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women and medicine

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What to know

One of the root causes of discrimination against women and feminine-presenting people in the health care system is that, for decades, medical research was done primarily on men. This means that everything from medication prescribing guidelines to an understanding of a disease’s symptoms was based on an “average” male body. Given this, a medication may not work as effectively in a woman as it does in a man, or a doctor may miss symptoms of a disease because a woman’s experience does not match the “standard” signs. Pregnant people in particular were often excluded from medical trials, in part to protect fetuses but also because it was felt that a woman’s hormones made her an unreliable test subject. Overall, a lack of medical knowledge has meant a lack of equal and effective treatments.

A prime example of this type of discrimination is how heart attacks are experienced and treated. Women tend to experience a first heart attack at a slightly older age than men, and can experience different symptoms than the typical chest pain that a man would likely have. Instead, women may experience less distinctive symptoms like nausea or dizziness. Because of this, women may not seek treatment as quickly as men, and when they do, they may not receive the standard treatments as quickly or as often. Due to these factors, the heart attack survival rates for women are not as high as they are for men. This is a clear example of the way a lack of medical knowledge can cause women to delay care, fail to recognize life-threatening symptoms, and receive suboptimal treatment. 

Another common source of discrimination within the health care system is the biased belief that women are “oversensitive” to pain and may exaggerate it. Because of this, medical staff may underestimate the severity of a woman’s pain and be less likely to prescribe the level of pain medication they might for a man; doctors may in fact be more likely to prescribe psychological treatment instead of pain medication. This can affect women’s experience of many common conditions, from arthritis to migraines. The flip side of this assumption is that men are often perceived as “stoic.” For this reason, there have been few studies of severe pain in men. Biases like this can make treatment less effective for everyone.

Endometriosis is an illness that exemplifies the way this particular bias can affect a woman’s experience. Endometriosis is a condition in which endometrial tissue, normally found only within the uterus, grows on additional internal organs, which can cause severe pain. In part because the symptoms may seem wide-ranging or similar to many other conditions, and partly due to the abovementioned misperception of women’s pain, the average length between onset and diagnosis of endometriosis is 6 to 11 years. Particularly when it comes to pelvic pain, women may have the heavy or painful periods of endometriosis dismissed as “bad periods.” This can happen with other common conditions as well, as when colon cancer symptoms that are not “typical” in a young woman are dismissed as irritable bowel syndrome (IBS). 

Consideration of the forces that continue to shape women’s experiences within the health care system is important when writing about a woman’s experience with an illness or disability. For instance, an understanding of the reasons a woman’s diagnosis may be delayed can help avoid language that diminishes or dismisses her symptoms, regardless of whether she has an official diagnosis. Experiences like this may also make a woman less likely to seek medical treatment; this does not mean she is not “really” sick or that her experience is not serious.

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Summary

Due to a variety of reasons, women and feminine-presenting people may face different kinds of discrimination within the health care system. Consideration of the forces that continue to shape women’s experiences within the health care system is important when writing about a woman’s experience with an illness or disability. For instance, an understanding of the reasons a woman’s diagnosis may be delayed can help avoid language that diminishes or dismisses her symptoms, regardless of whether she has an official diagnosis.