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August 6, 2024

June 5, 2024

Overcoming Gender Bias in Healthcare: How to Advocate for Our Wellbeing and Find Doctors Who Listen

E:
228
with
Dr. Karen Tang
MD and author

WHAT YOU’LL LEARN

  • How Gender Bias in Healthcare Started
  • Why Women’s Health Is Often Overlooked
  • The History of Gender Bias in Healthcare
  • Healthcare Gender Bias and Sterilization Access
  • The Relationship Between Intensive Mothering and Gender Bias in Healthcare
  • How to Find Doctors Who Will Listen and Respect Your Choices

Women’s health has long been misunderstood, overlooked, and dismissed—both by society and by the medical system. From a lack of understanding regarding reproductive health to medical gaslighting to inherent gender bias in healthcare, women’s health has historically suffered on a large scale. 

This has a real impact on our wellbeing. We might overlook hormonal health and wellness issues out of fear of being gaslit or minimized. Or we might not even realize the implication ourselves, believing that our symptoms are just part of what moms have to deal with. 

We might even neglect our own health due to lack of capacity or the social expectation that we should put everyone else’s needs above our own. 

Women’s health issues are real—they aren’t hysteria and they aren’t “just hormones. 

But women’s health issues are real—they aren’t hysteria, they aren’t “just hormones,” and they aren’t something that should be ignored, overlooked, or put on the back burner. 

Concerns like PMDD, PCOS (polycystic ovarian syndrome), endometriosis, or even universal experiences like menopause are still underresearched and underdiagnosed. The more we can understand these concerns—and advocate for doctors to take them seriously—the more we can help support women and moms everywhere. 

Today, I’m joined by gynecologist and reproductive health specialist Dr. Karen Tang, MD, author of It’s Not Hysteria, to discuss how we can collectively and individually overcome gender bias in healthcare and advocate for women’s health. 

How Gender Bias in Healthcare Started

Dr. Karen began creating videos to help spread awareness and understanding about myths related to gynecology after witnessing how many women had never been given the information they needed to make informed healthcare decisions. 

One of her first viral posts confronted misinformation about gender and biological sex. It became clear that so many people needed doctors like her to tackle myths and social media misunderstandings. 

But the overall misinformation about women’s health isn’t new to the social media age—it dates back centuries. Dr. Karen pointed out that many women’s health issues, especially those related to hormonal health, often slip through the cracks. 

Many women’s health issues require nuance and a more holistic approach to investigating symptoms.

Part of the problem is that these conditions, such as PMDD or endometriosis, can’t be identified by a simple blood test. They require nuance and often a more holistic approach to understanding symptoms. And because there is such a history of bias or dismissing women’s concerns as “hysteria,” there is also an element of being gaslit or overlooked. 

Dr. Karen wrote It’s Not Hysteria to give women the information they needed about a range of health issues, but also to address these underlying biases and encourage women to advocate for themselves. 

Why Women’s Health Is Often Overlooked

Dr. Karen believes that looking back on the history of women’s health can help us understand where we’ve gone wrong on a societal level. 

This ties into both physical and mental health. Women’s depression, anxiety, or stress can be dismissed as “just emotional” or “just hormones” rather than taken seriously. And physical symptoms of PMDD, menopause, or other health issues might be overlooked as well, chalked up to “just being tired or stressed out.” 

In some ways, this stems all the way back to ancient times, when any women’s health issues were often dismissed as your body or uterus malfunctioning. The tradition of misinformation continued, into Freudian times where women were told they were suffering from “female hysteria” when they expressed any concerns. 

This gender bias in healthcare continues now—not just in medical research, where women have long been underrepresented, but also in practice. Dr. Karen pointed out that if someone has many symptoms or something a bit more complex going in, they might be invalidated, told that they’re just dealing with “period issues” or “lady stuff.” 

Gender biases are often not intentional—healthcare practitioners often don’t even realize they carry them. 

Dr. Karen said that some gynecologic conditions, like endometriosis, affect lots of different organ systems and come with a wide range of seemingly unrelated symptoms. When healthcare practitioners have gender bias, their go-to answer might be that these things can’t be related or that women are overanalyzing their symptoms. 

These gender biases are often not intentional—many healthcare practitioners don’t even realize they carry them. They are shaped by a medical system that tells them to jump to certain conclusions. 

So the issue isn’t just “good doctors” or “bad doctors,” it’s a systemic problem that has resulted in people having to fight to get taken seriously and to be treated the way they deserve to be treated. 

The History of Gender Bias in Healthcare

The history of gender bias in healthcare has created an overall perception that women’s health is not as worthy—that it’s not real science and that it doesn’t require specialized research. 

Women’s physical and mental health, from postpartum concerns to menopause are often considered “niche” practices, even though they impact so much of the population. 

