Gender-Based Health Inequities--The Gender Health Gap

Author: Tarannum Rehal

People Interviewed: Esa Ahmed (4th Year Integrated Biomedical Sciences student at McMaster University) and Aniela Singh (3rd Year Chemistry student at Ryerson University)

Women and their bodies have been worshipped by numerous societies for centuries. However, as the majority of historical texts and medical findings were recorded under circumstances determined by men, it is evident that there exists a bias when we as a society, including healthcare practitioners, perceive, diagnose, and prescribe treatment to women and their ailments (Learmonth, 2020). Physicians in ancient societies used male corpses for dissection and research as it was believed that the biochemical processes and fluctuations in hormones in women would result in significant deviations from those of men, which would lead to inaccurate consensus in their findings. A common medical diagnosis to many female ailments was then hysteria and would be given to women displaying symptoms of conditions ranging from fatigue, lightheadedness, insomnia, shortness of breath, and fluid retention.

Menstruation is a biological process that women have been experiencing since even before human beings fully evolved as a species. However, until the 19th century, scientists did not link periods to ovulation. Prior to this connection, female menstruation was associated with witchcraft, and until as late as the 1920s, medical professionals disconnected the physiological relation of periods to women’s reproduction; they instead believed that periods were how women’s emotions and tempers were regulated (Learmonth, 2020). Such narratives, especially when made by men, who typically tend to hold the upper hand in society, perpetuate ignorant ideologies against female healthcare research and why there is a lack of desire, as well as an unconscious bias, by both male and female physicians to tackle the taboo surrounding female bodies and their specific ailments despite how far we may have progressed in overall healthcare.

In my interview with Esa Ahmed and Aniela Singh, we discussed how men have been viewed as the standard in medical industries for centuries, current challenges in the gender health gap, how race also affects disparities in healthcare, and ultimately how we can overcome these stereotypical biases and challenges.

Question 1: The male body and masculinity have been the industry standard for centuries. Evidently, we can agree that this results in a bias towards and misdiagnosis in women for general, as well as women-specific, ailments. How do you think or suggest that we as a society can work to better understand the female anatomy and its mysteries to tackle these disparities?

Esa: I definitely agree that men are often taken to be the default due to the patriarchy that has clearly served as a foundation since ancient civilizations. Not only does the gender health gap affect ailments that both genders experience but it also limits the amount of research that goes into some conditions exclusive to individuals who are biologically female or even identify as female. For example, endometriosis is a condition that exclusively targets people with uteri. However, there is still a very limited amount of research conducted regarding these female-exclusive conditions which lead to many people suffering from this every year. I don’t think there is a simple solution to this problem; there will always be a covert stereotype that women are exaggerating their pain. Bringing this to light and exposing it for the discriminatory practice that it is would certainly help to address some of these healthcare inequalities. Otherwise, ensuring that patients have the option to see either a male or female-identifying doctor would also help ensure the patient’s healthcare status is accurately diagnosed.

Aniela: Going off of what Esa said, there’s a common stereotype that states that women are too emotional and we have sensitivity issues. “Hysteria” is what people diagnosed us with back in the day for displaying even the most basic symptoms of what could have been a serious medical condition. This evidently reflects the way average folk and medical professionals, regardless of if they are male or female, perceive and understand female physiology and psychology. I feel like when it comes to diagnosing mental health, we’re more likely to be treated for depression automatically since we’re so “sensitive and weak.” In a way, being over-treated for mental health disorders, it’s invalidating our actual health and other complaints and issues. And as you mentioned, it’s actually crazy to think that despite all the otherwise tremendous progress we have made in medicine over the years, there is still a lack of desire to understand the root of sexism in medical practices, especially since those ideologies are centuries old and we should theoretically be more advanced when tackling such disparities. Yes, I agree that men and women may display or experience different emotions due to hormones, but I don’t think that it makes them fundamentally biologically different from one another in terms of basic biological processes.

