Sex-based representation in anatomical atlases: An analysis of illustrations used in anatomy teaching in Poland

Despite increasing awareness of issues related to sex and gender representation in medical education, previous studies have shown that anatomical atlases often present the male body as the default anatomical model, with female bodies more frequently depicted in sex-specific contexts. However, little is known about how such global visual patterns are reflected in atlases officially recommended within national medical curricula. The aim of this study was to assess sex-based representation in anatomical illustrations contained in the most frequently recommended atlases used at Polish medical universities.

Based on publicly available syllabi, curricula, and mandatory reading lists from Polish medical faculties, the most commonly recommended atlases were identified. In total, 5293 illustrations from the three most frequently recommended atlases were analyzed. Each image depicting the human body or its parts was classified according to sex (where identifiable), type of illustration, viewing perspective, mode of presentation, and presence of sex-specific anatomical content. Classification was performed manually using a standardized coding sheet; in cases of uncertainty, decisions were made by consensus among three members of the research team.

Images depicting male bodies were more frequent (13.5-25.3%) than those depicting female bodies (6.8-10.4%). In most cases (64.0-79.4%), sex could not be determined. Painted anatomical illustrations predominated across the atlases (81.6-95.1%), while sex-specific anatomical content accounted for only 6.4-11.2% of all images, with mammary gland anatomy representing less than 0.5%. Male bodies were more often shown in whole-body views, whereas female bodies were depicted predominantly in association with reproductive organs and mammary gland anatomy. The male-to-female ratio of sex-identifiable images ranged from 2.00 to 2.43.

The atlases most commonly used in Polish anatomical education demonstrate a persistent imbalance in sex-based visual representation. Male bodies are depicted more frequently in general anatomical contexts, whereas female bodies appear predominantly in sex-specific illustrations. Such patterns may limit students' exposure to anatomical variability and contribute to the persistence of androcentric norms in medical education. These findings highlight the need for more balanced and context-aware visual resources in anatomy teaching.