Missed diagnosis: Gender bias in the healthcare system  

In the UK, the health risks are currently higher for women than for men. There are plenty of examples, from anecdotal to large studies, of cases where gender should not have affected care but unfortunately does. For instance, it takes longer for women to be diagnosed with brain tumours and many cancers than men. A bystander is less likely to give CPR to a woman than a man. Women are even less likely to be given pain relief for the same level of reported pain and wait longer for treatment. 

Sexism in healthcare is by no means new– from the medieval notion of women’s wombs causing medical issues by wandering around their bodies, to the Victorian diagnosis of ‘hysteria’ and confining medically healthy women to asylums. Does this mean we should ignore gender in medical treatment? Unfortunately, because there is plenty of evidence gender does have a real effect on healthcare, it is not so simple. For example, due to being calibrated for men, Alzheimer’s tests carried out on women cause later diagnoses because their verbal memory is on average better to begin with. 

Despite this, we need to be careful in examining biases before we completely blame gender. It was commonly thought women presented with different heart attack symptoms to men, thus explaining why women were twice as likely to die within 30 days of a heart attack. However, more recent studies show women do not present with different symptoms, they’re just less likely to be noticed and do not receive the same standard of care. 

Another issue is diseases affecting only one gender. It’s not as surprising as it should be that conditions only affecting women receive less funding and fewer studies than those affecting men. Endometriosis, for example, occurs in a tenth of women and can cause incredible pain and fertility issues but is treatable. Despite this, it takes an average of seven years to be diagnosed. 

Much of this issue may well arise from the sexism already in our society, and therefore, unfortunately, in healthcare too. However, it also traces back to the clinical research, meaning the appropriate information to treat women is not even available. Often studies on mice and even cells use only males, with justifications including females having ‘hormonal interference’, though the evidence for this is weak. The result is drugs are prescribed to women without being fully tested. Evidence now shows women often need different dosages, leading to more side effects when prescribed dosages designed for men. 

What is also important to acknowledge here is many people are discriminated against in our healthcare system by race, age, sexual orientation, and disability, and these can all overlap with gender too. It is additionally worth mentioning sexism works both ways, with a higher life expectancy for women and large concerns around men’s mental health. 

In December 2021, after many independent inquiries and reports, UK ministers officially acknowledged healthcare in the UK is sexist. A call for evidence was put out earlier in the year, and a ‘Vision for Women’s Health’ was released after more than 100,000 responses detailing how many women felt dismissed and discriminated against. The government are also appointing a Women’s Health Ambassador to focus on addressing these issues, and full details are currently awaited for a new Women’s Health Strategy to be published this spring. It is expected to focus on six key areas: menstrual health, fertility and pregnancy, menopause, healthy ageing, mental health, and the impact of violence against women and girls. It has taken many years of advocating for these problems to be fully acknowledged, but hopefully, these strategies will finally be able to make a difference.

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Becky Sainty

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August 2022
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