Opinion: Textbook sexism creates misinformed doctors

Science textbooks — bereft of diversity and gender neutrality — use androcentric facts and figures that restrict physicians from understanding how to accurately diagnose and appropriately treat non-male patients.

As a result, women and people of color are often misdiagnosed, mistreated, or simply not treated at all, which in extreme cases, can result in death.

The United States urgently needs the demographic breakdown of its doctors to parallel the demographic breakdown of the American population, as greater diversity allows for greater cultural competence, increased innovation, and better patient care as a whole.

The white-washed, male-dominated nature of the medical world is partially a product of the classrooms from which future physicians are born. Through language with biased undertones, medical textbooks and literature fail to prepare physicians to treat their patients compassionately and competently.

The consequences are substantial for patients of color. Researchers from the University of British Columbia found that by displaying majority white patients, doctors may be ill-equipped to appropriately treat patients with darker skin tones. Some diseases, such as skin cancer, present themselves differently depending on skin color. If doctors are only taught how to identify such diseases on white patients, doctors will not be able to effectively treat other patients.

For women, covert sexism may linger behind what may seem to be otherwise unbiased descriptions of biological processes. In her seminal article “The Sperm and the Egg,” anthropologist Emily Martin details how the language in biology textbooks surrounding reproduction overcredit the role of sperm in the process of fertilization, reducing the ovum to a passive bystander waiting to be acted upon by the sperm.

Moreover, a 2013 study led by Cardiff University researchers underscored the shortcomings of anatomy textbooks in particular. Some medical students involved in the study highlighted the lack of body diversity, noting how their anatomy textbooks only depicted female bodies with “perfect breasts.” Additionally, many textbooks have historically used androcentric descriptions of anatomy — such as describing the clitoris as a diminutive form of the penis — creating misconceptions surrounding female anatomy.

In fact, one group of researchers sought out to combat the confusion surrounding female genitalia by producing a comprehensive account of the clitoris. In doing so, they noted that most textbooks “lack detail and include inaccuracies” when diagramming female genitalia. The same can hardly be said for the penis.

This is because current medical textbooks draw upon centuries of data and information collected by male scientists from male subjects.

A recent report produced by Brigham and Women’s Hospital in Boston highlighted the consequences of male-dominated research. By failing to include women in clinical toxicology studies and/or acknowledge the impact of sex on the data collected, researchers have restricted physicians from being able to appropriately care for their female patients.

The Institute of Medicine, a non-profit organization dedicated to public health, explains that the difference between possessing XX and XY can have a greater effect on one’s health than historically believed and, therefore, scientists should consider sex at “all levels of biomedical and health-related research.”

Cardiovascular disease kills more Americans than any other disease, regardless of gender. Yet, men make up two-thirds of clinical trial subjects. Of the research that does include female subjects, only 31 percent account for sex in the outcome. Cardiovascular disease manifests differently in women than it does in men. Nonetheless, physicians treat female patients based upon data from mostly male subjects.

By not presenting images of diverse patients, textbooks have failed the patients of color whose skin cancer was misdiagnosed. Textbooks must include a diverse array of skin tones when drawing upon examples of skin diseases.

By not using gender-neutral language, textbooks have failed the women who have been viewed as lesser versions of men. Textbooks need to ensure they present unbiased information in order to avoid perpetuating societal stereotypes and prejudices.

By citing research conducted by scientists who neither acknowledge sex in their research or findings, textbooks have failed the 44 million women in the United States affected by heart disease. Researchers must also look into how diseases specifically affect trans and non-binary people in order to ensure no individual receives second-rate treatment due to their identity.

The solution lies in the hands of those who hold immense power in the scientific community: textbook publishers and scientific researchers. Publishing companies must ensure their books are not presenting human physiology in a whitewashed, androcentric manner, and researchers must take sex into consideration while collecting and interpreting their data.

Lily Borak PZ ’21 is a neuroscience major from Newton, MA. She enjoys informing others that Fig Newtons are indeed named after her hometown.

 

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