The vision of the goalkeeper on biases in medical research: contempt for women’s health belongs in the past | Editorial
SIX YEAR After the successful book by Caroline Criado Perez, Invisible Women attracted the attention of a mass reader to the long history of sexist bias in medical research, it is shocking that women and their diseases are always underrepresented in clinical trials. The Guardian of Data analysis collected for a new study showed that from 2019 to 2023, 282 trials involving only male subjects were submitted for regulatory approval in the United Kingdom – against 169 focused on women.
Health inequality is a complex and multifaceted problem. There are massive socioeconomic differences in life expectancy and infantile mortality, as well as racial inequalities – for example, in maternity and mental illnesses. These disparities and others, as well as those relating to disability, can also be mapped geographically.
Women, on average, live longer than men, so in this sense, men can be considered disadvantaged. But in addition to the risks associated with pregnancy and childbirth, many more women have dementia, while survival rates of cancers specific to women and men – and other diseases that affect differently – are very variable.
The five -year period of this study, which was carried out by the University of Liverpool and the Regulatory Agency for Medicines and Health Products (MHRA), was not necessarily typical. This does not reveal how funding was divided. But by taking on these warnings, it is difficult to see a benign explanation so that there are 67% more trials investigating the health of men than women. We could reasonably expect that this gap in research inputs contributes to a disparity of the results further.
This is all the more disappointing recent progress in the fight against the exclusion of women in health research. For decades, as Ms. Criado Perez and others have documented it, many clinical trials were carried out solely on male subjects. The researchers preferred to avoid what they considered to be complications associated with the female reproductive system, in particular pregnancy – although experts consider the concerns that the hormones of women could distort the results as having been wrong.
Eighty percent of the British trials of the MHRA study involved both sexes. It is not possible to compare it precisely with past practice, because the data have not been examined in the same way before. But increased recognition of the variable effects of drugs on men and women has led regulators and donors to modify their policies. In the United States, the National Institutes of Health have forced investigators to consider sex as a variable since 2016. In the United Kingdom, the Medical Research Council has changed its rules in 2022. Since then, the experiences carried out on animals should include both sexes-limited exceptions (as when the condition studied affects a single sex).
The lack of medical research on pregnant women appeared during the pandemic, while many were not vaccinated and alarming figures were found in intensive care. The reluctance of testing drugs on pregnant women is often linked to the Thalidomide scandal in the 1960s, when thousands of babies were damaged by a drug given to their mother for morning nausea. But although caution can be deserved, in pregnant women themselves and researchers, there is no shortage of women who are not pregnant. The disparity of specific sex research indicates an anti-feminine bias. Ministers, donors, hospitals and the pharmaceutical industry should all be affected.
