Introduction to the Problem
Women seeking help for certain gynecological disorders may have their symptoms gaslighted by their doctors or nurses, a new study suggests. The flood of dismissive and invalidating remarks by health care providers about disorders affecting the vulva and vagina can be devastating for women, sometimes leading them to abandon their search for help with their pain, researchers reported Thursday in JAMA Network Open.
The Study
The study focused on patients at a vulvovaginal clinic who were seeking medical care for a variety of disorders that may cause pain, sexual dysfunction, and bowel or bladder dysfunction, according to NBC News. OB-GYN Dr. Chailee Moss, lead author and an adjunct professor at George Washington University, said the roots of the research lay in “the years and years of hearing such experiences from patients and feeling like the broader medical community didn’t know how distressing the comments were to patients.”
Methodology
Moss and her colleagues devised a survey that included dismissive comments and behaviors patients regularly encounter, such as doctors telling women to lose weight, go to therapy or drink more alcohol to cope with pain. The survey was completed by 447 women between August 2023 and February 2024. Some of the survey questions included:
- “Of the health care providers you have seen, how many made you feel your symptoms were ‘all in your head?’”
- “Have you ever been told that you just need to relax more?”
- “Have you ever been told your vaginal opening was just ‘too small?’”
- “Have you ever been told that you just ‘need a glass of wine’ or a similar suggestion?”
- “I have been told that the pain I experienced during my physical exam was normal despite reporting significant pain during the exam.”
Findings
The participants reported that an average of 43.5% of past practitioners were supportive. But more than a quarter of the providers were belittling and about 20% did not believe the patient. Overall, just over 40% of the women were told they just needed to relax more, about 20% were recommended to drink alcohol, and 39.4% said they were made to “feel crazy.” Many women said they stopped coming for care because they felt their concerns were not being met. An estimated 20% of the patients were referred to psychiatry without medical treatment.
Impact of Gaslighting
“In particular the comment ‘Just have a glass of wine’ was a particularly pervasive piece of advice that pain patients reported was very distressing,” Moss said. The findings are significant because women whose conditions are dismissed may stop seeking medical care and experience a delayed diagnosis, the researchers said.
Limitations and Future Directions
There are notable limitations to the study. It was conducted at one clinic and may not be representative of a diverse population. The researchers did not explore whether there were more problems with male or female caregivers, although Moss said a number of participants felt they were treated differently based on the clinician’s gender. And the survey was based on patient recall. However, Moss believes similar results would be found in other centers.
Expert Insights
Dr. Roger Dmochowski, a professor of urology, surgery and gynecology at the Vanderbilt University Medical Center, said the new report underscores what women with urinary and pelvic floor complaints often experience. “It’s my impression that women are traditionally undertreated and their symptoms are minimized or marginalized,” Dmochowski said. “Women are persistently ignored or depreciated for their symptoms.” An important factor in providing care is paying attention to what the patient is saying, Dmochowski said. “A really critical part is listening to what the patient says,” he added. “Many patients have a very complicated presentation: pain, pelvic floor dysfunction, urinary problems, sexual issues. And each piece of the puzzle is important. Empathy is critical.”
What Women Should Do When Doctors Don’t Listen
Dmochowski said patients shouldn’t hesitate to go to a different provider. "Don’t give up," he said. "A couple of negative experiences should not dissuade you from seeking care." Dr. Alessandra Hirsch, an assistant professor of obstetrics and gynecology at the Columbia University Vagelos College of Physicians and Surgeons, wasn’t surprised by the study’s findings. “In the whole medical community there’s a history to contend with providers not believing in women’s pain,” she said. Hirsch hopes doctors who read the study “try to avoid falling into these habits.” It’s essential for doctors to listen, Hirsch said.
Conclusion
The study highlights a significant issue within the healthcare system where women’s symptoms and pain are often dismissed or minimized by healthcare providers. This can lead to delayed diagnoses, inadequate treatment, and a lack of trust in the medical community. It is crucial for healthcare providers to listen to their patients, believe their symptoms, and provide empathetic care. Women should not hesitate to seek a second opinion or change providers if they feel their concerns are not being taken seriously.
FAQs
- Q: What is gaslighting in the context of healthcare?
A: Gaslighting refers to the act of healthcare providers dismissing or minimizing a patient’s symptoms, making them question their own perceptions or sanity. - Q: How common is gaslighting in women’s healthcare?
A: The study found that over 40% of women were told to relax more, about 20% were recommended to drink alcohol, and 39.4% felt made to “feel crazy” by their healthcare providers. - Q: What should women do if they feel their healthcare provider is not listening or believing them?
A: Women should not hesitate to seek a second opinion or change providers. It is essential to find a healthcare provider who listens and believes their symptoms. - Q: Why is it important for healthcare providers to listen to their patients?
A: Listening to patients is critical for providing empathetic care, making accurate diagnoses, and developing effective treatment plans. It helps build trust and ensures that patients receive the care they need.