To add on, pain related to female menstruation and childbirth still have many misconceptions to this day. Of course, I believe that women are divine creatures, but the idea that women are necessarily by default more tolerant to pain because of their natural biological processes, which has been passed down from generation to generation, does not really sit right with me.

Aniela: Yeah exactly! I feel like our pain management isn’t taken seriously at all! While other women still tend to be considerate and understanding, I’ve noticed that men just think that we should be “used to it," or we should be expecting this level of pain due to our menstrual cramps and pregnancy/ childbirth. Yes, of course, the pain is natural and almost certain during these processes, but that doesn’t mean we should just be “used to it” and not have our concerns about pain taken seriously. Each person still has varying levels of tolerance towards pain. I wouldn’t be surprised if a woman came in one day with chronic pain and it was easily dismissed with the assumption that she’s on her period or it’s just cramps.

I’ve actually also heard in many societies and cultures, women, during childbirth are discouraged or completely denied access to an epidural because the pain is what defines them as a woman. Taking epidural or other sedatives and painkillers is looked down upon since it would “take away from a woman’s femininity."

Question 2: As greater volumes of physicians and nurses are females themselves as we progress in healthcare, do you think this gap in gender health is shrinking? If not, what do you think is preventing this gap from being closed up for good?

Esa: I definitely think having more women-identifying individuals in medicine would work and is currently working to help narrow this gap. Having more women in medicine gives women an opportunity to amplify their voice over concerns and issues that affect them today even in our current healthcare system overall. Having people advocate for women’s issues as they themselves may have experienced, or are at risk for, would help better complete the global healthcare perspective and better inform healthcare decisions in a way that’s equitable for all genders. The main thing that prevents this gap from being permanently closed up is the lack of research and education on these topics, especially in developing countries and regions where sexism is embedded in the culture.

Aniela: I feel like raising public awareness is the first step. The gap in gender health is not a very known concept to the general public or something that we think about frequently, and medical practitioners might not even consciously aware that the system still perpetuates these disparities. Doctors and nurses can vouch for their patients through nonprofit organizations, and even raise awareness in their workplace on how these inequalities can be tackled.

Question 3: Do you think there is a disparity in the healthcare system between people of different ethnicities in the same way that there is with gender? How do you suggest we can improve this to make healthcare more accessible?

Aniela: I do think that there is a disparity in the healthcare system in the same way. In terms of ethnicities, I am aware that there is often a bias present based on stereotypes and racism. I’ve noticed that people of color, and dare I say minorities, have received less medical attention and care. For example, it is a very common misconception that BIPOC individuals, and since we’re talking about gender in specific, BIPOC women, have a greater pain tolerance than white people and that their overall immune systems are stronger. These misconceptions are brought to reality more often than people think and have actually affected BIPOC individuals at a disproportionate rate, particularly during the COVID-19 pandemic. These racial prejudices and biases ultimately put BIPOC individuals at a great disadvantage, which negatively affects their mental health, their finances, and of course, puts further strain on their medical conditions. Education and awareness on the issues and concerns that BIPOC and other minority communities encounter is a great step forward in addressing the inequalities, especially in healthcare, especially during this pandemic. And social media has proven to be a great tool in the past year alone to amplifying the voice of these communities on various medical and social issues.

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Although I was aware that women and people of color overall experience inequalities in healthcare, the concept of gender health gap was new to me. I enjoyed reading through various articles and resources to further understand how this disparity has been passed down to our current society from centuries ago and still exists despite the otherwise great advancements we have made in healthcare.

Thank you Esa and Aniela for taking the time to participate in this interview and share your thoughts, as well as engaging in a very thought-provoking discussion with me.

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Sources:

https://thred.com/change/the-gender-health-gap-why-womens-bodies-shouldnt-be-a-medical-mystery/.

https://www.medicalnewstoday.com/articles/racism-in-healthcare#how-racism-impacts-health

https://www.womenshealthmatters.ca/feature-articles/read-articles-about/The-Health-Gap

https://www.bbc.com/news/health-56300404

https://plato.stanford.edu/entries/beauvoir/