The Yentl syndrome was theorised for the first time in the early nineties by Bernardine Healy, a cardiologist and, at the time, director of the U.S. National Institutes of Health. The syndrome has been accurately described in the relevant article published by the New England Journal of Medicine.
But what does the Yentl syndrome actually mean? It is named after the lead character of a novel by Isaac B. Singer. Yentl, the daughter of a Rabbi, was forced to dress up as a man to be able to study the Talmud, the sacred text of Judaism. Dr Healy wanted to highlight something she had often noticed: when diagnosing a heart attack, mistakes were more often made if the patient was a woman, and this, in turn, also led to wrong, non-resolutive treatments.
Traditionally, the studies of diseases that affect both men and women – and of the medication and drugs used to cure them – have been almost exclusively conducted on men and then applied to women too. The opposite happened in very few cases, while gender-specific studies are almost non-existent. The consequences of a lack of this type of study clearly impact the right to health and treatment.
As Dr. Healy had noticed, a heart attack is something that has always been associated with men, hence the diagnoses and treatments have been studied accordingly. Despite heart attacks are the first cause of death among women, they are seldom diagnosed, because symptoms in women may differ compared to the symptoms experienced by men.
The case of heart attacks is the most common and renowned one, but it’s not the only one. That’s why gender-specific medicine and studies have been increasing over the past years. As Dr. Giovannella Baggio says, “It is not a new sector of medicine. It is a cross-gender approach that strives to understand the different symptoms the same disease causes in women and in men and, consequently, how to prevent and treat it”.
Until 1993, women were excluded from drug experimentation studies, for a number of reasons.
For example, from a historical standpoint, women have always been considered inferior to men, biologically speaking (cf. Galen and Vesalius). Another issue is the fact that female organs are more complex to study. Starting from the very first menstrual cycle, the hormonal system of women varies much more than that of men. These changes also affect response to and absorption of drugs. Hence it is more complicated and costly to involve women in drug experimentation.
The situation has now slightly improved, but figures show that there still is some imbalance, in terms of percentages. The different metabolic systems of women and men tend to be ignored, just as the fact that women, on average, take more drugs than men, hence are more exposed to harmful effects.
The steps taken towards gender-specific medicine are particularly relevant at this time, since we are studying the novel coronavirus and experimenting treatments for it.
Women who contract the virus and develop Covid-19 are much less likely to die from it than men (the ratio is almost 1 to 3 in people aged less than 80). There are several hypotheses as to why this is the case and it is high time to consider them seriously.
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