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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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October 17 2017

Gender Bias in Medical Research: How It Operates and Why It Matters

By Mark Sisson
54 Comments

Inline_Gender_Bias_ResearchSome months ago the issue of gender bias in medical research came up on the comment board. It was certainly an issue I’d occasionally read about. But I’m also a proponent of lifestyle design and intervention. I don’t spend as much time as others on the nitty-gritty of medical treatment for good reason, but the conversation got me thinking. Maybe it was time for an article after all….

And, so, the questions started coming. How does gender figure into medicine, and what exactly is gender bias in this context? How does it operate? How has it been measured? What consequences are there? How much should it influence our trust in medical literature and subsequent recommendations—the validity of findings, the efficacy of treatment, the safety of drug prescriptions? And, finally, what if any progress are we making or can we count on in the near future?

That Was Then, This Is Now: The Beginnings of Gender Bias 

Bias is a form of systematic error that influences scientific investigations and distorts the findings. Bias will always be present in some form during a study, but the goal is to minimize it to the point where the results can still be trusted. Gender bias, then, refers to errors that arise due to differences between male and female participants or target subjects.

Way back when, gender bias was rife in the medical community. Up until the late 19th century, women were commonly diagnosed with “hysteria,” a (very convenient) condition to imply emotional instability was at the core of any complaints, particularly when related to the female reproductive organs. Thus, where medical practitioners were faced with female patients they couldn’t (or couldn’t be bothered to) diagnose, it was accepted practice to chalk it up to her mental state. Surprisingly, this medical mindset remained entrenched up until at least the 1970s, where a 1972 textbook titled Gynecology and Obstetrics, Current Diagnosis and Treatment suggested that nausea during pregnancy was the result of resentment and ambivalence towards childbearing.

In response, legislation was passed in the same decade to prevent gender discrimination in research in an attempt to ensure studies included box sexes and thereby maintained “equality.” Despite this, the emotional and cultural misconceptions that had skewed female-related medical research and treatment for centuries remained very much entrenched, while women were still regularly left out of trials for fears of pregnancy-related complications…despite the fact that drugs were still being administered to pregnant and breastfeeding women.

Then in 1994, there came the big break that gender-aware researchers had been hoping for. The U.S. National Institutes of Health (NIH) issued a guideline for the study of gender differences in clinical trials to ensure those drugs were suitable for both sexes.

The guideline addressed the exclusion of women from trials based on unfounded safety reasons, forcing researchers to consider the fact that men and women can have very different responses to the same drug. As a result, an estimated 80% of prescription drugs were withdrawn from the US market due to newly uncovered women’s health issues.

These days, there’s more women than men enrolled in clinical trials. Nonetheless, to some extent gender bias continues to underpin many aspects of medical research.

An Issue of Equality and Inequality

So, what are the different forms of gender bias still prevalent in today’s medical research realm? Let’s dig in here….

A Swedish study conducted from 1997 to 1999 sought to uncover the reasons behind why researchers excluded women from clinical trials. Based on 26 different case studies, they determined that the reasons behind these exclusions were:

  • lack of knowledge regarding the physiology and metabolism of women of childbearing age
  • a continuing desire to base repeat studies on former (male) study populations, and
  • tight research budgets that enabled inclusion of men but not women

Today, the almost universal inclusion of women in clinical trials might give the impression that things have improved markedly, but there’s plenty of problems still operating under the radar. A 2017 meta-analysis of 2,742 case reports showed a “statistically significant gender bias against female case reports,” while the Society for Women’s Health notes that the richest charities aren’t pushing for the inclusion of more women in medical research and that only 3% of grant proposals measured sex differences.

Ultimately, these biases exist due to polarizing assumptions of equality and inequality. On the one hand, researchers have long entertained the assumption that men and women suffer from the same symptoms and similar disease risk factors. Many clinical trials on men carry the assumption that the findings can be equally applied to women.

Despite this, those trials that compare the effects of drugs and treatments between men and women continue to highlight marked differences in the way women metabolize drugs and respond to treatments. Thus, the assumption of equality puts women at risk, not only reducing disease treatment efficacy but also risking exposure to unforeseen adverse side effects.

