- There is a much-needed revolution In the study of womanhood in the life and social sciences.
- Until the 1970s, scientific data on the female body was woefully lacking because of a “male norm” in biology.
- The three main models to studying sex are: sex differences, feminist biology, and gender medicine.
Cat Bohannon was inspired to write Eve: How the Female Body Drove 200 Million Years of Human Evolution after seeing the movie Prometheus, the prequel to Alien1. In the movie, the heroine, Elizabeth Shaw, was impregnated with a large vicious alien squid. Shaw must find a way to abort the “alien” inside her without bleeding to death. At the futuristic surgery pod, she asks the computer for a C-section. “Error,” it said. "This medpod is calibrated for male patients only.” Bohannon thought, Who does that? Who sends a multi-trillion-dollar expedition into space and forgets to make sure the equipment works on women?
It Started With the “Male Norm” in Biology
Bohannon, a researcher and author, wrote Eve as a user’s manual for what it means to biologically be a woman. She found that the study of the female body has lagged significantly behind that of the male body; scientific and medical data on the female body has been woefully lacking. In the biological sciences (as well as in the social sciences), there is the “male norm," which refers to the fact that be it mouse or human, it is the male body that is studied. Unless specifically studying ovaries, uteri, estrogens, or breasts, women are not study subjects. As Bohannon says, this is an intellectual problem that has become a social problem. But it is not necessarily sexism; many researchers use male subjects for practical reasons. Bohannon reminds us that a good scientific experiment is a simple one with as few confounding factors as possible—and fertility factors are difficult to control for. It’s just easier to do clean science with men than with women. In fact, in the 1970s, researchers were “strongly advised” not to use female subjects of childbearing age.
Currently, the National Institutes of Health (NIH) mandates that all NIH-funded research must include women and racial and ethnic groups unless there is a compelling reason not to do so.
Examples of Consequences for Women
Bohannon tells us that while women are more likely to be prescribed pain medication than men, such drugs have not been tested on nearly enough women. The dosage to achieve pain relief is based on weight and age. However, information about dosage for women is not currently built into the guidelines because women have not been included in the relevant drug clinical trials on which they are based. Brian Prendergast, a University of Chicago psychologist and researcher, reports that drugs are optimized for how they work on male bodies.2 He and his co-researchers tell us that prescribers need to immediately reevaluate the widespread practice of prescribing the same dose of drugs to men and women.
Pendergrast’s caution is particularly important in the use of opioids, which are common prescription painkillers. Bohannon points out that female bodies process opioids differently than men. Women clear it from their systems too soon and then they want more to manage their pain.
In 2022, there were 325,669 liposuctions performed; it's the most common surgical cosmetic procedure.3 Bohannon informs us, though, that women’s fat is not the same as men’s.4 And the fat deposits throughout our bodies are not the same. Our gluteofemoral fat—the fat on our hips, buttocks, and upper thighs”—is “chockfull” of unusual lipids. We women know that these are the first areas where we gain weight and the last areas from which we lose it.
It turns out that in the last trimester of pregnancy, when the brain of a fetus is fast developing, the mother’s body starts retrieving and sending those lipids to her fetus. This “feeding” of lipids to her baby continues during the first year of breastfeeding. Some evolutionary biologists think that we women evolved to have fatty hips because they provide the building blocks for human babies’ brains.
These are just two examples of the impact on women of having a “male norm” in life science research. Other examples of how the male norm misses significant differences in the biology of women include: heart attacks, anesthesia in surgery, and treatment for Alzheimer’s.
The Quiet Revolution
Bohannon has good news: There is a quiet revolution in the study of womanhood because there are more women biologists. With the increase in women researchers in the life sciences and the social sciences, including psychology, women are bringing new approaches to the study of women. However, more traditional research approaches continue to be used in sex research. Currently, biological and psychological research is conducted using three different main paradigms when sex is what is being studied: sex differences, feminist biology, and gender medicine.5
Research approaches see sex as categorical—people are either male or female—and the investigators seek biological explanations for the differences between them. Sex differences biological and psychological research often focuses on cognitive abilities and behaviors, which has led to the idea of “the female brain.” Indeed, Louanne Brizendine published The Female Brain in 2006, in which she claimed that women say about 20,000 words a day while men speak about 7,000.6 This tidbit was reported in newspapers around the world. A linguistics professor investigated the claim and found no academic citation supporting this claim. While Brizendine retracted her statement, the damage was done: The claim that women talk three times as much as men lingers in people’s minds. Research grounded in sex differences has a large cultural audience outside academia.
