Sexism in Healthcare is Alive, and Patients are Dying

With over 330,000,000 residents, the United States is the third most populated nation on Earth, and females comprise approximately 51 percent of that population (Statistica, 2020). One hundred years after the women’s suffrage movement, women still fight for equal pay and equal rights. Some claim that women exaggerate claims of sexism, while others claim that sexism remains a vestigial and insidious part of our society. When a PEW research study probed Americans’ beliefs on gender equality in 2020, 64% of women said that the U.S has not gone far enough to give women equal rights compared to 49% of men (Igielnik, R., & Horowitz, J. M, 2020). When the study asked participants whether “overlooking gender discrimination” or whether “people claiming it exists where it does not” is a bigger issue, 67% of Americans say the bigger concern is people “not seeing discrimination where it does exist” while 33% responded that the larger issue is people seeing discrimination “where it does not exist” rather than “where it does exist” (Igielnik, R., & Horowitz, J. M, 2020). The numbers suggest that not all Americans are experiencing or witnessing the same instances of sexism and even that they disagree on the degree to which sexism is a prevalent or concerning issue in our society. Clearly, sexism is a contentious issue. However, there is a multitude of data suggesting that sexism does exist - especially in the healthcare system. 

As a matter of fact, gender-based discrimination affects millions of women every year, and when women are suffering, they receive less effective medical treatment than men.  Several studies have been conducted to demonstrate that women’s pain is often ignored, overlooked, and seen as exaggerated. Women receive fewer painkillers for higher levels of pain compared to men for the same procedures. Perhaps most astonishing is that when women are in distress, they are prescribed a different type of drug: sedatives. Following bypass surgery, 50% are less likely to be prescribed painkillers as compared to men undergoing the same procedure (Fenton, 2016).

There are additional areas where healthcare disparities between gender exist that can be extremely dangerous, including  access to timely healthcare. When women seek out healthcare, it turns out there is a lot to be desired. For example, a 2008 research study found that women are “25 percent less likely to receive opioid pain medications to treat their pain despite reporting the same pain scores as men” and that in order to receive the medication, they wait an additional 15 minutes (or more) compared to men (Baxt et al., 2008). Women wait longer, only to receive less treatment from the providers they wait for. They actually wait an average of 65 minutes before receiving a pain medication for acute abdominal pain in the ER in the United States, while men wait only 49 minutes (Fassler, 2015). Pain management is certainly an important aspect of healthcare and can drastically affect the quality of life of a patient and patients who happen to be women get the short end of the stick. 

When an emergent healthcare problem arises, minutes, or even seconds, can mark the difference between positive and negative healthcare outcomes. Women’s concerns are often dismissed and they wait longer to receive treatment when compared to men. This creates a significant issue when women go to their doctors, particularly if their providers have a hard time correctly identifying their symptom presentations in the first place. This is evident with heart disease, which is the number one killer of women in the United States (Doshi, 2015). Paradoxically, men are more likely to be diagnosed with heart disease, although women comprise more than half its fatalities (American Heart Association News. 2016). Part of the reason for this is that the symptoms differ by gender. Men experience chest pains, but women experience discomfort in the neck, jaw, shoulder, back, or arm, nausea, vomiting, or a feeling resembling indigestion (Doshi, 2015). Alarmingly, symptoms that occur in women are labeled as “abnormal” because they do not match the standard model of symptoms in patients that have been studied – men. The cost of the lack of understanding is needless death, pain, and suffering for thousands of women and their families.

Part of the problem is that medical professionals simply do not understand how women experience pain or their underlying physiology as a result of gender based bias in scientific research.  Following the National Institute of Health’s policy, Consideration of Sex as a Biological Variable, regarding gender being a variable that might affect the results of a study, research has primarily focused on male patients and used male animal models. The studies that have investigated pain in women found that women suffer with pain more intensely than men do but still receive less pain medication than men (Rettner, 2012). Indeed, despite women comprising 70% of the patients who suffer chronic pain, 80% of pain studies are conducted on male mice or human men. 

The policy was created with the idea that “biological differences between males and females may exist….as a result of varying physiology and hormone levels in males and females”, yet, according to the NIH, around 95% of research studies are done solely on male patients, male stem cells, and male mice for clinical and biomedical trials. Consequently, there is a large gap in understanding women’s reactions to drugs or their symptoms. In 2005, “8 out of 10 prescription drugs were withdrawn from the US market because of women's health issues” (Holdcroft, 2007). The result: a serious gap between the understanding and funding of research that covers females and males. While the evidence paints a dark picture for women, the more evidence there is of disparities in healthcare, the more of a chance there is for change. In 2014, the U.S. National Institutes of Health, or the NIH, determined that in future studies it funds, an equal number of male and female rats must be used. This gender parity in lab rats might just lead to real breakthroughs in the human development of safe and effective treatments for human men and women in the near future. 

Whether sexism in healthcare providers is implicit or explicit, the consequences are dire. Sexism is a real human rights issue that will affect billions (millions within the borders of the United States alone). According to Johns Hopkins University Experts, 250,000 deaths result from medical error, including misdiagnosis, each year in the United States which makes it the 3rd leading cause of death every single year (McMains, 2016). The sobering fact is that women are 20 to 30 percent more likely to be misdiagnosed (Dusenbery, 2018). When one looks at the overabundance of data, it is clear that women are experiencing setbacks in access to health care, delays in timely treatment, and dismissal of their pain and suffering. So long as sexism is alive in healthcare, millions of Americans will pay the ultimate price: their lives. 

References

American Heart Association News. (2016, January 25). Heart attacks in women undertreated, experts say. https://www.heart.org/en/news/2018/05/01/heart-attacks-in-women-undertreated-experts-say

American Heart Association News. (2019, October 04). 6 things every woman should know about heart health. https://www.heart.org/en/news/2019/10/04/6-things-every-woman-should-know-about-heart-health

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Fassler, J. (2020, June 02). How Doctors Take Women's Pain Less Seriously. https://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515

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