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Gender Equality Directory of Good Practice and Research
  1. Gender Equality Directory of Good Practice and Research
  2. Professor Chloe Orkin: Reducing gender research gaps, health gaps and workforce inequities

Reducing Gender Research Gaps, Health Gaps and Workforce Inequities

Professor Chloe Orkin

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Please outline the work you lead and how it relates to progressing gender equality

The SHARE Collaborative for Health Equity focuses on reducing health gaps and research gaps in people with minoritised identities (e.g. gender identity, ethnicity, disability, older age and sexual orientation). My work on gender seeks to reduce gender health gaps by improving gender research gaps. The ILANA study exemplifies this approach by devising an explicitly anti-sexist, anti-ageist and anti-racist recruitment approach to evaluate the implementation of a novel longer lasting HIV therapy in people with diverse identities. This is important because these groups are significantly under-represented in HIV treatment trials which are not representative of the global population of people living with HIV. In the ILANA study, we demonstrated differences in the primary endpoint (feasibility) i.e. worse outcomes in Black participants and in women. This provides us with evidence where the gaps are AND data on how to tailor services to meet their needs.

In terms of HIV prevention, we have shown that cis women represent only 2% of people who receive pre-exposure prophylaxis (PrEP) to prevent HIV. Recent innovations in PrEP include a 6-monthly injection to prevent HIV. Our clinical and mixed methods studies are evaluating ways of ensuring that everyone will benefit from the implementation of this innovation.

What has inspired and motivated you to progress this work?

My research on gender health inequities is inspired by health feminism, which is informed by my own experiences of sexism.  As a woman who lives with a life-long medical condition (an invisible disability), I have experienced testimonial injustice in the health system. By this I mean that my account (testimony) of my symptoms has been disbelieved or minimised by healthcare professionals.  This is a common experience for women and in my case led to delayed diagnosis and poorer health outcomes. In the workplace, I experienced testimonial injustice around my need for workplace adjustments. This led to me resigning from a fantastic job opportunity. Fortunately, these experiences did not happen at Queen Mary or Barts Health NHS Trust which is why I can hold senior leadership positions here.

My leadership on gender is inspired by my experiences of extensive misogynistic trolling as a woman speaking about science in the media. The trolling related to my appearance with slurs relating to my gender, sexuality and assumed gender identity.

How do you hope that this work will make a difference to promote gender equality and have you seen any impact so far?

The ILANA study has been cited in the World Health Organisation Antiretrovirals in Pregnancy Toolkit as a best practice example and is the basis of a commissioned editorial on inclusive trial design. The study won the NIHR CRN North Thames award on reducing health inequalities.

During the initial mpox pandemic, the SHARE Collaborative pioneered the evaluation of clinical characteristics and transmission routes of mpox among women (including transgender women) and gender non-binary individuals. This research is cited in the World Health Organisation Clinical Guidelines.

In the broader context of feminist research, as the former President of the Medical Women’s Federation, I have collaborated with junior doctors to conduct research that assesses gender inequities within the medical profession. This work was cited as a beacon activity within the FMD Athena Swan gold award application.

What did you enjoy most about this piece of work and do you have any plans going forward?

SHARE brings together clinical, biomedical, social science and community expertise to investigate the inequalities that lead to poor health outcomes. We aim to ensure no one is left behind. We believe that the intersectional identities of the research team are integral to the design and delivery of our research activities. Our team is proud to comprise researchers, many of whom are women, from racially minoritised backgrounds, LGBTQ+, neurodivergent and disabled communities, together with older adults and people with lived experience of HIV and other health conditions. Members of the senior team hold or have held national leadership roles in HIV and/or health equity, are influencers and have been recognised for their expertise and contributions.

My future clinical research will concentrate on ensuring equitable research design and implementation of novel therapeutic innovations. I will work with my colleagues to focus on gender (and other) inequities in the medical and academic workforce. A more diverse workforce is crucial to delivering research that is relevant to everyone.

Please share any publications or resources from your work that would like to highlight

The SHARE Collaborative website: www.shareresearch.org.uk

Publications:

 

 

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