Since the 1970s, feminists have resisted the sex difference paradigm of research. About this time, buoyed by the feminist movement, increased academic job security, and the success of a growing community of feminist primatologists, a group of women in biology formed a new paradigm of sex research, identified as feminist biology.
Ruth Bleier of the University of Wisconsin-Madison, who authored the 1984 work Science and Gender: A Critique of Biology and Its Theories on Women, inspired the university’s Endowed Fellowship for Feminist Biology.7 The aim of the fellowship is to enhance biology by incorporating feminist critique in matters varying from the mechanisms of cell biology and sex selection to the consideration of the meaning of “gender” and “sex.”
Second-wave feminism’s distinction between sex (as biological) and gender (as culture) sought to weaken biological essentialism—the belief that gender identity and sex as assigned at birth are inseparable and biologically determined—that assigns women’s inferior status to biological differences.8
A third paradigm of sex research was generated in the 1990s, identified as “gender-specific medicine” or “gender biology,”9,10 which calls for greater inclusion of women as subjects in medical research. This approach argues that the treatment and diagnosis of women risks unforeseen harms if medical research remains focused on men. Researchers using this perspective note that sex and gender differences in diseases are more widespread than is typically assumed. Gender medicine is seen as a novel medical discipline that looks at the effects of sex and gender on the health of men and women to improve the health and health care for both. These researchers and clinicians are concerned about the preferential use of male animals in drug development, the underrepresentation of women in cardiovascular clinical trials, and sex differences in pharmacology.
Gender medicine reflects aspects of both sex difference and feminist biology paradigms. It starts with the idea that there are categorical sex differences, but it explicitly aims to help women and correct problematic assumptions about sex in research.
The Revolution Continues
The debates about these paradigms are ongoing with research, publication of scientific articles, and popular media advancing a chosen paradigm. The proponents of each approach have entered various subfields of biology including endocrinology, neuroscience, and genetics. Those of us interested in both the life and social sciences of womanhood will continue to pay attention to:
- The inclusion of women as subjects of biological and psychological research.
- The frame of reference—sex differences, female biology, or gender medicine—that is guiding the research question.
- Watching for new paradigms of biological and psychological research that address the question of sex and gender.
The policies that require male-female comparisons in biomedical research have given rise to challenges as to how sex is operationalized in research projects. There is growing awareness that sex is a set of biological traits (e.g., chromosomes, hormones, hormonal expression, internal and external genitalia) rather than an essential property of individuals.
Those promoting this view of sex research argue that the definition of sex and sex-related variables, and whether they are relevant in biomedical research, depends on what the researcher wants to study. In other words, whether and how “sex” is operationalized will be specific to each experimental question. Sex as a variable in biological and psychological research can no longer simply be categorized as male and female. This emerging paradigm of the study of sex is called “sex contextualism.”11,12
1. Bohannon, C. Eve: How the Female Body Drove 200 Million Years of Human Evolution. New York: Alfred A Knopf, 2023.
2. Lerner, L. “Women are Overmedicated Because Drug Dosage Trials are Done on Men, Study Finds.” University of Chicago News, June 22, 2020.
3. _________ “American Society of Plastic Surgeons Reveals 2022’s Most Sought-After Procedures.
5. Lockhart, J.W. “Paradigms of Sex Research and Women in STEM.” Gend Soc. 2021 Jun;35(3):449-475. doi: 10.1177/08912432211001384. Epub 2021 Mar 19.
6. Aponte, C. “A Marriage of Equals.” Berkeley: She Writes Press, 2019.
8. Sanz, V. (2017) “No Way Out of the Binary: A Critical History of the Scientific Production of Sex. Journal of Woman in Culture and Society, Vol 43(1).
10. Regitz-Zagrosek, V. and Seeland, U. (2013). Sex and Gender Differences in Clinical Medicine. In: Regitz-Zagrosek, V. (ed.) Sex and Gender Differences in Pharmacology. Handbook of Experimental Pharmacology, vol 214. Springer, Berlin Heidelberg.
11. Richardson, S.S. “Sex Contextualism.” Philosophy Theory and Practice in Biology, (2022) 14:2.
12. DiMarco, M., H. Zhao, Boulicault, M., and Richardson, S.S. (2022) “Why ‘sex as a biological variable’ conflicts with precision medicine initiatives. Cell Reports Medicine, Vol 3(4).