Medical gender wars

First came the whining feminists. Next, the inevitable male backlash. Health research has become a casualty of the battle between the sexes.

By Cathy Young

Sep 20, 2000 | On the way to Las Vegas to collect his Teamsters endorsement on Monday, Al Gore made a stop at the University of Nevada at Las Vegas to deliver his latest smarmy valentine to the female voter. In an appearance at a women's health event, Gore pledged to fight for legislation that would give new protections to women enrolled in managed-care plans, forcing HMOs to pay for mastectomies, routine OB/GYN services and hospital stays of at least 48 hours for breast cancer surgery.

Women's healthcare, on the face of it, looks like the kind of motherhood-and-apple-pie cause that no reasonable or decent person could oppose. It probably has more bipartisan support than any other "women's issue." Eager to woo women back, the Bush campaign is also portraying George W. as the real women's health champion, pointing out that as governor of Texas he signed into law many of the same benefits Gore is now promising. But this seemingly wholesome women's crusade has a dark underside. It has used fictions and half-truths to polarize the sexes and promote fear and resentment among women. Combining elements of radical feminism and traditional paternalism, it has turned healthcare into a battleground for gender politics in which men, too, are now vying for the title of victim.

For one thing, the women's health movement, which became an influential political force in the early 1990s, is based on a myth. The myth is that, until this movement rode to the rescue, women were the victims of what feminist wags like Leslie Laurence and Beth Weinhouse call "medical mal(e)-practice" -- systematic abuse and neglect by a patriarchal medical establishment.

This fiction flourishes not only in the literature of advocacy groups ("medical research has mainly been done on men, for the benefit of men only," proclaimed the National Women's Health Network in 1994), but in the media and in political rhetoric. At a Women for Gore rally last year, the vice president not only pledged that "women's health will always be at the top of my agenda" but proudly spoke of his long record of fighting for "more research funds for those diseases so recently considered less important because they befell only women, such as breast cancer."

Eight years ago, Al Gore's boss was riding the same bandwagon. "Women have had their particular concerns grossly underfunded," candidate Bill Clinton declared during a campaign stop at a Chicago hospital, citing breast cancer as "the most obvious [and] the most painful" example of this inequity.

In fact, breast cancer was one of the most extensively studied and most generously funded diseases even before the rise of women's health activism. In 1991, the National Cancer Institute gave more research dollars to breast cancer than to any other single type of cancer -- more, in fact, than to lung cancer (the leading equal-opportunity killer) and prostate cancer combined.

From 1981 to 1991, the NCI spent $658 million on breast cancer research and $113 million on prostate cancer. Medline, the comprehensive database of medical journals, has nearly 18,000 entries for breast cancer in 1966-1991, compared to fewer than 1,800 for prostate cancer and about 8,600 for lung cancer.

But who needs to bother with such facts when you've got a good theory? In 1990, as the Congressional Women's Caucus declared war on male bias in medicine, now-retired Rep. Patricia Schroeder explained, "I've had a theory that you fund what you fear. When you have a male-dominated group of researchers, they are more worried about prostate cancer than breast cancer."

The Women's Caucus, by the way, was especially incensed by a government report showing that less than 14 percent of the money spent by the National Institutes of Health in 1987 went to research on female-specific illnesses. What the congresswomen forgot to mention was that fewer than 7 percent of the NIH budget was allocated to male-specific problems, while the bulk of the money was spent on studying the far more numerous diseases that afflict both sexes.

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