The default human

Are you?




How many times have you seen that question?  How many surveys, questionnaires, and/or polls have you been asked which gender you are?  How many times have you seen it asked the other way?

Are you?

Toilet sign, blue on a pink wall with woman first and man second
Photo from Flickr by user mrkathika





I’ve seen it asked that way once.  Once in 36 years (of which I’ve probably been filling in forms for 20 of those years).

Men come first.  Men are naturally the default human, women are secondary, definitely not the default human. This doesn’t just come out in surveys of course, there are many other places where being male is assumed to be the default, and being female is other, odd, unusual, problematic, or unexpected.  Let’s take medicine as an example.

A recent post, linked to all over the place, describes how heart attack symptoms manifest differently in cis-women than they do in cis-men, and reinforce the fact that for medical researchers, the default is cis-male:

Heart attacks kill people of both sexes, but they affect female bodies differently than they affect male ones. The problem with having “male” as the default in medical research, and even in public health awareness campaigns, is that it fails to account for these differences, often with serious or even fatal consequences. The common heart attack symptoms for female bodies are ones we often associate with panic attacks or anxiety, especially when they appear in women.

Male being the default in medicine isn’t a new discussion.  A mental health clinic opened at the Alfred Hospital in Melbourne in 2010 specifically to treat women:

Centre director Professor Jayashri Kulkarni said the impact of gender on the way mental illness manifested in different patients, and how they responded to treatment, had previously been under-appreciated.

”The mental health field has been somewhat gender blind … with a one-size-fits-all approach to diagnoses and treatments,” she said.

”This clinic is unique in that consultations and treatments will be informed and shaped by the specific biological, hormonal and gender factors that are often implicated in the symptoms and conditions which women experience.”

Women are more likely to experience chronic pain conditions, but the efficacy of drugs used to treat pain work differently in women than they do in men – and most pain research is done in male mice.

But it’s only recently that researchers have begun to study the exact genetic, physiological, hormonal and psycho-social factors that may underlie these sex differences. In part, that’s because pain researchers have been hampered by one rather shocking fact: most basic pain research is still done in male mice and rats.

”This has been a catastrophe,” McGill University pain geneticist Jeffrey Mogil says. He says the old rationale that menstrual cycles make females too difficult to study is bogus. Men and women, in fact, can be so different in the way their nervous systems process pain that one day there may be ”pink pills for women and blue pills for men,” he says. The lopsided research exists solely because of ”inertia”, he adds.

Others agree, among them Dr Roger Fillingim, lead author of a 2009 review of sex and pain research published by the American Pain Society. In that paper, Fillingim, a pain researcher at the University of Florida, says that while the United States National Institutes of Health now require inclusion of both sexes in human studies, much animal research ”continues to eschew females”. As pain is mainly a female problem this means research ”that excludes females is incomplete at best and invalid at worst”.

Treating women as something different to the norm, and considering the fact that most women have a hormonal cycle (men do too by the way), means that something as simple as anemia can be attributed to the fact that many women tend to menstruate.  This can potentially be fatal:

Second, the main culprit for iron-deficiency anemia (IDA) in men is upper-gastrointestinal bleeding, so when men present with IDA the first thing they do is an endoscopy. When women present with IDA they give her iron supplements and tell her to go home because it’s just her ladybusiness. Kepczyk et al (1999) decided to actually do endoscopies on women for whom a gynecological source was diagnosed by a specialist for their IDA. They found a whopping eighty-six percent of these women had a gastrointestinal disease that was likely causing their IDA. Therefore, menses likely had nothing to do with their IDA, and the assumption that menses made them pathological actually obstructed a correct diagnosis.

The majority of the women in that study were bleeding internally, and no one had figured it out until then because they had periods. [emphasis in original]

Ladies, unless you are menorrhagic (bleeding more than 120 milliliters each cycle) your period is not doing you wrong. If you have iron-deficiency anemia and your doctor is insisting it’s because you slough off your endometrium from time to time without doing a single test to confirm it, you may want to insist on an endoscopy. It could save your life.

When you actually take things that work in treating women, there can be added benefits to the male population:

The Alfred Hospital’s Psychiatry Research Centre in Melbourne tested the hormone treatment, usually reserved for women, and found positive results for men with the mental disorder.

The centre found low doses of estrogen given during a two-week trial reduced depression and anxiety symptoms.

Professor Kulkarni says she was surprised by the results of the trial.

“What’s good for the goose is also good for the gander, because in a lot of ways the estrogen is a brain steroid, not just a reproductive girl’s hormone,” she said.

“It does have quite important properties in the brain and so this study is an important study because it’s a first.”

Sadly due to the effects of estrogen on men the trial was not continued for more than two weeks.

And that’s just medicine.  There are plenty of other fields where men are considered as the default, business being one (most people assume CEOs and managers are male), and advertising is another.  If there wasn’t a default = male, the flood of penis enlargement spam at the beginning (and continuing) of the internet would have been equally balanced with breast enlargement spam (or as I’m currently receiving, weight loss spam – perhaps aimed at women or just people who use the internet).

There are lots of other occupations where the default is male – comedians and female comedians (or comediennes), as if being female means that you need a rider to describe you.  There are authors and “women authors” because authors are male by default. And of course, in the same vein as that last link there are toy sets and then there are girl toy sets.

On day, hopefully not too far in the distant future, there won’t be a default human.  Children will be able to play with whatever toys they wan to.  Job titles will belong equally to men and women and no assumptions will be made as to what the default gender for that role is.  Medicine will be able to treat people more effectively with an understanding that physiology can sometimes play a part in how drugs react in patients with certain profiles, and that menstruation does not lead to anaemia.  We’re not there yet, and it looks like we have a really long way to go, but lots of great work is being done everywhere to take a stand against having a default human.

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