There’s also the valid point that men and women (as a whole) differ in environmentally and culturally influenced risk behaviors and exposures, and perhaps in their varied perception of symptoms. These are all valid concerns when it comes to clinical trials, but the biomedical model that governs most medical and clinical research tends to brush over this consideration—men and women are simply biological entities separated by hormonal and muscular variations.

At the other end of the spectrum, assumed inequalities occur when physicians consider women’s complaints to be less severe than men’s, due to the cultural notions of male stoicism and the fact that men have a lower average life expectancy and higher rates of mortality. This is reinforced by more frequent research into male-centric chronic diseases, which solidifies the notion that men are more “at risk.” This assumption contradicts the fact that women have higher rates of non-fatal chronic conditions which seriously impact their quality of life, particularly during those “additional” years when they’ve statistically outlived their male counterparts.

Consequences of Systemic Assumptions

The repercussions of this long-standing sex bias in the research realm are sneaky but far-reaching. For starters, larger proportions of women are diagnosed as having “non-specific symptoms and signs,” perhaps reflecting a disease classification system more suited to men than women. These same women might actually be suffering from a fully identifiable illness, but practitioners fail to diagnose it, due at least in part to traditionally male-based diagnostic criteria or to female-centric complaints that aren’t highlighted or even understood by historically (predominantly) male-based research. As a result, many women may receive no or improper treatment of their unidentified disease, something that can be frustrating at best and downright dangerous at worst.

Next, despite the fact that primary healthcare is used more by women than men, research indicates that short-stay and emergency hospital services may be more accessible to men. In one study of patients with the same ultimate diagnosis, women waited longer in emergency rooms and were admitted less often.

Then there’s the issue of incorrect drug dosages arising from insufficient trials on women. Eight of the ten prescription drugs that were withdrawn since 1997 posed greater health risks for women than men. Half of those drugs were withdrawn not because more women took them than men, but because their effects on women weren’t well known prior to FDA approval. For example, antihistamines Seldane and Hismanal and gastroprokinetic Propulsid “can in some circumstances prolong the interval between the heart muscle’s contractions and induce…a potentially fatal cardiac arrhythmia. Women have a higher incremental risk of suffering an arrhythmia after taking these drugs than do men probably because (1) the interval between heart muscle contractions is naturally longer for women than for men and (2) male sex hormones moderate the heart muscle’s sensitivity to these drugs.”

At a less morbid level, the FDA recently reduced female doses of Ambien, a common sleeping aid by half. Ambien and similar products had been on market shelves for years, but it wasn’t until the FDA completed tests on a new sleeping aid, Intermezzo, that they realized women metabolized the active ingredient much more slowly than men. Up until that point, it was assumed that women had the same response to the drug as men, and therefore that the recommended dosages should also be the same.

Because of lingering research bias, I’d say women probably have ample (more) reason to be more skeptical of pharmaceutical recommendations. 

Gender Bias In Literature and Practice

Coronary Heart Disease

Despite the fact that coronary heart disease is very much a disease of both genders, its role in female mortality rates is arguably under-appreciated. Women with coronary heart disease tend to have worse outcomes than their male counterparts, and they generally receive less evidence-based treatment than men with CHD.

A 2014 study that examined access to care for 1123 admitted patients exhibiting coronary symptoms found that men were more likely to receive faster care compared to women. Researchers also observed that, when women were anxious, doctors tended to underplay the severity of their condition, while anxious men were still admitted quickly. Even more interestingly, both men and women with “feminine character traits” were less likely to receive timely care than those with masculine traits.

Statins and NSAIDs

In a review of 27 trials of statin use for CHD and 25 trials of NSAIDs for osteoarthritic pain, the two drugs showed a huge difference in inclusion of women. While NSAID trials reflected the population in which they were used, only 16% of women were included in trials despite 45% of statin users being female.

These statistics become even more alarming when we consider the fact that women are often more at risk of adverse side effects from statin use than men. Elderly women, for example, face a higher risk of developing muscular disorders following statin use, while postmenopausal women are at an increased risk of developing diabetes mellitus from statin use. 

