View Full Version : Discrimination in the medical field/mental health field because you are female.


sarahsweets
06-17-15, 03:20 AM
I didnt want to put this here because I would like to get responses from many people but since it did involve being a woman I figured what the hell. Anyone is welcome to weigh in.
I have railed against discrimination and bias in the medical fields when it comes to having mental illness and needing medical care but something else I was thinking about was the old adage of women being "hysterical" or out of hand.

An example: A few years ago I had lots of pain and a few trips to the ER. I knew in my gut it was my gall bladder however preliminary tests that were not thorough, led the medical "experts" to tell me it could be psychosematic. I found a good general surgeon who decided to take a look inside and walla! Bad gallbladder and it needed to vacate the premises immediately.
Last year, my husband had the exact same thing going on. They did the same tests, and got the same results but decided while he was at the ER to call in a consult for a surgeon to take a peek, and his gallbladder had to come out as well. He was in the ER for 12 hours, and then had surgery. I was in the ER 3 times over 2 weeks and had to find my own surgeon and for the same outcome.

Now, I know it sounds like there is info I am leaving out but I swear everything was the same and he was believed, and I was doubted. I really think it had to do with the fact that I am female. I have experienced this in different ways in various medical settings as well. I dont know if its a combo of me being female and having bipolar or what but it has popped up when the bipolar wasnt even mentioned.

What gives? And I am not one of those people who obsessively looks for some kind of social injustice or bias, or rights violation in everything I do. I dont play the men are dogs, women are oppressed game, (even though that seems to be going on) . Not all men are bad, not all doctors are bad, its just something that I have noticed. Interestingly enough, all of the medical professionals that both he and I dealt with were male.

What do you guys think? I am not sure if this can be changed, or if will ever be different, and I know that I have learned to adapt but I thought it could be a lively discussion as long as we all play nice.
Please do not get my thread closed. There's room for everyone in the sandbox.

Nifferka
06-17-15, 07:10 AM
Two things:

First, I think that the bias against women when it comes to diagnosis of both physical and mental health problems is partly due to the over-use of male subjects in defining the parameters of a disease. Because of certain physiological differences, lots of health issues present differently in men than in women. As a popular example, I'm sure you've heard that the classic heart attack sypmtoms--pressure in chest and pain shooting down your left arm--do not show up in many women, and so minor heart attacks are under-reported in that half of the population. My favorite example is Kholberg's theory of moral development. He presented the same moral problem to subjects of various ages, and used their responses to define a series of stages people go through in their moral development from childhood to morally mature adulthood. But he only used male subjects when developing this scale, and then found females to be morally lagging behind their male peers. Carol Gilligan, who worked with him, has since drawn attention to this inherent bias created by using male test subjects.

(I've tried writing this out several ways, but I can't do it coherently without just explaining the test. Subjects were told about Hans, a man whose wife was dying and could only be saved by a particular drug. But Hans can't afford the drug. Subjects were then asked if he should steal it. Younger subjects would say that he shouldn't, because stealing is wrong, while older ones would say that he should, because human life is more important than property rights. This is an over-simplified explanation, but that's basically it. Even the older female test subjects tended to say that he shouldn't steal it. When asked why, they would say that stealing is wrong, and why couldn't he explain to the druggist his dilemma, or ask family, friends, or the government for help? The point was that females tended to think there must still be some other option out there, and that surely communication would help, but because the moral development scale required an either-or answer, because it was developed with males who never asked about a third option, they registered as valuing property rights over human life.)

Using male subjects in the initial development of a diagnosis naturally excludes female presentation of symptoms. So yes, it's inherent in the system.

Secondly, I think the general bias against women in modern western society becomes more apparent to you as you get older. I know it has to me. When you're younger, you assume you're not being heard because you're young. The value placed on youth and beauty means that, as you age, you gradually see your value in society dropping, which is distressing. And when you notice that your male peers aren't suffering the same creeping invisibility that you are, the gender inequality becomes more and more obvious.

I probably have a lot more to say, but I have housework to do.

Fuzzy12
06-17-15, 07:57 AM
Interesting. I don't think, I've ever experienced anything like that but that doesn't mean it doesn't exist. Also, apart from mental health services (:rolleyes:), I haven't really used much other medical services. I guess, gender bias or not, it's very difficult for any health care professional (or anyone for that matter) to not allow their personal beliefs and attitudes to affect their clinical judgment. It still doesn't make it right though and it still doesn't mean that we need to try to eliminate as much as possible any detrimental bias. I can also imagine that gender biases work both ways, i.e. that in some cases, men get sub-optimal treatment just because they are male (e.g. under diagnosis of depression in men, etc.)

