Against the standard human: The sociology of the 'inclusion-and-difference' paradigm in U.S. biomedicine

In the United States over the past quarter century, a diverse set of advocates, experts, and policymakers have launched a widespread and effective campaign against the reliance on a “standard human” in health and medical research. Reformers have sought not only to make medical research more inclusive through the addition of more women, racial and ethnic minorities, children, and the elderly as research subjects, but also to make it more meaningful by testing for outcome differences across categories such as sex, gender, race, ethnicity, and age. In this presentation, I describe how this distinctive way of thinking about bodies, identities, and differences gained supporters, took institutional form as law and policy, and become converted into common sense. I also consider some of its many consequences (intended and otherwise) for research, drug development, “profiling” practices in health care, the reduction of health inequalities, and scientific and cultural understandings of the meanings of sex and race.