‘The Invisible Women’ written by Caroline Criado Perez expresses an exceptional yet disturbing male default mindset in the current societies, where characteristics of the male body including the immune system are dominated in the existing literature and studies (1). The lack of sex-disaggregated data in the medical field forms an essential issue in defining and modelling treatments for different gender in encountering various diseases and medical conditions.
It is already well-established knowledge in the medical field that women are more prone to mental illnesses such as depression, anxiety, eating, and somatoform disorders. While men on the other side are more prone to disorders such as impulse control, substance use, and antisocial personality disorders (2). Evidence up to the early 2000s suggests that women are twice more likely to develop major depressive disorder and dysthymia than men in their lifetime (3). Other differences between the male and female human bodies include the different lung capacities, the different tolerance to alcohol consumption, the different exposition to various hormones, etc. Some researchers argue that sex bias is characteristic of autoimmune disease (4) and ‘sex differences (is evident) in every tissue and organ system in the human body’. (5)
https://www.youtube.com/watch?v=K-_7YwpsvI0
According to sex-disaggregated data collected by Global Health 5050, Covid – 19 has a higher overall case fatality ratio in men than women, with a 68% of men and 32% of women in the ICU admission data. (6) This trend of difference in the reaction of the human body towards disease is also evident in the SARS – CoV where research demonstrates more men were infected in comparison to women (7). Furthermore, through an experiment conducted with both male and female mice with estrogen receptors and SARS – CoV infection, it was suggested that estrogen signalling plays an important role in protecting the female mice from lethal infections (8). This experiment along with other hypothesis presented suggests the sex chromosome and genes is an important factor in the different regulations of the immune system between the two sexes. In addition to the different immune system between the male and female body, women in COVID – 19 is also impacted by the medical equipment provided to them which are essentially designed for the male body. These apparent disparities between the body system and physical characteristics of males and females illustrate the importance of sex-disaggregated data and the hazardous male default mindset in the medical field.
Despite the clear evidence of differences between the male and female body, specifically, their immune system is encountering Covid – 19 and other diseases, scientists or medical professional are unable to determine the cause of such differences other than stating it as a possible different immune system between the two sexes. Perez argues that the fundamental reason behind such catastrophe is the over-dominated medical data collected from men in the existing medical literature. The overpowering male medical data gradually formed the gender bias in medical education to an extent where Travis concluded in her book ‘The Mismeasure of Woman’ that ‘The male body … is the anatomy itself.'(9) This is supported by the gender data gaps evident in the images presented in medical textbooks and medical curriculum in higher education. (10) The lack of sex-disaggregated and female data in the current medical field endangers the health of women especially regarding the admission of vaccines as women often ‘develop higher antibody responses and have more frequent and severe adverse reactions to vaccines'(11). In a study produced in 2014, it was proposed that a male and female version of vaccines should be produced in encountering the different body structures between the two sexes. However, in 2021, during the COVID – 19 pandemics, such versions of the vaccines are still non-existent, it does make me wonder why medical professionals are negligent to engage in this topic despite the overall evidence in the topic.
Reference
- Criado-Perez, C., 2019. Invisible women : exposing data bias in a world designed for men / Caroline Criado Perez.
- NR Eaton, KM Keyes, RF Krueger, et al (2012).An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sampleJ Abnorm Psychol, 121 , pp. 282-288 Christine Kuehner,Why is depression more common among women than among men?,The Lancet Psychiatry,Volume 4, Issue 2,2017,Pages 146-158, ISSN 2215-0366, https://doi.org/10.1016/S2215-0366(16)30263-2.
- Gale, E., Gillespie, K.(2001) Diabetes and gender. Diabetologia44, 3–15. https://doi.org/10.1007/s001250051573
- Global Health 5050. “COVID-19 Sex-Disaggregated Data Tracker”. Available at: http://globalhealth5050.org/covid19.
- Plataforma SINC (2008), ‘ Medical Textbooks Use White, Heterosexual Men As a ‘Universial Model’, SicenceDaily, sciencedaily.com/release/2008/10/081015132108.html.
- Channappanavar R., Fett C., Mack M., Ten Eyck P.P., Meyerholz D.K., Perlman S.(2017)”Sex-based differences in susceptibility to severe acute respiratory syndrome coronavirus infection”. J Immunol ;198:4046-4053.
- Alghamdi I.G., Hussain , Almalki S.S., Alghamdi M.S., Alghamdi M.M., El-Sheemy M.A.(2014) “The pattern of Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive epidemiological analysis of data from the Saudi Ministry of Health”. Int J Gen Med ;7:417-423.
- Channappanavar R., Fett C., Mack M., Ten Eyck P.P., Meyerholz D.K., Perlman S.(2017)”Sex-based differences in susceptibility to severe acute respiratory syndrome coronavirus infection”. J Immunol ;198:4046-4053.
- Tavris, Carol, 1993. The Mismeasure of Woman. Feminism & psychology, 3(2), pp.149–168.
- Dijikstra et al (2008)
- Klein, S. L., & Pekosz, A. (2014). Sex-based biology and the rational design of influenza vaccination strategies. The Journal of infectious diseases, 209 Suppl 3(Suppl 3), S114–S119. https://doi.org/10.1093/infdis/jiu066