Interestingly, the editors of Human Anatomy, the textbook with parity, are Elaine N. Marieb and Katja Hoehn, both women, while the textbook with the worst ratio was edited solely by men.Madelene Hyde, the vice president for content and education at Elsevier, which publishes several top anatomy books including Gray's Anatomy, said they are "trying more and more to be as balanced as possible with our textbook images.""We take gender and racial diversity seriously and are working to include more diverse images in our textbooks," she told Motherboard in an email.
"The textbook with the worst ratio was edited solely by men"
In some cases, showing a female body makes sense, if the content is specifically about female health. But Parker found that even in cases where there is no reason to show one sex over another, men are more likely to be depicted as the "normal body." This lines up with previous research from 1992 that found that even when it comes to medical imagery around reproduction, men outnumbered women in textbooks 2.5 to 1."For the anatomy titles that do not solely focus on surgical anatomy (interior rather than exterior), we do our best to provide images of diverse subjects," Hyde said in her email. "When possible, we try to replace older images of rare clinical conditions. As a provider of a significant volume of global health content, we try more and more to be as balanced as possible with our textbook images."
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And sometimes illustrators are explicitly told to not include certain kinds of bodies. Parker said that in her research, she heard stories from illustrators who reported being asked not to show female nipples unless the illustration had something to do with breast health, for example.By using past books as examples, illustrators are also perpetuating the bias. "Frank Netter, the father of medical illustration—his work is 100 percent white people," said Gregory. "It's a matter of not being lazy thinkers and starting to be, like, 'I shouldn't just default to the same skin tone.'"This is exacerbated by the fact that the majority of medical illustrators are white (85 percent of people who responded to an Association of Medical Illustrators survey in 2018 identified as such), a problem that the association started tackling head on a few years ago with a special diversity committee (which Gregory is a member of).The solution lies in the hands of publishers and illustrators. Gregory says that it's crucial to explain to people working in the field why this bias is harmful. "It's really about awareness. It takes time for people to say, 'Oh right, I should use diverse skin tones, maybe someone in a wheelchair, different kinds of people.'"But are things getting better? Parker isn't so optimistic. She points out that doctors have a really rigid idea of what a healthy body looks like, and that's a hard thing to change. "No, I don't think it's changing," she told me. "I do think that maybe the gender disparity is slowly changing. But the intersections with ethnicity and body type, I don't think they're being paid attention to, and are getting worse."Gregory, on the other hand, sees progress, even if it's been slow. She says that even she has changed her methods around this issue over the years. "Ten or 15 years ago I was maybe throwing something in for the heck of it, but now every time I approach an illustration I think about how I can include diversity in my images." Between that and recruiting a more diverse set of illustrators in the field, Gregory has hopes that things will get better.Correction: In the original version of the story, Frank Netter's name was spelled incorrectly.
"It takes time for people to say, 'I should use diverse skin tones, maybe someone in a wheelchair'"