When It Comes to Medicine, ‘Women Are Not Small Men

In her book Sex Cells, Phyllis Greenberger says doctors didn’t consider biological sex. If it was successful on a man, they’d blanketly use it to treat a woman.
www.staging.webmd.com/women/v...
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Does your biologic sex impact your health? Does it have any play in how you're diagnosed, how you're treated, in terms of what symptoms you have? Of course, it does. We all know that.
But that's not something that many people believed 5, 10 years ago, certainly not 20 years ago. And it was only because of leaders like my guest today, Phyllis Greenberger, who really championed the need for research on women's health. She has a new book out, which I love. It's called Sex Cells-- The Fight to Overcome Bias and Discrimination in Women's Health Care.
Please welcome my very good friend, Phyllis Greenberger. Phyllis, it's great to see you today.
PHYLLIS GREENBERGER: It's great to see you as well.
JOHN WHYTE: Now, you and I have been talking about this for easily two decades.
PHYLLIS GREENBERGER: At least.
JOHN WHYTE: And some people think, oh, of course, it makes sense. So I saw you disagreeing that not everyone still believes that. But what has been that journey? Why has it been so hard to make people understand? As you point out, early on in your book, women are not smaller men.
PHYLLIS GREENBERGER: And I think the basic reason was that it was just believed that men and women were the same, except for their reproductive organs. So minus the reproductive organs, whether it was a device, a diagnostic, or a therapeutic, if it was used and successful on a male, that it would be successful on a female.
We're really very far from understanding the differences. And there's still a lot of distrust, and disbelief, and ignorance about it. And so there's still a long way to go.
JOHN WHYTE: But you talk about that in the book, that there's still a long way to go. Why is that? What's the biggest obstacle? Is it just misinformation, lack of information, people don't understand the science? There's still resistance in some areas. Why is that?
PHYLLIS GREENBERGER: I think it's misinformation. And I gave a presentation, I don't know how many years ago, at least 20 years ago, about the curriculum. And at the time, there was no women's health in the curriculum. It was health. So if it was on cardiovascular issues or on osteoporosis, it was the basic.
And at the time, there were maybe be one woman whose job was women's health. And she'd have an office. And otherwise, there was nothing. And maybe they talked about breast cancer. Who knows?
But I spoke to someone just the other day, in view of all the attention that the book is getting now, whether that's changed, whether it's necessary and required? And she said it's not. So it's not necessarily on the curriculum of all research and medical institutions.
And even if, "women's health," quote unquote, is on the curriculum, it doesn't mean that they're really looking at sex differences. And the difference is obvious. I mean, gender is really-- it's a social construct. But biological sex is how disease occurs and develops. And so if you're not looking-- and because there's so there's so little research now on sex differences that I don't even know-- I mean, how much you could actually teach?
JOHN WHYTE: So what needs to change. This book is a manifesto in many ways in how we need to include women. We need to make research more inclusive of everyone. But we're not there yet. So what needs to change, Phyllis?
PHYLLIS GREENBERGER: During this whole saga of trying to get people to listen to me and to the society, we really started out just looking at clinical trials. And that, as you mentioned-- I mean, there are issues in rural communities. There's travel issues for women in child care. There's a lot of disbelief or fear of clinical trials in some ethnicities.
I do think, going to the future, that technology can help that. I mean, if people have broadband, which, of course, is also an issue in rural areas.
JOHN WHYTE: What could women do today? What should women listeners hear and then be doing? Should they be saying something to their doctor? Should they be asking specific questions when they interact with the health care system? How can they make sure they're getting the best care that's appropriate for them when we know that sex cells matter?
PHYLLIS GREENBERGER: Well, that's a good question. It depends on, frankly, if your doctor is aware of this. If he or she has learned anything about this in school, which as already said, we're not sure about that, because research is still ongoing and there's so much we don't know.
Transcript in its entirety can be found by clicking here: www.staging.webmd.com/women/v...