While the era of entrenched gender stereotypes is coming to an end, when it comes to health, there are important differences between women and men that have significant implications for our health. For many diseases, women experience significant delays in diagnosis and greater side effects from new drugs than men. And women are often described as having “atypical” symptoms, even though the disease is more common in women.
How can that be?
Until recently, almost all health research focused exclusively on men. Sex and gender refer to different but related constructs. Sex relates to biological traits, while gender relates to sociocultural expectations based on a person’s gender identity. These variables affect our health in complex, interconnected ways. However, there is minimal research into how sex and sex affect health. Perhaps it’s no wonder that women suffer more serious health consequences from common illnesses.
One would think that knowledge about women’s health would have caught up in the last few decades. Unfortunately not. In Canada, women’s health research has received only 5 percent of Canada Institute for Health Research funding over the past 12 years. The federal government allocated $20 million over five years to a national women’s health research institute, just 0.5 percent of the $1 billion annual budget for health research.
Funding matters! Consider the impact of the Ice Bucket Challenge on ALS research. This campaign raised $115 million and in 7 years doubled the number of researchers and publications, tripled further ALS funding and dramatically increased approved drugs.
Although the US, Canadian and European Union governments have taken steps to correct inequalities, flaws in the guidelines mean that sex and gender data are rarely examined, with only 5 percent of scientific studies reporting sex or gender analysis. But when you examine them, three quarters of the studies find that the sexes differ. Gender differences exist in the effectiveness of transplant, stroke and cancer treatment, highlighting the life-saving opportunities to fill these knowledge gaps.
In addition, women’s health should not only be studied in comparison to men’s. Many women’s health funding applications and publications are rejected because they only look at one sex or sex. Some even consider the study of women’s health to be synonymous with sexism.
Nonetheless, female experiences such as the use of hormonal contraceptives, pregnancy and pregnancy disorders, menstrual cycles and menopause affect health and disease outcomes. As well as gender-specific experiences with the health system and more general determinants of health. This, of course, applies to male/male and non-binary health – which also require special attention.
But women’s health isn’t just about fertility or “bikini medicine.” Waves of feminism have led to women being more than just reproductive organisms. When it was discovered that heart disease was the leading cause of death in postmenopausal women, with different symptoms and worse outcomes than men, it became clear that women’s health is far more than reproductive health.
So what’s the solution?
- Funding institutions need to be aware of gender implementation issues and gender mandates for grants and allocate funding specifically for women’s health.
- Publishers need to prioritize research questions related to women’s health and challenge omissions from sex and gender analysis.
- Medical institutions need to correct androcentric bias in curricula and equip professionals with knowledge of gender-to-gender differences in symptom presentation and treatment protocols, and the skills to address the specific health needs of women.
- And the public needs to be aware of symptomatic differences and biases in diagnosis and treatment to support self-advocacy within the healthcare system.
Ignoring these recommendations is costly. Women make up 70 percent of the world’s healthcare workforce, contribute significantly to the economy and, when healthy, are directly linked to more productive and better educated societies. But much more than that. Women deserve to be healthy. Do we have to burn our bras again to prove it?