You’ve heard of the gender pay gap, but what about the gender pain gap? Or the gender research gap? That's right, despite all the progress that’s been made on the road to equality, there are still a bunch of gaps letting everyone, aside from cis-men, down when it comes to the most important areas of our lives - our health. But where do these gaps come from, and what can we do about it? Let’s do a Lunette deep dive.
*Please note that throughout this article, we reference ‘women’ to make points about historical bias, but we acknowledge that many of the people impacted by these ‘gaps’ do not identify as female.
What is the gender health gap?
We know that misogyny impacts most areas of society, but you’d like to think that things based on facts (like science, medicine, and academic research) might escape the patriarchal nightmare. Well, unfortunately, that’s not the case!
The truth is that your gender can hold you back from getting the medical care you need and deserve. This can be even worse if your gender intersects with another factor such as race or class or if you are part of the trans community. Here are some of the scary facts that highlight the reality of the gender health gap:
- Women are 25% less likely than men to receive pain relief.
- Women are 50% more likely to be misdiagnosed when having a heart attack.
- Black women are 5 times more likely to die in childbirth.
- Conditions like endometriosis are constantly misdiagnosed and it can take up to 12 years to get a conclusive diagnosis
The reasons the gender health gap exists are complex and layered - and go back thousands of years!
The gender health gap herstory
To understand where we are now, it’s important to look back - way, way back. From the start of civilization, people with uteruses have been confusing the hell out of supposedly very intelligent men. Even Aristotle, the man many see as the father of modern medicine, once described the female body as “a mutilated male.” Wow.
This total disregard for the incredible complexities of the female body is something that continued through the ages. Rather than do the research, doctor’s would blame symptoms like fatigue, anxiety and sexual desire on our wombs ‘wandering’ around our bodies. Later, these (very normal) symptoms of our menstrual cycle would be labeled as ‘hysteria’ a mental disorder (interestingly only associated with women) that could land you in an asylum.
It wasn’t until the early 20th century that doctors started to understand the endocrine system - and (finally) our hormones and menstrual cycle and yet the label of hysteria was still used well into the 1980s!
All this means that whilst men have been at the center of medical research for millennia, we’ve only been investigating the female body accurately for the last 100 years - aka we’ve got a lot of catching up to do!
Mind the research gap
We’d love to tell you that things changed dramatically once doctors got their head around the endocrine system and our hormones finally got their time to shine. However, the truth is that it actually put another blocker in our way.
The guys in charge felt like hormones and our menstrual cycles would introduce ‘too many variables’ into medical trials and therefore research should solely be focused on men. This didn’t change until the early 90s when the FDA finally decided that women should be included in clinical trials - by which point nearly another century had passed of research being based on the male body.
The assumption at the time was that male and female bodies were only different when it came to our sexual organs and women were “just men with boobs and tubes,” as Dr. Alyson McGregor puts it in her incredible book on male centric medicine. If that’s your thought process, it makes sense why people thought it was totally acceptable to leave women out of research.
This narrow minded assumption explains why the world we are living in is designed for men - from the size of our phones to the standard temperature of office air con. But whilst these are (seriously annoying) issues, they aren’t life threatening. However, some of these errors definitely are.
The cost of the gap
There are so many examples of the gender research gap putting women at risk - and that’s before we even get into reproductive health. From cars being tested for safety using crash dummies based on the average male body, to women accidentally overdosing on Ambien because the dose was based on male focused medical trials, the list is long and scary.
So it’s clear that dangerous issues arise when women are left out of medical research, but what about conditions only impacting people with female reproductive organs? What research gets done then? The answer, sadly, is very little. This is down to a combination of bias and lack of funding (which spoiler alert, is still attached to gender bias).
Less than 2.5% of publicly funded research is dedicated to reproductive health, even though one in three women will suffer from a gynecological problem at some stage of their life. Even pregnancy, the one area of reproductive health not shrouded in shame and stigma, doesn’t escape the disparity. American research shows that although 10% of women become pregnant each year, just 2% of funds is spent on pregnancy research. Here’s a fun statistic for you. There is five times more research into erectile dysfunction, which affects 19% of men, than into PMS, which affects 90% of women. Not cool at all.
The pain of unconscious bias
A gap in research and a lack of funding create a perfect storm for women to be underserved in healthcare - but is their classic sexism at play too? Potentially.
According to a study written in The Journal of Pain, gender does matter when it comes to the perception of pain in a medical situation. In the study participants were shown video footage of men and women in pain. The women were more often dismissed as exaggerating their pain, whereas the men were taken seriously - and prescribed painkillers in most cases. This bias is even worse when we look ethnic backgrounds - and particularly black women. A study of white medical students found that over half of them believed that black people have a higher pain threshold compared ot white people. And this was in 2016…
These stereotypes are one of the key reasons so many women struggle to get the support they need when it comes to painful periods or other gynecological conditions. A staggering 90% of people suffering with endometriosis report being disbelieved when telling people about their symptoms.
What can we do?
This all might sound a little scary - and that’s because, to be honest, it is! However things are starting to change and there are ways you can support a cultural shift and also protect yourself from the impact of the gender health gap.
- Donate - to causes that are dedicated to researching medical conditions impact people with female reproductive organs. The World Endometriosis Research Foundation and Wellbeing of Women are great places to start!
- Read - Knowledge is power when it comes to these things! Learning more about the gender health gap will help you call it out. We love ‘Sex Matters: How Male-Centric Medicine Endangers Women’s Health—and What We Can Do About It’ by Dr. Alyson McGregor and Invisible Women: Data Bias in a World Designed for Men by Caroline Criado-Perez
- Use your voice! - Nobody knows your body better than you, use your voice and your power to advocate for yourself in medical situations and challenge the bias you may face. It can be tough and intimidating at first but you can do it!