Nothing seems to be more self-evident than gender differences, and yet when we have to establish what these differences are, things seem to become complicated. Is it the reproductive system that clearly determines if we love pink or blue? Perhaps it is the endocrine system? Or is it the genes that are different?
Feminist research started decades ago to build a trail through the forest of myths and symbols surrounding gender differences, and has shown how biological differences between women and men are not so simple to identify. As the social sciences have demonstrated well, many differences between men and women, including some in the field of health outcomes, are attributable to social rather than to biological factors.
A recent special issue of Scientific American presents some of these reflections. Although most of the articles are behind a paywall, the Introduction sets the tone for an interesting series of articles that aim to show the complex ways in which gender and biology connect. The Conversation has also started an interesting series of articles on gender and medicine.
Other research highlights new ways in which gender can play a role when it comes to health. An analysis on blood transfusions performed in the Netherlands has showed a higher risk of rejection in cases in which a blood donor and recipient are not of the same gender. These results are not conclusive and further studies should be conducted to understand if and how matching blood donors and patients by gender can have a role in improving survival rates in transfusions. However, these results already sparked a debate in the medical community about whether blood should be sex-matched, and some clinicians are inclined to avoid risks and are willing to include this element in the current blood transfusions practices.
For a long time, cardiac conditions have been considered a prerogative of men and thus cardiac symptoms have been underestimated in women. Recent research has not only shown that this cultural bias can be a risk factor for women, but also that physiological elements of female anatomy should be taken into consideration when diagnosing and treating cardiac conditions in women. Physiological factors can also explain why women are more prone to some inflammatory diseases, in particular autoimmune ones. In this regard, an article in an Italian newspaper describes how the endocrine system can be one of reasons why women and men respond differently to anti-inflammatory therapies. This can be true also for psychological conditions. Hormonal variations in women are considered to be among the possible causes of a stronger predisposition to disorders such as depression or anxiety. However, social factors that influence mental well-being should also be taken into consideration. Indeed, the ways in which women are educated and the expectations that society has of women can make them more vulnerable and prone to depression or anxiety. Social and cultural factors can also explain women’s exposure to violent medical treatment. An interesting article published in the French newspaper Le Monde reminds us that women were indeed the main victims of the lobotomy, when this practice was still considered valid.
Women’s financial vulnerability can also play a role in health decisions. In discussing new end-of-life legislation in Australia, an article published in The Conversation argues that older women might be driven by their greater social and economic fragility to resort to assisted suicide more often than men do.
Medical knowledge of the human body has been for a long time based on the study of the male body, with women considered as “small men”. This approach is gradually losing ground and more nuanced studies are giving a more significant role to women in medical research and clinical trials. These are, of course, important steps toward the production of a more inclusive and accurate biomedical knowledge. However, the recognition of gender specificities within medical research are strongly focused on physiological dimensions. A greater interdisciplinary understanding of gender would help medical research to take into consideration the social dimensions of the gender system and help to avoid the risk of biological essentialism.
Cinzia Greco obtained her PhD from the École des hautes études en sciences sociales and the CERMES3 laboratory, with a Cancéropôle Île-de-France scholarship. For her dissertation, focused on the experience of postmastectomy breast reconstruction, she was awarded the Barbara Rosenblum Dissertation Scholarship for the Study of Women and Cancer. Cinzia is currently a Newton International Fellow at the Centre for the History of Science, Technology and Medicine of the University of Manchester where she is working on the recent history of metastatic breast cancer.