- Women are more likely to have their chronic pain dismissed as caused by stress and excessive emotion.
- Experts say it’s a structural problem caused by sexism, and the stress from it can make the pain worse.
- The doctors ignored one woman’s pain by ignoring it, and this led to her going blind.
- Visit the Insider home page to find out more.
Sitting in the surgeon’s office, with clinical lighting illuminating scanned images showing every inch of my painfully deformed ankles, we begin planning the next year of my life and how it will evolve around major reconstructive surgery.
He explains that if my tarsal coalition – the fusion of two different joints present from birth – had been diagnosed as a child, my skeleton would have been malleable enough to remove the fusion and allow the normal foot structure to emerge in its place. Now I am in my early twenties and too old to try to work on anything “normal”.
Instead, I must have a complex surgery during a global pandemic, restructuring the foot to correct bone deformities and help me walk, albeit abnormally.
This late diagnosis is not due to a lack of struggle with my angle or lack of symptoms.
Rather, it’s because doctors don’t believe that I have more than growing pains or a deep-seated need for attention. I spent many hours with doctors – both in general practice and hospitals – unable to walk normally, but no one seemed to believe that I was really in pain.
It took eight years to be heard.
This is a reality for many others. And, unsurprisingly for those who have experienced it for themselves, it disproportionately affects women.
Several studies have used a mechanism called GREP (Gender Expectation of Pain Assessment) to understand how a patient’s gender changes perception of pain.
These studies show why women wait longer for medical attention than men. This gender bias could be exacerbated by global delays in the provision of non-COVID health services due to the pandemic. For example, insider Kate Duffy recently reported delays in the UK health care system – as a result, life-threatening delay in cancer treatment and cancellation of surgeries.
Many GREP studies have shown that women are more likely or faster to report pain and are more sensitive to pain than their male counterparts.
“Women complain more than men; women are not accurate reporters of their pain; men are more stoic, so when they complain about pain, “it’s real”; and women tolerate pain better or have better coping skills than men. , “A landmark study on this topic – The girl who cried in pain – wrote.
Another study published in May 2021, found that, in general, women are perceived to be in less pain than men, even if they rate their pain at the same level as their male counterparts.
In short, women are considered more sensitive, more dramatic, so their pain is perceived as an overreaction rather than a debilitating reality to the point that when men go to the emergency department with acute abdominal pain, they wait an average of 49 minutes for painkillers. For women, this is 65 minutes.
This can be devastating.
Sarah Harris, 24, a 24-year-old journalist based in Nottingham, England, told Insider that she believed invalidating her pain caused her to permanently lose 95% of her vision – something that could have been saved if the disease would be corrected. previously.
“One day I woke up with back pain and after 24 hours I could barely move. Over the next few days, the symptoms began to slowly worsen, but the doctors kept telling me it was stress.
“After I went to the doctors almost every day, I accidentally got to a regular visit to the opticians. The optician looked me in the eyes and said that I needed to go to the hospital immediately, so I went and was diagnosed with Idiopathic intracranial
(high pressure around the brain).
“I was in the hospital for a month and every few days I had lumbar punctures, and eventually I needed urgent surgery to insert a tube into my spine. Ultimately, if my doctors had listened to me earlier, we could catch and prevent many diseases. irreversible damage to the eyes, brain and nerves. “
Dr. Ruby Nguyen, assistant professor in the Department of Epidemiology and Public Health at the University of Minnesota, told Insider that there are four main reasons for this pattern; physicians misunderstand the relationship between the psychological and the physical, poor diagnostic models, social stigma and misogyny.
“When it comes to pain, men are more likely to be perceived as having something specific. So its, for example, back pain is justified because men are considered more active, more hardworking people, said Dr. Nguyen.
“But there is a stigma in society that women should not experience physical pain because their lives are considered less labor-intensive. Thus, it is believed that women have no excuse for physical suffering. This is partly due to the fact that society underestimates the work that women do. …
“So, when a man complains of pain, the person in his life can answer:“ Go to the doctor, of course, your back hurts – you are a man, you are a strong, busy person, why not ”does your body hurt? But when a woman says so, the most common response is, “Oh, you’re just stressed.
“Delay in making a diagnosis often leads to the need to go to several clinicians to be heard and diagnosed.”
Zoe McKendry, a women’s rights campaigner and domestic violence adviser based in Brighton in the south of England, told Insider about her experience with this phenomenon, called medical misogyny.
“I went to the doctor in my operating room and explained that I had pretty severe headaches for several hours a day,” she tells Insider.
“He said, ‘Some women just have headaches’ – I told him that I rarely get headaches, and he said something about ‘aging’ even though I was only 19 years old.
“I continued to suffer from headaches for eight months and went to the dentist because I started to experience severe toothache in the upper part of my mouth. my teeth. The dentist prescribed antibiotics for me, and after a few days the pain went away. I never went to the therapist again. ”
This form of disability often leads to a different course of treatment for women. For example, one study found that in cases of chronic pain, while men are more likely to receive prescribed pain relievers, women will be prescribed psychotherapy — pain management “all in their head”.
Dr Melinda Nicola of Murdoch University, Australia, said disability adds another dimension of suffering to ignored pain.
“Disability pain causes stress and anxiety. In addition, the data support the idea that stress triggers inflammatory responses in the body and thus could be expected to exacerbate pain. “
This is not to downplay the experience of many people – regardless of gender – with a delayed diagnosis and invalidation of chronic pain.
For example, ankylosing spondylitis, a form of inflammatory arthritis that mainly affects people between the ages of adolescence and 20 years, takes on average more than eight years to be diagnosed regardless of gender. This is due to a number of factors, Dr Nicola Insider said, including a lack of awareness of the condition and the influence of stereotypes about what life with arthritis looks like.
However, there is also a gender factor in medicine, due to which women suffer more and more from chronic pain.
“Unfortunately, here we see that doctors often associate gender with the way we feel about things – seeing women as more dramatic and less credible when describing pain,” said Dr. Nguyen.