Women are gaslighted all the time, but nowhere more than in the healthcare sector. Gaslighting is manipulating someone, through mixed psychological messaging, into questioning their own judgment, even sanity. Say, a doctor attributes your ovarian cysts to “normal period pain,” hypertension to anxiety, autoimmune deficiency to depression, migraines to PMS. Women like being good patients, but seriously.
When your well-being is on the line, be prepared to push back if you feel dissatisfied with a diagnosis (or lack thereof) or ignored by a doctor or his/her team. This approach may seem awkward and aggressive, but consider the alternative.
“Women can be harmed by practicing one-sex medicine or gender-blind medicine,” said Dr. Marjory Jenkins, chief scientific officer at the Laura Bush Institute for Women’s Health. “We need to stop ignoring the mountain of evidence that men and women are different.”
Bikini Medicine.
Doctors, primarily male until the 1970s-1980s, used to think any health differences between men and women were isolated to reproductive organs. Women’s healthcare was dubbed “bikini medicine” because it focused on breast disease and gynecologic/obstetric issues, with everything else considered the same as men’s bodies.
In the 1970s, the FDA excluded women from important clinical and drug trials to protect a possible fetus in the event of pregnancy, and since researchers “viewed women as confounding and more expensive test subjects because of their fluctuating hormone levels,” according to a 2016 paper in Pharmacy Practice. Women are slowly being integrated back in.
“We now know that there are differences between the sexes in every health condition. Any organ system that you pick, any health condition that you pick,” Dr. Kim Templeton, former president of the American Medical Women’s Association, said. But the subject is not routinely included in health professionals’ education, including in medical schools.
Door-to-Balloon Time.
“It’s the women who keep coming in over and over again without a diagnosis that I see so often that just makes me feel we have to do better at figuring out women’s specific physiology,” Dr. Alyson McGregor, director of the Division of Sex and Gender in Emergency Medicine at Brown University, told TODAY.
McGregor is also an ER physician who often treats young women who are having a heart attack. She has to fight to convince other doctors to recognize what’s happening, despite heart disease being the No. 1 cause of death in U.S. women.
- Every minute counts during a heart attack, but men get rushed to the catheterization lab quicker than women — as measured by a metric known as “door-to-balloon time” — so that doctors can open a blocked artery.
- Women’s immune systems are more robust than men’s, but more than 40 percent of women eventually diagnosed with a serious autoimmune disease were told by a doctor, at least once, they were a “hypochondriac.”
- Osteoarthritis is the most widespread chronic condition among women, but doctors give women with chronic knee pain less medical information and encouragement about undergoing a total knee replacement than men.
- Women with chronic abdominal pain have to wait 16 minutes longer for pain medication than men and are less likely to be prescribed pain medicine.
- The U.S. has the highest maternal mortality rate of any high-resource country, especially among Black and other minority women.
Do This If Your Doctor Doesn’t Listen. (Do It Anyway.)
- Google your symptoms prior to a doctor’s appointment.
- Make a thorough list of questions before you go.
- At the end of your visit, slow down and check to see if they’ve ALL been answered to your satisfaction.
- Bring along an advocate (friend or family) for moral support.
- Participate in discussing your physician’s opinion. You don’t have to agree.
- Find out which other tests are ordered and what they intend to uncover.
- Discuss follow-up or referral appointments (and follow up).
- Do not be afraid to be insistent.
- If symptoms persist or worsen, ALWAYS get a second opinion.
- Listen to your gut.
Medical gaslighting is more than doctors being dismissive or manipulative. Experts say much of medical complacency is unconscious and frankly, lazy — a generational habit used to disguise the physician’s vast knowledge deficit about women’s bodies.
Yet, doctors still know peanuts about the female anatomy, hormonal sovereignty, pain tolerance and psychiatric patterns, compared to men. Medical education is set up to instruct that a 70-kilogram (154-pound) male is the norm, with everyone else being a variant of that.