There is no doubt that the perception of heart disease as a "man's disease" has sometimes caused women's symptoms to be neglected -- not only by doctors but by women themselves. Overall, though, studies do not support the charge that women are less likely than men to receive aggressive tests and treatments, such as angioplasty or coronary bypass grafts, when it's warranted by their condition. (If anything, there is evidence that men at low risk are often subjected to unnecessary invasive procedures.) And vital statistics certainly do not suggest that women have failed to benefit from medical advances against heart disease. From 1970 to 1989, according to the National Center for Health Statistics, mortality from cardiovascular illnesses fell by 29 percent for men and 26 percent for women -- a minuscule difference, probably due mostly to the decreasing gender gaps in smoking and other risky behaviors.

Another myth is that nearly all drug testing until recently was done on men. True, from 1977 to 1993, Food and Drug Administration guidelines barred women of childbearing age from the early and most dangerous stages of drug trials, with an exception for life-threatening illnesses. (These rules were enacted in the wake of publicity over vaginal cancer in women whose mothers had taken DES while pregnant.) However, women participated in later stages of trials, when drugs are tested for efficacy and minor side effects, and their long-term use is monitored in larger samples. Indeed, the guidelines specifically required drugs to be studied in the groups that would use them; FDA surveys in 1983 and 1988 found that "both sexes had substantial representation ... in proportions that usually reflected the prevalence of the disease in the sex and age groups included in the trials."

This is not to say that medical research hasn't had some blind spots where women are concerned, particularly in areas stereotyped as male. Thus, studies of alcoholism have disproportionately focused on men. AIDS is another area where female-specific problems initially received too little attention. By the mid-1990s, though, women were actually overrepresented in NIH-funded AIDS clinical trials: They made up more than 30 percent of the subjects, even though they accounted for about 12 percent of AIDS cases, according to Satel's research.

To further their cause and whip up the indignation of the woman in the street, women's health advocates have relied on a number of bizarre claims. Sen. Olympia Snowe, R-Maine, has repeatedly asserted that until she and her female colleagues intervened, even breast cancer studies were conducted on men. Former NIH director Bernadine Healy told the Ladies' Home Journal in 1997, "There may be no better example of gender bias in the annals of medicine than the neglect of STDs in women." In fact, a Medline search shows that of the articles on sexually transmitted diseases in medical literature in 1966-1990, 12 percent dealt only with men and 20 percent only with women.

What's more, with some activists, "patriarchal medicine" can't win no matter what it does. First, male doctors are accused of doing too many hysterectomies and gratuitously cutting up women's bodies. (While hysterectomies are far more common in the U.S. than in Western Europe, this difference seems to reflect less gender bias than the overall scalpel-happy attitude of American physicians; it is just as stark with regard to male-specific surgical procedures like prostatectomy.) As a result, HMOs try to curb questionable hysterectomies and are accused of denying care to women. First, a highly politicized breast cancer movement claims that a terrible disease that affects only women has been neglected. Then, in 1999, a women's health exhibit at the Maryland Science Center blames our society's fixation on breasts as a "symbol of women's sexual desirability" for a disproportionate focus on breast cancer to the exclusion of some other diseases that pose a greater threat to women.

Even when a May 2000 report from the General Accounting Office showed that women substantially outnumbered men in NIH-funded clinical research -- they made up 62 percent of all participants and only 29 percent those enrolled in cancer studies -- women's advocates and the media managed to put a women-as-victims spin on this news. "Government-Funded Studies Deny Women Key Health Data," read the headline on a USA Today editorial, which focused on the fact that not enough study findings were being broken down by sex. Yet Satel argues, as do many other experts, that meaningful clinical sex differences are surprisingly few and that analyzing all medical data by gender would raise research costs to truly prohibitive levels.

The politics of women's health may have skewed some priorities. In 1997, when a National Cancer Institute panel challenged the standard recommendation of annual mammograms for all women in their 40s and suggested that each woman should make the decision for herself in consultation with her doctor, an uproar ensued -- partly due to perceptions that the medical uncertainty was a result of shortchanging women. "If this was a health problem unique to men, would more money have been spent trying to figure out how to detect it and what to do about it?" inquired Dee Dee Myers on CNBC's Equal Time. The Senate quickly held hearings and voted 98-0 ("on the basis of some mysteriously acquired epidemiological insight," Washington Post columnist Jessica Mathews noted wryly) for a resolution criticizing the NCI report and affirming the benefits of early mammography. By the way, just a month later, a similar medical debate on prostate cancer screening for men over 40 went virtually unnoticed by the media or by politicians.

What's more, due to the pressure from women's health activists, men are now the ones who are getting short-shrifted, as the latest NIH data indicate. A men's health movement has already mobilized in response; organizations like the Men's Health Network, Men's Health America and several prostate cancer activist groups have tried to imitate the women's tactics. Over the past few years, they have achieved some success in boosting funds for prostate cancer research, with the help of famous survivors like Bob Dole and Gen. Norman Schwarzkopf. In June, Rep. Duke Cunningham, R-Calif., and Sen. Strom Thurmond, R-S.C., introduced the Men's Health Act of 2000, which would establish an Office of Men's Health within the Department of Health and Human Services as a counterpart to the existing Office of Women's Health -- though Congress hasn't shown much enthusiasm for the idea.

Some men's health advocacy groups make their own share of dubious claims -- for instance, that the six-year gender gap in life expectancy is due to medical neglect of men rather than biology. (While it's true that women's greater longevity did not manifest itself before this century, this was primary due to women's early deaths from childbirth and infectious diseases.)

But when the discussion of medical issues is taken over by the gender warriors fighting over a cut of the pie, one can expect some shrill rhetoric from both sides.

Now, we have Al Gore and George W. Bush trying to outdo each other in offering health privileges to women. But why do women recovering from breast surgery deserve more protection and consideration than men recovering from prostate surgery, or better yet, colon cancer patients of either sex?

Long before feminism, there is little doubt that most men were concerned about the health of their mothers, wives, sisters and daughters. (If anything, in the last few centuries, the Western brand of patriarchy included the view that women deserve greater protection from harm than men -- which may explain why so many politicos of all ideological stripes have so easily jumped on the women's health bandwagon.) Today, women who are concerned with women's rights are usually also concerned about the health of fathers, husbands, brothers and sons. At the risk of sounding corny, it's time to stop playing gender politics with medicine and to redirect our energy toward providing better care for everyone, regardless of their sex.

Recent Stories