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Iman Afif

Baking and petting street cats are Iman's top-tier dopamine boosts. Now, we fear she has gotten too powerful with her new oven and neighbour's kittens.

Ma’am, You Are Not In Pain

I have seen a loved one carrying a misdiagnosis for nearly a decade, an acquaintance prescribed medication for adenomyosis after countless doctors, and millions of women retelling the same stories differently. Women constitute half of the global population and yet, gender bias runs rampant in healthcare. 

Gender inequity occurs when people are assessed, diagnosed, and/or treated differently and often at lower regard specifically due to their gender than others with similar complaints. It may also assume that men and women ought to be treated the same when there are gender differences required to be addressed. 

A signature trait of gender bias is the dismissal of women’s symptoms and severity of pain. 

The common outline is to undermine the legitimacy of their concerns. If a woman holds a different opinion regarding her condition, she is called “hysterical” or “being difficult”. A research paper reveals hysteria narratives are often cited when doctors simply do not understand how the condition affects women. The stigma that women are constantly anxious and unreliable witnesses of their symptoms leads physicians to believe that, at most, the symptoms are psychosomatic or simply caused by a mental factor.

On the off chance that the concerns are accommodated, misdiagnosis is common as the patient’s symptoms carry less weight and are underestimated. From calling a woman’s heart attack merely anxiety to PCOS just regular period cramps, once a physician marks a woman’s concerns as unworthy of further medical attention, her right to access equitable healthcare is delayed 33% longer, if not immediately denied.

Even reproductive health, the highlight of women’s healthcare, is not an exception.

Intrauterine device, or IUD, has become one of the most popular forms of contraception among family-planning providers. Unfortunately, it comes with a dire complication – pain. 

More than 90% of respondents reported moderate pain during IUD insertion, while anecdotes of the procedure being a traumatising experience and even “worse than childbirth” are numerous. Yet, offering local anaesthesia or pain relief to patients undergoing IUD insertion is not mandated as a medical standard, citing that there is no requirement for it. Thus, patients are essentially gaslighted by gynaecologists into believing that the procedure would only involve mild discomfort and are not introduced to the option for analgesics to offset the pain. 

In other rooms in the hospital, the assault on women’s bodily autonomy occurs daily. From being pushed to reconsider tubal ligation because “the husband might change his mind” to being denied an epidural by partners, there is plenty more to discuss about healthcare fully recognising women as equally independent and rational human beings.

Evidently, women are dismissed in all departments and have to take it upon themselves to convince healthcare providers. It is an unlikely theory (the chances are never zero) that general practitioners are trained in medical school to become sexist and uncaring, so what is causing this indifference?

Source: AP Photo/ Charles Rex Arbogast

Stereotypes in literature and excluding women in medical science

Archaic beliefs surrounding women and their bodies have persisted throughout millennia. In one of his works, Aristotle characterised a female as a mutilated male; a narrative that has carried over in medicine continues to equate women’s physiology to that of men’s. From another standpoint, society has long viewed women solely for the function of reproduction, creating an assumption that the only difference between men and women is their reproductive system, with everything else being irrelevant.

Therefore, the majority of clinical trials exclude women entirely. Whenever women pose symptoms of diseases that do not match the traditional ones found in male-centric trials, they are “incorrect”.

Additionally, women are often regarded as having a higher pain threshold and tolerance as they are able to endure childbirth. While contradicting studies have made this theory inconclusive, women experiencing acute pain are less likely to be administered opioid painkillers nevertheless.

Other unsubstantiated beliefs can intensify other biases that further disenfranchise women of minority groups. For example, African-American and Hispanic women are aggressively hindered from choosing vaginal childbirth after past C-section births due to a racially-biased metric, namely the vaginal-birth-after-cesarean (VBAC) score.

 

Gaps in medical research

A woman’s body and physiology are very different from a man’s. Due to the specific female physiology being severely underresearched and underrepresented across the board, this gender-blind approach to treating women is dangerous.

In diagnosing heart attacks, women are regularly turned away not just for exhibiting acceptable symptoms, but also for passing current tests without showing textbook irregularities. Here, women are inferred to experience and display heart attacks differently from how men would. Unsurprisingly, there are no diagnostic tests that specifically detect potential heart attacks in women nor a revised list containing symptoms of the disease that women commonly suffer from.

Without a doubt, doctors continue to compare women against a chart of unrelated medical information. To mitigate gender disparity, medical practitioners must be reeducated and retrained regarding women’s health. To a further extent, this begs a reform of anatomy textbooks to include and discuss more images of female anatomy in medical curriculum to dispel implicit biases in students. Unless we reframe women’s health as a public healthcare crisis, the struggles women face in demanding equitable healthcare will be disparaged by underdiagnosis that will continue to bleed women dry.



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