Medicine’s trust problem among women

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The persistent legacy of female clinical trials, combined with frequent gaslighting by doctors and a general lack of research on women’s bodies, has led many to distrust medicine.

Why it matters: This distrust, as well as a constant barrage of misinformation, can influence women’s health decisions, including deciding not to follow recommendations for the COVID-19 vaccine.

The persistent legacy of female clinical trials, combined with frequent gaslighting by doctors and a general lack of research on women’s bodies, has led many to distrust medicine.

Why it matters: This distrust, as well as a constant barrage of misinformation, can influence women’s health decisions, including deciding not to follow recommendations for the COVID-19 vaccine.

Case study: Confidence in the COVID-19 vaccines has eroded some people due to misinformation linking the vaccinations to infertility and growing anecdotes about temporary changes in menstrual flow – leading to confusion and hesitation.

  • “A lot of women think that right away because, for one thing, we are plagued by all of the misinformation that is being very deliberately spread to weaponize views like fertility problems … to undermine the vaccine,” says Alice Lu -Culligan, a MD-Ph.D. Yale School of Medicine student who researched and wrote in the New York Times (subscription).
  • “And then as humans they will often be conservative and safe, especially about something as vague and heavy as fertility,” she adds.
  • While the COVID vaccine trials had roughly equal numbers of women and men participating, the decision in the early vaccine clinical trials to exclude pregnant women has fueled hesitation, several experts tell Axios.

Between the lines: While it’s a good example, the suspicion goes beyond the subject of COVID-19 vaccinations and comes from a number of factors including …

1. Gender differences are often ignored in study analyzes for drugs in a system in which “sexism is embedded” leading to a loss of key knowledge, says Namandjé N. Bumpus, director of the Department of Pharmacology and Molecular Sciences at the Johns Hopkins University School of Medicine.

  • Women, and even female animals, have long been excluded from studies because they believed that a woman’s menstrual cycle or an animal’s oestrus cycle could affect results, says Viki Male, lecturer in reproductive immunology at Imperial College London.

2. Representation in legal proceedings is particularly low for transgender women and women of color, who often do not receive adequate access or encouragement to participate in these studies, says Bumpus.

  • “So, you tell me half of it [of COVID vaccine trials] are women. That’s great, but what about these groups that are historically underrepresented? “
  • “I think that’s a big topic [for] Black women, Latinas, Asian women, and indigenous women. These people are still being excluded from clinical trials in many ways. So I think data needs to be reported, “adds Bumpus.

3. A persistent taboo to talk about certain topics about women’s biology, coupled with a lack of research, can lead to ignorance.

  • “We don’t understand enough about female biology in general, and we definitely don’t know enough about all of the things that can affect menstruation and what the mechanisms are,” says Bumpus.
  • “There’s not enough research. But despite what we have, we don’t talk about it enough,” says Male. “A lot of people don’t even know what the normal range is when it comes to the menstrual cycle.”
  • Lu-Culligan agrees. Many women have noticed that if they’re sick, stressed, or changing their exercise routine, their periods can change, but “we don’t know exactly why,” because the mechanisms are unknown, she says.
  • And when women want to talk about symptoms or problems, they are often confronted with gaslighting by their doctors – which is shown again and again through studies on pain management or disease diagnosis, as well as through personal stories.

The big picture: “We don’t know much about women’s biology, reproductive health, menstruation and pregnancy research. But the positive thing is that research on all of these topics continues to grow, ”says Lu-Culligan.