Gender bias in healthcare—a harsh reality in the 21st century
By Siti Junaidi
You know the infamous line: “It’s just that time of the month, isn’t it?”
More often than not, women’s feelings are brushed off as dramatic or ‘overly emotional’, with their menstrual cycles getting thrown under the bus for every outburst. This flippant dismissal of women’s stress and pain carries real consequences. Anxiety and depression are frequently overlooked or written off as mood swings, while autoimmune diseases—chronic and life-altering—go undiagnosed for years because a woman’s pain isn’t taken seriously.
Why does this happen?
This pattern of sexism isn’t new. As far back as 1900 BC, ancient Egyptians had believed that hysteria was caused by the movement of the uterus inside a woman’s body. And thanks to brilliant Hippocrates, who coined the term ‘hysteria’ from the Greek word hysteron (meaning uterus), the idea of ‘female hysteria’ became entrenched for centuries. The result? Women’s pain and mental health struggles continue to be misunderstood and misdiagnosed.
Until today, echoes of this stigma still shape medical opinions. Society expects women to be accustomed to pain, simply because they are biologically built to endure menstrual cramps or childbirth. Research reveals that women’s bodies are still under-studied, often due to concerns that fluctuating hormones might affect results or cause disruptions in women of childbearing age. In addition, there is a historical bias of predominantly male researchers, who assume male-focused studies apply to humankind.
Ironically, women’s physical conditions are often dismissed as psychological, while actual mental health struggles are brushed off as “just stress.” Instead of proper care, they’re told to try yoga or adjust their diet. Worse, women are prescribed opiates twice as often as men—an easy fix that ignores the root causes of their pain. This overmedication has created an opioid gender gap, leaving women trapped in a cycle of misdiagnosis and neglect. Ultimately, sexism in healthcare continues to fail women, both in over- and under-diagnosis of their mental health and physical conditions.
The woman’s body
Women are more susceptible to autoimmune diseases and mental health conditions, and this is deeply tied to their biological makeup. While some aspects of their biology, like hormonal balance, offer protection, others make women more vulnerable in unique ways.
For instance, women’s immune systems are generally stronger, helping fight off infections, but this can also backfire. The exact strength can cause the immune system to mistakenly attack the body’s own tissues, leading to autoimmune diseases. This is partly due to women having two X chromosomes. While these chromosomes offer protection against certain genetic disorders, they also carry genes that can over-activate the immune system.
This is influenced by hormones too, especially estrogen. While estrogen helps boost immunity, it can also overstimulate the immune system, making women more prone to autoimmune conditions. Beyond the immune system, estrogen also affects mood. It can cause emotional ups and downs during your period, pregnancy, or menopause, sometimes leading to anxiety, irritability, or depression.
Other hormones like thyroid hormones, progesterone, and testosterone also affect women’s health in different ways. Thyroid hormones regulate energy, progesterone reduces anxiety, and testosterone influences mood and motivation. It’s this delicate hormonal balance that makes women more vulnerable to emotional instability and autoimmune diseases.
The link between mental health and autoimmune diseases
Mental health challenges and autoimmune diseases often go hand in hand, and for women, these issues can be intertwined in ways that are hard to separate. Hormonal imbalances, stress, and the immune system’s response all play a role in both. It’s crucial to understand the signs of each, as early diagnosis and treatment can make a significant difference in outcomes. This awareness empowers you to make informed choices and assertive decisions to get yourself checked, even if your concerns are initially dismissed.
Mental Health Conditions
- Anxiety
Symptoms:- Persistent worry or fear, often disproportionate to the situation
- Physical symptoms like increased heart rate, sweating, or muscle tension
- Difficulty relaxing or concentrating
Anxiety is often dismissed as just stress in women, but it’s almost always more than that. If it’s interfering with your daily routine, talk to a doctor. Treatment can help regain control, and without it, anxiety can lead to panic attacks or even depression.
- Depression
Symptoms:- Persistent sadness, emptiness, or hopelessness.
