Pulse of health research: Strange sexism of science

It's probably not news to you that science in general, and health and medicine in particular, are struggling to increase the numbers of women practicing at the highest levels. Male domination of these fields has of course nothing to do with any innately superior male aptitude for sciences, but rather societal tendencies to view science as a male rather than female domain. It's probably also no surprise that women are underrepresented as subjects in medical research, especially late stage trials of new medications. The typical depression drug, for example, is studied in middle-aged white males (MWMs) who are not suffering from any other condition, even though women are more likely to be afflicted by depression, and most patients in general suffer from multiple conditions at the same time. The elderly and children, meanwhile, are treated as if they are smaller versions of MWMs, despite biological evidence to the contrary.

While none of this is news, I was appalled to learn that male preferences in the health sciences extend beyond humans to encompass rats, mice and other lab animals as well. An article in the well-respected scientific publication Nature reports on the bizarre practice of lab researchers to prefer male mice, even when performing early stage animal trials of medicines for diseases that may only effect women. A study of the use of male versus female lab animals across 10 disciplines and 42 journals in 2009 found that 80% of disciplines favored the use of male animals. Why this bias? Since female mice ovulate, their hormonal cycles could confound study findings. A major problem with that logic: If mouse hormones influence treatment, wouldn't you want to know that, since it suggests that human hormones might have similar effects?

Funding and oversight agencies, including the Food and Drug Administration, National Institutes of Health, and General Accounting Office, have recognized this bias for years, enacting policies or recommendations to correct it. But such policies are either having no effect, or making very slow progress. And editors at scientific journals have only recently begun to ponder the disparity. Published studies in neuroscience research, for example, are still five times more likely to examine men rather than women. Many clinical trial results are not analyzed for differences among their male and female participants. And early stage safety trials typically enroll only a quarter as many women as men.

This foolish assumption that women are just smaller men has a number of troubling effects: Women's care can suffer when we don't know enough about how treatments effect them, which is often quite different than the effects in men; and both men and women's care can suffer when drug's aren't approved because regulators don't see enough data about drug safety and efficacy in women. This strange sexism is a reminder that even in professions such as health science that value objectivity, social values of sex-preference continue to have powerful effects, and need aggressive policy implementation to be overcome.

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