Women have more strokes than men, but new European Guidelines remove 'women' bc it omits 'non-binary' & transgendered people.

Medicine keeps acting irrationally in the name of political correctness

Vinay Prasad

For people with an irregular heart rhythm called atrial fibrillation, the risk of stroke can be substantive. For a long time, there was a risk score called CHADS-2-VASc that awards points to give you a sense of risk. More points.. more risk.

Over the age of 75… 2 points. Having had a prior stroke… 2 points. Being a woman… 1 point (because women, age-adjusted, have higher stroke risk than men).

Unfortunately that’s no longer PC in Europe. The European Society of Cardiology has decided to remove women as a risk factor because “The inclusion of gender complicates clinical practice both for healthcare professionals and patients. It also omits individuals who identify as non-binary, transgender, or are undergoing sex hormone therapy”

Wow. The only justification I could imagine to remove women from the algorithm is if a) being a woman is not a independent risk factor for stroke (current evidence suggests it is, and the ESC authors don’t dispute it), or b) if women are more likely to experience harms of anti-coagulation (what the score is used to decide).

But the problem with b) more broadly is that the CHADS-2-VASc guidelines merely quantifies risk of stroke, and doesn’t include risk of bleeding (e.g history of falls, etc.) Its not meant to decide whether you need anti-coagulation, but to quantify stroke risk and suggest settings where it might be considered. Here is the original score,

Medicine risks becoming co-opted by political movements if we change the practice of medicine to suit political correctness, rather than the best available care based on the data. Inclusion of gender doesn’t complicate clinical practice, it is easy, in fact.

I agree with Professor Gebhard, and worry about the direction medicine is headed. Removing race and gender from medical consideration might easily have effects that harm women and minorities. It is important for evidence to guide these discussions not activism.

Source: Vinay Prasad's Observations and Thoughts