Sex and Gender Representations of Myocardial Infarction in German Medical Books

Abstract

Mandatory teaching of sex-and gender-specific medicine (SGSM) is an essential tool to prepare future physicians for clinical care. Textbooks still play an important role for physician training in Germany. They are one of the main sources of structured and validated information. The present study was conducted to investigate the incorporation of SGSM knowledge about myocardial infarction (MI) into the standard cardiology textbooks used for teaching by German medical faculties. Additionally, the analyzed books were screened for implicit and explicit gender bias in a qualitative manner. Ten books were selected for analysis; they were issued in the years 2008-2012 and present in 30% or more of the 36 German academic medical libraries. Quantitative and qualitative analyses of content, language, and visual representations of the sexes in discussions of MI were conducted. All of the analyzed books describe the symptoms present in male bodies as the norm and 7 of the 10 books describe women as ''special'' or ''abnormal''; hence, they fail to address the unique experience of women suffering from MI. Sex and gender bias are widely present and the depiction of women in German cardiology textbooks is discriminatory.

Impact of an Automated Best Practice Alert on Sex and Race Disparities in Implantable Cardioverter‐Defibrillator Therapy

“… 15 The overall low referral patterns demonstrated in our cohort could be attributable in part to providers’ unfamiliarity with guideline recommendation for ICD therapy in the context of severe cardiomyopathy. One could postulate that providers’ implicit bias may also be at play, 10 , 19 whereby providers may unconsciously overlook referrals for women or Black patients to the electrophysiology service for consideration of ICD therapy. Explicit biases and structural racism, which have also been strongly implicated in health care inequities, cannot be excluded.…”