- Loss of interest or pleasure in activities once enjoyed.
- Fatigue, changes in sleep or appetite, and difficulty concentrating.
If depression lasts more than two weeks, it’s important to seek help. Depression leads to bigger health problems if left untreated. A mental health professional would help you understand what’s causing it and work with you to feel like yourself again.
- Trauma
Symptoms:- Flashbacks or intrusive memories of a traumatic event
- Nightmares or sleep disturbances
- Emotional numbness or detachment
- Avoidance of reminders of the trauma
Trauma, particularly PTSD, affects women at a significantly higher rate than men, two to three times more. For many, this trauma stems from deeply painful experiences such as sexual assault or childhood abuse, which are often difficult to talk about due to the stigma. It’s heartbreaking to know that about 1 in 3 women will face sexual assault in their lifetime. PTSD can bring about long-lasting emotional and physical challenges, but it’s important to remember that healing is possible with the right support and care.
- Autoimmune Diseases
- Hyperthyroidism
Symptoms:- Unexplained weight loss, despite increased appetite.
- Rapid heartbeat or irregular heartbeat.
- Sweating, nervousness, and irritability.
Hyperthyroidism is often mistaken for anxiety because their symptoms overlap. In older adults, it can even be confused with depression or dementia. If you’re experiencing unexplained symptoms, don’t ignore them—demand the right care.
- Systemic Lupus Erythematosus (SLE)
Symptoms:- A butterfly-shaped rash across the nose and cheeks.
- Joint pain, swelling, and stiffness.
- Extreme fatigue, fever, or chest pain.
Women with SLE often face challenges getting a proper diagnosis, which can delay treatment. If you’re dealing with unexplained rashes, joint pain, or fatigue that doesn’t improve with rest, it’s important to get checked. Early diagnosis is key to preventing long-term organ damage.
- Systemic Sclerosis (SSc)
Symptoms:- Thickening or tightening of the skin, especially on the hands and face.
- Difficulty swallowing, joint pain, and swelling.
- Shortness of breath, especially with exertion.
Many women with SSc find their symptoms overlooked or misunderstood. Because the condition is rare and its symptoms can be unclear, it’s easy for doctors to miss the diagnosis. To avoid long-term complications, it’s important to demand a diagnosis and treatment as soon as you notice any signs.
- Rheumatoid Arthritis (RA)
Symptoms:- Pain, stiffness, and swelling in the joints, particularly in the morning or after sitting for long periods.
- Symmetrical joint pain (i.e., both hands or knees affected).
- Fatigue and fever.
Joint pain is often brushed off as “normal for women,” which can delay an RA diagnosis. If your symptoms point to RA, getting diagnosed early can prevent lasting damage. Ensure you’re heard and seek the right treatment to avoid unnecessary suffering.
- Multiple Sclerosis (MS)
Symptoms:- Numbness or weakness in limbs, often on one side of the body.
- Blurred or double vision.
- Difficulty walking, with balance problems or fatigue.
MS is often misdiagnosed because its symptoms can resemble conditions like migraines and fibromyalgia, and women are more likely to experience this. This can lead to delays in getting the right care. An accurate diagnosis is key to managing symptoms and slowing the progression of the disease.
How everyone can advocate for better women’s healthcare
As much as it can be tough to get doctors to listen to a woman’s pain, it’s crucial to keep speaking up and demanding the care you deserve—not just for your health, but for the women who come after you. By pushing for answers and refusing to dismiss your symptoms, you can help shift the narrative and create a healthcare system where women’s experiences are taken seriously.
If you’re dealing with symptoms that persist, worsen, or disrupt your daily life, please do not hesitate to seek help. With your determination, early diagnosis and treatment can make a world of difference.
References
Clinical Practice & Epidemiology in Mental Health, Higgs LLP, World Economic Forum, Biological Sciences, McLean Hospital, Annals of the Rheumatic Diseases, Frontiers in Neurology
