International Women's Day

The gender gap in medical diagnosis

The gender gap in medical diagnosis

Women in Australia generally have much to be grateful for.

While there is still a long way to go to achieve true equality, many of us enjoy greater freedoms than we did even a single generation ago.

Great strides have been made towards equality among people across the gender spectrum, in social, familial, and professional settings.

However, gender bias continues to be a barrier to equal opportunity and wellbeing for women in medical settings.

One in three women have health concerns dismissed by their doctor

A recent study found that women are twice as likely to have health concerns dismissed by their treating physician, with one in three women having symptoms ignored, invalidated or misinterpreted.

This information highlights a trend of women having poorer experiences with health professionals that can have serious mental and physical health consequences.

Further research into this area revealed that women are less likely to feel like their doctor listened to them carefully, respected their opinion, and spent enough time to fully understand their health concerns.

These negative experiences can be a deterrent from seeking healthcare for women, who already face additional barriers to prioritising their health.

Women were also more likely to delay seeking mental health support because of its cost compared to men, perhaps as a result of lesser financial means thanks to the gender pay gap, or a tendency to prioritise the financial and health needs of the family over their own.

Women also receive appropriate and timely pain management at a lesser rate than men, and frequently have serious or chronic pain ignored or dismissed.

It is a concerning trend that highlights how medical research has historically been centred on men’s anatomy and physiology, as well as society’s habit of expecting women to suffer in silence.

Doctors kept telling me I was ‘crazy’

Lee* knows all too well how gender-based medical negligence can cause years of needless suffering, having lived with undiagnosed postural orthostatic tachycardia syndrome (POTS) and probable Ehler’s Danlos Syndrome (EDS) for two decades.

Lee first sought help for chronic knee pain as a teenager but was told to simply lose weight to alleviate her symptoms, despite being a perfectly average size.

After seeking help from multiple other doctors, all of whom failed to adequately investigate her symptoms, Lee resigned herself to a life constricted by severe knee and back pain.

Following a stint of poor health brought on by a virus, Lee eventually found a practitioner who listened to her and took her symptoms seriously in the form of a physiotherapist.

Lee was diagnosed with a degenerative disc disease which, had it been found earlier, would have had great prospects for timely treatment. As it was, the neglect she had faced in medical settings meant that the damage was now permanent.

“I jumped from doctor to doctor, with them more or less telling me I was crazy every time, and that I just needed to suck it up,” she said.

“I was very ready to give up and just accept that it was in my head.”

With the support of her physiotherapist, Lee continued to seek answers, despite continued disappointment and disrespectful conduct from several doctors who were quick to jump to conclusions based on her physical appearance.

“I’m still seeking a definitive diagnosis of EDS, as it was never officially documented despite being told verbally that was the diagnosis,” said Lee.

“I’m still looking for answers to other symptoms, but I’m burnt out on medical care and having to fight be to believed. I recommend joining online groups for your condition or suspected condition to get recommendations for good doctors.”

Lee still lives with the impacts of permanent damage to her spine and possibly other joints in her body, as well as the huge emotional and physical toll of seeking treatment in a world determined to misunderstand or dismiss women’s pain.

The gender gap in medical diagnosis

‘I thought I would die on the operating table. I said goodbye to my kids’

Nadia* is another woman who experienced the serious risks of medical gender bias, in her case resulting in the need for an emergency hysterectomy in her forties.

After noticing a lump in her abdomen that didn’t cause pain and was only noticeable from certain angles, Nadia sought the advice of a male doctor.

He was quick to brush her off, saying she was just worried about gaining weight like “many women her age”, despite her explaining that she had noticed it growing in size.

“I thought perhaps he was right, and did nothing for another two years,” said Nadia.

Eventually, Nadia found a supportive female doctor, out of concern for the lump’s continued growth. After hearing Nadia’s history, she was immediately given an internal examination which confirmed all of her fears and instincts; there was definitely an abnormal growth present.

Thus began a long, exhausting and uncomfortable process entailing several types of tests and examinations to determine the precise nature of the growth. These tests were ultimately not completely conclusive, however fears of it being malignant were compounded by how long it had gone unaddressed.

“They were not able to confirm whether it would be cancerous,” said Nadia.

“They did say it had spread to such an extent that they could not be sure whether part of my bowel would need to be removed. They also advised it would be much quicker, simpler and surer if they performed a total hysterectomy, as this growth seemed to be spread over that entire area.”

Terrified, Nadia took the advice of her doctors and underwent a full hysterectomy before the age of 50. While she is in the recovery process now, she is still haunted by thoughts of how much simpler and safer she could have been with an early diagnosis and a caring doctor years earlier.

“This entire sequence of events was very stressful, as they were not overly optimistic about my recovery,” she said.

“I actually thought I would die on the operating table. I said goodbye to my kids.”

Ignorance no longer an excuse for medical negligence

People from all walks of life and gender identities can and do encounter less than ideal medical experiences. However, the trends of who is paying the highest price for medical bias and discrimination is unequivocal.

Women still have to fight to be heard, respected and adequately treated by far too many professionals. These barriers become even greater for women of colour, women with disabilities, women who live in larger bodies and trans women.

On some level, it may be understandable that there are gaps in knowledge, empathy and awareness that creates implicit biases in medical settings. Many of us are not immune to this, and we are constantly learning and unlearning the lessons ingrained into us by a world of white supremacy, fatphobia and misogyny. However, when the consequences of sustained, willful ignorance among even the best medical practitioners is often fatal, something must change.

For many, that begins with education and seeking alternative perspectives on issues we have long based in assumptions and stereotypes. With this awareness and open compassion for all, we can start to open up a dialogue that will liberate so many from terrifying medical experiences, and literally save lives.

For those interested in learning more about how to unpack internal biases, here are some recommended readings and websites:

Women with Disabilities Australia

Reach Out LGBTIQ support services

LGBTIQ Health

Australian Human Rights Commission National Anti-Racism Framework

Butterfly Foundation: Weight Bias, Fatphobia and Diet Culture

 

*Name has been changed to protect privacy.

Emma Lennon

Emma Lennon

https://linktr.ee/emmalennon

Emma Lennon is a passionate writer, editor and community development professional. With over ten years’ experience in the disability, health and advocacy sectors, Emma is dedicated to creating work that highlights important social issues.