Gender bias in medical diagnosis
[1] Female patients face discrimination through the denial of treatment or miss-classification of diagnosis as a result of not being taken seriously due to stereotypes and gender bias.
[10] This can be attributed to differential treatment, specifically; preventative measures, refined diagnostic techniques and advanced medical and surgical capabilities that are directly catered to men's health.
[13] However, more recent studies have shown that women respond differently to a variety of common drugs than men, including sleeping pills, antihistamines, aspirin and anesthesia.
[3] A study from NIH regarding aversion to medical attention shows 33.3% of participants receiving “unfavorable evaluations”, largely deriving from skepticism in physician care.
[35] The original purpose of the DSM–IV was to provide an accurate classification of psychopathology, not to develop a diagnostic system that will, democratically, diagnose as many men with a personality disorder as women.
Whereas it is plausible that there are gender-specific expressions of these disorders, DSM–IV criteria that function differently for men and women can systematically over-pathologize or under-represent mental illness in a particular gender.
[36] Considerable evidence indicates a prominent role for trauma-related cognitions in the development and maintenance of posttraumatic stress disorder (PTSD) symptoms.
The present study utilized regression analysis to examine the unique relationships between various trauma-related cognitions and PTSD symptoms after controlling for gender and measures of general affective distress in a large sample of trauma-exposed college students.
Both patients with BPD and PTSD may present as aggressive towards self or others, irritable, unable to tolerate emotional extremes, dysphoric, feeling empty or dead, and highly reactive to mild stressors.
This practice occurred despite biological differences in disease presentation between females and males, and the fact that women are more prone to experiencing adverse reactions to medication.
Pro-Publica and NPR published a story about racial disparities in maternal mortality and the birth experience of Dr. Shalon Irving, a CDC epidemiologist studying how structural inequality influences health.
The Laura W. Bush Institute for Women's Health at Texas Tech University was founded in 2007, and has supported integration of "sex-specific instruction in medical education.
[49] Communities of color use CAM to feel more in control of their health, partly due to mistrust in healthcare amid cultural reasons and medicinal preferences.
See main article: Menopause Contemporary healthcare approaches face a significant gap in understanding and addressing age-related diseases specifically in females.
Menopause is a gradual hormonal change, typically onset between the ages of 48-52 wherein menstrual periods cease, and women are no longer able to conceive and bear children.
[53] The Women’s Health Initiative (WHI) hormone therapy (HT) trials, conducted between 1993 and 2004, demonstrated efforts to address gender bias in medical diagnosis by providing insights into managing menopausal symptoms.
It also advises caution in older age groups considering HT due to the increased risk of vasomotor symptoms and CHD.
[52] This study, involving 61 women from various backgrounds, discovered that patients reported experiencing symptoms of menopause in their early thirties and late forties.
[56] Women also exhibit a higher susceptibility to dementia compared to men, experiencing more frequent and rapid declines in cognitive function with aging.
Women, including those with dementia, are more frequently prescribed specific classes of psychotropic medications, such as sleep aids, which may heighten the risk of cognitive impairment.
For example, a 2000 study found that emergency department nurses had varying views on the importance and likelihood of myocardial infarction among male and female patients seeking evaluation and treatment.
Healthcare providers' failure to recognize the symptoms of myocardial infarction in middle-aged women may contribute to higher morbidity and mortality rates among this group.
While a seemingly positive statement, this kind of thought process can ultimately lead to gender biasing because it does not note the differences between men and women that must be taken into account when diagnosing a patient.
[64] Other ways to avoid gender bias includes diagnostic checklists which help to increase accuracy, evidenced-based assessments and facilitation of informed choices.
[18][66][67] The initial large studies on the use of low-dose aspirin to prevent heart attacks that were published in the 1970s and 1980s are often cited as examples of clinical trials that included only men, but from which people drew general conclusions that did not hold true for women.
[72] A review of NIH-funded studies (not necessarily submitted to regulatory agencies) published between 1995 and 2010 found that they had an "average enrollment of 37% (±6% standard deviation [SD]) women, at an increasing rate over the years.
In 2016, the United States Congress passed the 21st Century Cures Act which codified into law the strengthening of women's health research through government funding.
Women's overall health has long been associated with their reproductive abilities; further compounded by traditional views of sex, female gender roles, and femininity.
More specifically, if a woman did not meet the expectations of reproductive functions (such as inconsistent menstruation cycles, inability to conceive or carry to term, as well as display negative reactions such as nausea, pain), it was assumed that she held resentment or non-desire to bear and raise children, as well as being defiant of her feminine nature and role.
[86] Conversely, if a woman were not to behave in alignment with femininity and gender role expectations (such as unable to maintain and care for family and housework, insubordinate, sick or in pain), then they were labeled as mentally ill or disturbed, often diagnosed with hysteria.
