Today, many scientific journals publish research results without taking into account the gender of the people who make up the samples studied. This can have serious consequences for women’s health. Here’s how it works.
One winter evening, as I was lost in the abyss of the Internet, I came across an interview with Cara Tannenbaum, Professor of Medicine at the Université de Montréal. Dr. Tannenbaum is Scientific Director of the Institute of Gender and Health and the Canadian Institutes of Health Research (CIHR). She is also co-author of an article published in the prestigious British scientific journal Nature, entitled Sex and gender analysis improves science and engineering.
The professor explains that scientists wrongly assume that female specimens should be excluded from experiments due to the variable nature of the data caused by their reproductive cycle. The widespread belief that these cycle-related hormones could influence results. In fact, research has shown that males exhibit equal or greater variability than females due to fluctuations in testosterone levels, among other things. So female specimens are just as relevant as males. However, scientists decide to use the latter predominantly, resulting in an over-representation of male results in many scientific studies.
From road safety to cancer treatment to new technologies
The failure to consider sex and/or gender in studies can have consequences on many levels.
At the therapeutic level, for example, as in the treatment of people with melanoma or lung cancer, cured with checkpoint inhibitors, a treatment that involves administering substances to stimulate the body’s immune defenses to fight various diseases. The 2015 publication, How sex and age affect immune responses, susceptibility to infections, and response to vaccination, reveals that a higher proportion of men achieve remission. Had the study not taken gender into account when analyzing the treatment, its efficacy could have been misjudged and either be considered ineffective when it’s just not equally suited to women and men.
Another example is the design of products intended to protect us, such as safety systems in motor vehicles. Belts and airbags have been designed and evaluated for average male body measurements (height, injury tolerance, response of the affected body region). The 2011 study Vulnerability of female drivers involved in motor vehicle crashes: an analysis of US population at risk, based on national crash data from 1998 to 2008, showed that female drivers wearing seatbelts were 47% more likely to be seriously injured than male drivers involved in the same crash under the same conditions.
And the examples are numerous and cover a wide range of fields, from gender bias in artificial intelligence to the impact of climate change.
Guides and directives: a framework for official publications
Fortunately, guidelines are appearing to redress the balance. In Europe, The EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network published a guide in 2016 entitled Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use to frame scientific publications. From now on, it must be stated when a study includes men and women, or whether it involves only men or only women, and this must be stated in the title to avoid generalizations.
In Canada, the Canadian Institutes of Health Research (CIHR) has launched a three-part online training module to improve practices: sex and gender in biomedical research, sex and gender in primary human data collection, and sex and gender in the analysis of secondary data from human subjects. These training courses help researchers to understand the importance of sex and gender data in their research.
Another solution is underway, and this one has been introduced by the federal government. The Canada Research Chairs program requires compliance with federal non-discrimination and employment equity policies. By integrating women into the scientific teams conducting studies and research, the perspective will no longer be that of men alone. Hopefully, this will have an impact on the type of research carried out and the decisions made as a result.
We can imagine that it will still take time for sex and gender data to be properly integrated into research processes, but I remain optimistic. It’s important to consider these data as variables, and also to understand that they won’t be systematically relevant, because although gender can have an impact on the results of a study or scientific research, sometimes it has none at all. However, improved practices will undoubtedly enhance the social responsibility of science.
