Women's Healthcare is Not Men's Healthcare

Going back to the ancient Greeks in which Aristotle described female bodies as mutilated males, the general thinking was that women’s bodies were not that much different from men’s bodies. Minus a few details and hormones.

To this day, women are often ignored, unheard or dismissed by healthcare professionals, impacting the length of diagnosis time as well as having a detrimental effect on healthcare outcomes.

Fair Representation for Women

Even with the passage of the 1993 federal law, women are still not fairly represented in clinical trials for a number of reasons but it all boils down to a lack of access and trust — which is more prevalent for women of color.

The medical community, in general, has trouble understanding and relating to female bodies and under-represented groups because their medical training didn’t include these groups in an equitable manner. It focused on the premise that all bodies are alike.

How can physicians encourage patients to participate in clinical trials if they cannot relate to their patient’s needs?

Other factors that hold women back from greater participation in clinical trials are the way trials are designed, logistical barriers, access and unconscious bias. In a 2022 study, 80% of black women with breast cancer said they would love to participate in clinical trials, however only 40% of them were offered entry into the trials. Clearly we can do a better job of broadening access to those who would benefit..

Better Healthcare Results

Given the aforementioned hurdles, how can we ensure that women are fairly represented?

Progress has been made in partnering with patient advocacy groups that focus on women and women’s health. These groups have also worked with researchers to design studies that specifically address the needs of women. Providing training for the clinical trial staff has been effective in removing unconscious biases that prevent access to finding the right population.

One of the biggest drivers of change in how clinical trials are conducted was the COVID-19 pandemic which created a sudden and urgent need in seeking a cure.

In an unprecedented measure, the clinical trial process was quickly adapted to increase participation and efficiency in which the process was conducted completely online from recruiting participants to conducting follow-up meetings and remote monitoring of their progress. Digital participation is now a standard process for all applicable clinical trials.

Continuing on the progress made, in December 2022 President Joe Biden signed a law requiring researchers and companies seeking approval for late-stage clinical trials to submit a plan to the FDA ensuring diversity among trial participants.

Since 1993, the FDA reported that we are close to having parity with 50% men and 50% women in some trials. However, we still have a long way to go in ensuring that women of color and minorities are fairly represented in that 50%. There is also more work to be done to ensure that all studies of underrepresented groups comprise an equal percentage weighting for the diseases that affect those groups.

Women are still not fairly represented in clinical trials, but the dynamics are changing, and more importantly, diversity in clinical trials — once not even part of the conversation, is becoming more top of mind across the medical community.