Artillery Row

No, Keir, sex does matter

Denying biological reality is worsening a public health crisis

The Labour Party is currently pretending not to know what a woman is. On International Women’s Day, the Shadow Minister for women went on BBC Woman’s Hour to say that being a woman “surely depends on the context.” 

Every time Keir Starmer is asked about it, he does an awkward little dance with lots of wincing, like he has just been bamboozled by a maths question in an exam he hasn’t revised for. This week, answering questions from the public on LBC, he refused to answer whether women have penises, preferring instead to talk about “tolerance.”

The next day, during an interview on Sky News, Angela Rayner, chimed in to implore everyone to please stop talking about genitals, as if the difference between males and females reduces down to our bits. Questioned on whether it was reasonable to ask male cancer patients if they are pregnant, the Deputy leader responded: “When we debase it to . . . what genitalia you’ve got, I think all that does is damage people and it doesn’t help us go forward on some of the real issues that people are facing.”

Genitals represent a miniscule portion of the vast impact biological sex has in our lives. Sex is a matter of chromosomal differences that permeate every single cell in our bodies. Whether Labour can step back from this brink, time will tell. But what is clear is that they are prioritising ideological conformity over science, and most importantly, over women’s health. 

Medicine must acknowledge the harm done when we pretend women are default males

But of course, every politician (including some in the Conservative Party) playing dumb on the “what is a woman?” question is being disingenuous. They know perfectly well what determines a woman. Everybody does. If simply by virtue of the fact that all of us were born from a woman whose female body shapeshifted to accommodate us. Those female bodies do far more than gestate and feed children, as we are now discovering through scientific research into the importance of understanding sex differences in all aspects of medical research, drug development and healthcare treatment. 

Dr Alyson McGregor, author of Sex Matters: How male-centric medicine endangers women’s health and what we can do about is currently fighting an uphill battle. Her seminal work on the urgency of acknowledging sex differences comes at a time when political leaders across the globe are being compelled to state that sex does not exist. McGregor’s mission to force the medical establishment and the public to acknowledge the harm done to women when we pretend women are default males is eye-opening. Sex Matters also represents a clarion call that we need to stop playing around and start getting real about women’s health because this is a matter of life or death.

Aside from her day job as a practicing doctor, Dr McGregor is the cofounder of the Sex and Gender Women’s Health Collaborative and the director of the first programme in sex and gender emergency medicine at Brown University. She writes

In every aspect, our current worldwide medical model is based on, tailored to, and evaluated according to male models and standards. This is not an abstract statement or even an observation. It’s a fact. All our methods for evaluating, diagnosing, and treating disease for both men and women are based on previous research performed on male cells, male animals, and male bodies.

We now know that female bodies are physically different from men on every level: from our chromosomes to our hormones to our bodily systems and structures. For example, coronary artery disease is the leading cause of death for men and women, but women are less likely to recover. A 2010 study that “the under-recognition of heart disease and differences in clinical representation in women leads to less aggressive treatment strategies and a lower representation of women in clinical trials.” Women are more likely to be diagnosed with a psychiatric condition when they are experiencing a stroke, irritable bowel syndrome, autoimmune disorders and neurological disorders.

Even in circumstances where genitals are relevant, women’s symptoms often go ignored. On average, it takes 7.5 years for a woman in the US to be diagnosed with endometriosis, a condition where menstruation causes pain so excruciating that women can barely walk and often have to miss days of work. Rather than providing medical solutions, women are encouraged to go home, take some painkillers, and hope that a heating pad makes it all better.

A 2012 study found severely injured women are less likely to be taken to the emergency room by paramedics

When women demand a fair and accurate response to their symptoms, they are habitually dismissed with a word that has become commonplace: anxiety. Another psychological condition, the ubiquity of this diagnosis reminds me of the old “wandering womb” theory that blamed women’s menstrual cycles for a whole host of issues. Speaking about the overdiagnosis of women with anxiety, Dr McGregor writes: 

Every day, across all areas of medicine, in doctors’ offices and emergency rooms around the country, women are told some variation of that patronizing statement: “honey, it’s all in your head”

This applies even to cases where women’s lives are in perilous danger. A 2012 study found that severely injured women are less likely to be taken to the emergency room by paramedics (49% of women versus 62% of men). The reason? “Perceived difference in injury severity, likelihood of benefiting from trauma centre care, or subconscious gender bias,” read the study.

This issue hits home. During my teenage years, I used to suffer from almost monthly asthma attacks that required medical intervention. It would usually happen at around 3am and my mum, who was working two full-time jobs, would take me to the hospital every time, uncomplaining but sick with worry. It became so frequent and everybody felt so helpless that the likely cause was pinned on me. “You are probably somatising things. This is your body reacting to your emotions”, I was told over and over again. It felt like everyone was blaming me for making them worry about me. We later found out there were environmental factors and genetic conditions that were triggering my attacks, but this experience explains why I feel so passionate when I say that: sex matters. It also explains why I feel so frustrated at politicians refusing to accept these emerging scientific developments.

Every time a politician pretends not to know the difference between men and women, they confine half the world’s population to the Dark Ages of medical research. With their confused pronouncements about biology, politicians of all partisan stripes are not only uttering platitudes to appease a vocal minority, they are putting women and girls lives at risk. Sex matters. This is not as a niche battle cry. It is an international public health crisis. 

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