Note: The following article uses the terms male/man, and female/woman interchangeably to express biological sex differences in the human body.
Our world has been shaped around the human– emphasis on the “man”- and has categorically marginalized females. What else can we add to the long list of ways the patriarchy has failed us? A system that has overlooked women’s physical and emotional well-being, causing severe health impacts.
For years, decades, centuries, as long as the western medical practice has been documented, the perfect image of “health” has been based on male physiology. Because of this, infections, diseases, disorders, and disabilities in women have been misdiagnosed, undiagnosed, and ill-treated because the symptoms and therapies have only been developed and tested on bodies that are anatomically, hormonally, and molecularly unlike their own.
Originally it was just assumed that women and men would have the same response to illnesses and treatments, so in the medical field, women were seen as unimportant to study. However, anatomical differences have been noted since the 18th century when some of the first-ever drawings of human anatomy were published.
In these drawings, women’s skulls were depicted as smaller than men’s and their pelvises were depicted as larger, reinforcing the notion that a woman’s value was in reproduction and they were of too little intellect to participate in science and scholarship. I’m sad to report that we took this model and ran with it.
Until recently, there has been little data to support women’s health, but it’s been concluded that how an illness presents itself, affects the body, its side effects, and treatment all differ for males and females and are apparent in many different conditions. But the model for diagnosis remains aligned to males, even in illnesses where symptoms are presented differently.
From chronic fatigue to irritable bowel syndrome, care and prevalence of diabetes, musculoskeletal diseases, cardiovascular disease, sexually transmitted infections, certain types of cancer, autoimmune diseases, even sports injuries- and the list goes on- all present themselves differently, are more prevalent, or require different treatment in females compared to males.
However, historically, women have been viewed as hysterical when seeking medical help. To this day, heart attacks in women go undiagnosed up to 59% more often than in men, depending on the type, because women are seen as overly anxious and misdiagnosed accordingly. That may be a factor in why cardiovascular disease is the number one cause of death in women. Yet, even in female-specific diseases, such as endometriosis, women are still looked at as overly emotional and hypersensitive, often receiving an improper diagnosis.
Beyond severe illnesses, this healthcare structure has also impacted diagnoses of developmental disabilities, such as autism, in women. Even though the signs are the same, women are undiagnosed 3-4 times more frequently than men. Best guess as to why this happens? Some say it’s because women have more pressure to fit into society and are better at masking their neurodiversity; others plead the hysteria narrative.
To add to the insufficient diagnosis model, treatment has also been developed around male physiology. Not until 2016- I repeat: 2016– were sex differences considered an essential factor for clinical drug trials. Despite women’s suffrage, the women’s liberation movement, and countless other times females have fought for their rights and freedoms, in terms of health, women’s sex differences weren’t taken into serious consideration until the same year that Pokémon Go was released.
Even exclusively female-centric trials, like one related to how estrogen levels after menopause affect women’s cardiovascular health, used thousands of male subjects and not a single female subject. Because of instances like this, women are more likely to experience adverse reactions to prescription drugs, experience stronger side effects over 90% of the time, and are far more likely to develop fatal types of arrhythmia in response to medications.
Given this neglect, it’s crazy to think that women are still more frequently the ones using the healthcare system, attending health appointments, consuming prescriptions, and making decisions about healthcare for their families. But why half of society has been omitted for so long is the more pressing question.
Some have said that women were excluded from clinical trials because they have the potential to bear children (despite this not being the case for many women). So anything that could possibly cause harm to a womb or future fetus was to be avoided at all costs (see: first drawings of human anatomy). Others have said women are too expensive to use as test subjects because of their fluctuating hormone levels.
Well, with all of this to consider, you might be thinking: that’s depressing. I agree. But with this knowledge comes the ability to change it. Of course, the inclusion of women in studies is a massive step in the right direction. Still, we need to ensure that women’s primary care (medical, reproductive, and mental) is differentiated from specialty care. Regardless of the past, it’s about time we rearrange medical science to include women.
And don’t get too down- even with a healthcare system that has favored males since its existence, women are still living longer than men, so imagine how much more we can accomplish when we have the proper medical science behind us. If you’re interested in the science, policy, and education of sex differences relating to improving women’s health, check out the Society for Women’s Health Research.