A new national research, policy and education centre to improve health outcomes for all Australians will challenge the ‘one-size-fits-all’ male-centric approach to medical care that results in significant disadvantage for women and girls, people with variations of sex characteristics (intersex people), trans and gender-diverse people.
The Centre for Sex and Gender Equity in Health and Medicine, launching today at UNSW Sydney, is an initiative of The George Institute for Global Health, the Australian Human Rights Institute at UNSW Sydney, and Deakin University, with support from collaborative partners, the Victorian Department of Health and the Association of Australian Medical Research Institutes (AAMRI).
“More than 70 per cent of participants in early-stage clinical trials are white men, with male cells and male animals used as standard in the laboratory,” said Professor Robyn Norton, Founding Director of The George Institute for Global Health, Professor of Public Health at UNSW Sydney and Chair of Global Health at Imperial College London.
“When these results are generalised to women, intersex, trans and gender-diverse people, we see long delays in diagnosis and intervention, inappropriate treatment or dosing, different responses to medicines and devices, and dismissal of pain or other symptoms,” she continued. “This historical focus almost exclusively on the male means other populations have been understudied. Viewing trial protocols and analysis through a sex- and gender-sensitive lens can improve outcomes across the board.”
Through world-class research and advocacy, the new Centre will address the underlying, binary sex and gender bias in health and medicine that leads to poorer health outcomes, evidence gaps and inefficient health spending for women and girls, intersex people, trans and gender-diverse people, and in some cases men and boys.
“While women typically live longer than men, research shows they are more likely to encounter bias when it comes to addressing health-related issues across the course of their life,” said Alfred Deakin Professor Rachel Huxley, Executive Dean for the Faculty of Health at Deakin University.
“Women’s health research and services often focus only on their sexual, reproductive, and maternal health, rather than understanding how the leading causes of death and disability such as heart disease, dementia, and stroke, are experienced and best treated.
“Heart disease, for example, is a leading cause of illness and death for both Australian women and men, yet it continues to be primarily known as a ‘man’s disease’. As a result, women’s symptoms are often not picked up, attributed to other, often psychological causes, and treatment is delayed or not given at all, with serious consequences including death,” she said.
There is also a paucity of health data for intersex and gender-diverse people in most health areas, and for men and boys where a condition most commonly occurs in women. An example of this is osteoporosis, which is viewed predominantly as a disease of older women, yet men account for nearly a third of osteoporosis-related hip fractures. Data shows that men are rarely evaluated or treated for osteoporosis and tend to have a higher mortality rate than women from complications of this condition. All of which presents a serious challenge for health practitioners, policymakers, and funders.
“The first step to improving health outcomes for everyone, regardless of sex or gender, is to get a clear picture of the problem by gathering robust evidence,” said Associate Professor David Carter, an Associate of the Australian Human Rights Institute and Scientia Associate Professor in the School of Law, Society and Criminology at UNSW Sydney.
“This means educating everyone in the medical ecosystem on how to factor sex and gender considerations into health and medical research and practice, including anyone funding, conducting, publishing or applying research to treatment or policy.”
The establishment of the Centre is part of a global movement to address this issue, involving countries such as Canada, Japan, the United Kingdom and the United States. By putting a spotlight on this neglected cause of health inequity, the Centre expects to demonstrate significant improvements in outcomes for all population groups by ensuring that screening, diagnosis, treatment and follow-up are based on the best available evidence. The Centre will also work with government, researchers, communities with lived experience, service providers and many other stakeholders to develop and support implementation of policies aimed at changing behaviour.
Evidence and resources generated will directly inform government initiatives aimed at improving the health of women and the LGBTQIA+ community, including the activities of the National Women’s Health Advisory Council, the National Women’s Health Strategy, and the LGBTQIA+ 10-year National Action Plan (announced in 2023).
“For too long, women and LGBTIQA+ Australians have been underrepresented in health and medical research and have all too often had their experiences ignored," said Assistant Minister for Health and Aged Care, the Hon Ged Kearney MP.
"Labor is committed to a stronger, more inclusive health and medical research industry and I welcome this new Centre.”
The launch of the Centre is supported by a Health and Medical Research Sponsorship grant from NSW Health.