If you’ve ever left a doctor’s appointment feeling like you weren’t quite believed, heard, or were handed a pamphlet on “stress management” (the modern day equivalent of telling women they’re “hysterical”), you are not imagining things.
The truth is, women are statistically more likely to be dismissed by doctors— especially women of color.1 This gender bias in medicine has a long and ugly history; but thankfully these days we’re talking more about it, so women can be empowered to stand up for ourselves in the doctor’s office.
The Very Real History of Gender Bias in Medicine
For most of medical history, women’s bodies have either been completely ignored or treated as smaller, weaker versions of male bodies. In 1977, the FDA issued guidelines broadly excluding women of childbearing age from early-phase clinical trials, meaning, medications, and even important safety products like seatbelts were never tested on women’s bodies for dosing or safety. This policy that wasn't reversed until 1993, when the NIH Revitalization Act finally mandated their inclusion.2
Even now, this gap hasn’t closed. As recently as 2019, women accounted for only about 40% of participants in clinical trials for diseases that disproportionately affect them.3
And so of course, this shows up in the exam room. Studies consistently show that women are more likely to wait significantly longer in emergency rooms and are less likely to receive adequate pain medication.4,5
Conditions that specifically impact women like PCOS, endometriosis, and recurrent BV are frequently minimized or go undiagnosed for years. In fact, according to the University of York, the average time to diagnose endometriosis is about seven years.6
Let’s be clear: This isn’t about demonizing doctors. Many doctors are extraordinary and truly go the extra mile to listen to their patients. Studies show female doctors in particular spend more time with their patients, communicate more effectively, and deliver measurably better outcomes.7 But still, even amongst the best doctors, when there is systematic gender discrimination going on, it can feel like an uphill battle to be heard.
What Medical Gaslighting Actually Looks Like
Medical gaslighting isn’t always dramatic. Sometimes it’s so subtle you may not notice it until you’re halfway home; or perhaps not even until years later and you’re reading a blog post about what it actually looks like.
So here are some ways it can show up:
- Being told very painful periods are “just part of being a woman.” (They’re not and they could be a sign of something like endometriosis.)
- Recurring UTIs or BV being treated in isolation, rather than the root cause being investigated.
- Vaginal dryness being dismissed as minor, even if it is significantly impacting your quality of life.
- PMOS symptoms like irregular cycles, weight changes, excessive facial hair growth, and insomnia being written off as lifestyle issues.
- Having all the early signs of perimenopause— increased anxiety, insomnia, night sweats, vaginal dryness, changing libido— and being told “you’re too young.” (Remember, perimenopause can start in your 30s!)
- Being told you just need better sleep hygiene when you’re already doing all of the things, and you still wake up every night at 3 AM.
- Being told your pain or your symptoms are just in your head.
- Or that it’s "Probably just PMS.”
If any of this sounds familiar, keep reading.
How to Come Prepared
If you’re dealing with a health issue and not feeling heard, you might try walking into your next doctor’s appointment with a symptom log. Write down:
Duration: When did this start?
Frequency: How often does it happen?
Severity: On a scale from 1 to 10, how painful (or disruptive / itchy / insert appropriate adjective) is it?
Pattern: Does it seem to correlate with what you eat? Your menstrual cycle? Stress? How you sleep?
What you’ve already tried: Medications? Supplements? Lifestyle changes?
How to Push Back (Without Burning a Bridge)
Let’s just start by saying that the “without burning a bridge” parenthetical is only relevant if you like your doctor and want to stick with them. If you find that your doctor consistently dismisses you and you don’t like them, by all means, find a new doctor!
But here are some things you can say to advocate for yourself even with the best of doctors:
- “I want to make sure I understand. What makes you rule out X?”
- “I’ve been tracking this for [X amount of time] and it’s consistent. I’d like to explore further.”
- “What would need to be true for additional testing?”
- “I’d like this documented in my chart.”
- “Something isn’t right, even if my labs are normal.”
- “I’d like to explore a second opinion. Who do you recommend?”
When To Ask for a Referral
If you’ve seen your PCP multiple times for the same issue without any resolution, or if your symptoms are complex, chronic, or significantly impacting your life, it’s probably time to ask for a referral to a specialist.
If you suspect you have PMOS, you can ask for an endocrinologist or reproductive endocrinologist. For endometriosis, a gynecologist who specializes in endometriosis and / or minimally invasive surgery.
For recurrent infections like BV or UTIs, a gynecologist or urogynecologist may be appropriate. You are entitled to ask, and a good doctor will support you in doing so.
