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A new research centre dedicated to gender equity is hoping to change the one-size-fits-all male-centric approach to medical research.
The Centre for Sex and Gender Equity in Health and Medicine launched late last month at the University of New South Wales (UNSW Sydney).
An initiative of the George Institute for Global Health, the Australian Human Rights Institute at UNSW Sydney, and Deakin University, it has support from collaborative partners, the Victorian Department of Health and the Association of Australian Medical Research Institutes (AAMRI).
Historically, more than 70% of participants in early-stage clinical trials are white men.
The Centre will address how gender bias can lead to poorer outcomes, evidence gaps, and inefficient health spending for women and girls, intersex people, transgender and gender-diverse people, and in some cases men and boys.
Professor Christine Jenkins is the Head of the Respiratory Group, the George Institute for Global Health. She told InSight+ that the goal of the Centre is to improve equity in health care.
“This is unquestionably not a women’s health issue. This is about equity … Because there are times when men are very disadvantaged,” she said.
The impact of gender bias in health care
An example of gender bias can be seen in respiratory medicine, with differences in the way men and women present and also how different genders respond to treatment.
“We don’t know as much about women with chronic respiratory disease, especially chronic obstructive pulmonary disease (COPD) as we do about men with chronic respiratory disease. And yet we apply the findings of those research studies to men and women,” Professor Jenkins explained.
A person’s gender can even have an impact on the diagnosis they’re given.
“For instance in Spain, it’s been shown (and I don’t have reason to think this would be significantly different in Australia) that women who present with chronic respiratory symptoms and are found to have obstructive lung disease are more likely to be given the label of asthma than they are COPD. If you’re male, you’re more likely to be given the label of COPD.
“They are different diseases with a lot of overlap but, nevertheless, they have different prognoses. Treatments have different impacts, the natural trajectory of those two diseases is different,” she continued.
Associate Professor Severine Lamon is an Australian Research Council Future Fellow within Deakin University’s School of Exercise and Nutrition Sciences and co-head of the Melbourne hub of the Centre. Her research focuses on the physiology of sex differences in skeletal muscle health, where she found the majority of skeletal muscle research stemmed from male studies.
“A direct demonstration of that is that sarcopenia, which is an extreme form of age-related muscle wasting, is more prevalent in females than males. But there are no sex-specific models of care and/or practice for this particular age-related musculoskeletal condition,” she said.
The power of education
A key focus of the Centre is educating all health care professionals about sex and gender diversity.
“I think a key thing is to introduce it into medical curriculum, so that it is understood from the very start. Not just medical, in terms of people who are going to become doctors, but people who are going to become health professionals at any level,” Professor Jenkins said.
“We also need community awareness. And I think community awareness is best developed through progressively enabling people who don’t identify in a binary sex or gender classification to be able to speak out and to be heard.”
Their educational approach will also aim for those at the top.
“I believe that part of our role as the Centre is to also educate funding bodies so that they understand the importance of funding sex and gender equitable research, for the simple reason that it is not a good investment of money otherwise: because you’re only doing half of the research, it only applies to half of the population,” Associate Professor Lamon said.
Changing the way research is conducted.
According to Associate Professor Lamon, it’s important to educate new researchers about how to include gender diversity.
“We need new researchers that enter the field to know how to design research protocols, or studies that are sex and gender equitable. And this is about how and who to include in your study design and how to account for what. In the past we considered females/women too complicated because of the ‘potential confounders’ that we didn’t want to deal with. The easiest one to think about is the menstrual cycle. It’s not an exception but the norm in most females of reproductive age,” she said.
They are also encouraging researchers to look back at previous studies.
“Even retrospectively encouraging researchers to look back at their data, and to see what we can learn about sex and gender differences, could help health professionals to deliver better care, more targeted care, care that is focused and person-centred,” Professor Jenkins said.
At the recent launch of the Centre, they made a number of recommendations around how organisations can incorporate sex and gender into their research.
“How they can pre plan for it, how they can look at doing audits. A simple audit in a research institute and then audits of things like professional guidelines, audits of health professional granting bodies, to be sure that they are undertaking research studies incorporating sex and gender diversity,” Professor Jenkins said.
The future of gender diversity in research
Professor Jenkins admits it could take years to transform the way we think about sex and gender. However, she’s excited about how it might improve health care.
“Part of that is not treating people with things that don’t work for them, but treating people with things that will be helpful for them,” she said.
Associate Professor Lamon agreed.
“We want to tackle this problem from a very holistic way, where the common goal is to reduce health inequities in sex and gender,” she concluded.
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