Animal Studies

This is where things really get interesting. Many specialists now theorize that the high rate of adverse drug reactions in women may stem from biomedical research at its earliest stages—animal trials.

While over half of NIH-funded clinical research participants are women these days, the same progression in recognizing gender bias has not been reflected in animal research. Women have more strokes than men, but only 38% of animal studies on stroke used females. Many thyroid illnesses are up to ten times more prevalent in women, yet only 52% of animal trials used females. And studies that use mice and other rodents to test new drugs typically use only males, despite there being marked differences between the way men and women absorb and process drugs.

There’s plenty more where that came from. A 2011 review of gender bias in research on animals in 10 biological fields found that male bias was present in eight disciplines and most prominent in neuroscience, where male studies outnumber female by 5.5 to 1. According to researchers, in recent years male bias in human studies has declined while increasing in animal studies, and this doesn’t bode well for the safe development of drugs and disease treatments further down the line. This preponderance of males in animal research unfortunately runs the risk of obscuring key gender differences in clinical studies, preventing reproducibility in human studies, and is especially concerning given women experience higher rates of adverse drug reactions than do men.

Some Final Thoughts…

Clearly, there’s much that still needs to be addressed regarding gender inequalities in the medical research world, but we’ve thankfully come a long way from the days of “hysteria.” Women can now participate in phase one, two and three clinical trials, and the NIH continues to roll out legislation and training to ensure researchers don’t overlook or underplay the importance of including women in their trials. And in the animal research sector, the NIH has now enacted policies requiring a balance of genders in all future trial applications, unless sex-specific inclusion is unwarranted.

Unfortunately, however, many aren’t sure the solution is as simple as requiring equal gender representation in every study. As this opinion piece points out, “modifying experiments to include both males and females costs money and requires a duplication of time and effort—time that researchers might not have to spare or that might be better spent conducting other research—that is rarely practical or scientifically warranted.” The question appears to be one of practical resources, but I’ll admit something in me isn’t fully comfortable with this answer. A lot hinges on the definition of “unwarranted.”

Can we effectively prioritize funding for research where analyzing differences between the sexes promises to provide substantiated benefit—and opening the conversation more for defining that “benefit”? We’ll see. Providing the necessary funding for female or mixed-gender studies should at least ensure that scientists no longer have reason to exclude women from trials. And mandating disclosure when a study uses only male or female animals in the title should improve transparency and assist drug and treatment approval processes.

Thanks for reading folks. What say you? Are there issues and/or solutions you’d add to the mix? I’d love to hear your thoughts. 

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54 thoughts on “Gender Bias in Medical Research: How It Operates and Why It Matters”

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  1. Appreciate your discussion of the issue, Mark. Regarding “Being required to include females in a study where it’s unwarranted might simply increase variability and render the study findings useless. That said, I also understand how “unwarranted” might not always be as clear-cut as anyone would like to assume.” —OK, then I say let’s make female the default, see how that goes.

    1. Sylvie, I understand your point and had the same thought actually as I was writing. The existence of a default itself is the problem. Men are supposedly simpler to study, but if that’s the case we’re already dealing in gender differences that may not reveal the varying impact on women. It’s hard to make a fully blanket statement, but unless gender wouldn’t be considered an impactful variable in what’s being measured, then we may need to treat the sexes differently within the study – which means including both. I may add this to the post.

      1. Let me add to this with a specific example of how men are easier to study, cardiovascular disease in women. (“A Review of Cardiovascular Disease and Treatment Differences in Women”
        http://journals.sagepub.com/doi/abs/10.1177/0897190003016003003). It is behind a paywall, so I have excerpted the four reasons given for why there were fewer women in early studies. Look at bullets #2 and #4 in particular.

        Further, I am a researcher and write grant proposals, including to NIH. Proposals are evaluated in Study Sections based on what is proposed and how much it costs. You can see the list for NIH here (https://public.csr.nih.gov/StudySections/Standing/Pages/default.aspx). For NIH in particular, we present a research question and it is funded or not, based on experts in the respective sub-field. Study composition is one of the things that is evaluated. Requiring a certain study population is trickier than it seems on the surface. Let’s make up some numbers. Would folks accept 30% fewer studies in order to fully investigate gender effects for everything? 40%? Researchers try to make the question as narrow as possible, because it costs less and allows NIH to fund more proposals. I am against interfering in this process. To paraphrase Churchill, peer review by subject matter experts is the worst way to do science, except for all the others.

