In 1962, the anti-morning sickness drug thalidomide was discontinued. Lack of research and communication had led the drug to be prescribed to pregnant women, resulting in 10,000 birth defects. The US Food and Drug Administration then mandated that all women of childbearing age—15 to 44 years old, a full third of the human lifespan—be excluded from all drug trials. No data could be collected on the effect of drugs on women in this category. Nevertheless, women were still prescribed these medications, to unknown effects.
In 1993, the National Institute of Health Revitalization Act aimed to correct this deadly research gap. It required clinical trials to include women if they were to receive federal funding. Nevertheless, trials funded from other sources had no such requirements, and the act was rarely enforced.
Currently, in sex-specific diseases like prostate cancer or endometriosis, nearly three-quarters of the male-specific diseases qualify as “overfunded” (that is, accorded more funding than proportionate given the impact on the male population), while women’s diseases are almost universally underfunded. Outside of cancers, only two percent of all healthcare funding is allocated to women’s health conditions.
This research gap reinforces the absurd idea that the male body is the default, while female bodies are an imperfect alternative. Male bodies are constant, while female bodies cycle and are therefore more annoying to study. Such ideas underpin the categories of “anatomy” and “female anatomy,” or “health” and “women’s health.” A recent study of European and North American medical school textbooks found that non-sex-specific diagrams (such as diagrams of the nervous system) depicted men three times more than women.
Women constitute more than half the population. Women, like men, are normal, default humans.
When women are not included in trials, and their health is not studied and funded, the results are devastating. Sex differences can affect all areas of health, from lung capacity to heart disease. Women are generally smaller than men and carry a higher percent of body fat, which means that they metabolize drugs differently; nevertheless, drug doses rarely take this into account. It took until 2014 for the FDA to create sex-differentiated dosage requirements for the sleep medication Ambien, because women’s slower rate of drug metabolization was leading directly to an upsurge in fatal morning car crashes. Women’s heart attacks present differently from men’s, but a lack of funding and education has led doctors to miss women’s heart attacks throughout time: a recent UK study found that women are 50% more likely to have their heart attacks misdiagnosed than men.
Although deaths are important, it is also crucial not to neglect the severity of lowered quality of life: erectile dysfunction affects a fifth of men and is five times more funded than PMS (premenstrual syndrome), which afflicts 90% of women with symptoms far more life-altering.
Today, women’s needs and symptoms are regularly discounted, dismissed as hysteria and anxiety. In fact, some degree of anxiety is legitimate under the current system of treatment, when women’s health is not researched enough to know the true repercussions of many prescriptions. Until women are equally included in clinical trials, until there is research into the effects of medication on pregnant women, until drug dosages are sex-differentiated, women will not have any semblance of equality in the healthcare system.
(For more research on these topics, see Invisible Women: Exposing Data Bias in a World Designed for Men, by Caroline Criado-Perez.)