Even post-Covid, doctors are still dismissing women as attention seeking hypochondriacs

'Every woman has a story – whether it’s about her own experience or that of another woman in her life' writes Sarah Graham
'Every woman has a story – whether it’s about her own experience or that of another woman in her life' writes Sarah Graham

Has a doctor ever accused you of being an attention-seeking hypochondriac, when all you actually wanted was some healthcare?

That was the question I posed to my Instagram followers recently. Many of the responses were things I’ve, depressingly, heard dozens of times before – “you’re just stressed”; “you must have a low pain threshold” – but one in particular had me picking my jaw back up off the floor.

During a smear test, one woman wrote, a male doctor had asked some standard sexual health questions: Was she sexually active? (Yes). Was she on the pill? (No, she used condoms). When she explained that she’d tried the Pill, but that it had made her feel miserable, his response was astonishing.

"Lots of women say that, but I don’t believe them," he said.

“He literally had a speculum inside me when he told me he didn’t believe women,” she recalled.

For the last two years I’ve been running Hysterical Women, a blog exploring women’s experiences of being dismissed and disbelieved in healthcare. I’ve published dozens and dozens of stories in that time, so I often think I’ve heard it all. Yet I continue to be astounded by the horrifying things that some doctors say to women in their care.

From the doctor who wrote in a woman's notes that she had "a convincing story" to the woman who was asked "are you sure you're not stressed?" when she detailed her ongoing symptoms, and the one who was told "you must have a low pain threshold" when she asked for painkillers after a major surgery.

Credit: Hysterical Women

It’s a well-established fact that there is a global gender health gap, both at a research level and in frontline practice. Women - and even female lab rats - have historically been excluded from medical research and clinical studies. As a result, the (white) male body has long been considered the ‘default.

Conditions that predominantly affect women receive less research funding and are less well understood, and countless everyday medicines have largely been tested on men (including medicines specifically designed for women). During a recent virtual panel event, a doctor even told me she’d never been taught female surface anatomy at medical school. This lack of knowledge filters all the way through the medical system and has an impact on the care women receive.

When you combine that lack of knowledge with the kinds of dismissive attitudes described above, you have a perfect storm of healthcare gender bias – a system in which women’s symptoms are too easily dismissed as “hysteria”, “over-reacting”, or “all in your head”.

I started Hysterical Women in October 2018 after noticing these patterns in my freelance work. Two years on, I’ve learned a lot about the gender health gap and its impact on women’s lives. The thing I’m always most struck by is that every woman has a story – whether it’s about her own experience or that of another woman in her life. These tales come tumbling out whenever I speak about my work, and so frequently they begin or end in the same way: “I never realised this was a widespread thing. I thought it was just me.”

Women have these experiences across all aspects of health, not just gynaecological as you might assume. There are some obvious examples of course, like endometriosis (which takes an average of seven-a-half years to diagnose, or chronic vulval pain, such as vulvodynia and vaginismus (sufferers of which are frequently told to “try relaxing”.

But I also hear stories about all kinds of physical and mental health conditions being dismissed or misdiagnosed.

In some cases it’s quite literally a matter of life or death, like a delayed cancer diagnosis, or the fact that two women a day die needlessly from heart attacks because they receive worse quality care than men. In other instances, women are left needlessly suffering chronic pain, disability or mental illness, all because a healthcare professional didn’t take them seriously.

These stories are invariably frustrating, infuriating and upsetting to read – not least because I love the NHS and know there are many brilliant, over-worked and under-resourced, healthcare professionals doing their best to provide all their patients with the best possible care. This isn’t about blaming individuals, but looking at the deeply ingrained systemic issues at the root of the problem.

Like everything, gender bias in healthcare intersects with myriad other forms of conscious and unconscious bias, impacting all the more heavily on women of colour, lesbian, bisexual and trans women, disabled women, working class women, neurodivergent women, as well as trans men and non-binary people who are misgendered as women in healthcare settings.

Black women are five times more likely than white women to die during pregnancy or childbirth, for example, while members of the LGBT community suffer higher levels of mental ill health than heterosexuals and face widespread discrimination in healthcare.

Credit: Hysterical Women

All of this was the case long before any of us had heard of Covid-19, and the pandemic has both highlighted and exacerbated many long-standing health inequalities. But it remains to be seen exactly what long-term consequences coronavirus will have on women’s health.

Already we’ve seen the impact on maternity services, cancer screening and fertility treatments. We’ve also seen women struggling to access contraception and other sexual health services – although access to telemedical abortion may prove to be one silver lining of the pandemic.

Experts are already warning about the far-reaching indirect effects Covid will have. As both academic and frontline resources are, understandably, plunged into coronavirus research and treatment, there’s a real danger that the already neglected field of women’s health will be one of the casualties.

It feels more important than ever to keep sharing and shouting about these experiences. For all the deep-rooted complexities to be unpicked, the fundamental message is really very simple: listen to women, believe them when they say something is wrong, and work with them to find a solution. Many doctors are already fantastic at this but, until women stop sending me these stories, I’ll know there’s still work to be done.

Hysterical Women relaunches today, Monday 14 September, following a coronavirus hiatus. Find out more and share your own experiences at hystericalwomen.co.uk