Since ancient times, medical knowledge has been built around a predominantly androcentric vision of health, confining attention to female well-being exclusively to the reproductive sphere. This paradigm dominated unchallenged for centuries, until, around the 1970s, the scientific community began to recognize a fundamental problem: clinical studies were conducted primarily on male samples, based on the erroneous assumption that, beyond the reproductive system, men and women were biologically identical. This simplification proved not only incorrect, but potentially dangerous to the health of millions of people.

The final decade of the last century marked a turning point. The international medical community embraced a new research philosophy, characterized by a multidimensional and holistic approach that analyzes how gender-related differences—understood not only as biological characteristics, but as a combination of environmental, social, cultural, and economic factors—influence physiological processes, the onset of pathologies, and their clinical manifestations. Gender, in fact, is a highly complex concept that encompasses not only an individual's biological characteristics, now recognized as non-exclusively binary, but also their relationship with the world and society.

The World Health Organization today considers it a fundamental pillar for promoting global health, recognizing that health inequalities are rooted both in laboratories and in the fabric of society. The numbers speak for themselves: 435 million women live in extreme poverty worldwide, a health gender gap with dramatic consequences. Low education, social marginalization, and economic hardship thus become powerful determinants of health, creating invisible yet concrete barriers to access to care. It's not just a question of biology, but of social justice.

If for decades women have been systematically excluded from clinical trials, because they are considered too complex due to the hormonal fluctuations of the menstrual cycle, even when they are included in studies today, sex often remains a neglected variable in data analysis.

An emblematic case is that of troponin, a biological marker of infarction.It took medical research years to recognize that physiological parameters exhibit significant variations between men and women. This gap in knowledge has had dramatic consequences: numerous heart attack patients have fallen victim to diagnostic errors caused by the misinterpretation of their clinical values, which were considered normal by male standards when in fact they represented clear warning signs for the female body.

The problem also extends to medical devices, such as masks that we learned to wear during the pandemic, but also some advanced models of artificial hearts, too large for the female chest, even the needles for injections: everything is designed to measure for men.

A sobering statistic: in 80% of cases, a standard needle used on a woman misses the intramuscular target, effectively transforming the injection into a subcutaneous one. The result is a completely different absorption of the drug than expected, potentially jeopardizing the effectiveness of the therapy.

The implications of gender medicine cut across every medical specialty.

In pharmacology, the differences are even more pronounced. Women absorb and eliminate drugs differently than men, suffer more adverse reactions, and often receive dosages calibrated for a 70-kilogram man—a standard that for them may be excessive or insufficient.

In psychiatry, the gender gap manifests itself in a complex wayDepression and anxiety disorders affect women more frequently, while men are more likely to suffer from addictions and antisocial personality disorders. However, cultural stigma often prevents men from seeking help for mental health issues.

Finally, in immunology, an interesting paradox emergesWomen have stronger immune defenses but are more vulnerable to autoimmune diseases, while men are more susceptible to infections.