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In her book, Doing Harm, Maya Dusenbery tackles the hard-hitting issues that women have faced for generations. She also touches base with the problems in medical research and testing—past, present, and future.

“[Women] are at least twice as likely to have chronic pain conditions that affect 100 million American adults but that are woefully under-treated and under-researched. Then there are conditions like fibromyalgia, chronic fatigue syndrome, chronic Lyme disease, and multiple chemical sensitivities that are 70 to 80 percent female dominated and are so poorly understood they have yet to be fully accepted as real diseases by the whole of the profession,” (Dusenbery 3).

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Catalyst Research. “Women in Healthcare: Quick Take.” Catalyst, 24 Apr. 2020, www.catalyst.org/research/women-in-healthcare.

Dusenbery, Maya. Doing Harm: the Truth about How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. HarperOne, 2019.

“Examining Gender Bias in Medical Care.” Cedars, 2019, www.cedars-sinai.edu/research/news/cedars-science/2019/examining-gender-bias-in-medical-care.html.

“Gaslighting in Women's Health: No It's Not Just in Your Head.” Katz Institute for Women's Health, 2020, www.northwell.edu/katz-institute-for-womens-health/articles/gaslighting-in-womens-health.

Kiesel, Laura. “Women and Pain: Disparities in Experience and Treatment.” Harvard Health Blog, 7 Oct. 2017, www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562.

Levy, Gabrielle. “Why Women Struggle to Get Doctors to Believe Them.” U.S. News &amp; World Report, U.S. News &amp; World Report, 20 Apr. 2018, www.usnews.com/news/the-report/articles/2018-04-20/why-women-struggle-to-get-doctors-to-believe-them.

McGregor, Alyson. SEX MATTERS: How Male-Centric Medicine Endangers Women's Health and What We Can Do about It. QUERCUS PUBLISHING, 2020.

Paulsen, Emily. “Recognizing, Addressing Unintended Gender Bias in Patient Care.” Duke Health Referring Physicians, 14 Jan. 2020, physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient-care.

Pawlowski, Agnes. “Dismissed: The Health Risk of Being a Woman.” TODAY.com, 2019, www.today.com/health/dismissed-health-risk-being-woman-t153804.

Plath, Sylvia. The Bell Jar. Faber &amp; Faber, 2019.

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An Introduction to Gender Bias in the Medical Field

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An Introduction to Gender Bias in the Medical Field

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In Sylvia Plath’s The Bell Jar, protagonist Esther Greenwood spends much of her journey navigating the health system of the 1950s. Due to her battle with depression, Esther sought a remedy for her suffocating affliction, yet the care of the time often did little to help. From shock therapy and mental hospitals, to insulin treatment and group counseling, for better or worse, Esther experienced it all.

While it’s widely known today that treatments such as shock therapy are ineffective and unethical, many don’t realize that there are still discrepancies and insufficient care given within our medical system today.

I had little knowledge of the Medical Gender Bias issue beforehand, barely knowing that the topic existed at all. Yet the roots of the issue have an iron grip on American society, stemming from the rampant sexism found throughout the country's history.

For decades, studies have neglected to include women in their research, resulting in care and medical treatments that aren't meant for the female anatomy. And biased medical training leaves doctors unequipped to identify many illnesses when found in the female body. Combined with the gender stereotypes that have plagued society for centuries, many physicians, however implicitly, often have difficulty believing women to be "too emotional" and "overly dramatic" when it comes to their medical concerns.

Our Padlet is arranged into columns, beginning with an explanation as to what gender bias and a history of the subject, along with the origins of women's health. The latter having strong ties to the Women’s Rights Movement.

The topic then moves on to the biggest obstacle facing women who seek medical attention: being heard. Oftentimes, when doctors cannot determine the causation of a woman’s symptoms, if they believe the woman at all, they will dismiss the illness as anxiety, citing the “emotional” stereotype for reasoning. Leaving women to suffer without any help, but also dismissing their struggle entirely.

To end the Padlet are a few examples of when a lack of care for women created major medical mistakes in treatment.  Such as drug dosing and understanding of female anatomy as a whole. Finally, the last column is a brief mention of other areas of prejudice in the medical world, such as the discrimination female physicians face daily, in the workplace and beyond. Or how clinical trials are still struggling to include gender diversity.

I hope you all find this topic as fascinating and informative as I did. Medical Gender Bias is a particularly urgent issue, when missteps are made, the human cost is high: leaving women in chronic pain or drowning in medical bills, if the error wasn’t fatal to begin with. This is an issue that affects us all, and you can help by educating yourself and others, as well as by supporting researchers investigating the issue by donating to or publicizing their work.

Thank you and I hope you enjoy!

