Gender bias in medical textbooks: examples from coronary heart disease, depression, alcohol abuse and pharmacology

Abstract

This study aimed to review the availability and accessibility of gender-specific knowledge in current medical textbooks used in Dutch medical schools. Medicine has been criticised as being gender-biased by assuming male and female bodies to be generally the same. The authors wondered whether current nationally and internationally accepted medical textbooks reflect the state of the art on gender-specific knowledge. The authors selected medical textbooks recommended by at least two medical schools in the Netherlands in the academic years 2004-05 and 2005-06. Investigated disciplines were internal medicine/cardiology, psychiatry and pharmacology. The textbooks were screened on the following topics: coronary heart disease; depressive disorders; alcohol abuse, and pharmacology. We defined evidence-based, gender-specific aspects of each of the topics on which information should be accessible in current textbooks for medical students. Eleven textbooks were screened, including four on internal medicine/cardiology, four on pharmacology and three on psychiatry. Results show that gender-specific information is scarce or absent, and hardly accessible via index or layout. The scarce gender-specific information mainly applies to epidemiological data and reproductive items. Current medical textbooks are still gender-biased. They lack somatic and psychosocial information relevant to good medical practice. As a consequence, future doctors will be unaware of relevant differences between men and women in the presentation, diagnosis and treatment of illnesses.