        Frequently there is a large study that looks at a treatment or drug before it is available to the general public. In my opinion, that is where we should require gender, race, etc. to be proportionally represented. At that point, the science questions have been largely answered and we are looking for safety and efficacy.

        ————————-

        CVD IN WOMEN

        Few early studies enrolled significant numbers of women in prospective trial designs. Reasons for these discrepancies include the following:

        • Safety concerns in women of childbearing potential. [11] Initial Food and Drug Administration policies suggested that women should not participate in drug trials until animal reproduction studies demonstrated an appropriate safety profile. This policy was updated in the 1993 “Guideline for the Study and Evaluation of Gender Differences in the Clinical Evaluation of Drugs.” [12] It stated that women must be included in drug testing for any drug and disease affecting women.

        • CVD in women presents, on average, 10 years later in life than men. Inclusion criteria in many trials specify maximum ages for enrollment for reasons including uniformity of study population and avoidance of additional all-cause mortality. Men are more likely to be included in study populations because of their earlier disease presentation.

        • Cardiovascular symptoms presented by women are different than those presented by men. Women are more likely to present with chest pain that is not associated with coronary blockage. [13] Women are also more likely to demonstrate gastrointestinal symptoms when CVD or myocardial infarction (MI) is present. [14] Framingham Heart Study data demonstrated that 66% of women do not experience chest pain or typical angina symptoms prior to sudden cardiac death. The “masking of symptoms” and variations of presentation complicate the diagnostic work-up for CVD in women significantly.

        • Women are more likely than men to have additional comorbid disease states when CVD develops. Much of this can be attributed to the 10-year variation between men’s and women’s CVD presentation. Conditions such as diabetes, hypertension, and obesity complicate the clinical course for CVD progression. [15-17] As a result, investigators must focus additional efforts toward structure and power calculations to control for comorbidities in event rates.

    2. Also, if that inclusion increases variability, it can only be because there are some differences by gender – meaning it is actually NOT useless; normally if additional participants come from a similar population, adding participants makes for more precise statistical estimates, and should actually increase the power of studies. One issue in the replicability crisis plaguing alot of biomedical science is small samples and spurious findings. Even if men and women don’t differ appreciably, supporting larger sample sizes in clinical trials will increase the reliability of the findings.

    3. Gender Bias in Studies

      For everyone who wants to make changes to this, the best thing would be to increase the budget at NIH Let me add to this with a specific example of how men are easier to study, cardiovascular disease in women. (“A Review of Cardiovascular Disease and Treatment Differences in Women”
      http://journals.sagepub.com/doi/abs/10.1177/0897190003016003003). It is behind a paywall, so I have excerpted the four reasons given for why there were fewer women in early studies. Look at bullets #2 and #4.

      Further, I am a researcher and write grant proposals, including to NIH. Proposals are evaluated in Study Sections based on what is proposed and how much it costs. You can see the list for NIH here (https://public.csr.nih.gov/StudySections/Standing/Pages/default.aspx). For NIH in particular, we present a research question and it is funded or not, based on experts in the respective sub-field. Study composition is one of the things that is evaluated. Requiring a certain study population is trickier than it seems on the surface. Let’s make up some numbers. Would folks accept 30% fewer studies in order to fully investigate gender effects for everything? 40%? Researchers try to make the question as narrow as possible, because it costs less and allows NIH to fund more proposals. I am against interfering in this process. To paraphrase Churchill, peer review by subject matter experts is the worst way to do science, except for all the others.

      Frequently there is a large study that looks at a treatment or drug before it is available to the general public. In my opinion, that is where we should require gender, race, etc. to be proportionally represented. At that point, the science questions have been largely answered and we are looking for safety and efficacy.