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“I thought it sounded just like the sort of drug a man would invent… because the drug would make her forget how bad the pain had been,” (Plath 35).

During her visit to the hospital with Buddy, Esther witnesses a woman give birth, noting how the drug given to the woman didn't ease her pain, but help her forget it.  The drug has no consideration for the well being of the women who take it, and just want women to have more children.

Throughout medical history, there have been many medical missteps, often deadly, because care was not taken to consider women when researching their own medical well being.

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Statins
Statins are drugs used to lower LDL (bad) cholesterol that can clog arteries causing high blood pressure and later, potentially heart attacks and strokes.

For decades, these drugs have been prescribed to men and women alike, to help with high blood pressure and heart attack prevention. Yet recent studies have shown that the LDL cholesterol that the drugs limit, may not be a health risk factor for women in the first place. And only affect blood pressure when HDL (good) cholesterol is low.

In this case, the prescription women have been trusting for decades to lower their blood pressure and protect them from heart attacks and stroke does nothing for them and women have died because their "treatment" provided no medical value in lowering their risk of cardiac arrest.  #HealthcareEquality #FundWomensResearch

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Naltrexone
The drug is used to help those with substance abuse disorders avoid relapses, but was recently found to be potentially deadly in women.

While the prescription aids male patients on their road to recovery, the drug's purpose is actually inverted when in the presence of female brain chemistry. Naltrexone may cause more relapses in female patients as the drug is metabolized differently.

Because this drug was originally only tested on men, this fatal research flaw has cost countless women their lives, pushing them back into their addiction, instead of out of it.

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"’Suppose you try and tell me what you think is wrong." I turned the words over suspiciously, like round, sea-polished pebbles that might suddenly put out a claw and change into something else. What did I think was wrong? That made it sound as if nothing was really wrong, I only thought it was wrong,” (Plath 68).

Desperate for help with her depression,  Esther's session with Dr. Gordon left her feeling minimized and unheard.

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While female doctors are also often implicitly instilled with bias, their male counterparts are most often the biggest culprits, as society's stereotypes of women have the larger affect on their actions.

In her book, McGregor recounts the time she encountered a neurologist who claimed he had an "algorithm" for stroke patients:
"'Well,' the neurologist said,      smirking, 'When they come in... If they're male I say, let's do a CT scan. And if they're female, I say, stop! It's your anxiety acting up.'" (99).
#BelieveMe #Sexism #WorkplaceBias

While in this case, the neurologist claimed to be joking, the intent is the same: to belittle women. It would be difficult to argue that one could perpetuate stereotypes in their free time and remain completely unbiased at work. Cases such as these document the severity of the gender bias issue.

How can women receive the help they need if the ones tasked with helping them are the first to turn them away?

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Women are suffering needlessly, due solely to the miseducation of doctors. Despite the prevalence and severity endometriosis, it takes the average woman 7 years to receive a diagnosis.

In this scenario, Laura Kiesel illustrates how her medical concerns were not taken seriously. She expresses her frustration in her excerpt, which quotes are found below.

“The solution was: “…don’t dwell on the pain, and don’t try to fix it — no props, no pills. Eventually the mind should let go."

"Trying to ignore the pain didn’t stop endometriosis from strangling my large intestines and adhering my ovaries and fallopian tubes to my colon. To gain actual relief from that agony, I needed surgery, and I might need it again."

For the full article, click here

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Gender bias is the implicit (or explicit) differentiation in medical treatment between male and female treatment.

In a 2019 study, one-fifth of women said they felt they'd been treated differently by a healthcare provider due to their gender. The percentage was less than half that number for men. #todaynews #genderbiasstudy

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While not usually  explicit or intentional, gender bias affects millions of women across the globe the second they step foot in a hospital. Medical training textbooks are based upon symptoms and signs within the "average patient," a 75 kilogram white male (cedars-sinai.edu). Everything from drug trials and disease symptoms are studied using the male anatomy.
#DiversifyMedicalTraining #NotYourAverage Patient

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Every cell in the human body contains sex chromosomes, and "these chromosomes in turn influence every biological, chemical, sensory and psychological function performed by that body" (McGregor 12). In other words, the female body responds to everything: treatments, drugs, even diseases themselves, differently. Therefore, the female anatomy needs the same research and investigation the male anatomy as been receiving for decades in order to safely and effectively treat female patients.

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One such example is the sleep-aid Ambien. Clinical trials solely utilized male subjects, and extended dosage results to women. Women prescribed the drug awoke tired, dizzy, and nauseous for over 20 years, until further research was  conducted to determine the female metabolism requires a much smaller dose.

