April 12, 2023

How Bias Impacts Women’s Health Care

Have you ever wondered what makes a woman’s body powerful enough to give birth or what makes women prone to certain diseases?

African American patient explaining issues to Asian doctor using tablet

*The term “women” in this research context refers to people with the biological sex of females.

Have you ever wondered what makes a woman’s body powerful enough to give birth or what makes women prone to certain diseases?

In our new series, The World of Women’s Bodies, Discovery Place scientists dive into how unique women’s bodies are and what makes them remarkable. We are kicking off the series by discussing the gap in medical research and care regarding women and why it matters.

Is there truly a gap in the medical body of research between males and females?

The answer across almost all disciplines is a resounding yes. Despite the global population comprising more than 50% women, about 75% of research is performed on male test subjects. That number is significantly lower in fields such as exercise physiology, where only 6% of research studies include female-only participant groups.

Even in education, a 2016 national study revealed that only 43.1% of medical students believed their curriculum had given them a better understanding of sex and gender medicine. Only 34.5% would feel prepared to manage sex and gender differences in health care.

Why does this gap exist?

One reason a gap exists is it’s often easier to research males since they do not have menstrual cycles or pregnancies that could impact the results of a study.

In 1977, the U.S. Food and Drug Administration (FDA) recommended that women of childbearing age be excluded from clinical trials. This was the result of the thalidomide and DES tragedies years earlier; a move meant to protect women’s bodies ultimately created a medical system where diagnoses and treatment plans are based almost entirely on men’s biology.

Another reason is women couldn’t practice medicine until the late 1800s, leading to a systemic shortage of women in the medical field.

The exclusion of women from medical research and clinical trials has had significant consequences.

– Women are about 30% more likely than men to have a stroke misdiagnosed, and even once diagnosed, are less likely to receive the clot-busting drug tPA.
Women are diagnosed with heart disease an average of seven to 10 years later than men.

– Out of the drugs taken off the U.S. market between 1997 and 2000, eight out of every 10 were withdrawn because of side effects that occurred mainly or exclusively in women.

– In 2015, a cancer study revealed that females often waited longer to receive a diagnosis after symptom onset.

Evidence also indicates that women’s medical conditions and pain are perceived differently than men’s. According to a 2018 study, it was more common for doctors to view women suffering from chronic pain as “emotional” or “hysterical.” They were significantly more likely to treat women’s pain due to a mental health condition.

Another 2018 study revealed that many healthcare professionals believed that women exaggerate their pain (even though 40% of the professionals were women).
Other factors such as obesity, race and being a part of the LGBTQ+ community have affected women’s care. Women who are overweight or obese often see their symptoms written off as a product of their weight and are significantly less likely to get preventive gynecological and breast cancer screenings than people with a “normal” body mass index.

What can be done to bridge this gap?

While there are certain issues in women’s health care and medical research, strides are being taken to remove the biases affecting women across the globe.

– During the 1980s, a group of female scientists formed the Society for Women’s Health Research and began lobbying U.S. Congress to draw attention to the effect this gap in research has had on women’s health.

– In 1997, the FDA began requiring drug manufacturers to indicate safety and efficacy across different ages, sexes, and races, changing course from their 1977 recommendation of female exclusion.

– The National Institutes of Health (NIH) has called for researchers to account for “sex as a biological variable,” including both sexes is now required to receive NIH research funding.