Women’s Illness, Medical Bias, and Self-Gaslighting
It’s hard for me to admit, but for a very long time “not experiencing acute pain or illness” has been my definition of a good day. I feel knee-jerk embarrassment admitting to feeling unwell so often. Despite this, I have very rarely gone to the doctor in recent years. Then last week my symptoms of the moment landed me in Urgent Care, my first hospital visit in three years, where I was monitored for several hours, painfully and invasively examined, blood drawn, administered some symptom-alleviating drugs and graham crackers and sent on my way with the treatment plan of “no idea, but come back if you don’t get better.” It was only in 2011 in the European Journal of Health that a study showed that the reason women consistently rate their health worse than men do is that they in fact experience more chronic health issues. Not because of the conclusion long assumed by the medical community, that women merely overreport compared to men. We are steadily racking up new evidence that women’s pain is not taken seriously; not by employers, not by doctors, not by the general public. Women are less likely to be prescribed painkillers, and seven times more likely to be discharged from the hospital in the middle of a heart attack. This afternoon I have a follow-up appointment, a follow-up appointment I decided to make, that was not suggested by Urgent Care, despite the lack of resolution and severity of my symptoms. There is part of me that will feel embarrassed as I sit in the waiting room, reminding me that there’s probably nothing wrong, and it’s all in my head. Like many women before a doctor’s visit, while I wait I won’t be worrying about what might be wrong; I’ll be wondering how to be taken seriously and doubting myself that I even need to be. This weekend I emailed a friend who lives with chronic illness and has gone through her share of doctor’s appointments, to ask “How do you advocate for yourself without sounding like a hypochondriac?” She suggested being sure to share all the steps you’ve taken to take care of yourself and the issue (as to not sound like a helpless victim) while being honest that your symptoms are impacting your daily functioning. She encouraged me not to accept the end of an appointment without some kind of next step in place. This is excellent advice, and all I could think reading it was “I shouldn’t have to ask advice in order to get what I need from my doctor.” Abby Norman, author of Ask Me About My Uterus said in an interview this spring with the New Republic “Too often, a woman’s pain is not merely met with doubt, but suspicion, both within the medical community and outside of it.” It’s being met what that suspicion that I’m anxious about as I wait for my appointment. This wouldn’t be the first time I went to an office visit, and after being weighed and vitals taken, described my symptoms, only to be told I must be making a lifestyle mistake (too much coffee? not enough exercise? need more fiber? try yoga?) or alternatively that my ailments just weren’t as bad as I thought. It must be the tail end of a cold, or I was about to get my period, or I had seasonal allergies I wasn’t aware of. This is why I am gearing up for a fight, or at very least the need to present a persuasive and assertive argument, to get the treatment I need. And even as I write this, the programmed gaslighting blares away behind my rational mind “you don’t actually feel that bad, you’re exaggerating!” “you don’t take good enough care of yourself, if you feel bad it’s your fault!” “you just need to push yourself harder, not feeling well is just an excuse.” It’s been a lifetime of these voices greeting every illness and ailment, and it’s difficult not to give them credence.
It’s difficult to stay rational, and at times I nearly convince myself I am a hypochondriac, that my experience is not to be trusted. This kind of ‘self-gaslighting’ or cognitive distortion is not uncommon. The implication that women are not capable of accurately self-reporting pain and other health issues is deeply ingrained in all of us, even as women we often can’t take our own pain and illness seriously. It was only 66 years ago that the diagnosis of Female Hysteria was dropped by the American Psychiatric Association. We’ve been taught not to trust ourselves, which makes it challenging to get adequate care within a system that disputes or minimizes our every assertion of our need for treatment. How can we convincingly demand what we can barely assure ourselves we need? Almost every woman I know has had to fight for for her appropriate medical treatment, and I know many who have given up trying.
Today I did enough cardio that I had a sheen of sweat. I drank the appropriate amount of water and despite food aversion and nausea figured out how to eat the proper amounts of fats, carbs, and protein. I took ibuprofen. I got a luxurious 8.5 hours of sleep last night. Today was not unlike any other day, I’m just making a list to practice, for when I get to my appointment and I need to convince the doctor I’m doing everything I can, and I need some backup. Pin this for later: