Gender bias can kill

Based on her own experience, feminist historian Elinor Cleghorn published “Unwell women: a journey through medicine and myth in a man-made world” last June. and myth in a man-made world”, not translated into French).

This Brit tells in this book how women’s health has been consistently misunderstood and misinterpreted throughout history.

A different treatment of gender-related diseases

“The so-called nature of women, the representations made of them as weak creatures, have long permeated medicine”, confirms neurobiologist Catherine Vidal. For the High Council for Equality between French women and men, she wrote an enlightening report on the subject, released last year: Taking sex and gender into account for better care: a public health issue.

She explains there that, among the sick first of all, social codes related to feminine and masculine gender influence the expression of symptoms, the relationship to the body, the use of care. Among healthcare personnel, prejudices linked to gender are also likely to affect the interpretation of clinical signs and the management of pathologies.

Misdiagnosed diseases

The so-called “feminine” or “masculine” diseases seem to be a good example. Women are more vulnerable than men to cardiovascular diseases: 56% die against 46% of men. However, myocardial infarction is still under-diagnosed in women because it is wrongly considered as a disease of men stressed at work.

And women certainly suffer on average twice as much from depression as men, but the main reason is not due to female hormones as has long been claimed. Research has shown that gender difference in prevalence of depression varies by socioeconomic background.

Other diseases, which relate to the sexual and reproductive health of women, are also poorly taken into account. Thus endometriosis, now recognized, has long been under-diagnosed, in particular because it referred to the taboo of menstruation. “It was not until 2020 that this disease was included in the 2nd cycle of medical studies”regrets Catherine Vidal, who calls for a major effort to train health professionals on gender issues.

Women feel less concerned about their health

But delays in treatment or screening are sometimes linked to the women themselves. In France, a survey showed that women call the Samu on average 15 minutes later than men, in cases of infarction. This increases the risk of sequelae or less good care.

“They feel less concerned about their health, they often put it after their family or their work”, regrets cardiologist Claire Mounier-Vehier. At the origin of the itinerant operation “Bus de coeur”, which since September has aimed to offer screening and prevention advice to vulnerable women, this head of service at the Lille University Hospital is concerned that 200 women a day die of cardio-cerebrovascular diseases. “In eight out of ten cases, the disease could be avoided by screening”, she assures. It must be said that the warning signs of a heart attack are sometimes different, more sneaky when it comes to women, such as persistent fatigue or digestive disorders.

Here again, “if the health professional is not aware, we can fear a diagnostic error”warns Claire Mounier-Vehier. “We must stop believing that when a man collapses he has a cardiac arrest, but that when it’s a woman, it’s vagal discomfort”.