Several years ago, Deborah J. Cohan went to her doctor with excruciating pain in her abdomen. "I couldn't stand up straight. Eating and going to the bathroom were uncomfortable," said Cohan, who lives in South Carolina.Health. She suspected it was gynecological, but her doctor dismissed the idea. Rather than explain away the back pain, her doctor prescribed Cohan muscle relaxants.
They didn't work. So did over-the-counter pain relievers, ice, heat, chiropractic care or stretching.
A few days later, Cohan's pain was so bad that she went to the emergency room. But instead of getting help, she only suffered more setbacks.
The doctor on duty confidently announced that Cohan had done sofibroids, non-cancerous growths in the uterus. When Cohan pointed out she didn'thera longer uterus – it had been removed the year before at the same hospital – “the doctor was adamant I was wrong,” she recalled.
It wasn't until Cohan's gynecologist arrived on the scene that the correct diagnosis was finally made. Cohan's ovaries had twisted out of their normal position - a condition called ovarian cancertorsion of the ovaries. It is considered a medical emergency and if left untreated, the ovaries can die and affect fertility.
After immediate surgery to remove both her ovaries, Cohan recovered quickly. Still, "this experience confirmed what I had long believed," Cohan said. “Women need to embrace, trust, own and protect their own bodies.”
In other words, providers won't always do it for you. Your healthcare provider may even try to give you gas.
Gaslighting occurs when one person tries to convince another to doubt their instincts and doubt their perception that something is real. For example, medical gaslighting occurs when healthcare professionals downplay or dismiss symptoms that you know you are feeling, and instead try to convince you that they are caused by something else, or even that you are imagining them.
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As the #MeToo movement brought to light allegations of sexual harassment and assault, it highlighted another troubling gender-based crime: how health professionals sometimes ignore, underestimate or misdiagnose women's health problems.
'It's a real phenomenon'G. Thomas Ruiz, MD, said chief OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CaliforniaHealth. “Gender bias is a broad idea of why [it happens], but there is some pretty good research to support it.”
True, some gynecological conditions, such asendometriosis, are notoriously difficult to diagnose. But it's not just women's health issues that some health professionals often downplay.
For example, women are less likely to receive ICU care, regardless of the severity of the disease, according to research published in April 2021 in Intensive Care Medicine. The study found that ICU underutilization was most prominent among women under 45 years of age.
Also according to a September 2021 study published inBreast medicine clinicsMale patients are admitted to intensive care and use its resources more than female patients. This also applies to the medical system in general, as men, especially younger men, use more hospital services and have more accidents than women.
“Because of the pervasiveness of the message – that pain is a normal part of womanhood or girlhood – we have a systemic, societal problem in which all of us, including doctors, are not good at separating the normal from the abnormal for health. of women."Erin Jackson, a healthcare advocate and founder ofInspire health, a pelvic pain nonprofit told meHealth. “Women's truthful complaints about symptoms or illness can be labeled as whining, and we don't trust women to be experts on their bodies' experiences and autonomy.”
'It was scary to hear that I was doing well'
For 10 years, doctors told Jackson that her "stabbing, burning and tingling" pelvic pain was nothing to worry about. Despite severe cramps, vulva swelling and lower back pain, "I was told nothing was wrong or encouraged to seek psychiatric treatment," Jackson said. “It was scary to hear that I was doing well.”
Desperate for answers, Jackson consulted a "double-digit" number of doctors. Many insisted she was fine, assured her that her pain was "just bad periods" or encouraged her to manage her stress better.
“I've never felt more scared than when I was in the emergency room and felt like because the doctor wasn't listening to me, the doctor couldn't help me — but I had nowhere else to go,” Jackson said.
After finding a counselor who thought her pain wasn't just in her head and referred her to a pelvic floor physiotherapist, she has been pain-free ever since. But through her nonprofit, "I've heard from women whose experiences are so similar to mine that I could have written the story," Jackson said.
Many, she says, are repeatedly told by their doctors that painful periods and sex are just "normal." “If you don't stand up for yourself or the pain you are in, [your problem] may be overlooked,”Yvonne Bohn, MD, said OB-GYN at Providence Saint John's Health Center in Santa Monica, CaliforniaHealth.
An advertisem*nt forOrilissa, the very first FDA-approved oral medication for endometriosis pain, even plays on that theme. “Any pain?” a doctor asks a female patient who comes for a check-up. “So,” the woman shrugs apologetically. It's not until her inner voice comes to life and screams at her, "Say something!" she finally does.
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Of course, anyone can experience medical gas lighting. But research shows that women and other marginalized groups, such as people of color and the LGBTQ+ community, are particularly affected.
The 2015 American Transgender Survey found that a third of transgender people who visited a health care provider in the past year had at least one negative experience, such as being verbally harassed or denied treatment.
And a 2022 study compared the medical records of black patients to white patients. Researchers found that Black patients were 2.54 times more likely to have at least one negative descriptor in their history and physical notes, which can impact the treatment they receive from healthcare providers.
How to be heard
Do you think your healthcare provider will involve you? This is what you need to do.
Find a provider that you commit to.“You shouldn't look for someone to go out for drinks with. That's not the goal,” says Dr. Bohn. “But you want someone who is honest and direct” and really listens to you when you talk.
Prioritize your concerns.“As physicians, we are under a lot of pressure,” says Dr. Bohn. “We have too many patients and not enough time.” If you come to an appointment with a list of fifteen questions, your healthcare providers may have difficulty answering them all. Instead, focus on some of your most pressing concerns. You can send your questions in advance and your concerns will be addressed.
Advocate for yourself.“If you don't believe the first opinion you get, get another one,” Dr. Ruiz said. In some cases it may be necessary to insist on a consultation with a female health professional.
And you don't necessarily have to avoid male providers. “I know as many insensitive female gynecologists as male gynecologists,” says Dr. Ruiz. "Find a doctor who listens to you and takes your complaints seriously."
Medical gaslighting occurs when healthcare professionals ignore the symptoms you report to them or do not take you seriously. There is research to support that medical gaslighting or medical gender bias does occur. This bias can lead health care professionals to ignore, undertreat, or misdiagnose women's health problems. This bias can also occur among other marginalized groups.
If you think your healthcare provider is gassing you, find a healthcare provider you have a connection with, prioritize your concerns as you encounter them, andadvocate for yourself.
