Research bolsters evidence that gender inequality hinders access to healthcare; expert says bias leaves women seen as ‘whiners’
When they hear a Pain without an apparent cause and go to the emergency room, women do not receive the same treatment as men in a similar situation. They are asked less about the intensity of the symptom, measured using a scale, they wait longer consultation and receive fewer prescriptions for pain medications.
The conclusion comes from a study with over 20 thousand medical records from hospitals in the United States and of Israel. The results were published in the scientific journal Proceedings of the National Academy of Sciences.
Although it was conducted in other countries, the research reflects a reality that is also observed in Brazil, according to Telma Zakka, a chronic pain specialist at the Brazilian Society for the Study of Pain (SBED). “Assessing pain is a very difficult thing. I have to believe what you tell me, because I can’t measure it,” she says.
She explains that, unlike, for example, fever, which is measured by the patient’s body temperature, pain is subjective. “It depends on the other person to believe in their own subjectivity,” she says. For her, the study’s results reinforce the devaluation of women’s complaints.
Strengthen the evidence
The findings are not new. Previous studies have already highlighted the disparity in emergency medical care for pain depending on the patient’s gender. Evidence shows that women suffer from abdominal pain in hospitals less likely to receive painkillers. Those with chest pain have greater difficulty in obtaining an adequate diagnosis and treatment for a heart attack compared to men.
For Telma, there is a deep-rooted prejudice against women reporting. “From the beginning, women have been given the right to suffer, to complain and to feel pain,” she says, exemplifying the fact that girls, when they fall, are welcomed by their parents, while boys are encouraged not to show pain.
Furthermore, the SBED specialist emphasizes that women suffer from greater hormonal fluctuations than men. Especially in the premenstrual period, this leads to a greater sensitivity to painful stimuli. “There are also much more widespread pains in woman that in man, as migrainefibromyalgia and irritable bowel syndrome,” she says.
Finally, it highlights the fact that women are more affected domestic violence. “Women have a lot more painful conditions,” she analyzes. This can lead to a greater demand for health services, which fuels prejudices against reporting symptoms. “They see women as complainers,” she summarizes.
As a result, many patients do not receive adequate treatment. Prejudice can lead, for example, to women being prescribed antidepressants instead of painkillers. In the emergency setting considered in the new study, diagnostic error can lead to death.
Differentiated treatment is not exclusive to the pain zone. The call Female hysteria, for example, was used as a diagnosis for a wide range of symptoms reported by women.
It is not surprising that the Pan American Health Organization sees gender inequality as a limit access to health serviceswhich contributes to preventable morbidity and mortality rates.
Necessary changes
According to new research, bias was observed in the care of both male and female healthcare workers, demonstrating that gender stereotypes influence behavior in general.
For Telma, this shows how the problem lies in the training of those who take care of patients. “Healthcare workers – not only doctors, nurses, physiotherapists, psychologists – need to have this different perspective on women, yes,” she says.
She believes it is important for undergraduate and graduate students in health care to be introduced to the study of pain, as all specialties address the problem. For the physician, this can improve the professional ability to listen and understand patient reports, which is essential for an assertive diagnosis.
“When you interrupt a patient’s complaint, it rarely comes back to the same point (in the report). And so you lose the opportunity to make a good diagnosis,” he concludes.
Source: Terra
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