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October 26, 1994

Sex and Gender Bias in Anatomy and Physical Diagnosis Text Illustrations

Author Affiliations

From the Office of Medical Education (Dr Nieman) and Department of Medicine (Dr Levison), Medical College of Pennsylvania, Philadelphia. Ms Mendelsohn is a medical student at the Medical College of Pennsylvania, and Mss Isaacs and Lee are students at Cornell University, Ithaca, NY.

JAMA. 1994;272(16):1267-1270. doi:10.1001/jama.1994.03520160051042

Objective.  —To examine the sex and gender distribution of illustrations in two atlases, five anatomy texts, and five physical diagnosis texts.

Design.  —Of 4060 illustrations that were identifiable by sex and gender in 12 commonly used anatomy and physical diagnosis textbooks, 3827 were categorized by two reviewers as female, male, or neutral.

Results.  —Females were represented, on average, in 21.2% of the anatomy text illustrations; males were represented, on average, in 44.3%; 34.4% of the illustrations were neutral. Of the nonreproductive anatomy illustrations, a mean of 11.1% (range, 4.6% to 23.8%) depicted women and 43.1% (range, 35.4% to 56.2%) depicted men. Of nonreproductive anatomy illustrations, a mean of 45.8% (range, 27.2% to 59.9%) were neutral. Overall, the physical diagnosis text illustrations demonstrated a more equal sex and gender distribution (21.5% female and 24.8% male). However, in the reproductive chapters of the physical diagnosis texts, females were depicted in a mean of 71.1% (range, 63.2% to 79.0%) of the illustrations, while in the nonreproductive chapters, females were depicted in 8.8% of total illustrations.

Conclusions.  —In anatomy and physical diagnosis texts, women are underrepresented in illustrations of nonreproductive anatomy. The finding that males are depicted in a majority of nonreproductive anatomy illustrations may perpetuate the image of the male body as the normal or standard model for medical education.(JAMA. 1994;272:1267-1270)

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