Inferior: How Science Got Women Wrong – and the New Research That’s Rewriting The Story. Angela Saini

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СКАЧАТЬ that might affect how drugs behave in their bodies. But they are also factors on which men and women overlap. There are many women who are heavier than the average man, for instance. It’s not always the case that the sexes belong in two separate categories.

      What also counts is the experience of being a woman, socially, culturally and environmentally. ‘Both sex and gender are important factors for health,’ says Janine Clayton. Ideally, then, people should be treated according to the spectrum of factors that set them apart. Not just sex, but social difference, culture, income, age and other considerations. As Sarah Richardson has written, ‘a female rat – not to mention a cell line – is not an embodied woman living in a richly textured social world’.

      The problem is that ‘medicine is very binary. Either you get the drug or you don’t. Either you do this or you do that,’ says Sabine Oertelt-Prigione. ‘So the only step, I believe, is to incorporate the notion that there is actually not one neutral body, but at least two. I believe it’s just another way of looking at things. In medicine, just having a way to change paradigms and look at things differently can open up whole arrays of possibilities. It could be looking at sex differences, but there are many other things that could help to make healthcare more inclusive in the end.’

      ‘What are we trying to do? We’re trying to improve human health, right?’ says Kathryn Sandberg. ‘So if we see a disease is more prevalent or more aggressive in men than women, or vice versa, we can learn a lot about that disease by studying why one sex is more susceptible while the other is more resilient. And this information can lead to new treatments that benefit all of us.’ Understanding why women tend to live longer could help men live longer. Including pregnant women in research may open up the cabinet of drugs that doctors can’t currently prescribe because their effects on foetuses are uncertain. Medical dosages might be affected by a better understanding of how a woman’s body responds across her menstrual cycle.

      At the moment at least, the verdict of politicians and scientists seems to be that including sex as a variable when carrying out medical research can improve overall health. In 1993 the US Congress introduced the National Institutes of Health Revitalization Act, which includes a general requirement for all NIH-funded clinical studies to include women as test subjects, unless they have a good reason not to. By 2014, according to a report in Nature by Janine Clayton, just over half of clinical-research participants funded by the NIH were women.

      Since the start of 2016 the law in the USA has been broadened to include females in vertebrate animal and tissue experiments. The European Union now also requires the researchers it funds to consider gender as part of their work.

      For women’s health campaigners and researchers like Janine Clayton and Sabine Oertelt-Prigione, this is a victory. To have females equally represented in research is something they’ve spent decades fighting for. Male bias, where it exists, is being swept away. Women are being taken into account. Maybe we will finally understand just what it is that makes women on average better survivors, and why men seem to report less sickness.

      But as science enters this new era, scientists need to be careful. Research into sex differences has an ugly and dangerous history. As the examples of digoxin and zolpidem prove, it’s still prone to errors and over-speculation. While it can improve understanding, it also has the potential to damage the way we see women, and to drive the sexes further apart. The work being done into genetic sex differences by people like Arthur Arnold doesn’t just impact medicine, but also how we see ourselves.

      Once we start to assume that women have fundamentally different bodies from men, this quickly raises the question of how far the gaps stretch. Do sex chromosomes affect not just our health, but all aspects of our bodies and minds, for example? If every cell is affected by sex, does that include brain cells? Do oestrogen and progesterone not just prepare a women for pregnancy and boost her immunity, but also creep into her skull, affecting how she thinks and behaves? And does this mean that gender stereotypes, such as baby girls preferring dolls and the colour pink, are in fact rooted in biology?

      Before we know it we land on one of the most controversial questions in science: are we born not just physically different, but thinking differently too?

      3

       A Difference at Birth

      Girls and boys, in short, would play harmlessly together, if the distinction of sex was not inculcated long before nature makes any difference.

      Mary Wollstonecraft, A Vindication of the Rights of Woman (1792)

      ‘We live in jeans, don’t we? They go with everything!’ coos the mother. Her six-month-old daughter is wearing the tiniest pair of jeans I’ve ever seen, and she herself is dressed head to foot in denim.

      We’re sitting together in the baby lab at Birkbeck College in central London. It reminds me of a nursery, but a somewhat unusual one. A purple elephant decorates the door to a waiting area full of toys. Downstairs, however, a baby might be hooked up to an electroencephalograph that monitors her brain’s electrical activity while she watches pictures on a screen. In another room, scientists could be watching a toddler play, examining which toys he happens to choose. Meanwhile, in this small laboratory that I’ve been invited into, a baby is being gently stroked along her back with a paintbrush. She’s the thirtieth infant to be studied so far in this experiment.

      ‘She really just likes sitting and watching, taking it all in. I’m happy sitting and observing, myself,’ her mother says, bouncing the little girl on her knee. Researchers suspect that human touch like this has an important impact on development in the early years. They just don’t know how or why. So the goal of today’s experiment is to measure how touch affects a baby’s cognitive development. It’s one of countless ways in which children are affected by their upbringing, slowly shaped into the people they will become.

      Cute though babies are, studying them this way is not as much fun as it might seem. It’s almost like working with animals. The challenge is to come up with clever experiments that get to the heart of their behaviour without accidentally reading too much into what they do. A stare can be meaningful or mindless, while even the most charming smile may just be wind. In this particular case, the researchers are using a paintbrush in their touch experiment because that’s the only way to control for the fact that parents stroke their children in different ways. With a brush, they can be sure it’s the same every time.

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