Medicine and sex

It has long ago been established that medicine works differently on male and female persons – this is not discrimination but biological fact. We also know that immune responses are different in male and female persons.

If – and it is a very big if – it turns out the AstraZeneca/Oxford COVID-19 vaccine had very different side effects for male and female persons we shouldn’t really be surprised. But the test phase should have shown this.

A couple of years ago, back when Caster Semenya was in the news and I stumpled across the writings of Roger Pielke (first junior, then senior), I had the simplified view that sex was determined by chromosomes; XX or XY in humans. Had I thought a little harder about it, I should have realised that this is too simple as genes can exist on different chromosomes and be active or not.

Yes, I know that is much too simple as well, but it’s basically true so I’ll go with that. But of course, a biologist is more precise:

In mammals, which includes humans, the Y chromosome carries a gene (SRY) that encodes a testes-determining factor. If an individual has a Y chromosome with a functional SRY gene, they will develop testes and therefore will be biologically male. Absent a Y chromosome and functional SRY gene (unless the SRY gene has been transposed to an X chromosome), an embryo will develop ovaries and will therefore be biologically female. What’s important to note is that the presence of a Y chromosome, or two, or three, etc., all result in the development of testes and therefore these individuals are biologically male. Likewise, individuals with additional or fewer X chromosomes, in the absence of a Y, all develop ovaries and are therefore biologically female.
— Colin Wright, “Sex Chromosome Variants Are Not Their Own Unique Sexes

The point of this little excursion is, that we need to remember that biology matters. Sex is real and no matter how much someone believes in a gender stereotype, it doesn’t change the biology. We need to remember this so we don’t let ourselves forget to test how medicine affects both men and women.









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