“This is just anxiety, it’s all in your head,” is a diagnosis commonly doled out to women seeking medical assistance. Pain is ignored. Concerns are belittled. Serious symptoms are dismissed without so much as a simple health check. The consequences can be fatal.
The delegitimisation of women’s suffering is endemic in the healthcare system, stemming from deep-rooted gender biases in medical research. Gender bias refers to prejudice against one gender over another based on generalisations or stereotypes. A 2020 UN report found that almost 90 percent of people globally hold some form of bias against women, whether this be consciously or subconsciously.
Gender bias in healthcare is upheld by several misconceptions about women’s health. A survey by the Department of Clinical Health Psychology at the University of Florida found that many medical professionals believe women exaggerate their pain and symptoms. As a result of this, women’s pain is often dismissed as physical manifestations of psychological conditions. This stems from the age-old stereotype of the ‘hysterical woman.’ The word hysterical, in fact, stems from the Ancient Greek word for womb ‘hystera,’ meaning that to be hysterical is innately feminine. It was thought that women’s ‘excessive’ emotions physically influenced their bodies. Psychology professors at University College London conducted a study looking at perception of pain. It revealed that in many scenarios, participants perceived a woman’s pain as less extreme than a man’s, despite exhibiting similar reactions and expressions. This perception has contaminated modern medicine and influences how women are treated by medical professionals.
In addition to the belief that women’s pain is less severe and exaggerated, it is commonly thought that women have higher pain tolerances. This results in women being less likely to receive painkillers or treatment. Research published in the journal Academic Emergency Medicine on the treatment of abdominal pain found that women were up to 25 percent less likely to receive painkillers than men with the same symptoms. This deep-seated belief has arisen from patriarchal views in society which have sculpted medical research. Women were long thought to only differ from men in their ability to bear children: pain is perceived as ‘normal’ for women. An example of this is the commonly misdiagnosed uterine disease, endometriosis. It is all too common to hear of a woman’s severe abdominal pain being dismissed as ‘normal’ menstrual pain. In the UK, the average time to reach a diagnosis of endometriosis is an arduous seven and a half years.
Gender bias is reinforced by male dominance in medical research and the lack of knowledge surrounding the female body. Until the 1990s, clinical trials were made up of almost exclusively men. The reasoning for this was that female hormones and menstrual cycles were thought to interfere with the results of medical trials. Thus, men became the default in medical testing, and women were simply treated as ‘not men’, rather than as their own bodies which act uniquely. Despite the eventual inclusion of women in clinical trials, ignorance towards women’s presentation of symptoms and pain persists and is upheld by this historical bias.
Research into gender bias in the treatment of cardiovascular disease has revealed the disturbing consequences of these ill-conceived notions. Cardiovascular disease is often thought of as a ‘male’ condition, as it affects more men than women on average. It has been found that there is a considerable disparity in pain management for men and women experiencing the same symptoms. A study conducted by the University of Rhode Island found that women who received coronary bypass surgery were half as likely to be prescribed painkillers in comparison to men who had received the same surgery.
Even more concerning are the results from a 2000 study published in The New England Journal of Medicine on heart attack treatment. It revealed women were seven times more likely than men to be misdiagnosed and discharged from hospital mid-heart attack. Limited research into women’s cardiovascular health, and harmful assumptions, have contributed to this gender disparity. There have been conflicting theories on how men and women experience heart attacks. It is widely believed that women have different heart attack symptoms to men, and chest pain is not immediately associated with heart attacks for women. However, the British Heart Foundation (BHF) has suggested that the main symptoms of a heart attack do not significantly differ between men and women. Pain and tightness in the chest were found to be the most prominent symptoms for everyone. Research by the BHF found that women are more likely to delay seeking medical help due to not recognising the key symptoms. The persistence of misinformation and stereotypes is causing women to suffer needlessly: there is an urgent need for specific research into women’s health and their experiences of different conditions.
It is important to acknowledge that misogynist stereotypes are ingrained in the fabric of modern medicine. The centuries-old scientific theory that women’s nerves were too highly strung for them to receive an education sounds outrageous to us now, yet it was part of the systems that laid the foundation for the medical research we see today. The evidence presented in this article indicates that modern medicine and the healthcare system are inherently biassed against women. Without conscious recognition and rejection of this bias, women are at risk of mistreatment and neglect by the healthcare system.
