Women have a complex relationship with medical providers. For more than 4,000 years, women were diagnosed with conditions like hysteria and wandering wombs, which provided unscientific explanations to everything from postpartum depression to ADHD. The treatments for these diagnoses were also frequently ineffective – and at times inhumane. The very concept of hysteria remained a plausible diagnosis until 1980 when it was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).
Modern doctors and mental health professionals pride themselves on treating patients with respect and understanding the needs of anyone who seeks out their services, but many women still don’t get the care they need. This mistreatment has dangerous effects for all women – and particularly for women with disabilities. Here are just a few ways the healthcare industry as it stands negatively impacts the lives of women and girls.
Symptoms look different between men and women
The symptoms of many diseases and mental conditions look different between men and women. The classic heart attack, for example, depicts a man gripping his left arm in pain as a warning sign that something is wrong. This symptom doesn’t occur for women, and many people aren’t aware of what heart attack symptoms look like in women at all. Medical professionals are just now starting to discover how different genders react physically and mentally.
This lack of acknowledgment that men and women present differently significantly affects women with disabilities. Many women don’t receive diagnoses for several years for similar conditions that men are treated for. Both autism and ADHD are harder to diagnose in females, which means that young girls and women don’t get the support or care they would otherwise have if they were boys.
In a way, this lack of diagnoses comes from how society conditions women. While “boys will be boys,” girls are told to be ladylike and behave properly as future women. As a result, they learn to hide their disabilities.
“With social-imitation strategies, for example, autistic girls have fewer troubles making friends than autistic boys; they have seemingly more ordinary interests than boys; [they are] more adept at camouflaging their stereotyped and soothing ritual behaviors,” write Fabienne Cazalis and Adeline Lacroix. “In other words, their autism is less obtrusive, which means their symptoms are less obvious to their families, teachers, and doctors.”
This has led to a gender diagnosis gap, according to the National Autistic Society (NAS). While our knowledge about autism is still growing, more doctors are learning that women can also experience this condition as well. In 1998, only 18 percent of autism cases were in girls. This has increased to 23 percent in 2018.
Women tend to downplay their symptoms
Social conditioning plays a role in how women are diagnosed in multiple ways. Because women were thought to be hysterical for so long (and more prone to hypochondria) many women worry that they won’t be believed in a medical office – and many aren’t. This is particularly true when they seek out medical attention at early warning signs of pain or poor health.
“Women are often not taken seriously until health providers start getting external evidence that corroborates their accounts,” writes Liz Seegert for the Association of Healthcare Journalists. “Even in the emergency department, symptoms such as fatigue, dizziness or nausea are often discounted, and women often wait longer for testing and interventions than men.”
Because women are still viewed as the weaker sex, their fatigue is written off as feeling overwhelmed or overworked. Conversely, the symptoms of weakness in men are addressed more frequently because the male gender is perceived as strong and capable.
Too often, social conditioning and fears about treatment turn misguided stereotypes into dangerous realities. Women are taught that they shouldn’t speak up and their experiences reflect that they won’t be believed. As a result, their symptoms get worse and their conditions remain untreated until they become severe.
Men also experience harm from these gender stereotypes. The idea that a man has to be strong and stoic means many males in the United States also have untreated conditions because showing pain or asking for help is viewed as a sign of weakness. Strict gender roles hurt everyone.
Women are underrepresented in clinical trials
While many women need to fight against biases to get diagnoses, there are additional challenges that they are likely to face because of their gender. Namely, the majority of drug trial participants are men (and have been historically), which means women are more likely to experience unwanted side effects as a result.
For example, Irving Zucker at UC Berkely noticed that more women experience morning-after side effects from taking Ambien (a sleep medication). He worked with Brian Prendergast at the University of Chicago to study how women and men react to medication differently. They found that in more than 90 percent of cases, women have a stronger reaction to medication than men.
“I don’t believe anyone can reasonably find this acceptable,” says Zucker. “Some have tried to explain this in part as women have a lower threshold for reporting adverse drug effects, but much evidence suggests this is not the cause of the sex difference in adverse drug reactions.”
Once again, doctors are convinced that women are being too sensitive. They claim that women are more likely to complain rather than acknowledge their valid experiences. These are the misconceptions that Zucker wants to challenge.
Most recently, this lack of gender acknowledgment played out in the development of the COVID-19 vaccine. While the vaccine is safe, women experienced significantly worse side effects than men who receive it. They were more likely to experience chills or fatigue for a brief period compared to men.
Meanwhile, out of 45 COVID-19 randomized controlled trials, only eight broke out the results of the study by sex or gender. Neither the Pfizer-BioNTech and Moderna vaccine trials published results that showed the differences in efficacy by gender.
Until medical professionals acknowledge that women have different bodily responses than men, their care will be worse than their male counterparts.
Women with disabilities feel these effects even more
Women as a whole are not affected equally by healthcare discrimination. The effects that women of color, women with disabilities, LGBTQ+ women, impoverished women, and other minority populations face are much more severe than the discrimination experienced by those who are more privileged.
You can see this when we talk about race, where even Beyonce and Serena Willians couldn’t get doctors to acknowledge their pain during childbirth. You can see this in the LGBTQ+ community, where women with disabilities are afraid to get care. You can see this in organ transplant discrimination, where people with disabilities can be denied in 25 states because of their conditions.
The issues that women in healthcare face won’t be reversed just by removing hysteria from the DSM-V. They are deeply rooted in societal conditioning and beliefs about women in our culture.
Learn more about the various types of disabilities, both visible and invisible.
Comments