A staggering two-thirds of females have encountered gender bias or discrimination in healthcare. They shared experiences of being called “anxious”, “pushy”, or even “hysterical” while seeking treatment for a range of debilitating symptoms.
Medical misogyny refers to the systemic bias and prejudice women face in healthcare systems, a topic that is increasingly gaining attention.
Whether through misdiagnosis, inadequate pain management, or dismissal of symptoms, medical misogyny results in poorer health outcomes for women and perpetuates gender inequality.
It is rooted in historical misconceptions about female biology and the patriarchal underpinnings of modern medicine, and it continues to manifest in harmful ways for women globally.
“One-size-fits-all, male-centric” approach to healthcare
The bias ingrained into the very fabric of modern medicine is a result of the historical structure of healthcare “delivered and designed for” men. Women’s health – by contrast – was often rooted in myth and pernicious gender stereotypes.
The problem of medical misogyny can be traced back to the long-standing characterisation of women as “hysterical” or overly emotional, leading to the frequent dismissal of their symptoms. They were considered unreliable reporters of their pain, often told their discomfort was “all in their head.”
It was insinuated that their pain was attributed to emotional causes rather than biological ones. Even in modern medicine, women say they are still being gaslit – disbelieved and patronised – in medical settings.
A lack of diversity in medical research compounds the issue and has created huge knowledge gaps.
Early-Stage Clinical Trials Bias
According to Professor Robyn Norton, a public health expert, “more than 70% of participants in early-stage clinical trials globally are still white men, while male cells and animals are used as standard in the lab.”
The results from these findings are then applied to women, which causes issues when diagnosing them, understanding the root of their illness, and choosing the best treatment for them.
The gender lens on healthcare needs to be focused more on the women’s bodies as a whole – women are more than their breasts and uteruses.
Misdiagnosis and Pain Dismissal
The bias in healthcare treatment remains prevalent even today, and it greatly influences the way women’s symptoms, particularly those that differ from the “male norm,” are treated. Women are disproportionately affected by misdiagnosis, especially with conditions like endometriosis, fibromyalgia, or autoimmune disorders.
For instance, women present different symptoms during heart attacks, yet their complaints of nausea, breathlessness, or fatigue may be seen as “atypical” and often dismissed as anxiety or stress, prolonging the time it takes for a correct diagnosis.
These diseases are often characterised by chronic, invisible pain, a type of suffering that the medical community has historically downplayed, particularly when it affects women.
For example, endometriosis, a condition affecting an estimated 1 in 10 women, often takes years to be correctly diagnosed. Women suffering from chronic pain are sometimes told their symptoms are a result of stress or psychological issues rather than receiving the care they need
For instance, Nadiah Akbar. She told the BBC that she was once told by a doctor in Singapore that the extreme fatigue she was experiencing was due to the “stress” of being a busy mother. This “stress” was later revealed to be thyroid cancer.
Years later, in remission and having migrated to Australia, staff at a Melbourne hospital failed to diagnose a cartilage tear in her hip socket and a slipped disk in her back.
Instead, they suggested the crippling pain could be linked to “depression” or being “overtired”. It led to Ms Akbar paying for two costly MRI scans out of pocket to be taken seriously.
Intersectionality and Disparities in Healthcare
Medical misogyny does not exist in isolation; rather, it intertwines with other forms of systemic discrimination, worsening health outcomes for many women.
Research shows that healthcare systems disproportionately fail women who belong to marginalised groups.
Women of colour, especially Black and Indigenous women, experience unique challenges in healthcare due to the historical and ongoing racial biases ingrained in medical systems. For example, Black women are more likely to die from pregnancy-related complications than white women, a stark disparity attributed to systemic racism and the longstanding myth that Black people feel less pain than their white counterparts. This racial bias extends into pain management and diagnostic delays, with Black women often receiving inadequate care due to misconceptions that they have a higher pain threshold.
Conversely, white women are sometimes viewed as more “fragile” or deserving of special care, further exacerbating these inequities.
Women of colour, disabled women, and working-class women often face compounded difficulties in accessing quality healthcare. This intersection of race and gender further deepens health disparities.
Cultural Factors Perpetuating Misogyny
Beyond the direct patient-doctor relationship, cultural norms and institutional practices reinforce gender stereotypes in medicine. The assumption that women should be “nice” or “not assertive” can discourage them from advocating for their own health.
The cultural stigmas attached to women’s bodies in the form of taboos surrounding menstruation, reproductive health, and sexually transmitted diseases can silence women, particularly those from conservative or religious backgrounds, and prevent them from seeking care.
For instance, young girls from these backgrounds might be hesitant to discuss reproductive health issues openly, leaving them vulnerable to undiagnosed conditions like polycystic ovary syndrome (PCOS) or endometriosis.
In healthcare settings, gender biases also interact with cultural and religious stigmas. Women from immigrant or refugee backgrounds may struggle with language barriers, cultural misunderstandings, or fears of judgement from healthcare providers, further limiting their ability to access quality care.
For example, Muslim women wearing hijabs may be stereotyped as “submissive” and are thus less likely to be taken seriously in clinical settings.
Female doctors, too, often struggle with being taken seriously. They must balance authoritativeness without seeming “too arrogant.”
This systemic issue is evident when female physicians are mistaken for nurses or support staff, perpetuating the idea that men are more suited to prestigious roles in medicine.
Women are Under-Represented in Research
The reasons behind medical misogyny are as complicated as misogyny itself.
Social structures that have disadvantaged women throughout history continue to be felt today. Gender bias in health care is one example of this continuing to trickle down and impact the lives of women.
But a crucial factor for its persistence in modern health care is the tendency of medical research to focus exclusively on male study participants.
For example, in the US, it wasn’t mandatory to include women in clinical trials until 1993.
Experts say the failures of research to account for the differences between men and women has led to poorer health outcomes for generations of women and girls.
Earlier studies have found that women are less likely to be referred for diagnostic tests or to a specialist if they present with heart disease symptoms. It is becoming clearer that those heart disease symptoms typically present differently in women than they do in men.
Combating Medical Misogyny: The Path Forward
Combating medical misogyny requires both systemic change and individual awareness. Raising consciousness about how deeply ingrained stereotypes affect medical decisions is essential.
Medical institutions must adopt gender equity frameworks to improve patient care for women. Encouraging self-advocacy, as feminist movements like the Boston Women’s Health Collective have done, can help empower women to push for better care.
Ultimately, addressing medical misogyny is critical not only for women’s health but for public health as a whole. Ensuring that all patients are treated equitably, regardless of their gender, race, or socioeconomic status, will result in better health outcomes and more humane healthcare systems for everyone.
