Even in an age of high modernity and medical advancement, the gender divide still prevails – especially in a patriarchal system where men have been historically accorded prime importance in most medical research. Disturbing as it is, there is mounting evidence in medical research that shows one’s gender may well dictate the direction of disease diagnosis.

Researchers contend this disparity is evident in all levels of healthcare delivery from office visits to ward care. There is no doubt that gender bias may hinder accurate diagnosis – resulting in unequal medical interventions and higher mortality for women, particularly in the area of coronary heart disease (CHD).

Nonetheless, when the media amplifies how celebrity Maria Menounos had her non-malignant brain tumour promptly diagnosed, gender bias may seem a myth. For most ordinary female folks, however, this may not be the case.

Majority of women still continues to face scepticism in their health concerns. And doctors are quick to send them home with the refrain that it is all emotional or psychological. Some doctors prefer to send women for psychological evaluations rather than work on an accurate diagnosis.

“It’s all in the head”


Women report doctors as perceiving them as more irrational or emotional than men – and condescending when they tell women it is ‘all in their heads’; instead of having a physical basis for their pain. Conversely, men are generally seen as more rational and when they complain of acute pain – in which doctors take their symptoms seriously as having physical cause rather than assuming an emotional basis.

Clinical studies reveal that even in the presence of clinical tests which show women’s pain as real, doctors are more likely to see the pain as emotional rather than physical. Researchers J. Crook and E. Tunks noted that women with chronic pain conditions are more likely to be wrongly diagnosed with mental health conditions, as compared to men – and prescribed psychotropic drugs, as doctors conclude their symptoms as hysterics.

Researcher Karen Calderone found that women are more likely to be given sedatives as treatment, instead of pain relieving drugs, which are likely to be prescribed to the opposite sex. It is clear that doctors prefer to shift their priorities from relieving women’s real distress to returning them to a ‘calm and rational’ state.

This shift translates to women being left in severe pain for longer periods than men, as sedatives may make them appear calmer on the outside, while masking real symptoms which remain undiagnosed.

Also, research has found that male patients are consistently given more time and attention from medical professionals than female patients with the exact same symptoms. In a test case, nurses were given vignettes with imaginary patients, listing their supposed symptoms and medical history. The nurses would then calculate how much time the patient would require for treatment and emotional support. Male patients who had the same symptoms and background as their female counterparts were consistently allocated more time.

Physicians tend to see women as overly anxious


Heart disease is listed as the leading cause of death among women, but Harvard Health Publications reports that “many women say their physicians never talk to them about coronary risk and sometimes don’t even recognise the symptoms, mistaking them instead for signs of panic disorder, stress, and even hypochondria”.

In a 2014 study by Johns Hopkins University, women having a stroke were 30% more likely than men to be misdiagnosed in the emergency room.

Research shows that many women with autoimmune disease were not given appropriate care. It was estimated that about 50 million Americans have one of the 100 known autoimmune diseases – and 75% of those afflicted are women. According to the association’s research, on average, patients see four doctors over three years before receiving a correct diagnosis.

The association’s president and executive director, Virginia Ladd, says that the number one concern among women with autoimmune disease is that doctors do not listen to them.

Indeed, some 40% of women who eventually are found to have a serious autoimmune disease have been told by a physician that they are complainers or simply overly anxious.

When these women finally find out what is wrong, they are thankful. “Finally, somebody listened to them,” says Ladd.

Being attractive is perceived as healthy


For elderly women, they have to battle with not just sexism, but also ageism.

American freelance health writer, Emily Dwass, shared that her mother-in-law (who was in her 80s) had gone from one doctor to another seeking treatment for her severe abdominal pain. Dwass wrote that at one appointment, the doctor noted her mother’s age and flippantly asked, “What do you expect?” By the time doctors arrived at an accurate assessment, the cancer was everywhere.

Sexism extends, too, to the A&E. Research has shown that when men and women complain of severe abdominal pain, the waiting time for men is 49 minutes compared to 65 minutes for women – and the latter is prescribed less pain-relieving medication even when the controls for weight are applied.

Attractiveness is perceived as requiring less treatment. A research paper titled “Beautiful faces in pain”, wrote that due to a “strong ‘beautiful is healthy’ stereotype” – doctors subconsciously assume people who look ‘better’ on the outside, are healthier; and subsequently requiring less treatment. The ‘attractiveness bias’ could imply that women’s pain is often underestimated – resulting in poor treatment outcomes.

As ironic as it sounds – in the scientific and impartial world of medicine – the gender gap still exists, which points to a sustained prevalence of sexism that could pose barriers to women accessing healthcare.

Until this issue is seriously addressed, women will continue to suffer in silence, caged in the web of gender stereotypes. It is a bitter pill that cannot be ignored, especially at a time when men and women have made comparable strides in society, and when feminists harbour hope for greater equality between the sexes. MIMS

Read more:
Women at higher risk of contracting cancer
Where are the fault lines? A look at the causes and prevention of diagnosis errors
The doctor’s unconscious bias: Keeping it in check

Sources:
http://www.latimes.com/opinion/op-ed/la-oe-dwass-gender-bias-medicine-20170726-story.html
http://www.independent.co.uk/life-style/health-and-families/health-news/how-sexist-stereotypes-mean-doctors-ignore-womens-pain-a7157931.html
http://repository.uchastings.edu/hwlj/vol6/iss1/3/
ww.healthline.com/health-news/gender-bias-against-female-pain-patients#1