      ————————-

      CVD IN WOMEN

      Few early studies enrolled significant numbers of women in prospective trial designs. Reasons for these discrepancies include the following:

      • Safety concerns in women of childbearing potential. [11] Initial Food and Drug Administration policies suggested that women should not participate in drug trials until animal reproduction studies demonstrated an appropriate safety profile. This policy was updated in the 1993 “Guideline for the Study and Evaluation of Gender Differences in the Clinical Evaluation of Drugs.” [12] It stated that women must be included in drug testing for any drug and disease affecting women.

      • CVD in women presents, on average, 10 years later in life than men. Inclusion criteria in many trials specify maximum ages for enrollment for reasons including uniformity of study population and avoidance of additional all-cause mortality. Men are more likely to be included in study populations because of their earlier disease presentation.

      • Cardiovascular symptoms presented by women are different than those presented by men. Women are more likely to present with chest pain that is not associated with coronary blockage. [13] Women are also more likely to demonstrate gastrointestinal symptoms when CVD or myocardial infarction (MI) is present. [14] Framingham Heart Study data demonstrated that 66% of women do not experience chest pain or typical angina symptoms prior to sudden cardiac death. The “masking of symptoms” and variations of presentation complicate the diagnostic work-up for CVD in women significantly.

      • Women are more likely than men to have additional comorbid disease states when CVD develops. Much of this can be attributed to the 10-year variation between men’s and women’s CVD presentation. Conditions such as diabetes, hypertension, and obesity complicate the clinical course for CVD progression. [15-17] As a result, investigators must focus additional efforts toward structure and power calculations to control for comorbidities in event rates.

      1. Let me apologize for the multiple posts. I copied and pasted, had a browser crash, and here we are. First time commenter, so I am unacquainted with this comment system.

  2. I’m very confused by your final thoughts. You list all these issues from gender bias in medical research, and then roll over and wave a white flag when it comes to suggesting anything be changed.

    “Being required to include females in a study where it’s unwarranted might simply increase variability and render the study findings useless.” sounds like a complete misunderstand of how statistical research/analysis works. If there’s an issue of two different response patterns to a treatment, then subgroup analysis would get around that by considering each gender on its own, and in fact by no including enough women to “reduce variability” in the entire sample such that you still get a statistically significant finding when considering the two groups as one is disingenuous and unethical research, leading to EXACTLY the issues the entire article above discusses. And if you don’t have enough people to have the statistical power to find something, then you shouldn’t have done that research in the first place and wasted the time and resources. Speaking of…

    ““modifying experiments to include both males and females costs money and requires a duplication of time and effort—time that researchers might not have to spare or that might be better spent conducting other research—that is rarely practical or scientifically warranted.”” is such a cop-out excuse I’m surprised you’re letting them get away with it, rather than pushing back on it harder. First, you just talked about a bunch of examples where that sort of duplication SHOULD have occurred, and would have found something extremely useful and potentially life-saving. So it’s obvious that this duplication of time and effort is warranted in at least some cases. And from there, it’s easy to conclude that it’s in fact warranted in all cases when the research findings are going to be extended to the entire population, because otherwise the findings are completely useless as the claim can’t, in fact, be made for groups that were not represented in the study.

    If time and money is such an issue that researchers can’t slow down and do their first research correctly before moving onto the second improperly-designed research, then they need to stop doing so many faulty studies and just fix the ones they’re doing so these issues are corrected. A dozen broken studies are actually more harmful than no studies at all, and both are less helpful than a few well-designed and well-conducted studies.

    I’m seriously disappointed that these were your final thoughts after such a build-up of the problem that exists.

    1. If you take a close look at Sweden, its current problems, and how they are being covered up, and what caused them, it will be quite apparent why these studies that have been performed are being biased towards women through not including them to avoid any mention of negative trait statistics on said agenda – in other words, distorting studies and burying ones head in the sand – all in the name of trying to prove that there is no difference between the genders – because this would be clear facts that make current political ideology in Sweden to be shown based on totally false premises.

      1. When did Sweden come into this, and how is it possibly connected to American medical scientific research? Please be explicit in your connection between a faraway country with “its current problems” and why you think studies are biased against women.

