Zoe Spikerman
We sat in a small room lined with fold-up chairs, medical diagrams, and plastic corpses begging to be resurrected. Our CPR instructor stood front-and-center, showcasing a CDC-issued presentation titled “Responding to Heart Attacks,” the statistics on heart disease ingrained into her tongue. As we watched actors desperate for Hollywood fame reenact cardiac arrest, our instructor listed the most common symptoms of heart attacks.
With a sheepish, solemn smile, she informed us that these symptoms predominantly affected men. “To learn the heart attack symptoms that affect women,” she continued, “you’ll have to research on your own.”
An awkward tension plagued the air. Twelve people in this room hoped to become first-aid & CPR certified. All of them were women. We paid to learn how to save lives, but we weren’t learning how to save our own.
Inequality in modern medicine has existed since the dawn of the Band-Aid. Even in the 21st Century, an era defined by social justice advocacy, the medical world still belittles anyone who’s not male. Even though activists have fought for legal change and protection, we’ve just begun to achieve minimal reform.
Only thirty years ago did Congress pass the National Institutes of Health (NIH) Revitalization Act, “which required the inclusion of women and ‘racial and ethnic minorities’ in NIH-funded clinical trials.” This legislation also revoked the FDA’s sexist policy that prevented women with “child-bearing potential” from participating in clinical trials. The FDA’s clinical trials, I’ll remind you, determine the safety and ethicality of our nation's food, drug, and vaccine supplies.
However, the FDA isn’t the only organization that performs clinical trials, and not all clinical trials are funded by the NIH. According to Johns Hopkins, the drug and device industry now funds “six times more clinical trials than the federal government.” The exponential increase in private clinical trials proves worrisome, as these companies pursue profits over public health. Quick, cheap trials yield greater profits, and since our society stigmatizes the inclusion of women in medical research, these organizations opt for the “less difficult,” “less hormonal” cis-gendered male.
On the other hand, NIH-funded trials—supposedly more fair and equitable—aren’t necessarily reliable: “Indeed, NIH-funded trials are required to actively recruit women and people of color among study participants, but there is inconsistency in reporting on the inclusion of these populations.” Who can we even trust?
Medical institutions don’t just lack our trust—they lack vital information! What does this mean for those born female during a pandemic? It means there’s a severe dilemma.
COVID-19 is a novel, foreign mystery. Consequently, the medical world must rely predominantly on past data to procure a safe vaccine. The absence of clinical research on women, in turn, disproportionately harms those born female. Not to mention, as MedRvix explains, “sex and gender differences impact the [infection rate] of SARS-CoV-2 and COVID-19 mortality.”
Uncertainty perpetuates uncertainty. Frankly, it’s terrifying.
It’s also no surprise researchers are not considering sex and gender differences in clinical trials for COVID-19. I mean...why would they? It’s not like “sex differences characterize the frequency and severity of pharmacological side effects.”
As of September, “only 16.7% of the 2,484 registered COVID-19 trials mention sex/gender as recruitment criterion and only 4.1% allude to sex/gender in the description of the analysis phase.” Given the critical biological difference among the sexes, researchers must prioritize equality. But, as of right now, I doubt they will.