Not invisible women, but not stereotypes
As a result of the prevailing scientific and medical approach, women's bodies, symptoms and reactions have not been adequately considered in research and clinical studies. Historically, this approach has been based on the idea of biological uniformity among all, but it has had the male body as its main model.
Bernadine Healy, in her 1991 article “The Yentl Syndrome,” criticized that medicine focuses primarily on men, and that women must conform to men’s clinical standards for equal care; and they have often been misdiagnosed and treated. This encouraged gender medicine in order to classify and analyze the symptoms and effects of treatments according to gender variables. Differential morbidity has also been highlighted in the work of the renowned doctor Carme Valls Llobet; that the prevalence of diseases, risk factors and symptoms are different between genders. Examples of this are cardiovascular diseases, breast cancer and chronic pain, since women have special symptoms and evolutions.
But in gender medicine and among the feminist philosophers of science there are doubts as to how to approach gender, which is a category constructed on the basis of social norms, not merely biological. M. The philosopher Christina Amoretti identifies two trends that need to be examined: gender bias, which excludes significant differences, and gender stereotypes, which emphasise non-existent differences. Both lead to incorrect diagnoses and inappropriate treatments. To address the first problem, the NIH mandated in 2016 to consider sex as a biological variable (SABV) to improve research and health care. With regard to the second, Amoretti argues that the gender perspective should be used with all genders, not only women. To do this, the categories that are made must be understood in continuity, not only as binaries, since people can be placed in them in different ways throughout their lives. In addition, the influence of gender intersects with other variables (race, ethnicity, socioeconomic level), which has a complex effect on health.
Sarah S. is among the critical voices questioning the use of sex as a biological variable. The work of the scientific historian and philosopher Richardson. There are risks in basing sexual variables on a possible purely biological distinction between naturalizing rigid categories of men and women and concealing gender diversity, and ignoring the heterogeneity within this dichotomy. In addition, social factors, age, race or lifestyle are excluded, although they have a significant impact on health. In response, Richardson proposes the contextualism of sex in biomedical research: not always understanding sex as a binary and essentialist variable, but defining it by context. For example, in one experiment, four sex categories can be distinguished by estrogen levels instead of two. Therefore, it defends a nuanced, flexible and evidence-based understanding of sex.
Even in biological research, researchers in animal behaviour, behavioural ecology and evolutionary biology require the use of descriptive, precise and practical terminology. For the researcher Malin Ah-King, the binary interpretation of sex as a biological variable does not guarantee this. It is therefore useful and necessary to distinguish between them on the basis of sexual variables, because in some cases they reveal the inequalities hidden by gender blindness, but at the same time there is a risk of reinforcing gender stereotypes.
-> From cells to the whole organism
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