The science of medicine is based on male bodies, but researchers are beginning to realize how vastly the symptoms of disease differ between the sexes.
, Barbra Streisand plays a young Jewish woman in Poland who pretends to be a man in order to receive an education. The film’s premise has made its way into medical lore as “Yentl syndrome,” which describes the phenomenon whereby women are misdiagnosed and poorly treated unless their symptoms or diseases conform to that of men. Sometimes, Yentl syndrome can prove fatal.
Perhaps the greatest contributor to the numbers of women dying following a heart attack, however, is that their heart attacks are simply being missed by their doctors. Research from the UK has found that women are 50% more likely to be misdiagnosed following a heart attack . This is partly because women often don’t have the “Hollywood heart attack” as it’s known in medical circles .
Assuming a woman gets lucky and has her heart disease diagnosed, she must then navigate the obstacle course of male-biased treatment: sex differences have not generally been integrated either into “received medical wisdom” or even clinical guidelines. For example, say a man and a woman are both diagnosed with a swollen aorta .
Medical practice that doesn’t account for female socialization is a widespread issue in preventative efforts as well. The traditional advice of using condoms to avoid HIV infection is simply not practicable for many women who lack the social power to insist on their use. This also goes for Ebola, which can remain present in semen for up to six months.
More broadly, researchers suggest that because women are socialized to “take turns in conversation, to downplay their own status, and to demonstrate behaviors that communicate more accessibility and friendliness,” the traditional medical interview model may be unsuccessful in getting the information from women that is needed to diagnose them effectively. But sometimes — often — women are providing the information. It’s just that they aren’t being believed.
This may be easier said than done, because failing to listen to female expressions of pain runs deep, and it starts early. A 2016 study from the University of Sussex played a series of cries to parents of three-month-old babies. They found that although babiescries aren’t differentiated by sex lower cries were perceived as male and higher cries perceived as female.
The full answer to these questions is beyond the scope of this book. But one possible explanation for at least part of the disparity is that women are being prescribed antidepressants when they are not in fact depressed. Women’s physical pain is far more likely to be dismissed as “emotional” or “psychosomatic.
The result is that US women no longer have more active years than men, despite their longer lives, and while women account for 57% of US citizens aged over sixty-five, they make up 68% of those who need daily assistance. In 1982 both men and women who lived to eighty-five could expect two and half further years of active healthy life. For women, that figure hasn’t changed, but an eighty-five-year-old man alive now can expect to be active and healthy until he’s eighty-nine.
We have only one treatment for women with weak contractions, and it doesn’t work half the time. Compare this … to the around fifty drugs available for heart failure. The failure of pharmaceutical companies to step in here and capitalize on what is surely a gold-plated commercial opportunity may seem baffling, but it’s quite possibly just another data-gap problem. In an email, Legro told me that, for cost reasons, the pharma industry “doesn’t usually fund investigator-initiated projects,” particularly of drugs that are available generically.
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