New report reveals depth of sex and gender bias in Australia’s ‘gold standard’ healthcare guidelines
A new report from Monash University has found that gender inequities are entrenched even at the highest levels of healthcare, with most clinical guidelines failing to consider sex and gender differences appropriately.
The gender gap in the health system is well documented, with women, girls and gender-diverse people more likely to suffer poor health outcomes including delayed diagnosis and treatment.
Dr Maggie Kirkman from Monash University’s School of Public Health and Preventive Medicine is lead author of the report, commissioned by the Commonwealth Department of Health and Aged Care to provide a sweeping review of the literature addressing sex and gender bias in the health system.
“These inequities persist across a range of health issues and settings, from medical emergencies like heart attacks and stroke, to mental health care,” Dr Kirkman said.
“Compounding the sex and gender-based discrimination we see at the point of care is a deeper bias in health and medical research, where historically the male body has been the focus of investigation.”
As part of the review, the authors conducted a deep dive into Australia’s clinical practice guidelines to assess the standard of sex and gender awareness being reflected in the advice issued to healthcare practitioners in a wide range of health conditions and settings.
The findings, published in the Medical Journal of Australia today, showed that of the 80 clinical practice guidelines reviewed across 27 different areas of practice, 15 per cent made no reference to ‘sex’ or ‘gender’, more than 40 per cent used the terms sex and gender incorrectly, and more than half did not include consideration of gender in clinical practice.
Assistant Minister for Health and Aged Care, the Hon Ged Kearney MP, stressed the importance of tackling gender discrimination at every level of the health system. “We owe it to women, girls and gender diverse people everywhere,” she said.
“As a former nurse I know just how important clinical guidelines are. This report shows us current guidelines are letting Australian women down – it’s not good enough. I’m proud the Albanese Labor Government commissioned this report through the National Women’s Health Advisory Council as part of our efforts to end medical misogyny.”
The report makes several recommendations, among them a minimum requirement to report where there is a lack of sex or gender-specific evidence and increasing the participation of women and gender diverse people in guideline development panels.
NHMRC CEO, Professor Steve Wesselingh said that the Council agrees that “clinical guidelines should reflect best practice for all. “We are working to ensure that all clinical guidelines we endorse and develop consider and account for sex and gender differences throughout the guideline development process,” Professor Wesselingh said.
“To strengthen the evidence base we have released the Statement on Sex, Gender, Variations of Sex Characteristics and Sexual Orientation in Health and Medical Research with the Department of Health and Aged Care.”
Dr Kirkman added that she is optimistic that gender equity will be achieved in clinical guidelines in the future.
“Our findings have identified an important avenue for making an impact. Setting standards for clinical guidelines to address gender inequity has the potential to spark a transformative shift in practice, and mandatorily reporting gaps in sex and gender-related evidence will serve to target and prioritise future research,” she said.
“This is an easy game changer for women and gender-diverse people.”