Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature

Background: Historically, medical studies have excluded female participants and research data have been collected from males and generalized to females. The gender gap in medical research, alongside overarching misogyny, results in real-life disadvantages for female patients. This systematic scoping review of the literature aims to determine the extent of research into the medical research sex and gender gap and to assess the extent of misogyny, if any, in modern medical research. Methods: Initial literature searches were conducted using PubMed, Science Direct, PsychINFO and Google Scholar. Articles published between January 01, 2009, and December 31, 2019, were included. An article was deemed to display misogyny if it discussed the female aesthetic in terms of health, but did not measure health or could not be utilized to improve clinical practice. Results: Of the 17 included articles, 12 examined the gender gap in medical research and 5 demonstrated misogyny, assessing female attractiveness for alleged medical reasons. Females remain broadly under-represented in the medical literature, sex and gender are poorly reported and inadequately analyzed in research, and misogynistic perceptions continue to permeate the narrative. Conclusion: The gender gap and misogynistic studies remain present in the contemporary medical literature. Reasons and implications for practice are discussed.

Changes in Facial Shape throughout Pregnancy—A Computational Exploratory Approach

Facial cognition serves an important role in human daily interactions. It has been suggested that facial shape can serve as a signal for underlining biological condition, and that it is correlated with, among others, health, fertility, and attractiveness. In this study, 14 women were photographed during three consecutive trimesters of pregnancy, and the levels of their facial sexual dimorphism, asymmetry, and averageness were computed. Facial sexual dimorphism in first trimester was higher than in the second trimester (F(2, 22) = 5.77; p = 0.01; ηp2 = 0.34, post-hoc Tukey HSD test p = 0.007). Similar pattern was visible for asymmetry (F(2, 22) = 3.67; p = 0.04; ηp2 = 0.25, post-hoc Tukey HSD test p = 0.05). No statistically significant changes in measurement of averageness were observed. Results from Bayesian complementary analyses confirmed the observed effects for sexual dimorphism. The evidence for trimester differences in asymmetry and averageness was inconsequential. Based on the preliminary results of this exploratory study, we suggest that previously found decrease in observed facial attractiveness during pregnancy can be related to the decrease in computed facial femininity (possibly mediated by the changes in facial adiposity).

Inflammaging: Blame the sons. Relationships between the number of sons and the level of inflammatory mediators among post-reproductive women

OBJECTIVES

Reproduction is costly, but sons and daughters differently influence maternal physiology, also in older age. In particular, having sons may negatively influence maternal health and may be associated with a shorter life span of mothers. Sons may also contribute to increased inflammaging, a chronic sub-clinical systemic inflammatory state characterized by elevated levels of serum inflammatory mediators. The aim of this study was to examine the impact of the total number of children, and the number of daughters and sons separately on concentrations of C-reactive protein (CRP), and proinflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α).

MATERIALS AND METHODS

The participants were 378 women aged 45-92 who had 3.9 (SD 2.12, median = 4, range = 0-13) children, including 2.1 (SD 1.46, median = 2, range = 0-8) sons and 1.8 (SD 1.44, median = 2, range = 0-7) daughters on average.

RESULTS

We found a positive relationship between the overall number of children and IL-6 levels. CRP and IL-6 concentrations were positively associated with the number of sons but not with the number of daughters. Each son increased maternal CRP level by 11%, and IL-6 level by 6%. Neither the total number of children nor the number of daughters or sons were related to the TNF-α concentration.

DISCUSSION

Aging-associated inflammation in post-reproductive mothers with a higher number of sons supports the hypothesis of trade-offs between reproduction and health. Furthermore, these results provide new evidence contributing to the idea that having sons may have more detrimental effects on the maternal organism than having daughters.

When and how does the number of children affect marital satisfaction? An international survey

The present global study attempts to verify the links between marital satisfaction and the number of children as well as its moderators in an international sample. Data for the study was obtained from our published dataset and included 7178 married individuals from 33 countries and territories. We found that the number of children was a significant negative predictor of marital satisfaction; also sex, education, and religiosity were interacting with the number of children and marital satisfaction, while there were no interactions with economic status and individual level of individualistic values. The main contribution of the present research is extending our knowledge on the relationship between marital satisfaction and the number of children in several, non-Western countries and territories.

Oxidative stress as a hidden cost of attractiveness in postmenopausal women

Perceived facial attractiveness, a putative marker of high biological fitness, is costly to maintain throughout a lifetime and may cause higher oxidative stress (OS). We investigated the association between the facial features of 97 postmenopausal women and their levels of OS biomarkers 8-hydroxy-2′-deoxyguanosine (8-OHdG), superoxide dismutase (Cu-Zn SOD), and thiobarbituric acid reactive substances (TBARS). In study 1, 966 judges rated the composites (facial averages) of women with higher OS as more attractive, healthier, younger, and less symmetric. In study 2, Geometric Morphometric analysis did not reveal significant differences in facial morphology depending on OS levels. In study 3, measured facial averageness and symmetry were weakly negatively related to 8-OHdG levels. Maintaining higher perceived facial attractiveness may be costly due to increased oxidative damage in the postmenopausal period. These costs may remain hidden during the reproductive period of life due to the protective mechanisms of oxidative shielding and revealed only after menopause when shielding has ceased.

Difference in Perception of Onset of Old Age in Traditional (Hadza) and Modern (Polish) Societies

Despite relatively clear physiological indicators of old age, little is known about cross-cultural differences in psychological perceptions of the transition to old age. Although recent studies suggest consistency between modern countries, the subjective perception of old age onset in traditional societies remains poorly explored. Therefore, we compared the perception of timing of old age between a traditional tribe of hunter-gatherers (the Hadza) and a Polish sample representing a modern, industrialized population. The results indicate that the Hadza perceive old age onset as being significantly earlier than do the Poles. Furthermore, we found between-gender differences in the Polish sample: men set a lower threshold of old age onset than women. The Hadza showed no between-gender difference. Although the samples were matched for age, a larger proportion of Hadza considered themselves old. We discuss these findings from cultural and demographical perspectives.