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Sex and gender in biomedicine: promises for women and men. How incorporation of sex and gender in research will lead to a better health care Ineke Klinge 1 Abstract In this paper I introduce the field of Gender Medicine: what does it represent, what are current activities and which outlook for the future does it offer? First a short historical overview will be given on how Gender Medicine came into being as a new research domain. Second comes the discipline of Gender Medicine today: what are current features and characteristics? In a third part I will highlight the EU gender equality policy for research as a driving force for Gender Medicine. Finally some examples of sex and gender sensitive knowledge and innovative research avenues are presented as gathered in successive EU projects that I was involved in. 2 How Gender Medicine came into being as a new field of research and as biomedical discipline Gender studies involvement with life sciences and biomedical research has a longstanding tradition. The innovation of ‘traditional’ biomedicine started with the women’s health movement and the feminist critique of science in the 1980s. 16 Ineke Klinge Involvement with life sciences and biomedical research is visible in publications as early as ‘Alice through the Microscope’ by the Brighton Women and Science group in 1980 which focused on science and women’s lives (1). In that book a patriarchal science was unveiled that neglected or stereotyped women’s bodies, health and lives. Soon after, pioneering feminist biologists like Lynda Birke and Anne Fausto-Sterling started academic critiques of biomedicine, addressing biology and medicine in the first place (2, 3). The strategies they employed were directed towards the biomedical method itself. Both authors could demonstrate that the scientific method was not as objective as it was believed to be; instead, effects of gender were visible in the production of biomedical knowledge . The claim that processes of gender had an influence on the production of biomedical knowledge at the same time opened up possibilities for change. Much knowledge that was regarded by feminists as ‘biology is destiny’, turned out to be far from determinist. If the influence of gender on biomedical knowledge production was taken account of, many myths about women and women’s roles could become dismantled. Although it is a biological fact that only women can give birth to a child, in no way this is a blueprint for who (mother or father) should be charged with caretaking during the consecutive years. Londa Schiebinger has twice produced an overview of the feminist involvement with science in her books Has Feminism changed Science? and Gendered Innovations in Science and Engineering (4, 5). She described what had been accomplished in various fields including biomedicine. Developments in biomedicine have been two-fold: a first change in research practices was a methodological one. In the USA the Office of Women’s Health Research (OWHR) at the NIH strived for a change of the standard practice by which women as objects of research were excluded. A joint effort of academic feminists, congressional leaders, medical doctors at the NIH and the women’s movement, resulted in legislation and in guidelines on inclusion of women and minorities in clinical research from 1994 onwards (6). More epistemological critiques focused on effects of gender in the production of biomedical knowledge. Those scholars pointed to gaps in knowledge, for example knowledge on urine incontinence in women (7). The critique also pointed to the interpretation of observations and research data, whereby men and processes in the male body were seen as normal and women and processes in the female body as deviant or pathological. An example of this are the ‘atypical’ symptoms of cardiovascular disease in women in contrast to the ‘typical’ symptoms in men; or the ‘stable’ hormone levels in men and the ‘changing’ hormone levels in women making them unreliable for positions with high responsibilities . Other gender effects are language issues and metaphors. Ethological research for example speaks about ‘the lion and his harem’. “Metaphors are not innocent devices used to spice up texts. Analogies and metaphors […] function to construct as well as describe – they have both a hypothesis-creating and a proof-making function ” as Londa Schiebinger (1999, 149) has framed it. The focus on activities of Sex and gender in biomedicine 17 males limits researchers’ ability to ‘see’ what lies outside the logic of the metaphor.1 Since the 1980s extensive efforts by gender scholars and women-and-health researchers at various places have...


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