Gender stereotypes undermine health care

Myocardial infarction? A male disease. Depression? A female disease. Gender stereotypes affect the way women, and health professionals, face health problems.

At first she had pain in her legs. The doctor believed it was a gout problem, or maybe pregnancy symptoms.

For seven years, she endured the pain because she herself doubted the diagnosis, until she ended up in an emergency. And she again received the information that the malaise was due to the baby she had just had: “toxic postpartum heart disease”.

Finally, a rheumatologist identified the source of the problem: lupus.

This is the testimony of feminist historian Elinor Cleghorn, who last year published in English “Sick Women: A Journey Through Medicine and Myth in a Man-Made World” (“Unwell women: a journey through medicine and myth in a man -made world”).

The book’s thesis is that women’s health has been constantly misunderstood and misinterpreted throughout history.

taboos

“The ‘nature’ of women, the representations that they made of them as fragile creatures, have permeated medicine for a long time”, confirms French neurobiologist Catherine Vidal.

In a report recently presented to the French agency for equality between men and women, the researcher explains that “social codes linked to female and male gender influence the expression of symptoms, the relationship with the body, the decision to ask for help”.

Among health professionals, gender-related biases can influence the interpretation of clinical symptoms and care.

For example, women are actually more vulnerable than men to cardiovascular diseases: 56% die from them, against 46% among men.

And yet, myocardial infarction remains underdiagnosed among women and more related to work stress in men.

Women suffer from depression on average twice as often as men. But the main reason is not hormones, as long thought. Research has shown that gender differences in the prevalence of depression vary by socioeconomic status.

And other diseases, related to women’s sexual and reproductive health, are also misdiagnosed. This is the case of endometriosis, much underestimated for a long time because it was linked to the taboo of menstruation.

In France, a study showed that women call emergency services 15 minutes later than men when they have a heart attack.

“They feel less concerned about their health, often putting family or work ahead,” laments cardiologist Claire Mounier-Vehier.

Signs of a heart problem are often more subtle among women. They arise with persistent tiredness or digestive problems.

“We have to stop believing that when a man faints he has a heart attack, but when it happens to a woman it’s just a faint,” says Mounier-Vehier.