Women, especially women of color, are often dismissed and ignored by healthcare providers. In this HealthyWomen article, Mindpath Health’s Tiffany Gishizky, PMHNP-BC, DNP, explains how to self-advocate when you feel unheard.
Christine Topham nearly died while giving birth when she was 33 years old. She needed an emergency hysterectomy, but her healthcare provider never fully explained the seriousness of the surgery to her.
“Before I could even get my head around what it would mean to have no uterus, the doctor said to me, ‘Don’t worry — your husband won’t notice any difference,’” said Topham, now 65.
The healthcare provider seemed more concerned with her husband’s sexual experience than the physical and emotional toll Topham was facing, especially with the sudden loss of her fertility.
Mashon Thomas, 38, had opposite fertility goals but a similar experience. At age 25, Thomas knew she didn’t want to have children and asked a healthcare provider about permanent birth control options.
“Instead of being given my options as an adult — old enough to drink, smoke, vote and go off to war — I was flat out told by a male doctor that any permanent options were unavailable for me,” she said.
Thomas’ healthcare provider assumed she would change her mind.
“I was asked to think about ‘What if I met a man who wanted kids?’” she said. “As if I couldn’t make my own decisions with my own body.”
Dismissing women’s concerns is not a new problem, said Tiffany Smith Gishizky, PMHNP, psychiatric nurse practitioner at Mindpath Health.
“For centuries, women who reported symptoms were told they were being hysterical,” she said. “Unfortunately, this problem persists today, with women being told that their symptoms are ‘all in your head’ or due to hormonal variations, resulting in genuine and potentially severe conditions being overlooked or delayed.”
The consequences can be dire. A 2018 study showed that more than 5 out of 10 women who went to the hospital with a heart attack reported that their healthcare provider didn’t see their symptoms as heart-related, compared with less than 4 out of 10 men.
“The longstanding and misguided belief that women are excessively emotional is one reason why the healthcare industry has a record of invalidating and disregarding women’s concerns even today,” said Judith Leitich, FNP.
There are more practical causes as well, according to Barb Dehn, R.N. “I don’t think any healthcare provider goes into the profession thinking they will dismiss or minimize their patients,” she said.
But, Dehn said, many healthcare providers have 15 to 20 minutes with each patient, not enough time for in-depth interactions — and listening takes time.
Lack of diversity in research and training hurts women
A lack of data on women’s health is another factor that may lead healthcare providers to dismiss women’s symptoms.
“Most medical research and training are on men,” Gishizky said. “Society is just now shifting the focus to include sex and gender studies, and that a ‘one-size-fits-all’ database is inadequate.”
The lack of diversity in clinical trials also extends to race, which may help explain extensive evidence that women of color are often less likely than others to be diagnosed with or treated for legitimate medical conditions.
A recent survey from the Pew Research Center found that 71% of Black women ages 18 to 49 said they have had at least one bad healthcare experience, such as feeling a healthcare provider didn’t take their pain or women’s health concerns seriously, compared to 58% of all adults.
“The [lack of access] to high-quality healthcare facilities, elevated rates of maternal death, reduced rates of preventive care and exceptional health complications related to their ethnicity escalate the likelihood of insufficient medical care, leading to more erroneous diagnoses,” Leitich said.
Leitich said improving the healthcare system starts with more diversity in leadership roles. We also need more support for women’s health conditions and resources to address the health disparities among women of color.
What to do if your doctor dismisses you
If you don’t feel like you’re being heard or taken seriously, it’s important to know that you can advocate for yourself. That can be easier said than done, especially if your doctor ignores your pain or can’t diagnose you. But experts urge women to take charge of their health.
“It is important to trust your instincts,” Gishizky said. “If you feel something is wrong and you’re not being heard, speak up. Be persistent. If you still feel dismissed, find a new provider or a second opinion.”
As a younger woman, Thomas didn’t fully understand or know how to exercise her rights, but her early negative healthcare experience still influences her today.
“I’ve learned and grown from that experience — although it took me years — that I must always stand up for what I believe no matter what a doctor tells me,” Thomas said.