Women as Patients

Despite good intentions, gender bias persists in health care. A survey conducted in early 2019 by TODAY found that more than one-half of women, compared with one-third of men, believe gender discrimination in patient care is a serious problem. One in five women say they have felt that a health care provider has ignored or dismissed their symptoms, and 17% say they feel they have been treated differently because of their gender—compared with 14% and 6% of men, respectively.

Studies show that women’s perceptions of gender bias are correct. Compared with male patients, women who present with the same condition may not receive the same evidence-based care. In several key areas, such as cardiac care and pain management, women may get different treatment, leading to poorer outcomes.

Few physicians think intentional discrimination is at play here. Instead, it’s a result of the vestiges of disproved beliefs and outdated conventions. “The origins of this situation go back many years,” explains Janine Clayton, MD, director of the Office of Research on Women’s Health (ORWH) at the NIH. Much of medical science is based on the belief that male and female physiology differ only in terms of sex and reproductive organs, she says. Because of this, most research has been conducted on male animals and male cells, Clayton explains. “This is a major root of this issue.”

In addition, women—especially those in child-bearing years—were excluded from clinical trials for many years, in part to protect them and their fetuses from potential adverse effects. Researchers also felt that they could not adequately control for women’s variable hormonal status. “Because we have studied women less, we know less about them,” Clayton says. “The result is that women may not have always received the most optimal care.”