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A Brief History of Gender Bias in the Medical World

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A Brief History of Gender Bias in the Medical World

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"That's one of the reasons I never wanted to get married. The last thing I wanted was infinite security and to be the place an arrow shoots off from. I wanted change and excitement and to shoot off in all directions myself, like the colored arrows from a Fourth of July rocket." (Plath 44)

Ester's longing for freedom, specifically freedom from the societal standard of family and motherhood, is a continuing theme throughout the novel. In a way, Esther was ahead of her time, and society wouldn't hear her her sentiments until long after the events of the novel, during the Women's Rights Movement of the 1960s and 70s.

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In 1970, the Boston Women's Health Collective published the book Our Bodies, Ourselves and launched the Women's Health Movement (an offshoot of the Women's Rights Movement) of the 1970s. The Movement created greater access to birth control and gynecological resources. And due to the movement's overlap with the Civil Rights Movement, clinics were  created in areas with a largely Black demographic, as Black women often took (and still take) the hardest blows when it comes to prejudice. They experience bias on account of their gender, as well as their race.
#WomensRights #MyBodyMyChoice

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Additionally, prior to the 1970s, there were little to no restrictions or oversight of clinical drug trials. In the 1950s and 60s, thalidomide, was marketed as a safe anti-nausea medication for pregnant women. The drug was later found to cause severe deformities in fetuses, and over 10,000 babies were born worldwide with missing limbs and damaged organs.
#ThaliodomideBabies

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To keep such a catastrophe from occurring again, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was created. But because of what happened with drugs such as thalidomide, pregnant women and women of childbearing ages were labeled as "protected" subjects. They could still be utilized in trials, but with special precautions, which caused clinical trials to solely use men instead.

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A Male Dominated Field in More Ways than One

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A Male Dominated Field in More Ways than One

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“When I enrolled in the main building of the hospital, a slim young woman had come and introduced herself... I was surprised to have a woman. I didn't think they had woman psychiatrists,” (Plath 98).

In many ways, little has changed since the 1950s: female physicians still face constant bias and prejudice in the workplace. From patients to co-workers, for many women in medicine, simply getting through the day is a constant battle to be respected and heard.

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Throughout the novel, Esther’s mental heath concerns and cries for help are ignored by her mother, doctors, and friends:

“[Buddy] was very proud of his perfect health and was always telling me it was psychosomatic when my sinuses blocked up and I couldn't breathe.” (Plath 38)

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Sex- and gender-based medicine specialist, Dr. Alyson McGregor, explains in her book Sex Matters, that today's "male-centric model [of medicine] has classified women's very real symptoms as 'psychosomatic.'" (16). For almost 70 years, women's medical concerns have been dismissed as psychological, "psychosomatic." The medical world has abandoned millions of women to suffer with their conditions, untreated.
#AlysonMcGregor #Male-centricMedicine #NotAllInMyHead

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In this clip, women discuss how being told “it’s all in your head” affected their lives and what they had to do to find help.

#findhelp #genderbias #ad #ListenToMe

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Gender Disparities in Healthcare | Cedars-Sinai

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Oftentimes, when doctors cannot determine the causation of a woman's symptoms, or when symptoms do not align with the textbook definition of a disease (which are based upon research done on male bodies), they simply diagnose "anxiety."

McGregor notes that women under the age of 55 who went to the emergency room with heart attack symptoms were "seven times more likely to be sent home than their male counterparts." (104) Instead, women are often given an anxiety diagnosis. Yet the majority of these women "don't actually meet the diagnostic requirements for anxiety." (McGregor 105).

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Many criteria for an anxiety diagnosis are only observable over a long period of time, or are natural and are an expected piece of any stressful situation (such as an unexpected visit to the emergency room).

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This dangerous trend continues well into today, as "... studies are done exclusively on male laboratory animals and then the results are just extrapolated to, or assumed to be, identical in females." (cedars-sinai.edu). For decades, women have been excluded from medical research. Resulting in treatments that are inefficient, even dangerous, in the female body.

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In addition to patient experiences of bias, female practicians and surgeons face sexism throughout the medical field.

Women account for over half of enrolled medical students (51%), yet only 40% of licensed and practicing physicians/surgeons.

These women begin facing discrimination before they ever step foot in a hospital. In 2019. over 45% of female medical students reported experiencing sexual discrimination or harassment. #MeToo #SurvivorNotAVictim

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“To return to the issue of chronic pain, 70% of the people it impacts are women. And yet, 80% of pain studies are conducted on male mice or human men.”

Furthermore, doctors are less likely to prescribe women painkillers, and often prescribe a smaller amount of pills when they do. Often because physicians may believe that a woman is feigning symptoms and that there is nothing medically at fault.

This leaves women in pain and ignored, as even if a woman is prescribed painkillers, the underlying cause of the pain hasn't been investigated.