SEX MATTERS

A physician urges women to speak out against the abuses of “male-centric” models in medical research and practice.

As McGregor, who co-founded the Sex and Gender Women’s Health Collaborative, cogently shows, women’s and men’s bodies are different not only in their sex organs, but in all their cells, brains, and the ways in which they metabolize drugs and experience disease and treatments. From her job as an emergency department physician in an urban trauma center and her teaching and research experience, she has amassed ample data and cases to prove her point. A woman with vague chest pain, fatigue, and nausea may be seen as emotionally overwrought and prescribed an anti-anxiety drug rather than perceived as a potential heart attack patient because women don’t experience the crushing chest pain and left arm pain that men do. Unfortunately, writes the author, the anxiety diagnosis is all too often the “go-to” choice, on par with a dismissive, “it’s all in your head.” In the early chapters, McGregor cites older studies such as a hormone replacement therapy trial that showed that the post-menopausal use of female hormones raised serious blood-clotting risks rather than preventing heart disease. The author is to be commended for showing how medicine has long skewed male and harmed women. Especially spot-in are the later chapters on implicit bias, treatment of women of color, and issues affecting trans individuals. The author concludes with to-do lists, questions women can ask their providers, and suggestions for advocacy roles to raise awareness of the issues.

Good ammunition for mandating sex- and gender-based differences in health professional education, research, and practice.