        This comment sounds like you have a bone to pick and you’re forcing it into every discussion in hopes of derailing it.

  3. This is so true, and it’s not just an academic problem; the effects are very evident in everyday medical treatment. E.g., why was I taught that 98.6 was the “normal” body temperature, without ever being told to expect that my normal, base temperature would routinely be between .5 and 1 degrees cooler during the first half of my cycle than the second? And for that matter, why are most mainstream doctors so uninterested in paying any attention to the details of a woman’s cycle? If she has a problem like excessive cramping, instead of taking the trouble to figure out what’s going on, most doctors would much prefer to simply put her on the pill to fix it. Granted, it’s easier, but one suspects if it weren’t just a “female problem” a lot more care would be taken to diagnose and address the causes of the problem.

  4. I have participated in various clinical trials. In my personal experience of searching for trials that pertained to my health, I never had any problems locating trials that accept women. One of my considerations is, do I want to participate in certain invasive trial or not? Or I consider the risks involved?

  5. Thank you for addressing this issue! Not only is there a gender bias in medical research, but in my personal experience, there is a gender bias in personal medical care for women as well! On more than one occasion, I have gone to see a medical professional and been told my pain is “normal” and I need to “wait a cycle or two” and see if it goes away, referring to monthly hormonal cycles. Or worse, that the issue is “in my head”!?! (Needless to say, I did not go back for further treatment there; I had food sensitivities, of course antibiotics were not going to help!) I am a young female professional with two engineering degrees from an Ivy League School and a professional license; I am not a hypochondriac. I do not appreciate my health concerns being dismissed because the cause is not immediately evident in a 5 minute consultation, nor do the women in my peer group.

    1. Great comment, but I think the whole issue with your example is medical billing as a whole. I had the same problem when suffering severe medical issues (turned out to be a simple food allergy), but all the doctor was concerned about was getting me in and out as fast as possible and getting me some type of meds. Worst of all, this was the better doctor. While gender gaps in studies is an issue, related to specific care, it is more about doctors trying to satisfy their real customers, the insurance companies paying the tab.

      1. And the drug companies that push their products, my sister worked for doctors and they were taken out to lunch several time a month by the drug reps pushing their products. Sigh.

      2. Keith – what’s worse is that they are finding that many women once they get the medical position, end up giving up and loosing interest, after the government has thrown a lot of money into them, end up quiting to be stay at home mom’s any way. Most men when trained as a doctor rack up much more “return time” for the initial amount invested. The end result is less qualified doctors who are actually career committed.

        1. That will always be an issue. Women will always have to confront the reality that if they want to focus on their career, time with family will have to take a hit. There is only so many hours in a day. I have seen it in my family, too, although not on the medical side. When a family member’s wife realize that she was learning about her child’s developments through daycare, she switched to being a stay at home mom, creating quite a negative economic impacy on the family.

        2. @tribal I’d rather see a female physician working 40-60 hours a week, that takes time to listen to my concerns, than a male physician who works 120 hours a week and wants to get me out the door with pills in my hands as fast as possible. The whole “women can’t do it because they have a womb” argument is old and simply untrue. Not all women want children any more than all men want to spend their entire waking hours working.

          1. I think you mistake that a female will automatically listen where a male doctor won’t. They can both be equally good, or bad more focused on billing than with patients.

          2. The ability to be a good physician who listens to their patient is not tied to sex, or cultural background (although I have found doctors of certain backgrounds far more dismissive of their patients due to the class structures that exist in their homelands), and this skill cant be taught at university – it is something the individual has/doesn’t have in their nature. Good and Evil are not tied to a particular sex, although the devil would like this if you believed it, makes it easier to put you off guard and deceive you.

    2. Unfortunately, the current political influence is based around proving there is no difference between the sexes – a two edged sword I guess.

      Studies that show any negative traits of females result in the institution doing the studies having its funding cut, as it is going against the “gender neutral” theme.

    3. The studies that show alignment with the motives of the parties providing the funding are the ones who continue to get the funding. The motive in this case is to erase any evidence that suggests gender inequality – the big brother has sanctioned this.

