Medical Discrimination Is A Patriarchal Weapon

Words by Jamie Murray-Todd

What kind of symptoms would you look for if you thought you were having a heart attack? If you answered chest discomfort or pain, shortness of breath, and nausea or lightheadedness, you’re correct! Only if you’re a man, though. For women, the signs can be different; unexplained fatigue, dizziness, sweating, and neck, back, and jaw pain can be just as telling of a heart attack as the symptoms also experienced by men. If this is new information to you, I’m not trying to scare you – it’s just important to know, for your wellbeing and for that of those around you. Heart disease is the leading cause of death for women across the world, so it’s important that we look out for ourselves and each other. The thing is, symptoms of heart disease and attacks in women aren’t common knowledge. And there’s a reason for that.

What we know about heart disease comes primarily from information gleaned through cardiovascular clinical trials. From 2010 to 2017, only 38% of participants across 740 cardiovascular trials were women. It wasn’t until 1993 that the National Institutes of Health mandated that women and “members of minority groups” be included in clinical trials in the United States. Years later, these same demographics are still underrepresented. In Australia, we do not have any equivalent policy mandating equal representation in clinical trials. Most medical research is conducted with white, cisgender men as the default subject, and so they’re often overrepresented in information accessible by the general public. This puts everyone else at risk, because we’re so often looking for the wrong symptoms, or don’t even know that we should be looking for alternative symptoms at all. Alzheimer’s and lung cancer are further examples of health issues posing significant risks to women, whose gender-specific symptoms and treatments are often excluded from the conversation.

Let’s be clear: systematically excluding particular demographics from clinical trials is medical discrimination. Samesex couples have historically been exluded from the medical trials of couples in regards to their sexual health. Transgender individuals are consistently excluded from HIV research and countless other clinical trials. This is linked directly to the widespread lack of knowledge of transgender healthcare among medical professionals, which puts transgender and nonbinary individuals at risk every day. Even when LGBTQIA+ individuals are included in clinical trials, data about sexual orientation and gender identity is often not collected. Information related to disability is also excluded from many clinical trials reports.

People of colour and Indigenous people are greatly underrepresented in clinical trials, too. In the United States, only 5% of breast cancer trial participants were Black women, who have a 41% higher mortality rate from breast cancer than white women. From 2008 to 2018, only 1.5% of clinical trials in Australia focused on the health of Aboriginal people. Whiteness as the default in medical research stems back to the birth of race theory in Europe, and is a result of eugenicist ideas that have been used to justify colonisation and genocide. To this day, healthcare for people of colour is often based on ‘race corrected’ measurements that are blatantly false. The overrepresentation of whiteness in clinical trials means that this misinformation is continuing tocause needless harm instead of being swiftly corrected.

The lack of diverse representation in clinical trials harms women and everybody else whose genetics and experiences don’t align with those of the medically standard white man – which, for the record, includes a number of white men too. Medical discrimination is just another in the long list of examples of how the patriarchy harms us all. Science strongly impacts how we interpret the world around us, which means that it is constantly evolving. Let’s not hinder its evolution by passively treating bigoted and eugenicist rhetoric established to uphold patriarchal, colonial standards as indisputable truth. The sooner we recognise the lingering effects of the long and pervasive history of medical discrimination, the sooner we can work to reverse them. I’d encourage you to do your own research on this topic, because I’ve only really scratched the surface here, and there are so many people out there working to bring about change. Nobody deserves to suffer because they’re uninformed against their will – accurate medical information and adequate healthcare should be accessible for everybody.