Nifferka, that's a really interesting study but if that is all that there is to the study, it seems extremely limited, not just with respect to females but with respect to everyone. There are so many reasons why someone might decide not to steal that have got little to do with valuing property rights over human life. I doubt you can draw any valid conclusions (especially not a binary conclusion) from any study that asks human subjects questions and only allows for two possible answers. There should at least be a third option like "Other". That's an aside though and I probably shouldn't judge without knowing anything about this study. I totally agree with your point though.

willow129
06-17-15, 08:18 AM
Interesting point Nifferka - not something I'd ever realized!

Another thing that could follow along with this convo and Nifferka's point about using the way conditions affect males to guide diagnosis...I think that girls in the past have tended to not be diagnosed with ADHD when they had it. Especially, or probably, because I think more girls tend to be inattentive and less hyperactive (I think)

One other anecdote I can give to this is in my family - brothers and sisters:

Half brother presented ADHD symptoms in middle school, struggling listening to directions and getting work done, he was diagnosed. (Interesting: definitely inattentive with him) Though he also had a very good, smart father who was taking care of him so there is that.

However, my [full] brother, struggled to get work done - I think he must have been diagnosed with SOMEthing because they put him on meds for a little while (that made him cranky so then he went off of them, and my parents never followed up) I've been meaning to ask him if he knows/remembers anything about this. If he's ADHD I also know he's more inattentive than hyperactive. So these two examples are even going against the hyperactive boy is easier to notice, thing!

Me: struggled in school, unorganized, FAILED social studies and went to summer school....nothin!!! And I have to say, right from the very moment I found out my half brother was diagnosed and we had really similar problems, my immediate thought is the reason no one thought anything of my problems is because I'm a girl. **shrug** I mean, I'm not mad and I don't feel sorry for myself, it's just the truth. There was, at that time, less research (I think?) and definitely less recognition of the fact that girls could have ADHD too.

Nifferka
06-17-15, 08:33 AM
Thanks, Fuzzy! Like I said, it was an over-simplification. The wikipedia (https://en.wikipedia.org/wiki/Lawrence_Kohlberg's_stages_of_moral_development) article goes into more detail. And I was writing about it from memory. Reading the above article just now, I saw that his name was Heinz, not Hans. How embarrassing... And you're right, more women than men are diagnosed with depression, partly because it manifests differently depending on gender. I read somewhere about male subjects being excluded from a study on depression because they were classified as having drug or alcohol abuse problems.

And Sarah, you are far from the first to notice this issue. If you have time, read this paper (http://scholar.oxy.edu/cgi/viewcontent.cgi?article=1005&context=sociology_student&sei-redir=1#search=%22gender-biased%20diagnosing%22).

Unmanagable
06-17-15, 02:02 PM
I've seen it and lived it. Especially working in the mental health arena for a little over 13 years. It was very heavily male driven, most especially in the administrative arena. One woman on the entire board at the time, and she was clearly responding out of fear of what the males would think. We had several one on one talks that made that very clear. I approached them with hardcore physical evidence of highly unethical wrongdoing on more than one occasion and was quickly silenced by them.

Their first line of response was to demonstrate an overly sympathetic tone in which they were highly concerned that "their key employee" was obviously suffering from some type of work overwhelm and should probably be seen by a counselor "for some objective support". (Translate: From that point on, they could then say, "She is seeking mental health services for some type of issue." to lessen my credibility with any future grievance - and they damn well did)

I followed all the processes by the book, had an overwhelming amount of credible evidence in hand, demonstrated strong presentation skills, and in some cases, even photographic proof of shady s***, and I was made to look like an overly emotional and moody female who was seeking outside mental health support to calm down and get back to business as usual. And this place of business was a vocational rehab center training folks with disabilities to get into, or return to the work force. What a slap in the face.

Seeing how students were constantly treated differently based on gender, race, economic status, etc. was a strong basis for some of my presented findings. It's a really f'd up scene there in so many ways, from where I was standing. I learned within that arena, no matter how high up I went to have the issues addressed, each one of them were more than okay with covering the others a** along the way, and kicking mine to the curb. I eventually resigned to maintain my health and sanity.

