Gender bias has a significant negative effect on medical diagnosis and the quality of healthcare people receive. It can lead to substantial delays in diagnosis, as well as misdiagnosis and even death.
Gender bias most severely affects women and other marginalized genders. However, it has a negative impact on everyone, and contributes to health inequity worldwide.
In this article, we explore gender bias in medical diagnosis, looking at what it is, how it manifests, and its impact on health and healthcare.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Gender bias refers to a preference for one gender over another. It is often based on prejudices and stereotypes.
Gender bias can be conscious, and something someone is aware that they have. Gender bias can also be unconscious, or something a person is not aware of. This is known as implicit bias.
In addition to gender, which refers to how a person feels inside, people can also be treated unfairly because of their gender. Sex is based on biological characteristics, such as a person’s reproductive organs and chromosomes.
Historically, people have used the biological differences between the sexes to perpetuate gender stereotypes. This includes the idea that women are not as smart as men because of differences in brain size.
This means that, even if a person was not assigned female at birth, people may make assumptions about them based on perceived femininity, or gender expression.
Most research on gender bias in healthcare focuses on men and women. Overall, it shows that gender bias reduces the speed, accuracy, and effectiveness of medical diagnoses. The impact is most severe for women. However, it has an effect on men, too.
Here are some examples of gender bias in medical diagnosis:
Overall, women experience more chronic pain than men. Despite this, a
Some of the studies also show that doctors are more likely to diagnose women with a psychological cause for their pain, rather than a physical one, compared with men. While chronic pain is complex and can involve psychotherapy as part of treatment, this does not explain this difference.
Other studies found that women received:
- less pain medication
- less effective pain medication
- more antidepressant prescriptions
- more referrals to mental health services
The researchers also note a general trend that doctors do not believe in women’s pain, or that females are “used to internal pain” because of menstruation and childbirth.
While men also experienced mental health difficulties as a result of chronic pain, doctors are more likely to describe them as stoic or strong.
Gender bias in chronic pain diagnosis can result in women receiving little medical support, incorrect diagnoses, and avoidable damage to their mental health.
Men may also be less likely to seek or receive a diagnosis for chronic pain, or to get treatment for mental health conditions that occur as a result.
These conditions affect both males and females. In the past, however, doctors believed they only affected males. This myth may still have an impact on bleeding disorder diagnosis today.
There is no medical reason for these delays. In fact, females are
According to a survey from the American Autoimmune Related Diseases Association (AARDA), 62% of people with an autoimmune disease had been labeled “chronic complainers” by doctors, or told they were too concerned with their health.
This figure applies to all the people AARDA surveyed. However, 75% of people with autoimmune conditions are women. This means that this dismissive attitude disproportionately affects women.
In cases of lupus, women make up 90% of patients. Although men receive lupus diagnoses at a later age than women, on average, it takes them less time to receive a diagnosis once they present with symptoms. The criteria that doctors use to diagnose lupus may be the reason for this.
Women are nearly
- gender-based violence
- lower social status
- lower average income
However, while gender inequity is a key cause of mental illness worldwide, gender bias in medical diagnosis can also cause doctors to focus more heavily on mental health conditions as a cause for symptoms in women than in men.
For example, doctors are more likely to diagnose depression in women than men, even when they have identical symptoms and depression symptom scores.
Additionally, a 2020 review shows that, even after controlling for higher rates of mental health conditions in women, women still receive a disproportionate number of mental illness diagnoses. They also receive more prescriptions for mood-altering drugs.
This bias in diagnosing depression may mean that women, men, or both are not receiving appropriate treatment due to assumptions doctors make about their gender.
Early evidence suggests that gender bias has also affected the management of the COVID-19 pandemic. A preprint of a 2020 analysis found that women with confirmed cases of COVID-19 were less likely than men to receive chest X-rays and blood tests.
Research on COVID-19 is still evolving. However, a 2020 article notes that most studies on COVID-19 have failed to take sex and gender into account. As a result, there is a gap in research about how gender bias has affected the diagnosis of COVID-19.
There are sex-based differences in how the symptoms of heart disease present in males and females. However, a lack of education on these differences can lead to doctors ignoring or misdiagnosing heart disease.
Doctors are more likely to regard the symptoms that affect females as “atypical” compared with the symptoms that often affect males. They are also less likely to refer females for diagnostic tests and treatment.
The same is true of heart attacks. Females are less likely to experience “classic” heart attack symptoms, and are less likely to receive treatment. The
Marginalizing the symptoms that females experience puts them at risk.
Gender bias is a result of sexism. Sexism is prejudice or discrimination based on sex or gender. In many cultures, sexism has historically meant that men have more power and influence than women and other marginalized genders.
The same is true in medicine. Until the 20th century, the study and practice of Western medicine was dominated by men. While this is no longer the case, systemic sexism still exists within medicine, according to a 2019 report from the
Here are some of the ways that sexism has influenced medical care, both in the past and present:
Gender blindness in research
In the past, many scientific studies excluded female participants in order to eliminate the possibility of female sex hormones influencing the results. Scientists also excluded females of childbearing age from trials to prevent the risk of drugs affecting a potential pregnancy.
Although some of these practices had good intentions, medical professionals now know less about how diseases and drugs affect women, resulting in the need to suspend drugs that doctors previously thought were safe for men and women.
In the United States, organizations such as the
Despite this, women
Many academic institutions are also working to increase the representation of women and marginalized genders among their faculty, and have enacted policies to combat discrimination.
Many countries do not have laws to protect people against gender-based discrimination.
As a result, women healthcare workers and patients do not always have support when they experience harassment, abuse, or violence. They may also have no way to challenge sexist practices and policies that disadvantage them.
Gender bias in medical diagnosis harms peoples’ physical and mental health. It primarily affects women and marginalized genders worldwide. This leads to a higher burden of illness among these groups.
Gender bias also harms the health of men. For example, the positive prejudice that men are strong and brave can cause people to avoid seeking medical help because they are afraid that this is a sign of weakness.
It is important for medical institutions and professionals to actively work to eliminate gender bias in medical diagnosis, as well as in research, workplace practices, and treatment protocols.