Gender is a set of social and cultural characteristics commonly associated with sex and with which a person identifies (woman, man or non-binary). It can influence lifestyle, the risks we take, how we perceive our health, how we care for ourselves, how we use medical services, and how these services treat us.
Do sex and gender influence the diagnosis of diseases?
All of this can influence the likelihood of developing a disease, its symptoms and its progression. In fact, science has already proven this. At the end of the last century, people were already talking about the need to adapt medicine to take sex and gender into account. Heart disease, such as heart attacks, was one of the first examples, but today we know that there are also differences in many other diseases, such as cancer, infections, respiratory diseases, and mental health problems.
For example, overall, cancer is more common in men, but some types of cancer are more common in women. In heart attacks, although women experience chest pain just like men, they often have associated symptoms, such as shortness of breath or fatigue. If we are not aware of these, the diagnosis of a heart attack may be delayed or not made at all, with the serious consequences that this entails. In addition, there are risk factors for heart attacks that are specific to women and are often ignored, such as certain complications of pregnancy or early menopause.
Gender differences in response to medical treatments
The response to treatment can also be different. One example is immunotherapy. Although it has revolutionized the overall prognosis for cancer, in some types of cancer, such as lung cancer, it is much more effective in men than in women. On the other hand, the toxicity derived from treatments in general is much higher in women.
The way women and men relate to the healthcare system is also different. Women tend to seek medical advice later when they have symptoms and they are more compliant with treatment. And some socio-cultural factors, such as poverty or abuse, which always have a negative influence on diseases, have a stronger impact on women.
Despite this, today’s medicine often fails to take these differences into account. Firstly, it is hard to differentiate between what is influenced by sex and what is influenced by gender. It is common to generalize when talking about women and men, and, therefore, the information obtained may not be sufficient. Furthermore, in scientific research there are two major problems. The first is that women are underrepresented: many studies include few or no women, especially if they are pregnant or may become pregnant. The second problem is that the results are often applied to everyone equally, without analysing the differences between sexes and genders. This means that very important data are lost and medicine is not as accurate as it could be.
Despite the difficulty, the efforts made so far must be continued, as failure to do so could lead to poorer healthcare and worse health outcomes. We must adopt a sex and gender perspective in order to rewrite medicine in a better, more personalized and more equitable way.
