An Untreated Epidemic
A woman complains of uncontrollable vomiting, up to hundred times a night and the only medical relief offered to her for years is in the form of antidepressants. A specialist finally examines her, only to discover her on the verge of death and must perform emergency surgery on her barely functioning gallbladder (Dusenbury 2018).
Unfortunately, that woman is not alone in her experience. Female patients across the world are denied the appropriate medical treatment that they desperately need as they must occupy an inherently discriminatory system that is shaped by stereotypes and bias. In particular, implicit biases that are not associated with consciously prejudiced attitudes contribute immensely to disparities present within the medical field despite the common perception that patients are treated equally. In fact, women's health care is placed at a significant disadvantage that is primarily attributed to the presence of implicit gender bias in the biomedical field that has been further cemented by the exclusion of women from clinical research and continues to influence diagnostic and clinical practice for female patients. Although the mistreatment and misdiagnosis of female patients due to implicit gender bias has been identified in the medical field, its prevalence and severe consequence on human health are understated.
Unrecognized implicit biases within the healthcare system create an aura of distrust for female patients that negatively influences patient care. As a simple illustration, Jackie suffered from chronic kidney problems, fevers, fatigue, and terrible menstrual and joint pain since the age of sixteen. She reached out to countless doctors and specialists all of whom dismissed her pain before her primary care doctor misdiagnosed her with depression and prescribed antidepressants. It was not until years later that Jackie was finally diagnosed with endometriosis and was able to receive the appropriate treatment (Dusenbury 2018).
The tendency of medical care providers to explain the illnesses suffered by female patients as psychological rather than physiological is indicative of an implicit gender bias that has very real and often devastating health consequences for women. Furthermore, “the long-standing concept of hysteria...has really impacted what we know about conditions that disproportionately affect women..there's a tendency to assume those conditions are psychosomatic until proven otherwise”(Levy 2018) thus influencing treatment and diagnosis of female patients. This alarming propensity to disregard women's symptoms is attributed to the common misconception of hysteria in current society, in terms of seeing women as more emotional and dramatic, and the fact that women are regarded using the colloquial terminology of hysteria. The treatment and diagnosis of gynecological conditions, such as endometriosis which in fact impacts ten percent of women is particularly influenced by implicit gender bias as indicated by the seven to eight year lag period it takes to be diagnosed by medical professionals (Schopen 2017).
Women’s issues are not taken seriously by doctors due to the preconceived stereotypes of hysteria that pervades the healthcare field. On the other hand, the fact that women are twice as likely to be reported as depressed than men is commonly attributed to the socio-cultural and biological processes of women. However, recent research on medical history suggests that even before depression was described and established as a diagnosis in Diagnostic and Statistical Manual of Mental Disorders-III, psychiatrists assumed that women were more often depressed than men (Hamberg 239).
A history of correlation of psychogenic disorders with women led researchers to establish diagnostic grounds for depression solely tailored to the female psyche, which in turn perpetuates the conclusion that more women than men are depressed and the stereotype of women as psychologically vulnerable. The preconceived notions of hysteria are deeply, even if not visibly embedded in the healthcare system in the form of implicit gender bias that pervades across all spheres of medical practice and treatment.
Women for no apparent medical reason, are not offered the same medical treatment as men, which raises the question of gender bias. In fact, men are investigated and treated more extensively than women with the same severity of symptoms for a wide assortment of diseases including Parkinson’s disease, irritable bowel syndrome, arthrosis, neck pain and tuberculosis (Hamberg 238). Women being less likely than men to receive advanced diagnostic intervention due to the pervasive influence across various fields of health care are severely impacted by the dearth of appropriate treatment further contributing to the disparity in women’s health care. As a matter of fact, a study found that even amongst the youth “boys were more likely to receive codeine and girls the gentler acetaminophen” (Seghal 2018) revealing the impact of the female caricature as the more "emotional sex” on children's health care.
More notably, the undertreatment of women for pain exposes the inattention and blatant disregard directed towards the suffering of female patients even as children. Furthermore, the influence of implicit gender bias extends to all stages of patient care through adulthood regardless of the affliction suffered by patients. Researchers at the University College of London discovered “that women with dementia receive worse medical treatment than men...receive less...monitoring and take more potentially harmful medication than men” (Schopen 2017). It is indisputable that gender bias affects the treatment of women and contributes immensely to the ingrained disparity present in the medical field when regarding the treatment of female patients. Both doctors and patients have difficulty in comprehending the extent of influence that implicit gender bias has on the clinical treatment of female patients.
Women have been excluded from the production of medical and scientific knowledge for centuries, thus establishing a healthcare system that exclusively benefits men and exacerbates the already pervasive influence of implicit gender bias on health care. Researchers have criticized the exclusion of women from clinical research dating back to the 1970s as a method of developing biased medical knowledge (Hamberg 238) that has significantly disadvantaged women’s healthcare due to the years in which females were and still are excluded from biomedical research.
Throughout medical history, "There was not the understanding that it really isn't scientifically appropriate to study men and apply your findings to women” (Hoff 2019) which has dangerous implications on how women are treated in the healthcare system. Consequently, women may be unknowingly exposed to treatment plans that influence their health in a negative manner simply due to the lack of appropriate clinical research. The need for establishing appropriate standards for clinical research is especially evident in the continued necessity for more inclusivity in clinical trials concerning the varying drugs and devices. Veritably, eighty percent of drugs taken off the market due to side effects were shown to more severely impact women in comparison to men (NPR 2016). It is clearly indicated that men and women react to medicines differently and the exclusion of female subjects from clinical trials further contributes to the disproportionately negative impact of drugs on women.
While more women are now included in clinical trials, the U.S Government Accountability Office has expressed the need to further study biological differences experienced by male and female test subjects in clinical research as recently as 2015 (Hoff 2019). The continued need for more inclusivity in clinical trials concerning the varying drugs and devices, particularly those used by women must be addressed in order to advance patient health care.
Consequently, the incorporation of female test subjects allowed researchers to observe the differing progression of multiple sclerosis has led to findings about how to treat multiple sclerosis in women (NPR 2016). As indicated, the study of female subjects in animal trials helps mitigate the negative side effects of drugs on women and lead to the development of new treatment possibilities and healthcare practices. The exclusion of women from biomedical research contributes to a lack of understanding of the female physiology, thus further aggravating the influence of implicit gender bias on the diagnostic and clinical practices for female patients.
The lack of proper recognition of implicit gender bias that stereotypes female patients in the medical field is further perpetuated by the exclusion of women in clinical research with devastating consequences on patient health. Research has indicated a strong tendency for physicians to more likely interpret and treat women’s symptoms as psychological rather than physiological. This dangerous proclivity has contributed to the misdiagnosis of serious health conditions that severely impact patient health simply due to the inadequate treatment of female patients.
The pervasive influence of the already existing implicit gender bias is further worsened by the dearth of female inclusion in clinical trials. The centuries of exclusion faced by women in the biomedical field is in part responsible for the distinctly limited knowledge available regarding the female anatomy that further strengthens the influence of gender bias on diagnostic as well as clinical practices. Patients must take a more proactive approach to their health care and consider the influence of implicit gender bias in their medical treatment and diagnosis. It is essential for both doctors and patients to recognize implicit bias, in order to address it within the biomedical field to ultimately improve patient care and achieve health equity.
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