Gender Disparities in Drug Side Effects May Not Be Due to Biology

More than half of Americans routinely take prescription or over-the-counter drugs, but women tend to experience side effects at up to twice the rate of men, according to the U.S. Food and Drug Administration. The difference historically has been chalked up to biological sex differences, but new research from Harvard’s GenderSci Lab debunks that view, proposing instead a set of gender-based social factors that better explain observed disparities.

“For a long time, the pattern in biomedical research has been to observe a sex disparity in outcomes, and to infer that this is due to biology,” said Sarah Richardson, Aramont Professor of the History of Science, professor of studies of women, gender and sexuality at Harvard University, and co-author of the study.

The authors’ gender hypothesis around the sex disparity in adverse drug events proposes a series of explanations.

For one, women are more likely than men to engage in “health-seeking behaviors,” such as taking prescription drugs or seeing a doctor. They’re also, according to the researchers, more likely to face bias and discrimination in the clinic, affecting the likelihood that an individual will be diagnosed with a condition or be treated properly. What’s more, the researchers continue, gender stereotypes, stigma, identities, and social norms influence how events are subjectively experienced. For example, women are likelier than men to perceive weight gain as an adverse event.

Finally, in a highly gender-stratified world, women and men experience, on average, different environments and exposures. Women are more likely than men to live in poverty, to experience intimate partner violence, and to encounter sexual harassment and violence at work, all of which are associated with mental and physical health problems.

“Our analyses show that gender — the social, structural, and experiential differences linked to individuals’ gender/sex identity across their lifetimes — is a powerful contributor to reports of adverse drug events and ultimately inequitable health outcomes,” said first author Katharine Lee, an assistant professor of anthropology at Tulane University in New Orleans.

The full study, “A Gender Hypothesis of Sex Disparities in Adverse Drug Events,” was published in the December issue of the journal Social Science & Medicine. It may be accessed here.