If you’ve been on the internet lately, there’s a good chance you’ve heard the word “gaslighting.” You may have seen people joking about others gaslighting them. The recent surge in the popularity of this word even led to “gaslighting” being named Merriam Webster’s word of the year in 2022. To gaslight someone means to manipulate them into doubting their perception of reality, and it can occur in many situations: between coworkers, family members, romantic partners, and more. Recently, many people have been using the term “medical gaslighting” to describe their experiences with healthcare professionals. 

Medical gaslighting refers to the dismissal many people face at the hands of health care providers. This is when doctors or other health care workers tell patients they are overreacting or dismiss their concerns. Medical gaslighting can affect anyone, but most often affects marginalized groups of people. For instance, many women who express serious concerns of physical pain to healthcare providers are told that their pain is merely due to psychological causes, an experience that is less common for men. 

Unfortunately, there is a long history of women being dismissed in medicine. When women in the past exhibited behavior outside of the realm of what was accepted, they were often labeled as experiencing “female hysteria”. Hysteria was believed to be caused by the uterus moving throughout the body and putting pressure on certain organs, leading to a variety of physical and mental symptoms. Hippocrates believed that women with ‘hysteria’ were experiencing it because of a lack of sex and needed to get married to be ‘cured’ of their illness. Women experiencing anything from insomnia to irritability could be diagnosed with hysteria.

Women who were actually struggling with illnesses such as depression or epilepsy had their symptoms dismissed and were labeled as experiencing hysteria. While the American Psychiatric Association stopped classifying hysteria as a psychiatric disorder in 1980, the effects of ignoring women in medicine have persisted — doctors may look at women who are nervous about something related to their health and assume that they are overreacting or their health issues are caused by stress. According to a survey conducted just last year, 71% of women said that they were told that their symptoms were imagined.

“There’s still this pervasive belief in the medical community that anytime a woman complains about her health, it’s either related to hormones or all in her head,” said Dr. Stephanie Trentacoste McNally, an OBGYN. “How often does a woman get angry, only to be asked if she’s about to get her period? How often does a perimenopausal woman go to her doctor’s office to complain about weight gain, only to be told that it’s related to hormones?”

Ilene Ruhoy, a neurologist from Seattle, shared her experience with medical gaslighting with the Washington Post. After experiencing concerning symptoms, she asked for a brain scan. Like many women who discuss concerning symptoms with a healthcare provider, she was dismissed and told that they were due to stress. “I was told I knew too much, that I was working too hard, that I was stressed out, that I was anxious,” Ruhoy said. After eventually receiving the brain scan, though, the doctors who dismissed her turned out to be wrong: she had a brain tumor and needed surgery right away.

Even celebrities have experiences with medical gaslighting. Serena Williams shared that after giving birth to her first child, she had a near death experience that almost wasn’t taken seriously. Williams has a history of pulmonary embolisms (blood clots that can block blood flow to the lungs), which can have devastating effects if not treated immediately. After giving birth, she recognized that she was experiencing the same symptoms she usually had when getting a pulmonary embolism. When she raised her concerns with her nurse, Williams said, she was dismissed at first. “She said, ‘I think all this medicine is making you talk crazy’,” said Williams.

The nurse did eventually alert the doctor, enabling her to receive a CAT scan and life saving treatment for the blood clot. Had she not been listened to and had the blood clot diagnosed and treated in time, there could have been devastating consequences. “Being heard and appropriately treated was the difference between life or death for me,” Williams wrote, noting that Black women in the U.S. are two to three times more likely than white women to die during or after childbirth. Many of these deaths are considered to be preventable, an unfortunate part of the country’s high maternal mortality rate.

Part of our country’s high maternal mortality rate can be attributed to a lack of universal healthcare in the United States. According to a survey conducted by the Commonwealth Fund, women aged 18 to 49 in the United States are more likely than women in other countries to skip or delay necessary appointments for their reproductive health because of the high cost. 

Another reason why the maternal mortality rates are so high could be because of medical gaslighting and bias. As seen in Serena Williams’ experience as well as many others, many women are not believed or are dismissed when raising concerns about their health.

Many women have similar stories to these, with varying degrees of severity. But whether their symptoms turned out to be caused by a life-threatening blood clot, as was the case for Serena Williams, or simply the flu, is irrelevant. When doctors don’t take their patients seriously, they put their patients’ health at risk. 

Everyone is at least somewhat biased, even if they are unaware of their biases. When you imagine a heart attack victim, the first thing that comes to your mind is likely an older man, his hand on his chest as he leans against the wall, an expression of agony on his face. Try to list the symptoms of a heart attack. Crushing chest pain, pain radiating from your chest to your arms and abdomen…if you thought of those symptoms, you had good reason to. Most people are taught these symptoms of a heart attack, not knowing that there are other symptoms (nausea, back pain, etc.) that primarily affect women. These symptoms are frequently labeled as “atypical,” with symptoms that men mostly experience seen as the standard. 

There are also many racial biases in medicine. Although many physicians do not think that they are biased, studies show that many of them have at least some implicit biases. According to this study, white medical students and residents believe myths about differences between Black and white people, such as the false idea that Black people have thicker skin and feel less pain. The fact that many medical professionals believe such asinine ideas demonstrates an urgent need for implicit bias training in all medical schools.

One instance of racial bias in medicine is that Black patients are prescribed less medication than their white counterparts for the same pain, likely due to the myths many doctors believe about Black people feeling less pain than white people. This disparity even persists in children, with Black children shown to be less likely to receive painkillers for appendicitis compared to white children. 

Another area in medicine where implicit biases may have a role in diagnosis or treatment is autism. Autism spectrum disorder (ASD) is something that many more boys than girls have been diagnosed with, as well as more white children than non white children. 

You may be wondering if this is simply due to the fact that more boys and white children experience ASD as compared to other groups of people. However, research shows that implicit bias may account for this disparity. An experiment conducted showed that non white children who met diagnostic criteria for ASD were less likely than their white counterparts to be diagnosed with it. Some think that this could be because of misdiagnosis or doctors interpreting autism symptoms differently among different races. 

Experts believe that the gender disparity in autism diagnoses could be due to the fact that the model for an autism diagnosis primarily aligns with the symptoms boys with ASD display. “The model that we have for a classic autism diagnosis has really turned out to be a male model,” said Dr. Susan F. Epstein, Ph.D, a clinical neuropsychologist. “That’s not to say that girls don’t ever fit it, but girls tend to have a quieter presentation, with not necessarily as much of the repetitive and restricted behavior, or it shows up in a different way.” 

Due to these biases, many people went undiagnosed with autism until later in life. Some autistic women only got diagnosed with ASD when their children started exhibiting symptoms. Dr. Morenike Giwa Onaiwu, PhD, told the New York Times that she got diagnosed with autism several months after her daughter did. “My daughter was just like me,” she said. 

One of the pillars of healthcare is empathy. Although doctors may be overwhelmed with the number of patients they have to see, it is still important that they treat their patients respectfully and don’t minimize or dismiss their symptoms. As for implicit biases in medicine, some medical schools offer implicit bias training that helps medical students recognize their implicit biases. Medical gaslighting and implicit biases that healthcare providers harbor can have detrimental effects on their patients, so it is extremely important to be mindful of these biases and treat all patients with respect and empathy.

Many women have similar stories to these, with varying degrees of severity. But whether their symptoms turned out to be caused by a life-threatening blood clot, as was the case for Serena Williams, or simply the flu, is irrelevant. When doctors don’t take their patients seriously, they put their patients’ health at risk.