  6. Gender bias (read that as marginalization of women) exists in every walk of life. Not surprising that it’s always been rife in the field of medicine. Various forms of inequality are not as bad here as in some cultures and it’s slowly improving, but I suspect it will always be a problem that women have to deal with.

    1. I would have to disagree with you here. Academically and economically, males are failing and falling behind. Women make up the majority on college campuses, and when traveling at the VA (which are often aligned with teaching hospitals), most residents are female. This is turning into a female lead world, although it takes time. Then you guy get to make all the rules and decide what gets spent on what. 🙂 Just need a little more patience.

    2. “but I suspect it will always be a problem that women have to deal with.”

      Certainly if you take the perspective that it’s always going to be there and will never change, but that’s being completely defeatist. EVEN IF it can’t be completely removed, why not strive to make things better and reduce its effect as much as possible? Particularly since there are clear avenues that would lead to that reduction that people aren’t taking because it’s inconvenient (see the Final Thoughts paragraph where Mark backs off his position that the bias is bad because it would make scientists need to properly do their job and that’s hard/time-consuming).

      1. Jackie, you’re reading too much into what I wrote. Dealing with the problem IS doing something about it, but, historically speaking, nothing is going to just fall into anyone’s lap. Gender bias is pervasive and must be continually exposed and chipped away. At some point in time it may disappear completely, but I don’t see that happening soon.

        Tribal, I’ve known women with MBA’s who were working behind the counter at Starbuck’s. A college education doesn’t necessarily equate to a decent salary if one is a woman. Also, your patronizing comments demo you as part of the problem rather than part of the solution.

        1. That is a problem with college degrees as a whole. Too many people bought into the whole a college degree is worth it (myself included) without thinking that most aren’t. If you get a STEM degree, you will do fine, but if you get one of the soft social sciences, the slogan “Do you want fries with that” will become your mantra.

          Also, it seems today people are way to sensitive and are looking to play the victim. If you want to play with the big boys, you need to learn the rules. Too many times, people believe culture needs to adopt to them, when in reality, you’re just one among many, and that goes for both sexes.

          1. on that one – “Social Science” is not a science – it just communist studies.

          2. Am doing social science. Have not studied communism outside of history and philosophy classes. It never comes up in any of the group meetings, or in the research I read.

            Dunno where you’re coming from with this.

          3. At the university level – the entire course is Marxist influenced, it is just not directly referred to (some subjects though do go into blatant Marxism).

        2. I’m being honestly curious here, because I don’t want to come across as patronizing: what part of my comment seemed patronizing to you?

          I’d also like to point out the big difference between “At some point in time it may disappear completely, but I don’t see that happening soon.” in your recent comment and “it will always be a problem that women have to deal with.” in the comment I was responding to. The latter is an absolute statement that hints at no possibility of change, regardless of action, while the former allows for that.

  7. My lab only uses female mice. They’re easier to handle and easier to house, since they fight less often. I’m not sure why people would use exclusively male mice unless the field is built on these biases and they’re trying to avoid confounding factors (which is a legitimate reason – generally you want to change as few variables as possible when building on past research). In any case, it’s good to see that clinical trials are more balanced now, as I think that’s the most critical stage of drug development.

  8. But it has gone the other way now. Men are manure to the medical community. More so disease has become politicized. More women die of heart disease and liver cancer each than breast cancer but breast cancer is the darling ’cause men usually don’t get it. Do you see any prostate cancer awareness months? How about prostate cancer walks, rides, telethons, bumper stickers, parades, national sports games dedicated to said? You know that answer. Men are manure and third class citizens. So pardon me if your articles doesn’t elicit much sympathy regarding the medical plight of women.

    1. Such an abundance of unwarranted self-pity! You are making all that up, Tuba. If you haven’t seen benefits/events, you’re not looking. September is Prostate Cancer Awareness month everywhere…Google it. ZERO Prostate Cancer Run/walks were held in DSM, STL, and Dayton, to name a few. Tour de Bleu and RCDCU biking events, among others. Prostate bumper stickers by Cafe Press, GiftMD, Choose Hope, and more. Prostate Cancer Awareness Dinner at the Pro Football Hall of Fame this last April. That’s pretty first-class attention. Try an informed comment next time.

