Women, pain, and the gender gap in healthcare.

23 May

Originally posted to the Community section at MyMedia.

This one is very tough to write about, for very personal reasons: the incredible gender bias in health care. How many times are women patients in critical circumstances, sent home with what is, essentially, a pat on the head, only to suffer severe health consequences later? That is not a rhetorical question, by the way. The answer is: several times more than men.

Some of you reading may remember reading on the news about a woman in Florida who was asked to leave the emergency room, since there was ‘nothing wrong with her,’ only to die right outside the hospital as the cops who had arrested her for non-compliance were trying to get her into the patrol car. Even as she’s lying on the floor, dying, people around her insist that there’s ‘nothing wrong with her.’

It’s easy to find excuses in the media for this particular case. She was loud, and had a history of being disruptive, she was heavy set (we are told her weight in the freaking headlines, for dog’s sake). But mostly, she was female (and also black), and complaining of pain.

Oh, you may say, but that’s just one case, why are you making noise about that?

Because it’s not one case. From the Journal of Law, Medicine and Ethics, in 2001–fifteen freaking years ago!–here’s the abstract from “The Girl Who Cried Pain”

In general, women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. The authors investigate this paradox from two perspectives: Do men and women in fact experience pain differently – whether biologically, cognitively, and/or emotionally? And regardless of the answer, what accounts for the differences in the pain treatment they receive, and what can we do to correct this situation?

Because health professionals (of both genders. though it does happen more with male doctors/nurses/etc), are less well educated on women’s health issues than men’s health issues, and thus, it just doesn’t occur to them that acute abdominal pain is not ‘oh, just kidney stones, they’ll pass, stop making such a fuss, honey’ but instead an ovarian torsion, which could kill her.

This bias towards dismissing women’s pain and health issues as “psychosomatic” (the new ‘hysteria,’ for those who care), means that women have to advocate fiercely, repeatedly, tirelessly for themselves–even when those health issues they are seeking help for are crippling them.

There’s this thread on twitter (go to the top for the full story) that brings this bias into even sharper relief:

“There was the time my doc said my chest pains were anxiety. I dogged him & ended up with a cardiologist. Turned out I needed heart surgery. Heart surgery that was “or you’ll probably die” kind of surgery. I would have died if I’d let my doctor write off my pain. But I almost did because, you know. He told me it was nothing. He told me I was probably “very sensitive to stress.” I’m one of those people who never want to go to the doctor, because it’s exhausting to have to fight to be taken seriously.”

“I was told chronic stomach pain was stress. It was ovarian cancer.”

“I was told my neck pain was from depression. I fought it. It was 4 herniated cervical discs.”

“I was told gut pain was ‘female problem.’ It was diverticulitis requiring 6hr surgery.”

And if you happen to be heavier than the accepted ‘norm,’ all your health issues are attributed to your weight, no further inquiry necessary. “Oh, you can’t breathe? No, dear it’s not asthma, it’s that you are fat.” “Oh, you don’t have energy? No, dear, it’s not a congenital heart defect, it’s that you are fat.”

PLEASE NOTE: I am not saying that men don’t go through horrible instances of medical neglect, injustice, abuse, misdiagnosis, etc. I AM saying that women go through this routinely.

For women, it is the rule not the exception–and if we dare talk about it, we are very often told to stop complaining. Our issues–women’s issues, be health, pay gap, societal expectations, rape, etc–are never THAT important, or that unique, and, don’t men suffer too?

So, we are told in so many words, over and over and over, be quiet, dear, and stop disrupting our peace and quiet.

11 Responses to “Women, pain, and the gender gap in healthcare.”

  1. Erin S. Burns 23/05/2016 at 9:28 AM #

    One of my sisters had ovarian torsion, and at first she was told it was kidney stones, and then when I got there and insisted it wasn’t effing stones. Then “Well maybe it is her gallbladder, and whatever it is you know her weight is a concern….” 18 hours later and she was in surgery just in the nick of time.

    • azteclady 23/05/2016 at 10:16 AM #

      This pisses me off, so, so much! What if she hadn’t had you to advocate for her? How much worse her situation was because of the delay? How many women have had relatively simple health situations become life threatening/life changing crises, because of the lack of importance placed, by the medical field in general, on women’s bodies?

  2. Alex Hurst 29/05/2016 at 6:16 PM #

    Let us not forget how many women are told their ailments are just menstruation issues, too. My sister was told to suck it up for years, only to find out at 25 that she had tilted uterus. I went for my first OBGYN exam at 18, only to be told “You’re not having sex, so nothing can be wrong with you.” (That same doctor actually asked me with a raised eyebrow THREE times if I was lying to her about having sex.)

    My mother was born with an extra vertebrae in her spine (bizarre) but didn’t find out until she was 50 freaking 5 because no one bothered to take an x-ray and check her out for the pain she was experiencing. What did they blame it on? Child labor.

    • azteclady 29/05/2016 at 6:20 PM #

      It really doesn’t matter what the actual cause of female pain is, the first and strongest instinct from the medical establishment is that a) there is no pain, or b) what pain there is, is not enough to justify the sufferer’s complaining.

      Because, as @gaileyfrey eloquently said, women are expected to live in pain, so complaining about is just bad form, and poor spirited to boot.

      • Alex Hurst 29/05/2016 at 7:04 PM #

        In Japan, I was often treated like I had “zero” pain tolerance, which may have contributed to doctors brushing me off. Though in one case, when I had to go in for an endoscopy, my nationality was the factor. “Americans can’t take pain, so you should probably go under for the treatment.” I forced him to treat me like one of his Japanese patients, because dude…. it’s uncomfortable. Not painful.

      • azteclady 29/05/2016 at 7:06 PM #

        The cultural differences on the perception of pain are also interesting, but the male/female divide is, I think, pretty universal.

  3. Bona Caballero 31/05/2016 at 11:41 AM #

    This is a very useful post, and something we women should be aware of. It’s not a question of doubting what the doctors say, but we have to know that perhaps what’s written in their books is based on experiences with men, so we have to take what they say with a grain of salt if what they say does not work with us. And consider that when they say it’s something psychosomatic, it could easily translate as ‘hysterics’, which we cannot accept. It’s like medicines, many of them has been tasted in men, so they might no act the same way with us because our biochemical composition can be different. At least we should be aware and be careful. The heart attack symptoms in women are usually different to those that men suffer, for instance. And what the Medicine books say is many times related to men, no women. The patient by default is a Western male adult. If you are not one of them, some things can work differently in your body.

    • azteclady 02/06/2016 at 7:33 PM #

      There are many factors influencing how women are treated by health providers, versus how men are treated.

      As you say, women’s metabolism is different than men’s in many cases–we may all produce the same hormones, but in different proportions, and this too changes as we grow up, mature, and grow old. This affects how our bodies react to medication, not only compared to men, but also at different stages of life.

      Lack of research into these differences is both cause and consequence–even specialists on women’s health don’t seem to be as knowledgeable as perhaps they could be.

      And finally, and this is something I see reflected in other women’s experience in every country I’ve lived, doctors tend not to consider what their women patients tell them about their own bodies. We are, all too often, dismissed out of hand.

      There are many (where many = countless) examples, but Natalie Luhrs wrote a very good post about her experiences here.

      And we are not even touching how very much harder it is for women in more overtly patriarchal societies that the US or Europe–my experience, in a Latin American country just over two decades ago, here in brief.


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