Disclaimer: In this article, I make frequent references to female bodies, using the term “woman.“ I am using the term ‘woman’ in a biological sense, referring to all people with female anatomy. It is important to recognize all people with female anatomy can be subject to such discrimination, not just cis women. Essentially, it’s a mixture of biological sex and gender expression that play a role in forming the gender pain gap.
We’ve all heard of the gender pay gap. It is the notion that gender significantly impacts how much money you earn and your likelihood of getting hired. However, this same gender discrimination, in fact, extends to a variety of other factors in women’s lives. The one I want to bring to attention here is the “Gender Pain Gap.” This refers to how gender and biological sex impact the quality of medical care we receive. The term also seeks to show how the historic discrimination of women has led to a gap in data and knowledge surrounding the female body. This gender bias is one that is so ingrained into our society that it often goes unnoticed.
Female pain has been frequently dismissed and downplayed by the medical community, often described as a ‘normal part of womanhood.’ Black women and women of color have been particularly impacted by this. Unconscious bias and a fundamental lack of research throughout history have led women to be misdiagnosed, neglected, and even prescribed the wrong treatment. This can have dangerous and often fatal consequences; it is essential that this gender bias does not continue to go unchecked.
So, where does the gender pain gap begin?
Throughout history, it has been assumed that there is not anything different between the female and male bodies besides reproductive organs. This assumption means that medical education has been largely focussed on a male ‘norm’ for hundreds of years. This ‘male default’ can be traced back to the ancient Greeks. That is where the female body was seen as a kind of ‘mutilated’ male body. Aristotle, for example, described the female body as the male body “turned in.”Such ideology provided the foundations for the gender pain gap. Of course, this terminology has long been abandoned, but using the male body as the model for the human body is still happening- just look at your standard anatomy textbook and see who is on the cover!
Another crucial factor that has helped to form the Gender Pain Gap is the exclusion of women from clinical trials. Since the male body has been used as the model for the human body for many years, a lot of medical research places the male body as its subject. It was believed that hormonal changes could disrupt the data.
Therefore researchers banned women of childbearing age from being included in clinical trials. This is true in the US, Europe, and Canada until the 1990s. It has been argued that female bodies are too complex, making it too costly for them to be tested on. This means there is a gap in knowledge and data surrounding how present pain and the side effects of drugs are impacted by the menstrual cycle. A 70kg white man has been the model used in clinical trials for decades. This means that a large amount of medical evidence is based on male physiology.
To quote Caroline Criado Perez and her book ‘Invisible Women,’ “these are not isolated rogue doctors, bad appeals that should be struck off. They are the products of a medical system which, from root to tip, is systematically discriminating against women, leaving them chronically misunderstood, mistreated and misdiagnosed.” (Invisible women, 2019). So, the gender pain gap is by no means due to individual medical professionals working in a biased manner. Rather, it is the product of this historical discrimination. This is evident in the exclusion of women from medical research and education, which has had a knock-on effect.
Some facts and statistics
Lets look at some of the facts and statistics which serve as evidence for the Gender Pain Gap.
- A US Government study found that 8 in 10 of the drugs taken off the market between 1997 and 2000 posed a bigger health risk to women.
- A 2015 review found that 79% of pain studies used only male mice.
- Important information regarding side effects and dosage of many drugs (paracetamol and ibuprofen) were never tested on women.
- A 2016 review of the inclusion of women in US HIV research found that women made up only 19.2% of participants in medical trials.
- 70% of chronic pain suffers are women (due to conditions such as endometriosis). However, 80% of chronic pain study participants are men.
- A 2014 paper found that of studies on female prevalent diseases that specified sex (44%), only 12% studied female animals (Perez, 205).
- Heart disease is one of the main causes of death for women. However, the criteria for diagnosis are based only on the symptoms experienced by men. Women are 50% more likely to be misdiagnosed when they have heart disease.
So, why do these statistics matter?
These statistics are important. This is because they show both how there has been a historical exclusion of women from medical research and that sex differences are substantial, despite what has been previously believed. Medical researchers have identified sex differences in every tissue and organ system in the body. Our heart, lungs, and cells all function differently depending on our biological sex. Continuing to carry out medical research with the opinion that biological sex ‘does not matter’ is profoundly misguided and dangerous.
This gap in research means that accessing appropriate treatment and medical attention is harder for women than it is for men. For example, on average, women are 50% more likely to be misdiagnosed when they have a heart attack. Since heart attack symptoms differ greatly for men and women, women are more likely to be mistreated, misdiagnosed, or told their pain isn’t valid. As you can see, the gender pain gap can be a matter of life and death. We, therefore, cannot afford to view the male body as the ‘default’ any longer.
Neuroscientist Jeffry Mogil wrote that failing to include both sexes in medical research “is not only scientifically idiotic and a waste of money, but it is also an ethical issue as well.”
Without reliable data, giving women sound medical advice is more challenging. This ignorance of sex differences is still happening today, leaving women misdiagnosed and mistreated, and dismissed.