Gender Bias In Healthcare
16 year old Jackie was suffering from chronic kidney problems, fevers, fatigue, and menstrual and joint pain. After numerous visits to a primary care doctor, urologist, and pulmonologist, Jackie was dismissed as simply having depression due to a lack of results from tests pointing out anything amiss. Years later, Jackie was finally able to attribute her symptoms to endometriosis and received the proper treatment (source).
Unfortunately, the initial stages of Jackie’s situation are more common than one might expect. Hundreds of women who seek the expertise of physicians are told that their symptoms are due to hormones, stress, or they are just “overreacting”, “hormonal”, and “making things up”. This phenomenon is referred to gender bias and stems from implicit bias that follows physicians into the clinic.
Similar to Jackie’s initial diagnosis of depression, many women often get their physical complaints attributed to mental illness. This attribution has roots in the history of the mythical illness “hysteria” that is blamed on a “wandering womb” or sensitive nerves. Eventually, hysteria was seen as a psychological illness in the post-Freud era. Although the terms used to describe hysteria have changed over time, the concept that the unconscious mind can produce physical symptoms has persisted in medicine and has most prominently been acquainted with female patients.
For a long time, women have been seen as the standard patient who has psychological problems. However, due to the diagnosis of psychological problems, physicians are more likely to dismiss physical complaints from women as being “all in their heads”. A study conducted in 1986 looked into a group of patients who had been diagnosed with neurological disorders who had previously been diagnosed with “hysteria”. The group found that such a misdiagnosis was common among women who had been diagnosed with a previous psychological disorder.
The gender bias in healthcare also stems from the belief that men and women only have physical differences when it comes to reproductive organs. Thus, most research was conducted on male animals and male cells. However, advances in science and technology show that there are more significant differences between males and females. Janine Clayton, MD, states that “because we have studied women less, we know less about them. The result is that women may not have always received the most optimal care” (Source).
It can be difficult to address gender bias in healthcare since we are often not aware of the issue. The first step in combating gender bias in healthcare is simply recognizing that this unintentional bias exists. Other steps we can take, as outlined by Duke Health, are encouraging open discussions of gender bias in healthcare and using substitution. Think about how you would address the same patient if they were of a different gender and reflect on the differences between the hypothetical interaction and the patient interaction. Additionally, we can make an effort to ask the patient open ended questions such as “What are your concerns for today?”
As Denise Davis, MD, says, “biases are not moral failings; they are habits of the mind”. With time and effort, these habits can be changed. But we first must acknowledge the seriousness of the gender bias issue in healthcare and make efforts to eliminate it.
By: Sreenidhi Saripalli
