The Gender Health Gap – and what to do if you’ve fallen in

The Gender Health Gap and what to do if you’ve fallen in

Have you ever been to a doctor who hasn’t believed you when you’ve talked about your symptoms – or told you they’re normal, or not that bad – or even that they’re all in your head?

Well, if you’re female, you’re not alone.

8 out of 10 women in the UK feel they’re not listened to by healthcare professionals – victims of what’s become known as the gender health gap. The gender health-gap describes the institutionalised sexism within healthcare, and the poorer service and outcomes women get as a result. The UK is thought to have the largest female health gap among G20 countries, and the 12th largest globally, with millions of women falling through it every year.

At the end of 2021, the UK government not only recognised the gender health gap but set out a clear ambition to close it. Its Vision for Women’s Health strategy was published after analysis of almost 100,000 responses to a call for evidence - and sets out key government commitments which recognise the system-wide changes needed to tackle the issue.

What does systematic discrimination in healthcare look like?

1. Normalising ‘women’s issues’

Society as a whole, and therefore the medical world, has a pre-conceived idea that things like heavy bleeding or severe period pain are ‘normal’, or that menopause symptoms, contraceptive side-effects and even birth damage are things that women ‘just have to put up with’.

These deeply embedded attitudes stop women seeking support in the first place - and often stop them getting either sympathy or effective support.

It also contributes to the gender pay gap, as these issues affect workplace participation and outcomes. In fact, workplace support is one of the themes of the new Vision for Women’s Health strategy.

2. Not being believed

80% of women feel medical professionals haven’t listened to them – or haven’t believed them.

One of the places that’s been most obvious is in the various medical scandals that we’ve seen over recent years. A recent inquiry found consistent denial of women’s concerns contributed to decades of avoidable harm. The damning report found serious medical complications were simply dismissed, including from now largely banned vaginal mesh devices, hormonal pregnancy tests, and an anti-epilepsy medicine that harmed unborn babies.

In all three cases, the women involved routinely had their symptoms attributed to ‘women’s problems’ or ‘psychological issues’.

3. Being called hysterical

The word hysterical comes from the Greek word for womb, and has been being used to undermine women’s experiences for hundreds of years – according to Caroline Criado Perez, author of the award-winning book Invisible Women.

As a result, women are more likely to be disbelieved, particularly about their levels of pain, and black women are even more likely to experience what’s known as pain bias.

4. Pain bias

 Research shows that when it comes to pain, men and women are treated differently.

Women in emergency departments are less likely to be taken seriously than men, and routinely get prescribed less pain medication than men after identical procedures. It’s the same reason that it can take so long for a painful condition like endometriosis to be diagnosed – 7 to 8 years on average, with 40% of women needing 10 or more GP appointments before being referred to a specialist.

5. Being unrepresented in medical research

Women are more likely to be misdiagnosed and over or under medicated for the simple reason they are underrepresented in medical research.

They are excluded from both clinical studies and drug trials because of unfounded concerns around hormone fluctuations - or concerns about the impact on a possible pregnancy, meaning we literally know less about female biology.

It's why the classic symptoms for a heart attack are for a male heart attack – and often miss out the slightly different first signs of heart attacks in women, who tend to seek treatment later and get poorer outcomes as a result.

6. Poorer outcomes

When women consistently get different, and poorer, outcomes than men, it’s clear there is gender bias at work somewhere.

At the beginning of this year, it was reported that women are 32% more likely to die after an operation by a male surgeon, than if the surgeon is female.

Women, who are more likely to suffer from dementia, also have fewer GP visits, receive less health monitoring and take more harmful medication than men do.

What to do if you feel you’ve fallen down the gender health gap

 If any of this sounds familiar, you might have fallen down the gender health gap. We spoke to Operations Director Rhonwen Beesley about what to do next. She says: “It’s not okay for anyone to have their health concerns disregarded - or to be made to feel stupid because they don’t feel well, or they just don’t feel quite right. So here are six practical things you can do about it.”

1. Make noise

 “Too often as women we’re trained to be the peace-keepers, to be nice, to be kind, to be polite, to be quiet. If you’re not getting what you need from your GP it is time to make some noise!

“Refusing to be dismissed isn’t being awkward or rude, it’s advocating for yourself. Just because they’re wearing scrubs doesn’t mean they know more about your body than you do.”

2. Prepare for your appointment.

“If you’re ill, you’re already vulnerable – and that’s when it’s often hardest to be assertive.

“I find it’s a good idea to write down exactly what I want to tell my GP – I’ll even take my notes in with me. You need to make the most of your 10 to 15 minutes, and you don’t want to forget any symptoms or information you think they need to know.

“It can be also helpful to take a trusted person along to the appointment with you. Yes, it’s personal, but having someone else there can help you feel more confident, and help you listen to, remember and understand the options or answers your GP is giving you.”

3. Ask to see a different GP

“If you’re not happy with the answers you get, ask to see another GP. It’s okay to want a second opinion. It’s okay to come back with the same problem if it’s not getting better.

“GPs are just people, like the rest of us, who have good and bad days. And they are under an awful lot of pressure, right now. Please don’t take it personally - but don’t take no for an answer either! Try again with someone different.”

4. Insist on a referral

 “Ask directly for a referral to a specialist department. You don’t need to wait for the GP to suggest it. Don’t be afraid to be direct.”

5. Use your health plan

“If you have a private health insurance plan, now is the time to use it. With an Equipsme plan, you can call our GP helpline 24/7 and book a telephone or online appointment at a time to suit you (subject to availability). It’s a great way to get a completely fresh eye on your situation or condition.

“If diagnosis and treatment are part of your Equipsme plan you can ask the GP for an open referral letter, refer all the details to AXA Health who will assess if your claim is covered, and if so have an appointment with a specialist privately often within a matter of days. Please refer to your plan details online and your Membership Handbook to find out what is and isn’t covered.

“The Vision for Women’s Health strategy includes recommendations for more education and training, more data collection, and more monitoring. Now the gender health gap has been officially recognised, I hope we’ll see it start to narrow. But in the meantime, if you’re  unfortunate enough to fall into it, that’s what Equipsme is there for – and it may just be able to help you climb back out. Please don’t hesitate to use it.”

Resources 

lordslibrary.parliament.uk/womens-health-outcomes-is-there-a-gender-gap/
www.theguardian.com/society/2022/jan/04/women-more-likely-die-operation-male-surgeon-study
www.standard.co.uk/futurelondon/health/gender-data-gap-caroline-criado-perez-on-how-healthcare-is-systematically-discriminating-against-women-a4246221.html
www.gov.uk/government/news/government-sets-clear-ambition-to-close-gender-health-gap--3
www.womenshealthmag.com/uk/health/female-health/a38599769/gender-health-gap/
www.theguardian.com/society/2020/jul/08/denial-of-womens-concerns-contributed-to-medical-scandals-says-inquiry
lordslibrary.parliament.uk/womens-health-outcomes-is-there-a-gender-gap/
www.bbc.co.uk/news/health-56300404
www.theguardian.com/society/2021/dec/23/finally-the-uk-has-noticed-its-rampant-sexism-in-healthcare-what-now
www.rcog.org.uk/en/news/rcog-calls-for-government-action-to-tackle-racial-inequalities-in-womens-healthcare/
www.bbc.com/future/article/20180518-the-inequality-in-how-women-are-treated-for-pain
carolinecriadoperez.com/book/invisible-women/
www.theguardian.com/science/2016/aug/10/black-patients-bias-prescriptions-pain-management-medicine-opioids
www.womenshealthmag.com/health/a35483492/racial-bias-pain-assessment-management/