Gender and sex bias in scientific research

The history of medicine is both scientific and cultural, therefore, sex and gender biases are not the only ones found in the field of science, nor are they only found in the scientific field. At the beginning of modern medicine it was thought that diseases did not have a sex, that they were the same in men and women. Men were studied and the results were extrapolated to women, assuming that the results would be the same. The only differences were those related to reproduction, such as pregnancy, childbirth or contraception.


It was from the 20th century, thanks to the feminist movements, when it began to be proposed that women's health is determined by social and cultural problems. In the 1960s, feminist health campaigns began to give voice to gender and racial bias in clinical research. But it wasn't until the late 1990s that it began to be seen how cardiovascular disease or certain cancers manifested differently in women and men.


From these facts, people began to talk and investigate the existing bias in science and medicine. And this has allowed certain consequences of these biases to be demonstrated over the years, such as a delay in the diagnosis of women compared to men; that women suffer medically unexplained disorders more frequently; that the ignorance of the origin of symptoms is more frequent in the female sex; the overmedicalization suffered by women, for example, at the level of psychoactive drugs. All of this has had and continues to have direct consequences on the care that women receive in the medical system, affecting their health and well-being.



But the production of ignorance is not always as simple as having a knowledge gap, as Tuana exposes in her study of 2006, there are different forms of ignorance that we will summarize below.

  1. "Know that you don't know, no matter what." It refers to those people who are in a position to initiate an investigation, but who show a lack of interest in investigating certain topics.

  2. "You don't even know that you don't know." Medicine was always based on the similarities and differences of diseases.

  3. "When they don't want us to know." There is knowledge, but companies are not interested in public knowledge in order to maintain profits.

  4. "Deliberate ignorance." Certain groups have been discredited as not knowing. Since the supremacy of race, there have been, for example, cases of racist discrimination.

  5. "By will, for not wanting to know." In this case, ignorance is not passive, it occurs when the scientific community denies the existence of bias and does not want to investigate. In this case, the research ceases to be neutral and objective since it responds to the interests of the researcher.




References:

Cleghorn, E. (2021). UNWELL WOMEN. A Journey Through Medicine and Myth in a Man-Made World. The Orion publishing group.


García & Pérez. (2018). Las ‘mentiras’ científicas sobre las mujeres. Catarata.

Guilleminot Coello, C. (2020). Sesgos de género en la construcción científica del conocimiento.


Jovani, V., Blasco-Blasco, M., Pascual, E., & Ruiz-Cantero, M. T. (2018). Challenges to conquer from the gender perspective in medicine: The case of spondyloarthritis. PLoS One, 13(10), e0205751.


Malterud, K. (2000). Symptoms as a source of medical knowledge: understanding medically unexplained disorders in women. FAMILY MEDICINE-KANSAS CITY-, 32(9), 603-611.


Nancy Krieger & Sally Zierler (1997) Accounting for health of women, Critical Public Health, 7:1-2, 38-49


Sans S, Paluzie G, Puig T, Balaña L, Balaguer-Vintró I. Diferencias de género en la salud autopercibida y el consumo de medicamentos. Gac Sanit 2002;16(Supl 1):74.

Tuana, N. (2006). The speculum of ignorance: The women's health movement and epistemologies of ignorance. Hypatia, 21(3), 1-19.


Westergaard, D., Moseley, P., Sørup, F. K. H., Baldi, P., & Brunak, S. (2019). Population-wide analysis of differences in disease progression patterns in men and women. Nature communications, 10(1), 1-14.


Wileman L, May C, Chew-Graham CA. Medically unexplained symptoms and the problem of power in the primary care consultation: a qualitative study. Fam Pract 2002;19:178-82.


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