"It's All In Your Head": What All Women Should Know About Medical Gender Bias

October 20, 2017

It's All In Your Head: My Experience With Gender Bias In Medical Diagnosis

Tears welled up in my eyes as I realized it was happening again. For the third time in my 32 years, a doctor didn’t believe my pain was real. The emergency room nurse stared at me shrewdly, “Do you have anxiety?”

I responded that I did, unsure of what this had to do with the symptoms I had presented.

“Do you take anything for it,” he snapped back coldly.

I responded in the affirmative again.

“When was the last time you took your medication?” He sounded angry. Why was he so angry?

“This morning,” I replied. My voice was getting shaky.

He turned to my stepmother. “The doctor will be in soon with her discharge papers. If she starts throwing up, gets the chills, or has a fever, you can bring her back.” He left the room and I sat there, baffled. I had a fever — it was rising. They had already thrown away one bag of vomit and given me an anti-nausea pill (which I promptly threw up). I had been shivering so hard that my muscles ached and tears streamed down my face. I had all the symptoms he had just listed, and they knew that my GP had already diagnosed me with a kidney infection. Why was he dismissing me?

I was so sick that I needed help getting back to the car. I threw up again on the way home, but I knew there was no point returning. They wouldn’t believe me. As far as they were concerned, this was all in my head.

Two hours passed and my symptoms worsened to the point that my father refused to simply sit idle and let my body go into septic shock. He practically carried me to the car and drove me to the other hospital in town, where the doctors took one look at me and saw the severity of the situation. Within minutes I was hooked to an IV and given saline for dehydration, antibiotics, and pain and anti-nausea medications.

It took two weeks in bed for me to even begin recovering my strength, and even a month later, I tire easily. If the doctors at the second hospital hadn’t believed me — if there hadn’t been another hospital to go to in the first place — I could have died.

I wish I could say my experience was unique. I wish I could say it would never happen to anyone else. But I’d be lying. As disgusting as it is, even in 2017, medical professionals routinely discriminate against women. The sexism inherent in the healthcare industry is so bad that it’s even kept women’s health technology startups from getting off the ground.

But why is this happening?

What’s Behind the Sexism in Medicine?

Referred to as “the gender pain gap,” the difference in how women and men are treated by medical professionals has serious and far-reaching implications. Here are just a few eye opening statistics:

A study carried out at the Hospital of the University of Pennsylvania found that when visiting the E.R. and complaining of the same level of severe abdominal pain, men wait an average of 49 minutes before being treated, while women have to wait for an average of 65 minutes. When they are given pain medication, they are consistently prescribed less than their male counterparts — even when controls for weight are applied. Because women’s pain is treated less aggressively, they often have to “prove” that they are as sick as male patients — a phenomenon referred to as “Yentl Syndrome.”

Furthermore, women with chronic pain conditions are more likely than men to be misdiagnosed as having a mental health illness and prescribed psychotropic drugs — even when clinical results show their pain is real. Doctors commonly dismiss their symptoms as being nothing more than hysterics. 

In her study on patients who had recently undergone coronary artery bypass graft surgery, researcher Karen Calderone found that, when presenting with the same symptoms, women are more likely than men to be given sedatives as treatment rather than analgesics. Again, women are perceived as being overly emotional rather than suffering any physical ailments, and as such, doctors fixate on returning women to a “composed” state in lieu of relieving their pain.

This startling lack of empathy — not to mention terrifying inaction and severe misdiagnoses — all come down to one thing: implicit (and sometime even overt) bias. For hundreds of years, doctors have wrongly perceived women as being more irrational and emotional than men. Unfortunately, these misogynistic stereotypes are still alive and well in the world of modern medicine — and it’s hurting women everywhere.

What Can You Do to Combat It?

Besides implicit bias, doctors have been set up to fail women in other ways. Most doctor’s offices, clinics, and emergency rooms function as poorly managed assembly lines, where medical professionals simply don’t have the time to properly focus on their patients. Healthcare administrations throw ethics out the door as they insist on finding more ways to enhance efficiency and make money versus hiring more staff to decrease nurse-to-patient ratios. But, whether your doctor is ignoring you due to sexism or lack of time, there are a few things you can do to make sure you’re heard.

  • If your doctor is brushing your symptoms aside or claiming them as being “all in your head,” feel free to disagree — loudly. Make sure you explain why you take issue with their diagnosis. Sometimes simply challenging your doctor is enough to get them to listen more attentively.
  • Take a family member or an advocate with you to every appointment. If you feel your doctor is not accurately recording your symptoms, record them yourself.
  • Listen to your body before anyone else. You should never be made to feel like your pain isn’t real — even if a doctor can’t explain or diagnose it. If you know something is wrong — and your doctor is not doing everything in their power to help you — it’s time to move on to a new physician.
  • Write a letter of concern to the hospital (or clinic) administrator or fill out a patient satisfaction survey. Healthcare administrators use patient feedback to monitor employee performance and identify gaps in service — and chances are, if you feel like you’ve been let down, many others have as well.

Thanks to the the handful of doctors and nurses that have treated me like a hysterical child (rather than someone who was in legitimate pain), I’m afraid to talk to doctors when I have a problem. The fear of not being believed when I’m telling the truth, being labelled as a malingerer or drug seeker, has given me severe anxiety issues. Fortunately I have a fantastic therapist who works through these anxiety problems with me, but I’ll never be truly free of the nightmares I’ve endured at the hands of sexist doctors. I can only fight the good fight now, and hope that the future of healthcare is brighter for women.

Have you ever had a doctor who implied that “It’s all in your head”?

Also by Liz: Good News! These 7 Traits Make Being An Introvert A Powerful Career Advantage 

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Liz Greene is a makeup enthusiast, rabid feminist, and an anxiety-ridden realist from the beautiful city of trees, Boise, Idaho. You can follow her latest misadventures on her blog, Three Broke Bunnies

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