In a healthcare system that works, all patients would reasonably expect equal access to diagnosis and proper treatment. Unfortunately, this isn’t always the case for women.
Increasingly, research is looking at the concept of unconscious biases against prevalent stereotypes held of women that seep into the healthcare system, and perhaps, inadvertently causes discrimination in providing treatment.
This is a tough pill to swallow as we would all hope that health providers are blind to sex, race, age and social class. But the research on this topic so far indicates that this isn’t necessarily true.
A study conducted in 2015 found that female cancer patients faced a longer wait time in receiving a diagnosis from the first sign of their symptoms. This was true for six out of 11 types of cancer in that study.
The delay was not because women waited too long to seek treatment, but was in the period after the first visit to the doctor.
Another study concluded that when compared to male patients, twice the number of female patients had to make at least three visits or more to a doctor before being able to get referrals to see a specialist.
The findings don’t just apply to cancer patients – females with suspected tumours, autoimmune diseases and others also face a similar dilemma. The consequence of this prejudiced apathy, of course, is that women face greater complications with their conditions, and even unnecessary deaths.
A significant delay
When a professional health provider concludes that your symptoms are “imagined”, they stop investigating your condition, and even you may start believing that it’s “just in your head”.
For example, a Welsh study reported that men who had Ehlers-Danlos syndrome – a group of genetic disorders that affect the body’s connective tissue – received their diagnosis mostly by the ages of five to nine.
Women, however, were mostly diagnosed between the ages of 15 to 19, even though out of 6,021 Ehlers-Danlos patients, 70% were women.
This is especially dangerous when a patient has an uncommon disease that really requires further observation and investigation. The result is multiple visits to the doctor for multiple opinions, along with potential misdiagnosis.
While some delay in diagnosing an uncommon disease may be inevitable, the average of eight-and-a-half-years gap between men and women found by the study is staggering and has serious consequences.
According to a Eurordis survey of 12,000 rare disease patients in Europe, those who were initially misdiagnosed with the wrong physical disease experienced twice the time it took to get to the right diagnosis.
Those who received a psychological misdiagnosis experienced an even longer period – by 2.5 up to 14 times more. Given that men seem to receive faster diagnoses on health issues, there shouldn’t be such a delay in women getting theirs.
A medical professional’s ability to determine a diagnosis shouldn’t be influenced by gender, yet it still seems to be an issue in medical practice.
Women voicing concerns about their health have historically been dismissed as being “overemotional” or “hysterical” – a practice that has carried over into modern times.
The notorious, albeit infrequent, occurrence of “hysteria” amongst groups of women, such as in all-female school dormitories, hasn’t really helped to quell the notion that this is a psychological condition unique to women.
While stress and anxiety are real and afflicts both genders, the idea that women tend to get overzealous about physical indicators of poor health is a learned behaviour that is very much alive in the healthcare space.
But if we delve further back to say, the 1950s, documented cases where women’s instincts about their health symptoms have been found to be reliable, is available.
After following up with 85 cases of women who were diagnosed with “hysteria” at the National Hospital in London throughout the 1950s, British psychiatrist Dr Eliot Slater discovered that more than 60% were found to have clinical neurological disease nine years later.
This included epilepsy and brain tumours, and at least a dozen of the women had passed away by then.
Make yourself heard
What’s clear is that the discussion on historical and current examples of discrimination against women when it comes to medical diagnosis is potentially endless, but you don’t have to be resigned to this.
Your doctor may be the professional, but as a patient, you are keenly aware of your symptoms, down to the last details. If you sense that you are dealing with a doctor who is sceptical, here are some guidelines to help make yourself heard:
- Keep a record of your symptoms and past treatments.
Do some research on credible websites, ask questions related to your symptoms and discuss previous methods of treatments, as all this information will help guide the discussion with your doctor on how you want the direction of your treatment to go.
- Don’t be afraid to bring up your concerns multiple times.
Your health is just as important as anyone else’s, so if you would advocate for an elder, a child or a spouse, then you should advocate for yourself as well.
Bring someone you trust to help advocate for you if you need the support – there is always strength in numbers.
- Find a doctor who will listen.
If the above fails to get your doctor’s attention, then it’s time to ask around for a new professional who will.
Don’t waste time with someone who refuses to listen as that will only cause misdiagnosis and prolong the suffering.
Women tend to get the shorter end of the stick when they seek treatment for symptoms of poor health.
This is due to an inherent prejudice against women being viewed as hysterical or overthinking their symptoms – an unfortunate attitude that still exists among some healthcare professionals.
Receiving a diagnosis can take up to more than twice as long for women compared to men, resulting in misdiagnosis, longer treatment periods and more female deaths.
To avoid becoming a statistic, insist that your doctor listens to you or find one who takes you seriously.
By Datuk Dr Nor Ashikin Mokhtar
Published in Star Newspaper, 10 Feb 2020