番茄社区

In this video, Melinda Wenner Moyer, freelance science journalist and author of a recent on "medical gaslighting," discusses why women and people of color are experiencing the problem and what physicians can do to change this systemic issue.

The following is a transcript of her remarks:

Many women and people of color have been speaking out about the frustrating and dismissive experiences that they have been having with medical professionals.

One common theme is that a person will visit a doctor or a medical professional complaining of some kind of physical symptom, and then their symptom will be dismissed as psychological, as all being in their head, or as being a result of their weight, or the fact that they're out of shape. Or a doctor will say something like, 'this just isn't something that you need to be worried about.'

People are describing these frustrating experiences at the doctor as 'medical gaslighting.'

One area where the problem of medical gaslighting is a huge issue is in the area of autoimmune diseases. So, we know that almost 80% of autoimmune disease sufferers are women, and there hasn't been nearly enough research into how to diagnose some of these diseases and how to recognize their symptoms. And as a result, a lot of women with autoimmune diseases say that when they have first gone to doctors, their symptoms have been dismissed, or doctors have said, 'It's just anxiety -- maybe you should go on an antidepressant,' something like that.

These experiences with medical gaslighting have been happening for a long time – even centuries. A long time ago, women were told that their symptoms were a result of hysteria that had to do with problems with their uterus.

One reason why we might be hearing more about medical gaslighting is because social media is making it easier for women and people of color to share their experiences. And there's kind of a snowball effect where when one person starts talking about it, other people start sharing their experiences. So, I think we're just hearing about these more, but these have been happening for a very long time.

Studies show that compared with men, women face longer wait times to be diagnosed with and with , perhaps because their symptoms are initially misunderstood or dismissed. Women are also treated less aggressively for a number of conditions, including , and they're less likely than men to be prescribed when they're in pain.

One study also found that women are as men to be diagnosed with a mental illness, when their symptoms are actually consistent with heart disease.

We know from research that people of color often also receive medical care, and doctors are more likely to describe black patients as 'uncooperative' or 'non-compliant.' And research suggests that this can that they receive.

As for why this occurs, there are potentially many factors contributing to it. One key problem is that there hasn't been nearly as much research on women's bodies and female biology than there has been on men's bodies and male biology. Women can have very different symptoms than men do for the same condition -- one example being heart disease. So doctors may only be familiar with the male presentation of the disease and then misdiagnose a woman.

This is, in part, because of historic fears that have excluded women from clinical studies. In 1977, the U.S. Food and Drug Administration began recommending that scientists exclude women who are in childbearing years from early clinical studies. The fear was that if they were pregnant, then their fetuses might be harmed through exposure to new drugs. There were also some concerns about hormonal fluctuations that might mess up results.

Of course, this means that women have not systematically for a long time been included in clinical studies, and that means that we know so much less about how their bodies work.

This has since changed. Now all NIH-funded research does require women to be included in trials, and there have to be considerations of sex as a biological variable. But the medical literature still very much skews towards male biology and how men present with different diseases.

We need more and better funding for research on women's health and women's bodies. A found that in most cases, research on diseases that affect men are far more heavily funded than research on diseases that affect women.

We also need to ensure that medical schools are spending enough curriculum time teaching medical students about women's health and about sex differences in how conditions can present.

The stress and time constraints that doctors face also fuel biased decision-making. We know this from research.

Studies have shown that when doctors are busy and stressed, as almost all of them are right now, they are more likely to make that reflect unconscious biases. So, one example might be assuming on some unconscious level that black individuals have a higher pain threshold; this is a misconception that some people hold. Or that many women's health complaints might be rooted in psychological issues rather than physical issues.

Because of the stress and time constraints that doctors experience, and the fact that we know that this can contribute to biased decision-making, it would also be very helpful if doctors didn't have quite so much on their plate all the time and if they were given more time with patients so they don't feel rushed to make diagnostic decisions.

Comment