Sex-based discrimination in medicine costs

Women with the same health conditions as men are less likely to be offered active treatment, a global research review has found. This inequality costs lives, with a British Heart Foundation study showing women receive less recommended care after a heart attack.

Research from 2018 estimated that more than 8,000 women's deaths in England and Wales over a decade might have been prevented had they received the same standard of care as men. The problem spans conditions from kidney and heart to liver problems, which have historically been treated as men's issues.

The clinical trial gap

The discrimination starts long before a patient reaches the hospital. Claire Williams, head of pharmacovigilance at a clinical trials technology company, states that women have been woefully underrepresented in clinical trials for years. Initial policies excluded women who might become pregnant, but ongoing challenges include women's busy lives managing home and work, which can make taking time off for trials impossible.

This lack of representation sidelines women's specific needs. Williams notes this is unacceptable given that women experience 50% to 70% more side-effects from drugs than men. Including more women in trials would be a significant step toward addressing health inequality.

A systemic bias beyond gynecology

Professor Geeta Nargund of the Health Equality Foundation argues this new research is significant because it goes beyond gynecological conditions. It shows medical misogyny is rife not just in "women's specialities," where conditions are often dismissed, but across all medical fields. This systemic bias contributes to women receiving less treatment and less help for their health problems.

A fundamental shift in attitude is required. Nargund calls for mandatory education in women's health and sex- and gender-sensitive medicine to eliminate bias during the training and continuing professional development of all healthcare professionals. She says education must also start in schools with stronger sex and health education to challenge stereotypes.

The need for accessible solutions

Professor Sophie Watson of The Open University welcomed more discussion of endometriosis but highlighted a continued disregard for many issues women face. She shared her personal experience with extreme pelvic pain, having seen several top male professors before a female gynaecologist, guided by a Guardian article, pointed her to a solution.

That solution was physiotherapy specifically directed at women's health issues and pain management. Watson argues these techniques need to be far more widely available and known. The renewed women's health strategy and the 10-year health plan for England provide an opportunity for action, with women needing equal access to timely diagnosis and effective care, not preferential treatment.