Did it hurt? When you...
had to thank Biden reluctantly?
As a fresh New York transplant from Los Angeles, I listened to a lot of Childish Gambino.
Girl crying on Ludlow, she still looks good though. No one cares about pain when that pain belongs to a woman!
Pain is a universal language—an internal alarm alerting us about dangerous stimuli or changes in our bodies. The problem comes when healthcare professionals discredit, underestimate, or trivialize patient-reported pain based on gender. If you think I’m talking about gender bias as it relates to doctors ignoring women’s pain, you’re right. This is a health equity issue. We’ve come a long way, but historically, researchers viewed men and women as interchangeable in clinical trials and opted to study effects on male biology (for ease! Women are so complicated!). We weren’t included in US clinical trials before 1993 (we’re still v underrepresented, even lab rats skew heavily male!). The NIH didn’t ask researchers to consider sex differences until 2016. Women are not small men; we can’t extrapolate results from all-male studies. This blind spot permeates all aspects of healthcare. It means there’s less funding for diseases predominantly impacting women. Medical providers ignore and dismiss pain (chronic or acute), meaning women receive inadequate care vs their male counterparts. The data back this up.
A 2022 study in Journal of the American Heart Association examined ER visit data from 2014-2018 and found that women seeking care for chest pain were less likely to be treated with urgency, to receive electrocardiography, and to be seen by a consulting physician vs men. On average, women in the ER for chest pain had to wait 29% longer to be seen than men. Women’s pain is explained away as anxiety or mental illness. Women are more likely to be prescribed sedatives or antidepressants for pain management in lieu of appropriate treatment for the underlying cause.
Moreover, the dismissal of women's pain has serious consequences, leading to delayed diagnoses, exacerbated conditions, and even preventable deaths. It’s the reality of many women, including those with endometriosis, ovarian cancer, migraines, and TMJ. This is amplified for women of color. In fact, the father of gynecology experimented on enslaved black women without anesthesia to create modern gynecological tools and surgical techniques.
To add insult to injury, Forbes reported this week that patients (men + women) treated by women doctors have lower mortality and readmission (return to hospital after discharge) rates than those treated by male doctors. The results were even more drastic when zooming in on women with male vs female doctors. This isn’t the first study to prove this hypothesis. As the medical community opens its eyes to this reality, we can hope women’s pain is taken more seriously. Some of this comes from social media (have you also fallen prey to IUD insertion Reddit nightmare posts?), where medical providers and policy influencers are learning from patient stories.
What can you do? Advocate for yourself or others in a clinical setting and seek a second opinion if you’re not feeling heard. Find a gyno like my friend’s, who offers local anesthesia for IUD insertions if her patients want it. Trust yourself. We’ve all heard anecdotal stories from people who felt like something was off and found a brain tumor (Aria, look away), or were told they’d feel mild cramping during an IUD insertion, but instead passed out from stabbing pain. It’s true that some may only feel mild cramping during IUD insertion or colposcopies, but not all. The point is healthcare providers should take pain complaints seriously.
Where does Joe Biden come into play? In this State of the Union, Biden called for a $12 billion NIH investment in women’s health research and is flexing his executive powers (via executive order). He’s also called on the FDA to help address research gaps and treatment availability for conditions that disproportionately impact women. Among other actions meant to close gender healthcare gaps, the executive order also flags the need to standardize data collection, which could improve data sharing and analysis. This shows women’s health is at last a policy priority. I hope Congress agrees.
Somewhat related, but not: A win for privacy! The Biden administration strengthened HIPAA to ban insurers or health workers healthcare providers from revealing private information to law enforcement/for criminal investigations. For example, whether someone crossed state lines to seek a legal abortion. Republican prosecutors in abortion ban states want these deets to protect their abortion laws. If you’re wondering why the executive branch can do this, DM me to chat about admin law applications in public health. But essentially if something is happening across state lines, it’s likely under federal agency jurisdiction. This kind of bridges the last two health policy newsletters nicely.
It’s 2AM in Marseille, goodnight!
xxsem
Thank you! Let me know if there’s any health policy topic you’d like me to cover :)
love your insights on health and policy with your MPH writing style! very sincerely smart and chic. hope marseille is treating you well ❤️