Dismissed by the doctor


"This is normal, there’s nothing physically wrong with you."
"It’s just a minor headache, nothing to worry about."
"Try getting some more sleep and reduce stress, it will probably go away."

Medical gaslighting is a term used to describe when healthcare professionals deny or invalidate the symptoms a person experiences by labelling them as ‘minor’ or wrongly attributing their symptoms to emotional and psychological factors. This issue has been heavily associated with women’s health issues as they are more likely to be misdiagnosed and dismissed by doctors. Many women have been on the receiving end of their symptoms being misattributed to something less concerning and often blamed on stress, hormones or being ‘emotional’.


The gender difference in the experience of seeking help from medical professionals is significant and troubling. Females with chronic pain are increasingly likely to report being dismissed and ignored by their care provider compared to males of the same age [1, 2]. Additionally, healthcare professionals are more likely to perceive women’s pain reports as being exaggerated compared to their male counterparts. These trends are alarming considering that women are more likely to experience pain across the life course [3, 4]. Not only are they at an increased risk of being bothered by unpleasant symptoms, but they’re also more prone to dismissal [1], less likely to be believed by doctors [5] and therefore less likely to be in receipt of appropriate treatment [6]. Women from minority backgrounds are even more vulnerable to being victims of medical gaslighting and having their symptoms downplayed. People from racial minority backgrounds report their symptoms and complaints of not being taken seriously and being left out of key decision-making processes related to their care [7, 8]. Such difficult experiences would understandably so result in hesitancy around making that trip to the doctor’s office.


Dismissal can be a traumatic experience, being told that your symptoms aren’t real and that they’re not as serious as you say is upsetting, stigmatising and humiliating. Medical gaslighting increases symptom distress, instils self-doubt, and can create feelings of shame around seeking help. Many people report questioning whether their symptoms are even real and that maybe this is a reality they simply must deal with. Medical professionals hold a position of power as they can help to alleviate your symptoms through medical investigation and subsequently deliver appropriate treatment. When doctors dismiss your experience and mistakenly label your symptoms as not being serious, this delays a diagnosis and denies people their right to access care. There appears to be several issues at play that need to be considered and addressed to improve patient-practitioner interactions


Why we need to acknowledge and call out medical gaslighting:

1. Delays the time to receiving appropriate treatment (potentially making conditions worse)

2. Mistrust in healthcare professionals and not seeking help when necessary

3. Causes stress, known to play a significant role in many health conditions

4. Increases the risk of anxiety and depression


By no means is this comprehensive of all the challenges that are faced in relation to medical help-seeking. Each experience is different - this is simply skimming the surface of the disparities that exist. Given the pattern of bias in medical help-seeking and the detrimental effect that medical gaslighting can have on individuals and their health outcomes, it’s important that seeking help and treatment is a collaborative process that promotes validation and discourages stigma.


References


[1] Defenderfer, E. K., Bauer, K., Igler, E., Uihlein, J. A., & Davies, W. (2018). The experience of pain dismissal in adolescence. The Clinical Journal of Pain, 34(2), 162-167.


[2] Hoffmann, D. E., & Tarzian, A. J. (2001). The girl who cried pain: a bias against women in the treatment of pain. Journal of Law, Medicine & Ethics, 29(1), 13-27.


[3] Nahin, R. L. (2015). Estimates of pain prevalence and severity in adults: United States, 2012. The Journal of Pain, 16(8), 769-780.


[4] King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011). The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain, 152(12), 2729-2738.


[5] Rusconi, P., Riva, P., Cherubini, P., & Montali, L. (2010). Taking into account the observers' uncertainty: a graduated approach to the credibility of the patient's pain evaluation. Journal of behavioral medicine, 33(1), 60–71. https://doi.org/10.1007/s10865-009-9232-5


[6] Stålnacke, B. M., Haukenes, I., Lehti, A., Wiklund, A. F., Wiklund, M., & Hammarström, A. (2015). Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?. Journal of rehabilitation medicine, 47(4), 365–371. https://doi.org/10.2340/16501977-1936


[7] Hamed, S., Bradby, H., Ahlberg, B. M., & Thapar-Björkert, S. (2022). Racism in healthcare: a scoping review. BMC Public Health, 22(1), 1-22.


[8] Altman, M. R., Oseguera, T., McLemore, M. R., Kantrowitz-Gordon, I., Franck, L. S., & Lyndon, A. (2019). Information and power: Women of color's experiences interacting with health care providers in pregnancy and birth. Social science & medicine, 238, 112491.



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