Olaya Madrid Pascual is an internal medicine physician from Spain. We think that this outlook can help to build a richer and more inclusive body of science and scientific community, with the ultimate aim of representing and benefitting our diverse society. Yet at the same time, as members of the affected party so to speak, we’d argue that we might be more sensitive to gender bias in research and finding ways to counteract it. Women researchers, as part of a scientific community that is heavily influenced by the wider environment (and the systems of power within it), can also be blinkered by the same biases as our male counterparts and overlook sex and gender in research. To our knowledge, research from groups of only men that present data about only men do not receive the same accusations of bias. They were assuming, once again, that manhood is the standard upon which everything needs to be compared. Those men who have raised concerns about our potential bias as a research group of only women need to understand that they are, at least, as influenced by their contexts as we are. Yet this should not be used as an excuse to discount a systematic error in the planning, data collection, analysis, and publication of research (otherwise known as “bias”). We appreciate that our understanding of the world is influenced by our own perspective and that there is no possible “view from nowhere.” We all are shaped by our sex and gender, ethnicity, personal history, or socioeconomic situation. Yet are there reasons to think that the caucasian male is representative of all human beings and should therefore be used as the default participant from which all effects are measured? Some people will challenge whether we have gathered enough evidence to show that medical interventions working equally well in men and women is the premise of an echo chamber. Conversely, for some reason, what comes from outside this echo chamber has the burden of proof. For too long, this is what the medical and scientific establishment has always assumed, but this convention has legitimised itself for centuries only by pure repetition. The real issue here is not whether researching the omission of sex and gender reporting in the scientific literature is “really necessary,” but whether the standard use of the caucasian male as a universal subject in medical research is still ethically, scientifically, and socially plausible. We would ourselves miss the point if we simply tried to answer those questions. Indeed, if anything, they’ve only encouraged us to carry on and expand our work, revealing how it is more relevant than ever. Not only do they show a worrying lack of awareness about the broad body of evidence that has shown how sex based differences can affect patients’ clinical presentations and responses to treatments, they’ve also failed in the attempt to shake the foundations of our work. We think that these kinds of questions largely miss the point. Some of the common responses we’ve faced could be summarised as follows: is reporting by sex and gender really necessary? Why would you expect sex and gender to affect the final results on an intervention? And what about your own bias, as a group of only women? While the value of investigating this is clear to us, several of the reactions to our research has made it apparent that some members of the scientific community find our motives for undertaking this work an unsolvable mystery. Cochrane systematic reviews are a cornerstone for treatment recommendations, nevertheless, we found that sex and gender is scarcely considered in their reports. We are a gender equity research team whose latest project investigated how many of the Cochrane reviews published in 2018 reported and analysed evidence on sex and gender, and how this correlated with the gender of the authors. The standard use of the caucasian male as a universal subject in medical research is no longer ethically, scientifically, and socially plausible, say Olaya Madrid Pascual and colleagues
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