Gender Bias in Healthcare 

By Reema Singh 

The statement “Health is for All” is not true after all. 

Stereotype-fueled gender disparities exist in all areas of life, and medicine is no exception. Gender bias affects multiple aspects of medical care, including diagnosis, treatment, research, and the interaction between healthcare professionals and patients. These disparities result in differences in health outcomes, such as life expectancy, mortality, and health status. Tackling these health disparities is crucial not only for promoting equity but also for enhancing the nation's overall health and economic well-being. 

History of gender bias in India

The history of gender bias in healthcare is rooted in a male-centric and male-dominated research approach, perpetuating stereotypes and assumptions about female health. In the 18th and 19th centuries, the term “hysteria” became a catch-all diagnosis to label any female sexual or emotional behavior that men considered “irregular” or “unwomanly.” This label significantly led to the forced hospitalization of women, a practice that persisted well into the 1980s. 

In terms of pain management, doctors continued to withheld pain relief medications during childbirth for decades even after use of anesthesia became available for surgery in the mid-1800s. They didn’t consider to use it as prevailing religious beliefs viewed pain during labor as a necessary suffering for women. Moreover, many physicians accepted maternal death as an inevitable risk of childbirth instead of adopting safer delivery practices, such as basic hygiene measures like handwashing between patients. 

Types of gender bias—gender blindness and gender stereotyping—although interrelated, affect healthcare. Gender bias in medicine can arise from the assumption of equality between men and women, disregarding real biological, pathological, or life experience differences. In other words, the healthcare professional is blind, either unintentionally or intentionally, to differences in how diseases manifest and progress in men and women, mistakenly treating conditions as if they are identical for both. However, gender bias can also stem from assuming differences when there are none, driven by fixed stereotypes about men and women. This "gender stereotyping" can hinder clinicians' ability to accurately observe and interpret clinical evidence, as they rely on preconceived ideas about a patient's condition based solely on gender. 

At present, these gender biases continue to impact healthcare in multiple ways, often detrimentally affecting patients’ health and well-being. 

Diagnostic and Treatment Bias: 

Gender stereotypes affect perspectives of doctors regarding treatment of illnesses and approach towards patients. Many healthcare professionals believe that women “exaggerate” their symptoms, thus women's pain is often taken less seriously than men's, leading to delays in diagnosis and treatment. A 2017 Guardian article aptly captured this stereotype as: “Men are silent stoics; women hysterical hypochondriacs.” Women are also more likely to be prescribed sedatives rather than pain medications, perpetuating the notion that women's symptoms are more “emotional” rather than physical.

In 2019, a study by Nature Communications examined health data from nearly 7 million patients in the Danish healthcare system over 21 years, finding that women were diagnosed later than men for more than 700 diseases. Additionally, doctors are also far less likely to recommend prompt treatment for heart disease and heart attacks in women. 

There’s also the persistent stigma surrounding female reproductive health issues. Because of this stigma, plus a general lack of knowledge of the menstrual cycle, you’ll find several stories about doctors dismissing severe pelvic pain as cramps and recommending over-the-counter pain medication. And in some cases, the actual source of the pain has been discovered to be conditions like endometriosis, ovarian cysts, and even cancer. 

Gaps in Medical Research: 

Historically, a vast amount of medical research has been conducted primarily on male participants or test subjects. However, the critical biological differences between the sexes can influence how diseases, drugs, and other therapies affect individuals. It wasn’t until 1990 that the National Institutes of Health (NIH) mandated the inclusion of women in NIH-sponsored clinical trials. Prior to this policy, we have a huge historical data gap when it comes to female bodies because women had been excluded from early studies of most drugs. 

In her 2019 book, Invisible Women: Exposing Data Bias in a World Designed for Men, British journalist Caroline Criado Perez highlighted the lack of health data specific to women. For instance, over a 15-year period, men outnumbered women by 3:1 in 31 clinical trials on congestive heart failure. Following this, the COVID-19 pandemic disrupted access to healthcare globally, and disproportionately affected women–worsening existing gaps. 

Addressing these gender biases

Despite known disparities in women’s healthcare and advocacy efforts, there is still a lack of patient-centred care for women. In clinical situations, it is important to consider whether the approach to diagnosis and treatment would differ if the patient were of the opposite sex. Gender issues should be incorporated early in medical education and included within specialized educational programs, helping students understand the effects of sex, gender, and bias on healthcare. 

Health organizations and researchers should commit to gender diversity in studies, investing in research to address knowledge gaps, particularly around women’s issues. By actively identifying biases and validating patient concerns, healthcare providers can work towards a more equitable system. 

In response to women’s exclusion from clinical trials, feminist advocates have promoted a new healthcare model where women engage actively in a broader range of health issues beyond traditional mental and reproductive concerns. As Sarah Moore observes, there’s been a shift: “femininity, once seen as an indication of sickliness, has come to be associated with healthiness, while masculinity is now deemed detrimental to health.” 

Men are not immune either

Although discussions on gender bias in healthcare often focus on women as well as transgender and nonbinary people, gender bias in healthcare also affects men. Mental

health issues like depression and anxiety frequently go undiagnosed in men due to stereotypes about masculinity and limited awareness of how these conditions may show up differently in men. Depression, for instance, can manifest with distinct symptoms in men, so they may not get the correct diagnosis right away. 

In conclusion, Gender bias often results in overdiagnosis, underdiagnosis, or even misdiagnosis, particularly for women patients. Shedding light on these inequalities could be the first step to walk towards the path of making improvements. However, mere understanding of biological differences is not enough to eliminate the risk of gender bias, which is often fueled by stereotypes, preconceptions, and a lack of awareness regarding gender-related health issues and discrimination. These biases must continue to be addressed in both medical research and education, emphasizing how gendered expectations and hierarchies influence health outcomes and diseases. Until these biases are addressed, the idea that "Health is for All" remains an incomplete truth. 

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https://link.springer.com/article/10.1007/s11245-015-9343-2 

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https://www.healthline.com/health/gender-bias-healthcare 

● Whiting, Kate. (2024, October 14). Women's health gap: 6 conditions that highlight gender inequality in healthcare. World Economic Forum 

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● https://www.concern.net/news/gender-bias-in-healthcare 

● https://www.qualityinteractions.com/blog/what-is-gender-bias-in-healthcare