I don't go looking to nit-pick stuff apart just to have something to complain about, either. But I damn well act upon my strong instinctual feelings of clear and present BS wherever and whenever it kicks in. Good thread, sarah.

Edited to add:
I don't remember exactly where I read it, but I recall reading about how medication dosages are typically prescribed based on testing that has typically been heavily male dominated. More specifically, it was referring to Ambien when the FDA reduced the safe dosage for women to half of the typically prescribed dosage of 10 mg. I was prescribed it at the time, but my prescribing doc nor my pharmacist notified me of any changes. If I hadn't happened upon the article, I would've continued. It prompted me to be even more on top of what all they were prescribing me and the amount of side effects I was experiencing vs. actual symptoms.

acdc01
06-17-15, 10:39 PM
men get sub-optimal treatment just because they are male (e.g. under diagnosis of depression in men, etc.)

I wonder if the under diagnosis of men is more because of the men themselves (i.e. pride keeps some men from seeing their symptoms or from sharing what symptoms they do see) or because of bias from the doctors?

BellaVita
06-17-15, 10:56 PM
I think I've faced more discrimination after mentioning what I'm diagnosed with more than anything.

Jenn1202
06-18-15, 12:50 AM
I agree.
another example: I was misdiagnosed with anorexia because I was a skinny female suffering from hyperthyroidism (a thyroid issue that causes weight loss) and gastric issues (gastric issues make it difficult to eat and keep food down). The fact that I thought I looked too skinny and was desperately trying to eat and gain weight didn't even matter to them (anorexics think they look fat, even when they're skinny). I know other females with similar misdiagnosis stories. I'm pretty sure that they would never have misdiagnosed a guy like that.

Fuzzy12
06-18-15, 02:00 AM
I wonder if the under diagnosis of men is more because of the men themselves (i.e. pride keeps some men from seeing their symptoms or from sharing what symptoms they do see) or because of bias from the doctors?

Good point!! Apart from pride I think, most people don't know how differently depression can manifest in men, including the men suffering from it themselves

stef
06-18-15, 03:57 AM
I havent encountered this myself, fortunately but maybe it's different in Europe...?

I wonder if some of it just isn't stereotypes. Women are "expected" to be more emotional and men to be more stoic. So a woman who is pale nearly in tears from pain might be considered less "credible" in the ER, than a man who is pale nearly in tears from pain ?

Of course there is no excuse anywhere for not getting proper treatment in the first place

mbrandon
06-19-15, 05:47 AM
Sorry to hear that Sarah, your story made me angry.

Pilgrim
06-19-15, 08:57 AM
Good point!! Apart from pride I think, most people don't know how differently depression can manifest in men, including the men suffering from it themselves

How do women express depression. My mother would just cry or be violent.

Little Missy
06-19-15, 09:18 AM
No violence here, but I would cry and walk in circles.

Little Missy
06-19-15, 09:35 AM
No violence here, but I would cry and walk in circles.

But wait! That was me before I was diagnosed ADD, doctors kept saying it was depression. It was frustration.

sarahsweets
06-22-15, 04:31 AM
I bet if you think about it though, being diagnosed with something and being female might have made a difference in how you were treated.

I think I've faced more discrimination after mentioning what I'm diagnosed with more than anything.

Lizzie80
06-24-15, 04:55 PM
:thankyou: Sarah, I love your post here - although I'm sorry you had to go through all of that - and can completely relate to what you're saying. I lost my left ovary in Jan. 2008, due to being told multiple times (during multiple trips to the ER) AND after two trips to a male gynecologist that I was merely being hysterical over pain so awful, I thought it was my appendix or gallbladder about the burst. I'd had a couple of kidney stones, so I knew what that pain was like. I was told the awful pelvic pain was "a normal part of a woman's cycle", despite the fact that I was only 27, no family history whatsoever of ANY cancers at all, and wasn't active in the bedroom department (for lack of a better way to put it...)

They saw "anxiety disorder" on the chart and fat on the body, and that was that. Besides being repeatedly dinged over my weight by every human being I saw no matter what their job title was at the hospital, I was accused of being a drama queen. Or I got the really enjoyable one to hear, that I was a drug seeker. Ha. Opiates do nothing for me. I could've swallowed an entire bottle of Oxy, wasn't going to make this level of pain go away! Nor was I asking them for medication, not even morphine in my IV. I just wanted the pain to go away, and begged them either to operate or find me a doctor who could figure out what was wrong, because I knew I wasn't crazy. During my last visit to the ER, the guy in the next bed over who came in with a 4.5 blood alcohol level (that is not a typo, not a joke) and a criminal record of repeated drunk driving was treated with more respect and dignity by the staff than I was. Pathetic.

