She’s Not Imagining It: The Continuing Medical Dismissal of Women

A recent survey of 900 women aged 25-34 found that 93% reported feeling dismissed when seeking medical help. The survey also found that over 40% visited multiple providers to receive a diagnosis, and almost the same percentage were prescribed medications without a full investigation into their symptoms. Many respondents were told that their symptoms were “just due to stress” or that they were too young for severe conditions.

Earlier this month, Healthy Women published the story of Rylie Toomey, who was diagnosed with advanced colon cancer after being dismissed by her health providers. In 2024, she experienced severe abdominal pain. When she drove herself to the local hospital ER, a CT of her abdomen was performed, and she was told that she was just constipated, so they sent her home. Every few months thereafter, she visited the same ER for testing and was told the same thing. She eventually arrived in the ER screaming in pain, and imaging at that point revealed that she had a perforated bowel and colon cancer that had already metastasized.

A 2018 study reported that more than half of women who went to the hospital with a heart attack reported that their healthcare provider didn’t see their symptoms as heart-related, compared with less than 4 out of 10 men. Kelly Shoul, a 34-year-old woman, was sent home from the emergency room despite severe stomach pain, which the ER doctor said was heartburn. Nine days later, she returned with a fever. Her appendix had burst, and she required emergency surgery, which included the removal of a section of bowel.

Dismissing women’s health concerns is not a new problem. For centuries, women who reported symptoms were told they were being hysterical. Janine Clayton, an MD at the NIH, stated, “The origins of this situation go back many years. Much of medical science is based on the belief that male and female physiology differ only in terms of sex and reproductive organs. As a result, most research has been conducted on male animals and male cells. This is a major root of this issue”.

Judith Leitich is a nurse practitioner and the medical director of a healthcare company. She believes, “The longstanding and misguided belief that women are excessively emotional is one reason why the healthcare industry has a record of invalidating and disregarding women’s concerns even today. The belief that women are weak has wrongly rationalized that their troubles are inflated and their reactions are exaggerated. This historically led to a tendency for healthcare professionals to attribute women’s grievances to psychological issues or emotional upset instead of treating them as legitimate medical issues”.

Why Women’s Concerns Are More Readily Dismissed

• Gender Bias. Despite good intentions, gender bias persists in health care. A survey conducted in early 2019 found that more than half of women, compared with a third of men, believe gender discrimination in patient care is a serious problem. One in five women says 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. Research confirms 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. According to Stephanie Trentacoste McNally, MD, “There’s still this pervasive belief in the medical community that anytime a woman complains about her health, it’s either related to her hormones or all in her head.
• Sex Differences in Clinical Presentation. According to an article in Circulation, young women with heart disease have a higher risk of dying of a heart attack compared with their male counterparts. The symptom presentation of young women with heart attacks remains poorly understood and has been hypothesized as the reason for delays in treatment. Women presenting without chest pain are more likely to have a greater variety of other symptoms, such as fatigue, nausea, jaw pain, and abdominal discomfort. These symptoms can be less intense than classic chest pain and may be easily misinterpreted as indigestion or general fatigue, leading to delayed diagnosis and treatment.
• Lack of Diversity in Clinical Trials. Historically, women, particularly women of color, have been underrepresented in research protocols. The result is that the available data is limited in this population.
• Psychological and Social Influences. According to Bella Grossman, MD, PhD, of Northwell Health, psychological and social influences contribute to female patients being more easily dismissed. She believes that her male patients tend to be more vocal and persistent about their health concerns. Women, on the other hand, may have a harder time confronting their healthcare provider when a diagnosis is not forthcoming. Some of her patients have a more difficult time advocating for themselves because of a desire to be a “good patient.”

What Could Even the Playing Field

• Advance research and data collection specific to women. This would require investing in studies that are specific to female physiology, disease presentation, and treatment response. This should also include increased female participation in clinical trials.
• Combat Sex Bias in Treatment. Medical schools should increase training in female-specific diagnosis and treatment. This should also include teaching students how to recognize and challenge gender bias in healthcare. Encourage student doctors to utilize a patient-centered approach that validates rather than dismisses the concerns of their female patients.
• Empower women to advocate for themselves when dealing with the healthcare system. According to Summer Allen of the Mayo Clinic, “It’s important to participate in the conversation with your healthcare provider.” She advocates for making a list of questions prior to an appointment. She suggests asking what information a recommended treatment or procedure will provide. Finally, if you and your provider do not click, you are not obligated to continue being a patient at that practice. Consider asking for recommendations from trusted friends and relatives, and conduct your own research.