Question

What are some of the health biases against women in the medical research industry?

What are some health biases that occur against LGBTQA people in the medical field?

How do health outcomes (generally) vary by gender/gender identity/sexual orientation?

What are the components of the Health Equity Promotion Model? Why are these factors important to consider when trying to figure out solutions to mental and physical health disparities?

Why do some medicines affect women differently than men? What are some examples of these medicines?

What are some instances of sexism/gender bias that people often experience from their healthcare providers? How does their experience tend to compare to men, and how do other factors such as disability status, socioeconomic status, etc. intersect with this experience?

Know examples of ways that healthcare in the U.S. and globally varies for people of different sexes, ethnicities, socioeconomic status, sexuality, and disabilities

What are some negative experiences and outcomes that are common to people with disabilities?

What is healthcare like for women in developing countries?

How do men and women differ in life expectancy? What about quality?

Answer 1

Answering the first four questions.

1. Gender bias against women in the medical research industry is emerging, rather it became prominent recently. To start with, what is bias? It is the inclination to a person or a group especially if the inclination is considered to be unjust or unfair. Here, we are talking about an inclination to men. Some of the gender bias in the medical research industry can be seen in:
   • Exclusion of women from clinical trials by researchers- reasons were given by the researchers were that there was a lack of knowledge of the physiology of women and they were not aware of the metabolism of women during childbearing age. There were tight research budgets which enabled the inclusion of men in research studies. There was a desire to repeat male based studies and ignore female based studies.The exclusion was due to inequality. The studies that focus on the differences of drug intake and metabolism between men and women often show that the drug has the same result on women, still, women are not included in the trials.
   • At times physicians consider the women's symptoms to be less severe when compared to men's. Thi again raises the inequality in the medical research field.
   • Some diseases women face do not get identified because the diagnostic criteria are often male based. Completely ignoring the female population.
   • Studies have shown that when women wait longer in the emergency room they were admitted less when compared to men.
   • Drugs administered or given have shown that often they have a greater risk for women than men. This is because the drugs which would have been suitable for women were not manufactured.
   • In medical literature, the effect of diseases on women is not taken into consideration.
2. For a lot of people sharing their intimate life with a stranger is quite difficult and when they have to reveal their orientation to someone who is sceptical or judgemental it can be really cumbersome. Studies have shown that doctors prefer to see heterosexual patient than homosexual patients. A report shows that transgenders often avoid seeking medical care or attention because of the stigma attached to their status. At times doctors refuse to treat gays because of the fear that they might have STD or HIV. Medical students most of the time do not reveal their orientation for the fear that they might get rejected. Because there often exists a non-inclusive atmosphere in hospitals, LGBTQ individuals often see themselves as heavily stressed and the side effects of living under the shell have greater health risk issues. They have a higher risk of poor mental health, psychological distress, suicidal ideation and mental health disorders compared to heterosexuals.
3. Implicit bias may lead to different outcomes for gender/gender identity/sexual orientation. As discussed in the first two answers if the approach of the medical treatment is not equal then there will be a definite cause for different outcomes. If there are negligence and ignorance by the medical professionals by not including masses of all categories in their medical research then there the chances for disparities in result will be high. The reliability of the research reduces. A lot of discrimination is faced by women, people having different sexual orientations as well as gender identity. Gender orientation and identity were often equated with deviancy, sickness, and shame. Homosexual behaviour was considered to be a deviance and sodomy was considered to be a criminal offence until the removal of it in DSM. Because of the discriminations, people who fall under this radar often suffer from severe psychological distress and mental disorders.
4. Components of the Health Equity Promotion Model:
   • social positions (socio-economic status, age, race/ethnicity)
   • individual and structural and environmental context (social exclusion, discrimination, and victimization)
   • health-promoting and adverse pathways (behavioural, social, psychological, and biological processes)

The model highlights (a) heterogeneity and intersectionality within LGBT communities; (b) the influence of structural and environmental context; and (c) both health-promoting and adverse pathways that encompass behavioural, social, psychological, and biological processes. It also expands upon earlier conceptualizations of sexual minority health by integrating a life course development perspective within the health-promotion model. The Health Equity Promotion Model revolves around the Minority Stress Theory and the Psychological Mediation Framework. It incorporates the life course development point of view within a health equity framework to highlight how (a) social positions (socio-economic status, age, race/ethnicity) and (b) individual and structural and environmental context (social exclusion, discrimination, and victimization) intersect with (c) health-promoting and adverse pathways (behavioral, social, psychological, and biological processes) to influence the continuum of health outcomes in LGBT communities . The model aims to consider the different levels and overlapping impact on the full continuum of LGBT health, especially as they connect to equity and resilience in LGBT communities. It aims to stimulate research that addresses the full component of factors influencing the range of LGBT health outcomes

The system focuses on the structural and environmental factors as determinants of health as well group and individual-level factors, highlighting resilience, human agency risks and resources. The importance of the components of the model highlights differences in experience between an LGBT person who came of age when homosexuality was considered a psychiatric disorder compared with an LGBT adult now in early adulthood during the marriage equality debates. Equally important, a life course perspective identifies an individual life trajectory as important in understanding current health outcomes.