Breaking Down Gender Bias in Research and Clinical Trials

StudyPages

Jul 27, 2022 • 4 min read

While improvements in equality in clinical trials have been made, there's still room for improvement.

The goal of clinical trials is to develop safe and effective treatments for various diseases and medical conditions. Ideally, clinical trials will have participants who represent a large, diverse set of the population. In reality, though, that is oftentimes far from being the case. Many studies have shown a gender bias in several areas of a medical study. Research and data are lacking with transgender and nonbinary participants, for instance.

So, what can physicians and other medical personnel do to solve these problems?

What Is Gender Bias in Research and Clinical Trials?

Gender bias in medical research has existed for much of history. For instance, Greek philosophers like Aristotle believed a woman to be a " mutilated male." Even in much more recent years, things like chronic pain or mental health issues in women were dismissed as " hysteria" by many doctors. Beliefs like this have led to uneven female participation in clinical trials. In turn, there's been misdiagnosis and mistreatment of medical conditions in female patients.

Which Areas of Study Have Over- or Under-Representation?

So, which specific areas of study have over-or under-representation of gender?

One study, published in JAMA Network Open in 2021, focused on the enrollment of female participants in clinical trials over 20 years. The study found women were the most under-represented in the fields of oncology, neurology, immunology, and nephrology. It was also discovered that less than half of the participants in clinical trials involving biological drugs and supplements were women.

JAMA Network Open also found gender bias affecting male participants. Males were most under-represented in clinical trials of musculoskeletal disease and trauma. In studies of trauma, males were less likely to enroll in mental health and prevention analyses. The JAMA study notes this is an important finding, as suicide, violence, and substance generate higher " premature mortality rates" in males.

What about other studies? One published by the American Heart Association in 2020 reported that only 38% of participants in cardiovascular trials are women. This finding reflects the disparity in female doctors providing medical care and trials. For instance, only 12.6% of cardiologists are female. Were more women acting as cardiovascular physicians, more female participants may be inclined to sign up for cardiovascular-related clinical trials.

One other big note about women in clinical trials concerns contraception. In the 1970s, women taking contraceptives were excluded from certain phases of clinical trials. This points to many problems that have affected contraception and clinical trials. Even if women were taking steps to prevent pregnancy or did not plan to get pregnant, there was still a desire to not include them. This came from fear from physicians of the risk of pregnancy occurring regardless of contraceptives. Many women were reluctant to participate in clinical trials because of this distrust of their lifestyle choices. Unfortunately, that reluctance still exists today.

How About Transgender and Nonbinary Participants?

There is also the issue of low transgender and nonbinary participation in clinical trials. In general, transgender and nonbinary patients are more hesitant to seek medical care. In fact, 37% of transgender people and 33% of nonbinary people report avoiding seeking medical care for fear of discrimination.

This fear also translates to not participating in clinical trials. Though there's been an increase in transgender individuals taking part in clinical trials in recent years, the overall participation level is still low.

What participation does occur, meanwhile, may not be complete. The non-profit organization Center For Info & Study on Clinical Research Participation reports it's also about "inappropriate curiosity" from medical staff. The lack of current education and resources on transgender and nonbinary participants can lead to miscommunication and misdirection from those running clinical trials. As a result, many transgender and nonbinary individuals who initially take part in clinical trials choose not to follow up.

The small amount of transgender and nonbinary patients in clinical trials can also lead to bigger issues affecting their community. There may be diseases, medical conditions, or other risks that could be affecting the community that remain unknown. As with female patients, ailments can then be missed, misdiagnosed, or mistreated. The only way to prevent these problems is to do as much research as possible, and that all starts with more inclusion.

Solving the Gender Bias Problem

Luckily, there are plenty of opportunities to solve the gender bias problem in clinical trials.

It's clear that the gender, transgender, and nonbinary bias in clinical trials needs to be dealt with, but what can be done? Luckily, there are several steps researchers can take, including the following.

Create More Inclusive Marketing Materials

The first step is for researchers to take another look at marketing materials created for clinical trials. Pamphlets or online ads should use inclusive language and photos that reflect diversity. For example, pictures could include a focus on women or gender-nonconforming individuals. Even this small change can be the extra push that inspires more people to participate.

Promote More Gender Inclusivity in Medical Offices

Speaking of gender-neutral, it's slowly becoming common practice to use more gender options in medical forms. For instance, on forms asking for gender, "non-binary" has become a more widely seen category. Using this option in clinical trials as well could attract a more diverse group of candidates.

Acknowledge That It's a Process

Ultimately, getting rid of gender bias in clinical trials is a process. There's still plenty to be done. Other steps include ensuring the use of correct pronouns and making sure that those who take part feel welcome and accepted. It will take time, but if done right, these measures can lead to wider treatment for all types of people out there.

Those who are interested in keeping up with all the going-on in research and clinical trials can follow StudyPages. StudyPages covers all the current goings-on in the clinical research field and even connects individuals with clinical trials happening in their community.

By keeping people aware and giving them access to clinical trials, more medical advancements can be made for the benefit of current and future generations.

- A Research Study Gives New Insight Into the 10,000 Steps Per Day Rule‌
‌- Breaking Down Gender Bias in Research and Clinical Trials‌
‌- Cardiovascular-Related Innovations from 2021