazine’s 10th anniversary event in King’s Square, London, on March 19.Visit health.wired.com to get tickets.