The Patriarchal System: The Exclusion of Women in Medical Case Studies

Focus
Patriarchy & Androcentrism defined
Sexism
Challenging Gender Bias in Research
Women's Health Movement
 

Focus

    All women are subject to the social environment in which we live. Namely, they are subject to the patriarchal system. Medically, women's' complaints are not legitimized, and they have consistently been left out of important case studies. The Women's Health movement has only recently emerged as a counter discourse to the patriarchal system of medicine.
 

Patriarchy & Androcentrism defined:

    Sexism is perpetuated by systems of patriarchy where male-dominated structures and social arrangements elaborate the oppression of women. Patriarchy almost by definition also exhibits androcentrism, meaning male centered. Coupled with patriarchy, androcentrism assumes that male norms operate through out all social institutions and become the standard to which all persons adhere. Males become the unit of analysis. This is extremely detrimental to women's health due to hormonal/physiological differences. As the oldest social institution, the family is seen as the place where patriarchy originated and eventually reproduced throughout society. The organization of the Latino culture is extremely patriarchal. A woman's role is constantly defined by her relation to the men in her life. She is a daughter, a wife, or a mother, she is never simply a woman.
 

Sexism:

    The categories of male and female are stereotyped such that members of the category are assumed to possess certain characteristics by virtue of their biological categories. This results in sexism, the belief that one category, female, is inferior to the other, male.
 

Challenging Gender Bias in Research:

    A major example of gender bias has been the virtual absence of female participants in clinical trials involving drug research and experiments in advanced medical technology. Androcentric medicine insists that biological differences between men and women have major, inescapable health consequences, but then routinely conducts research using only male subjects. Male is the medical norm.

    Consider a federally funded study which examined the effects of diet on breast cancer. Only men were used as sample subjects. (Tavris, 1996). What is known about the natural history of diseases and their treatment in men is inapplicable to women. Evidence suggests that gender bias has flawed some medical research. This bias in research extends to areas such as lack of analysis of study results by gender, scarcity of interdisciplinary research, inadequate funding for research on diseases primarily affecting women, and lack of female researchers (Giudice, 1991: Keville, 1993). In countering these trends there also needs to be the recognition that when women are used as research subjects, they are likely to be white and middle class (Rothman and Caschetta, 1995). The interplay of race and class in particular must be accounted for to make findings applicable to a diverse population of women.

    Research on heart disease and AIDS are notable examples where exclusion of women in clinical trials are ominous. Two widely publicized studies on the effect of low doses of aspirin and the risk of heart attack were conducted using study samples of 12,866 general subjects and 22,071 physicians, respectively. All subjects in both studies were male ( Rosser, 1994). The reduced heart attack risk that emerged from this research was considered so spectacular that the public was made aware of the potential results before the findings were published. These findings cannot be generalized to women, in part because the role of estrogen needs to be considered.

    And as Healy (1991) notes, the exclusion of women in research reinforces the notion that heart disease is primarily a male affliction. It is still the leading cause of death among women and women have a greater risk in the year following the first heart attack than men. Women also receive less aggressive cardiac care than men simply because heart disease is considered a male illness (Young and Kahana, 1993).

    As for AIDS, research has not kept up with its spread among women. There have been no published natural histories of women with HIV infection, although 1994 witnessed the first phase of a long-term study. As a result of this delay women have suffered the denial of benefits and programs because the Center For Disease Control (CDC) did not include women's conditions in their official list of what characteristics constitute AIDS.

    Another example of the patriarchal system at work is the emergence of Chronic Fatigue Syndrome. It is an illness that is in the same family as mono and Epstein Barr. When it first emerged it was prevalent among women. When these women complained about the symptoms from their illness, they were often dismissed as merely wanting attention. Some were told to simply change their hairstyle or to buy something pretty (Healy 1991). Often physicians referred these women to psychiatrists. It was not until recently that Chronic Fatigue Syndrome was recognized as a legitimate illness. The notion of the hysterical woman has been used by physicians to dismiss legitimate concerns.
 

Women's Health Movement

    Women are taking a much more active role in their health care. In addressing these and other health-related issues, several organizations, such as the Society for Women's Health Research, Caucus for Women's Issues, the National Women's Health Resource Center, and the American Medical Women's Association, have emerged as advocates to publicize and influence health policies (Giudice,1991). More women are entering the health care field as physicians, especially as gynecologists and hospital administrators, assuming more responsibility in decision making processes. The concept of a health care team tied to a holistic health perspective has helped in this regard. All this provides an impetus for change.

    The women's health movement has emerged as a challenge to mainstream modern medicine, which is dominated by attitudes and practices not in the best interest of a large segment of the population it is supposed to serve. Blatantly sexist attitudes regarding the sexual inferiority of women still run rampant in this system. The movement is helping to empower women with the belief that alternatives to traditional health care are not only possible, but beneficial. Women are encouraged to take an active role in all phases of health and health care.

    According to Zimmerman, a fundamental assumption of the movement is that women have not had control over their bodies or their health. This is demonstrated by an androcentric system that governs health policy, planning, legislation, delivery of services, and the important clinical roles that determine the creation of health knowledge. Note that it wasn't until 1994 that research was required to be done with women and minorities as test subjects. Most of the knowledge that is in use today was done on white males. Dosages for heart medications were achieved by conducting trials on only males. While it is clear that there are important physiological differences between men and women, women have not had an adequate amount of medical representation. The specific diagnosis, and treatment of diseases in women is based on a male-dominated system where actions can be harmful to the health and well-being of women.
 

Works Cited

 
This web page was developed by Joe Santillan to fulfill a requirement of the class CHI 21: Health Issues in the Chicano/Latino Community taught by Seline Szkupinski Quiroga in the Chicana & Chicano Studies Program at the University of California at Davis, Fall 1998.