when i was younger and stupid and in the (glass) closet i was dating the son of a pharmacologist. this man had made millions developing medications. he was fond of me and privately told me i was too funny and smart to be dating boys.
he also said that it was incredibly unlikely that sexism will ever be resolved in the medical field. that the majority of medications i will ever take - even some of which are "for women" - will not be clinically tested on my body.
the problem, he said, was in getting any human clinical trial approved. to test on a body with a uterus - any body, even elderly patients or those who have been sterilized - was often nigh-impossible, because the concern was that the test patient may, at any point, become pregnant. once/if the patient became pregnant, the study would not be about "the effects of New Medication on the body." instead, the trial would fail - the results would be "the effects of New Medication on a developing fetus/pregnant patient."
it was massively easier, he said, to just test without accounting for a uterus. that's how he phrased it - accounting for a uterus.
at the time, i remember him talking about the ethical implications of testing on a developing fetus; how such testing could theoretically bankrupt a company if a lawsuit was filed. he talked about informed consent and about how long it took for any legislation to be passed about this - that in 1993; the year i was born, it finally became illegal to outright exclude women and minorities from clinical trials.
i remember him shrugging. "that's not to say it doesn't happen," he said. my ears were ringing.
i was thinking about how every time i have been rushed to the ER, the first thing they have asked me is if i am pregnant. when i broke my wrist at 16 years old - despite never having had sex - they made me wait three hours for the test to come back negative before they gave me pain meds. the possibility of a child haunts my health.
how many people have died on the table because they were waiting for the pregnancy test before treatment. how many people have died on the table because they were pregnant, and the only thing we care about is the fetus.
it is hard to explain to other people, but it feels like some kind of strange ghost. our entire lives, we are supposed to "save" our bodies for our future partners. but really we are just saving the body for the future child, aren't we? that hovering future-almost that cartwheels around in a miasma. you can't get your tubes tied, what if you change your mind? think of the child you must have, eventually.
who cares about you and your actual safety. think about what you could be carrying.
Hi, epidemiologist and clinical research expert here!
Take this with the caveat that it might vary by region, but the situation is not quite as bleak as you make it out:
This definitely used to be more of a thing, but at least in the past 5-10 years I’ve been studying/working in the field, we try to ensure an approximately even split of make and female subjects. For drugs that we have some reason to believe might affect fertility or fetal health, we might check first that the subject is not pregnant or looking to become pregnant (this often goes for male subjects looking to imminently have children as well, because some drug classes can affect sperm quality). And while my experience with pharmacological testing has mostly been for non life threatening conditions, and therefore we have the leisure to wait for testing and pick and choose subjects, I’ve worked in enough hospitals to know that none would deny or even delay acute therapy in a life threatening case. Likely, they’d give the treatment, and if the patient turned out to be pregnant they’d have to present the case before the Institutional Review Board to determine if it was necessary treatment or a lapse in vigilance.
The world is be bleak, and there are definitely problems with sexism and bigotry in medicine. But not always.
