From cells to the whole organism
Sex affects both the development of diseases and the effectiveness of drugs, from the cellular level to the whole organism. For example, while male mice process pain primarily through microglia, females process it through T cells. Statins used to lower cholesterol are less effective and have more side effects in women, because the activity of the liver enzyme that helps metabolize this drug is different in men and women. This is not an isolated case; 80% of the drugs withdrawn from the market between 1997 and 2001 were particularly dangerous for women. Studies conducted only in one sex cannot be generalized to the other sex, and if the data are not discerned, the results dissolve and the specific benefits and harms of diseases and drugs are not observed. Not in vain, the Food and Drug Agency today calls for research to be tested on women and men before approving new drugs.
Not only differentiate, but also compare
In addition to the presentation of data by sex, Peters and colleagues claimed in their publication "A roadmap for sex- and gender-disaggregated health research" published in 2023 that one sex group should be used as the control group of the other to see if one has greater health disadvantages compared to the other. This recommendation was taken into account by our research team, which, when investigating hospitalizations in the Basque Country 2016-2018, found that women had more serious colon cancer admissions than those scheduled for men. It seems that women are diagnosed with this type of cancer later, although they are more likely to undergo an early detection test. The Gendered Innovations initiative of Stanford University offers an explanation for this phenomenon: it is more common in women to have cancer in the right colon than in men, and it seems that in screening tests the left one is better perceived. Likewise, in the distribution of data by sex during the Covid-19 pandemic, it was observed that the symptom of nausea appeared more frequently in women, knowledge that allowed the refinement of diagnoses.
Recognize differences without falling into discrimination
In health records, sex is separated in binary form, which is incorrect. Intersex people make up as much as 1% of the population as redheads, and we hardly know their hormonal levels and the advantages or disadvantages of combinations of sexual chromosomes against diseases and drugs. If we have started to investigate female physiopathology late in the healthcare industry, we have not even smelled the most intersex yet. On the other hand, there has also been very little research on how biological sex and gender roles interact in the morbidity of trans people, starting with the fact that the two (gender identity and biological sex) are not recorded together in databases. Finally, it is also important to know how to take the size of the differences when making comparisons. In the past decade, a study found that the male knee joint had a slightly larger angle than the female, and began selling knee prostheses with different angles for women and men. The results did not show, however, that the new prostheses were better, since the height of the person has a greater influence on the angle of the joint than the sex itself.
-> Not invisible women, but not stereotypes
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