      1. I did not know that about September. I thought that was what the foolishness of the “Momember” thing. Turns out us guys get two months in a row! Woo hoo!

  9. When you mentioned Sweden, they are one of the most left wing extremist cucked countries in the world, and are about to meet a destructive fate due to their obsession and unchecked political correctness, feminism, and uncontrolled socialism and migration – I guess nature/Darwin theory take no prisoners, this behaviour has led to nature marking them for elimination.

  10. When people say there is no difference between the sexes, its laughable – its like me saying to you if you are 25 years old, and I go “so why aren’t you sixty years old”.

    Facts and reality are simply facts and reality – no matter haw many social science PHD’s you have.

    Social science also is not an actual science – its what some people do when they fail at everything else in life.

  11. The power’s to be have decreed that there are no differences between the genders – therefore, any possible study needs to be increased, or limited (as in this case), so as to show no difference.

    This is the only way to maintain fanciful non-reality illusions about what really is.

  12. Its like this – at the moment there are forced gender quotas for say the military – based on an assumption that there are no differences between the sexes, and that all women can perform just as well as all men on the battlefield – should a study ever surface indicating that say women may have different health issues to men, then that would essentially undermine the whole basis of gender quotering.

    Ladies – equal rights WILL be enforced, at all costs – there will be enforced body bag gender quotering, equal rights means equal responsibility, and the equal right to die on the front line in a pointless battle.

  13. Mark – be careful with this post, you will have social justice warriors trying to take down your site for even daring to hint that the genders are not equal and that some studies are being biased to that end – no joke.

    1. Tribal, I don’t think you need to be too worried about that. Mark has written about gender differences several times before (in relation to fasting, for example) and as far as I know nobody has tried to shut down the site. I know what you mean but that particular bunch of noisy idiots won’t be able to attack an American company even if they had the nerve to try – they can’t even boycott it because the products are not sold in Sweden. Actually, I’m not even sure that they can do permanent damage inside Sweden – they are just too incompetent for that, and there are really much fewer of them than the noise they make would suggest.

      1. And what’s wrong with social justice warriors? I applaud Mark for his balanced discussion of the issue of gender bias in medical research, and as several commenters have pointed out, in health care. It’s high time we did some social warrioring about the disparities in health care–not just for women but for many minority groups as well.

        1. The problem is that social justice warriors have no connection with any actual social justice, it is a guess they portray to hide their own selfish agenda’s.

        2. The road to hell is paved with good intentions. The trouble with social justice warriors is that they rarely have the vaguest idea of what they are talking about, and therefore risk doing considerable damage to the groups they profess to wish to help.
          As an example, read the story about the “scientific discovery” this social justice warrior (whose particular cause is anti-racism, in case it is not obvious from the text) from Uppsala University believes herself to have made:
          http://www.independent.co.uk/news/world/europe/allah-viking-burial-fabrics-false-kufic-inscription-clothes-name-woven-myth-islam-uppsala-sweden-a8003881.html
          Now imagine this type of non-science applied to medical studies. Surely you can see how dangerous this is? Then compare it with Mark’s article above, which is objective without trying to fit scientific facts to a political narrative. I’m sure you agree that Mark’s approach is much more likely to produce objective improvements in medical care for women and other minority groups than the social-warrior one.

  14. That claim that 80% of drugs were recalled because of issues in women sounds wildly implausible. I know that’s what the page you cited says, but maybe they mean that 80% of recalls were due to women’s health issues. This was in the 90s. If 80% of prescription drugs were recalled, we’d remember it. That would have been a huge, huge deal.

    Also, why would they withdraw the drugs altogether? It would make more sense just to label them as not suitable for women.

  15. What thoughtful discussion. I do believe the population studied should be in the title.

  16. Not trying to justify or excuse anything, but for some trials, the many variables of a woman and her body could become complex or confounders. She might be pre-menarchal, of breeding age, or post-menopausal. And then within breeding age, where on the cycle and did she have a hysterectomy.

    Men? We are Johnny One Note.