Unconscious bias towards women is prevalent throughout medical practices in the United States, with results that seem comorbid with social stigma and stereotypes of racial minority groups. When Healthcare practitioners and researchers are conditioned by society to hold these biases, women suffer as a result.
It is well known that women are stereotyped to be over-reactive and dramatic, which unsurprisingly correlates to the acknowledgement of female pain in medicine. A study published in the Journal of Pediatric Psychology found that doctors perceive expressions of pain from female patients as exaggerated (1). They discovered this through the use of a video of a gender neutral looking child expressing pain from having blood drawn, doctors were shown the video with some being told the child is male and others that the child was female. On average the doctors who thought the child was male perceived the child’s pain at about 50/100, while doctors who thought the child was female perceived the child’s pain at about 46/100 (1). This correlates with the historical and prevailing stereotype that women are hysterical, even among medical professionals. Women generally face worse health outcomes than men due to this perceived hysteria, resulting in under-treatment especially in pain management and cardiovascular care (2).
An interesting thing about female stereotypes in medicine is that it seems as though it is male doctors who primarily carry these biases, due to the fact that women seem to have better health outcomes when being treated by women doctors (2). This is most apparent when looking at heart attack survival rates in women being treated by female doctors, as women are two to three times more likely to survive a heart attack when being treated by a female doctor (2). This is related to the stereotype of the hysterical woman, as early signs of heart attack can often be perceived as not very serious by a male doctor who unconsciously holds this bias. Since women are more likely to overlook this cultural bias, it allows them to more frequently recognize heart attack symptoms in women.
In the wake of the current BLM protests, social media sites like Instagram have given me more insight into the struggles of black women. One of the things that was brought to my attention is the disproportionate lack of treatment provided to women of color in the doctor’s office. In addition to enduring the discrimination in medicine that comes along with being a woman, they must also encounter medical discrimination that comes with being a person of color. For example, a study published by the National Academies of Science showed that up to 40% of medical students still hold beliefs about the physiology of people of African descent. These beliefs range from thinking that black people’s blood coagulates quicker to even thinking that black people have thicker skin and a higher tolerance to pain (3). These are all statements present in previous medical literature that are provably and demonstrably false, yet these falsehoods still permeate among those who are studying medicine and by extension those who practice medicine. The fact that black people are perceived to be more tolerant to pain combined with the fact that women are perceived to exaggerate pain means that black women are very likely to have many of their health grievances dismissed. Due to this pain dismissal, black women are also less likely to be sent in for diagnostic testing. This ultimately leads to a disproportionate amount of under-diagnosis and misdiagnosis in black female patients, resulting in preventable deaths and lower quality of life due to preventable illness (4).
In addition to the manifestation of harmful beliefs of medical practitioners, unconscious bias against women can be seen in biomedical research. It has been shown that women are underrepresented as participants in clinical research for a number of diseases. Ideally, the number of female study participants would reflect the number of female patients with the condition, however this is not the case. A study by the Allen Institute for Artificial Intelligence analyzed data from PubMed, a database for biomedical research, and clinicaltrials.gov, a research for clinical trial data, to study female representation in research over 25 years (5). The most striking examples of under representation occurred in cardiovascular disease, hepatitis, HIV, chronic kidney disease, and digestive disease. For example, 51% of patients suffering from cardiovascular disease are female, but in clinical trials to investigate treatment methods, only 39% of these participants are female (5). In many of these trials, sex related differences in treatment can be overlooked.
In order to make medicine better and more effective for all people, we must strive to remove cultural biases from our everyday lives, as these biases carry over into judgements about the nature of other people’s experiences in their own bodies.
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About the Author:
Hi, my name is Julia Caputo and I am a research intern here at EWAAB. I have always been amazed by science and technology. I am a biomedical engineering student from Queens, New York and I am entering my third year at Stevens Institute of Technology. On campus, I am passionately involved in the Society of Women Engineers and Alpha Phi Omega Service Fraternity. I recently got my Emergency Medical Technician license and I hope to go to medical school.