Gender medicine: when equality between men and women becomes a scientific imperative

In the realm of medicine, true gender equality might just be within reach—and it’s not merely about adhering to a noble principle of fairness. Rather, this is a real mandate from science itself, brought to light by the findings in gender medicine over the past 30 years. The World Health Organization defines it as “the study of the impact of biological, socio-economic, and cultural differences (determined by an individual’s gender) on the health and illness of each person“. Essentially, the concept emerged as a response to fill the gender gap within medical and scientific research.

Equality is seen as a necessity in this context—even before it is considered a right. It dawned on us quite recently in history that medicine has predominantly been tailored towards men, with women often being underrepresented in statistics and research outcomes. This discrepancy (known as gender blindness, which can lead to inaccurate assessments by researchers) was first noticed by American cardiologist Bernardine Healy. In the 90s, while analysing a cardiovascular disease study, she coined the term and concept of gender medicine.

As Barbara Tavazzi and Francesca Klinger, Professors of Biochemistry and Histology at UniCamillus actively researching in this field, highlight: “Gender Medicine (GM) is garnering increasing interest because all medical practice is encoded by fundamental guidelines derived from experimental and clinical studies, often on a large scale, conducted with an androcentric approach. GM aims not only to draw the scientific world’s attention to disease that more frequently impact one sex over the other, but to instigate a change that affects not just clinical practice, but the very methodological approach of scientific research. So GM is not a new speciality, but a necessary and rightful interdisciplinary dimension of medicine“.

The fundamental issue of gender equality does not challenge systemic distortions like the wage gap between men and women or the predominance of men in top positions in healthcare. It’s about a problem that significantly affects the health protection of individuals. In the epidemiological, clinical, and experimental spheres, the differences observed and examined in the onset, progression, and manifestation of a disease, even the most common one, between men and women are remarkable. This helps explain, for instance, why despite women generally living longer than men in Italy and many other Western countries, the expectancy of a ‘healthy life’ is substantially the same for both.

GM has many branches of scientific and clinical application in which it can develop—the UniCamillus professors explain—but for each one, countless aspects must be considered. Gender influences physiology, pathophysiology, and human pathology, i.e., how a disease develops, what its symptoms are, and how prevention, diagnosis, and treatment differ in men and women. In pharmacology, for example, critical factors include hormonal variations between the sexes, as well as differences in weight, body composition, gastric acidity and everything else that can affect the absorption and effectiveness of medicines, as well as their toxicity for people. Cardiology, cardiovascular diseases, immunology, skeletal system pathology and oncology are further areas where GM can have particular applications and yield useful results if the right clinical approach is used. According to a global view of the concept of health, thanks to GM we can achieve healthcare delivery that considers personalised treatment in the evaluation and management of disease, also considering gender identity, age, ethnicity, educational level, psycho-social conditions, and socio-economic factors”.

But achieving full gender equality in medicine is not just a goal to help society advance towards recognising individual rights. It is foremost a necessity for medical science to progress for everyone’s benefit. “Gender medicine—Professors Klinger and Tavazzi emphasize—cannot forego greater focus on inclusion and equality, starting from pre-clinical research, laboratory studies, all the way to clinical application. The study design phase is crucial to ensure collection of segregated data, leading to quality results that genuinely consider the differences between the participants in the study. However, always trying  to strike a balance in the enrolment of men and women would make research more complex, increasing both costs and the workload for staff. It’s important that researchers discuss among themselves the best strategies and working methods to make clinical research more inclusive. Private entities must also start addressing this issue, requiring all proposals to include an intersectional analysis of sex and gender. There’s still much ground to cover in closing this gap. The first step is to recognise that, by bridging this gap, we can finance a higher quality of science, making a real difference for both men and women“.