After several months of losing thousands of dollars both in lost pay at work, and major bills from what the health insurance didn't cover on all the ER and physician's charges, a female PA at my urologist's office told me that I did indeed have a large ovarian cyst show up on the x-ray taken to find my kidney stone. Her concern that day, and taking time out to have a conversation with me totally unrelated to what her practice was seeing me for undoubtedly saved my life. She told me that from the x-rays, she could tell it was the size of a lemon, and she couldn't fathom how the ER doctors (all male...) had missed it multiple times. I refused to return to the male gynecologist's office who had told me if I only had gastric bypass surgery, then poor old fat me would have no more pain, no more problems. :scratch: :eyebrow: :faint:

Anyway, I got myself to a female OB/GYN (sorry, gents!), a very kind lady who advised me it was a dermoid cyst, which always have to come out as they only get larger with time, and that I was very lucky it hadn't gotten much bigger. She also could not understand why doctor after doctor had refused to run lab tests on the cyst, or claimed it was undetectable on x-ray or during ultrasound, as the tests showed all along it was clearly there. The cyst turned out to have some cancerous cells in it. Long story short, I am supposed to get checkups every six months for the rest of my life to make sure that I do not have cancer cells show up again. Hysterical drug-seeker, my foot!

Ladies, if you are in continuous pain and no one seems to find a cause, I don't care what it costs...keep on demanding treatment until it gets resolved. If at all possible, see a female PA or physician, if a bunch of male ones keep droning on about your hormones or your mood swings or whatever they want to pin it on. Don't let medical providers bully you into thinking "it's all in your head", "If I just lose weight, all my problems will be solved", or anything else they tell female patients. A gastric bypass wasn't going to shrink and cure a dermoid cyst with cancer cells, not that these doctors had any business telling me about whether my weight was a factor in anything, since they didn't even know my medical history. The doctors that cost me an ovary do not have to live with the hormonal issues that show up from it (which are so fun to deal with when living with ADD). They didn't lose the ability to have children at a prematurely young age due to negligence- I did. Oh, and I was told after the surgery that unless I "got a gastric bypass immediately and dieted down to an 'appropriate weight'", I was putting myself at risk for more cancerous tumors. Because of course we all see that only heavyset people die from cancer, right? :doh:

And yes, I fully believe that a man's pain would have been taken far more seriously. A female friend of mine has Medicaid only at the moment, since she's in college full-time and only has a part-time job for right now. She lives in the same town I do, where we only have one hospital. Her gallbladder was causing her so much pain and was so close to bursting, the poor girl was coming into class every day with a green cast to her skin. The hospital absolutely refused to take her directly into surgery from the ER, despite clearly seeing that her gallbladder absolutely had to come out or it would definitely explode, and the fact that not one surgeon in a 50-mile radius took Medicaid. No out-of-network surgeons would operate on her without her paying $5,000 up front, which of course a FT college student with only a PT job and two children to raise as a single mom doesn't have. I believe that a man would have been treated differently, even if he only had Medicaid. When a man demands treatment, generally he gets it. When a woman demands treatment...well, you said it all, Sarah. Whether my friend's discrimination was purely based on gender or was also due to the stigma of only having Medicaid, I don't know. Either way, I can say the U.S. at least has SERIOUS problems with discrimination against women, and against those who have Medicaid. But that's a whole other topic unto itself...I won't even get started on the problems in getting quality mental health treatment for women- yikes!

Lesson: My fellow ladies, NEVER, EVER let a doctor or nurse or anyone else guilt-trip, belittle, or patronize you into denying yourself medical care. Your life may depend on being a hysterical bi-otch with a 'tude that no one likes. Your health is worth it, though. ;)

Sickle
07-02-15, 01:40 PM
some of it is certain practitioners in psych as well. I see a lady who will prescribe benzos and stimulants in some cases with men and women when both are needed (I use clonazepam PRN to tame manic stuff and thunderstorm induced panic as well as ADHD meds). I know male and female patients who see her and have bipolar and ADHD diagnoses and I hear a theme of complaints regarding how trustworthy see each gender has. I also think her trends are based on sexist norms (stop her from being emotional and hysterical; make him more productive and well behaved) and that there is a correlation in that as well as ERs etc.

