A new study shows a gender gap in kidney transplant rates. Unsurprisingly, women — or, I should say, certain women — are on the bottom end of that gap. This is the case even though women fare just as well as or better than men of the same age.
The researchers examined data from the United States Renal Data System, including a list of 563,197 patients who developed end-stage kidney disease from 2000 to 2005, and they calculated the likelihood of getting on a transplant list, adjusting for factors that would affect the patient’s survival after surgery.
They found that women 45 and younger were as likely as men to be placed on a transplant waiting list. But as women aged, their chances of getting on the list dropped, getting worse with each decade, said the lead author, Dr. Dorry Segev, a transplant surgeon at Johns Hopkins.
By the time women were 46 to 55, they were 3 percent less likely to be put on the transplant list. They were 15 percent less likely to be placed on the list at ages 56 to 65; 29 percent less likely at 66 to 75; and 59 percent less likely to be listed by the time they were 75 or older, Dr. Segev said.
What is the cause for the gap, and the way that it progressively widens as women age? Well, the answer to that isn’t known for certain, but Dr. Segev puts in an educated guess that sounds about right to me. He believes that women’s families are more likely to see them as frail and unlikely to survive a transplant, and therefore don’t put them on the list at all.
Of course, the stereotype of older women as frail is a very common one. The phrase “little old lady” rolls right off our tongues, and though it’s not unheard of, the phrase “little old man” is significantly less common. Older women are regularly portrayed by the media as having limited mobility and therefore helpless and fragile (a form of ableism as well as ageism, I think). Even though, as all of the research shows when it comes to the results of kidney transplants, they’re not.
That’s the thing about stereotypes. Lots of people like to argue that they’re “harmless.” And also, these same people tell us, they’re mostly based in reality, so it’s all okay. Except that stereotypes of all kinds cause things like this. I hate to get all dramatic, but it’s true, and this is only one of many examples. Stereotypes can, and regularly do, cost lives.
That’s no reason to put aside any and all other possible explanations for the gender gap. Off the top of my head — since women are taught to be so much less assertive than men are, and since we’re also taught from birth to not be a “burden” to our loved ones or make too much of a fuss — I wouldn’t be surprised to find out that women are statistically less likely than men to stand up to their families when these kind of decisions are made. Or that they’re more likely to make the decision themselves in an attempt to avoid being a “burden.” Elderly women are also at a higher risk of living in poverty than elderly men (pdf), and heart wrenching though it sounds, therefore may have more economic concerns influencing their decision. Or, after hearing the message for so long, these women could have simply come to seen themselves as more fragile than they are.
But I’d still be surprised if Dr. Segev’s speculation was based in nothing but fantasy. And regardless of whether or not he’s right in his speculation, my alternate explanations are more accurate, or there’s a wholly separate cause at work here, we clearly ought to be concerned.