White, heterosexual man is the medicine’s ‘universal model’

// 20 October 2008

Anecdotal evidence abounds that doctors and researchers work from the assumption that the standard body is white, male and heterosexual.

But a researcher in the US has conducted a study of the images appearing in text books used in some of the most prestigeous medical schools in Europe, Canada and the US.

According to Science Daily, 16,329 images in 12 key manuals were analysed in the research, carried out by María José Barral, a medicine professor at the University of Zaragoza.

Three times as many male bodies as female ones were illustrated in the six anatomical textbooks and six texts studied (14% compared to 4%, while in the remaining images it was not possible to deduce the gender of the body)

The picture is worse in European than North American manuals:

The six North American manuals studied used male bodies in 17% of cases and female ones in 5% to illustrate “neutral body parts”, while the six European ones used male images 12% of the time and female ones only 2%.

People of Caucasian ethnicity were the only ones represented in nine of the 12 manuals (all the European ones and half the North American ones), and were in the majority in the other three. Only one of the textbooks studied showed “parity in male and female images” and represented other ethnicities, although Caucasians still predominated.

Barral also drew some conclusions about the gender stereotyping demonstrated by text book authors – for example, most of the images of hands were male, which she suggests could reflect an implict belief that “manipulation, a sign of our species’ evolution” is male.

Does it matter? The answer is a firm yes:

“Medical research in terms of the diagnosis, treatment and prevention of diseases has been focused on this model of white, heterosexual men, who are a minority on this planet, and this does not reflect true diversity,” the researcher said.

The scientist says many of the doses for pharmaceutical drugs have been calculated using this body model as a basis, without taking differences into account, and that this is only now being corrected. “You are prescribed a dose for another body,” she stressed. “Using only one body type as a model and treating the rest as variations is dangerous for health,” she told SINC.

Via Shakesville

Image shared by rosefirerising, under a Creative Commons license

Comments From You

JENNIFER DREW // Posted 20 October 2008 at 5:23 pm

Good to read that Maria Jose Barral has conducted this in-depth research which categorically proves the world does in fact revolve around white male heterosexual men.

Emily Martin also conducted in-depth research in respect of medical textbooks on reproduction and her findings were that reproduction was always depicted from the male perspective. If one believed these manuals one would presume women play no part at all apart from containing men’s sperm and acting as a container to the man’s child (sic)!!

Book is entitled The Woman In The Body. And yes it does matter – it matters because once again women’s lives and experiences are being erased because patriarchy still refuses to accept or acknowledge the world in fact revolves around women and men.

I believe other feminist scientists have also analysed medical textbooks and their findings were identical to Maria Jose Barral. Still, it is depressing to see women’s lives and experiences are still being nullified and invisibilised. Who says women have now achieved it all?

lucy // Posted 20 October 2008 at 5:34 pm

Whilst I agree that the concerns Barral raises are important I have several reservations about this article:

Firstly, it is the endocrine systems of women that make their dosing more difficult, not only the attitudes of the pharmaceutical industry. Dosing of many drugs for women should not only vary with gender, but with the menstrual cycle – and as i mentioned in a comment on last week’s contraceptive post, the cost of clinical trials severely impacts pharma’s interest in innovating. The problem is not one of sexist scientists, rather of how dependant medical research is on straightforward capitalism.

Secondly, the differences in drug metabolism between genders and races are being studied, and were covered in thoroughly tedious detail in my pharmacology classes some years ago. I also worked on far more female than male bodies during human dissection classes – perhaps this is specific to my location, but i imagine that donor variance would impact your medical training as much as, if not more than, the images in text books.

Thirdly, bearing in mind the increasing proportion of women passing through medical school, one might assume that medical bias will also shift. On top of this, these female physicians may potentially be more likely to migrate towards teaching, as a more flexible form of employment than primary care, and then how will medical education be impacted?

Having said all that the male-centric medical viewpoint is currently driving me crazy. I’m working on a gender/menstrual cycle specific immune response to HIV which is turning out to be a nightmare to study.

Sian // Posted 21 October 2008 at 7:19 pm

I’m glad this research was done.

I’m a vet, and in our reproduction module there was a sheet with an illustration of uteri from 6 different species. They were labelled pig, horse, sheep etc. But one of the uteri was a human one-and it was labelled “man”. This is apparently grammatically correct!

james // Posted 21 October 2008 at 9:32 pm

“Good to read that Maria Jose Barral has conducted this in-depth research which categorically proves the world does in fact revolve around white male heterosexual men.”

I think you’re reading what you would like to be there, rather than what actually is there. The research showed 82% of illustrations were neuter. Surely this disproves anecdotal evidence that doctors and researchers work from the assumption that the standard body is male.

lucy // Posted 22 October 2008 at 8:00 am

Re: Jenifer

This “study” looked at 12 books and was not published. This is not “in depth research”, it’s one woman’s opinion piece presentation at a government conference in spain.

Re: Sian

By this logic the other animals should have been labelled “sow”, “mare”, “ewe”? I find it really hard to be offended by “man” being used to describe a species, but if you are, you might suggest that your course coordinator switches to “human”, like most contemporary texts have.

Soirore // Posted 22 October 2008 at 3:47 pm

James you are missing the point that of the figures where sex could be determined there were three times as many male as female models. The prevalence of male bodies can then lead to the assumption that the neutral ones are in fact male.

Anne Onne // Posted 22 October 2008 at 11:54 pm

Definitely a problem. I study science, and the white male model is the one most used in clinical trials. With the realisation of how the genetics of different populations affects treatment response,we’re getting more of a focus on trying to include different races and types and genders, but all the same the majority of diagrams and examples are still white males, at least in my experience. My guess is that it’s so deep rooted that it will take much more time and effort to eradicate this, especially since the majority of the research staff/academics writing books and doing research (as well as most research subjects) are white (probably heterosexual) men.

But it’s good to see this highlighted. Makes me feel I’m not the only one this annoys. :)

lauredhel // Posted 24 October 2008 at 7:05 pm

James, I’m intimately familiar with anatomy textbooks. The “non-gendered” images are images such as a closeup of a forearm, or a detail of the upper digestive system, or the heart valves, or the structure of the scalp.

Even then, images that are away from specific reproductive-system markers are more likely to show “soft” features of maleness: low subcutaneous fat, for example.

Images that are identifiably female are typically used only when the image’s femaleness is the key teaching point: a diagram of the uterus or breasts, for example. The female image is “marked”, the male image, default.

Anatomical descriptions carry the same issues, though things are slowly improving a little. The obvious example is the way in which the female reproductive images are traditionally described as simplified, diminutive, or mutilated versions of the male default. (Example.)

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