With women I know who see her, she is very liberal with benzodiazepines but is very stingy with stimulant meds, probably due to the trend of women taking stimulants for appetite loss. However, she thinks men who want benzos are looking to "get pill drunk" so she will barely give any of those to men but I have had no problems getting high doses of stimulant meds at all.

I notice that much when it comes to treatment standards. I hear women say they are assumed to be overdramatic from staff but as a male with bipolar I disorder/ADHD, the tip toe-ing and acting like I am going to murder or attack someone is something I experience with the bipolar diagnosis as a male. When I have had to be told that they disagreed with something and whatnot in the ER, they come in in a pack and stand by the door (I had a hernia once and was in pain and they assumed I was a drug seeker but when I explained that the pain was keeping me up.).

The impression I get and based on what I have heard, is that they give women they don't trust the idea that they are hysterical and men they don't trust the idea that they are deliberately lying. I know I sort of jumped on but I know first hand of some things and think there is a connection to sexist norms for both men and women. Even in my lows as a man, I have felt like I was seen as dangerous and have seen women get the "dramatic" treatment in that state in my experiences too. I think your complaint is valid. It is different for us guys but I have seen exactly what you are referring to though.

I also know my ADHD has come off as "manic" in some of my more intense periods. Kind of like women with ADHD being seen as depressed.

Corina86
07-04-15, 05:08 PM
I had an gynecologist (male) who insisted I should have kids, so I won't get ovary cysts again. Told him I never want kids, but he still insisted... (you can still get ovary cysts even if you do have kids, btw)

My cardiologist (male) insists I should have kids... for some reason, not related to my health anyway.

I went to get an x-ray scan for horrible back pain and I was turned away because young women can't get x-ray in that part of their bodies because they might make mutant babies (I was turned away by both a male and a female; doctor and nurse).

I went to the ER for abdominal pain and symptoms that resembled appendicitis. The doctor (male) insisted on a gyno exam, despite the fact I was still a virgin. He tried really really hard to persuade me to let him touch despite the fact there was no symptom of an issue with my lady parts. Turned out I just had an urinary infection.

I have a male psychiatrist who's cool though. Never asked me about my genitalia or gave me advice on what to do with it. I appreciate that!

4rch0n4n6313
07-28-15, 10:56 PM
I have blamed it on being fat, Ive blamed it on not wearing expensive enough clothes...Ive even blamed it on timing. That other women have gone through this makes me think that....there are even more hurdles to deal with....

Silvermoonstone
08-09-15, 12:03 AM
This really makes me sad, and it's a legitimate truth to it. (for anyone who doubts it)

Awhile back, I took a class on Women Studies, where it focused on the different psychological views of women receiving treatment. It was heartbreaking. Women were already labeled to be hysterical from the getgo. The general song was a woman diagnosed with an issue, there was something wrong with her - labelled. For a man, it wasn't his fault.

It doesn't help the fact that women psychology is VASTLY different from men psychology. It's a good thing people are aware of it now - it was awful in the past. Heck, penis envy was a legit thing for a long time (And seriously, that thought-process is one of the stupidest things I ever read).

Fortune
08-09-15, 12:45 AM
I don't think men and women are VASTLY different from each other, psychologically speaking. I think it is more likely that women's behavior is interpreted differently from men's behavior. There are studies that support such differences in perception, which are primarily informed by societal and personal biases regarding gender.

gothceltgirl
10-01-15, 10:26 PM
I feel very much that this happens to me and my BFF all the time. I am not taken seriously by a wide variety of doctors. I get discouraged every so often and swear off doctors alltogether. They treat me, continuously, like it's all in my pretty little head.

No matter how serious and matter of fact I am. I come in with lists of symptoms and typed up info for them, which of course they don't even read or look at. I try to be as forthcoming and complete as I can be, yet still no joy.

I'm thinking that I'm going to try one more time w/my PCP and make him listen and also clear up a few things which I should've clarified before, but didn't. You know sometimes you leave and you say to yourself "I didn't say blank! Or I forgot to tell him such and such..." It always happens. No matter how prepared or thorough I am. And w/AD(H)D on top of that. Even the best of minds at the best of times have trouble remembering what to say to the doc.