The funding for women’s health is also a small fraction of overall healthcare funding. For example, Dr. Karen pointed out that the amount of spending for smallpox is often more than twice that of funding for fibroids, even though fibroids affect a very large percentage of the population, whereas smallpox was eradicated in the 1940s. 

Changes are on the horizon, however. Advocacy groups are gaining attention and traction, calling for changes in women’s healthcare.  In the United States, a recent healthcare initiative allotted a major increase for women’s health funding—something Dr. Karen pointed out is a big step in the right direction. 

Anger can fuel us to push for change, but we don’t want to get so caught up in it that we can’t focus. 

This can bring up complicated feelings—gratitude that we are moving in the right direction and frustration and disbelief that these disparities have been so great for so long. 

Dr. Karen said that we often have to strike a balance between optimism, productivity, and rage. Anger can fuel us to push for change, but we don’t want to get so caught up in it that we can’t focus and achieve what we need to be moving toward. 

Healthcare Gender Bias and Sterilization Access

Another major healthcare hurdle for women is sterilization. Many women who either know they don’t want to have any children or that they are done having children struggle to find doctors who are willing to do tubal ligation or other sterilization methods for them. 

This has increased since the overturning of Roe v Wade. Dr. Karen pointed out that with many states having strict laws around abortion or birth control, the issue of sterilization has become very high-stakes and urgent for many people. 

There is an active need for doctors who will listen to patients and provide these services. Dr. Karen shared that she was placed on a list of about a thousand OBGYNS on Paging Dr. Fran who were willing to do sterilizations for people who were childfree—and that she sometimes got 50 calls or more a day from this list. 

The people who sought her out weren’t just childfree women—they were women who wanted no more children, trans men, and nonbinary people as well. Some of them were young, in their 20s, but many were older and were still being turned down by doctors when they requested sterilization. 

Doctors will often tell women that they will regret this procedure or that they need to have already had children before making this decision. Some doctors have told women no for arbitrary reasons, like that they need to have four children before they will consider performing sterilization or that their “future husband” will want kids so they should wait. 

Women are actively losing control of the decision-making in their own reproductive health. 

Women are actively losing control of the decision-making in their own reproductive health, at the mercy of doctors with personal biases who fear repercussions from irreversible sterilization decisions. 

Dr. Karen said that it’s frustrating to see that instead of informing people about options and risks and allow them to make their own healthcare decisions, doctors are jumping into decisions they really have no right to make. 

The Relationship Between Intensive Mothering and Gender Bias in Healthcare

In some ways, reproductive access to sterilization also reflects intensive mothering ideology, the overarching perception that motherhood should be the ultimate fulfilling experience for women—that we’re biologically made for it and that it should be our most wanted and prized role. 

This ideology is tied in with these gender healthcare biases. Doctors are turning down women’s access to medical procedures because of the idea of a “biological clock” that will later change their minds about wanting to be mothers or to mother more children. 

We would never hear a doctor say, “oh we shouldn’t treat you for cancer because of your future husband.”

Dr. Karen pointed out that if we apply these same concepts to other medical procedures, it just becomes silly. We would never hear a doctor say, “oh we shouldn’t treat you for cancer because your future husband might not want you to receive this procedure.” 

While men might face some questioning when seeking a vasectomy (the equivalent of sterilization for men), their ability to decide for themselves is not in question and it’s typically much easier for them to get access to the procedures they want. They get to be autonomous in their decision, unlike women, who are subjected to other people’s thoughts, values, and biases. 

How to Find Doctors Who Will Listen and Respect Your Choices

Dr. Karen said that it’s important to find healthcare providers who listen to and respect your choices—but it’s often easier said than done. She shared that there are two ways to find doctors who are willing to listen to your needs and offer sterilization procedures. 

The first is visiting the childfree subreddit, which has a list of surgeons by geography, broken down into both gynecologists and urologists. The other is to visit Dr. Fran’s website, where she offers many resources including her “TikTokTubal List” of doctors. Both of these lists can lead you to a doctor near you who will listen and respect your wishes without giving you grief. 

Dr. Karen also said that you can find similar lists cultivated for whatever you are looking for—for example, doctors who will listen about PCOS, endometriosis, or perimenopause. 

If you find that you’re not getting answers or you’re being dismissed, she urges you to turn to online networks like these and find recommendations based on other people’s experiences. 

She said that doctors should listen to you—they shouldn’t dismiss your symptoms or minimize what you’re going through without any further discussion or investigation. But she also said that if they only offer one treatment option, such as a hysterectomy or one specific medication, they might not be the right doctor for you. Be willing to advocate for yourself or push for other treatment options—and if you’re shut down, don’t be afraid to go get a second opinion. 

Sometimes seeking a specialist is beneficial—like someone who specializes in hormonal health or endometriosis. Dr. Karen pointed out that general practitioners or even general OBGYNs can’t know everything and won’t always understand how to navigate every nuance. Seeking a specialist can often help you get the care you need. 

If you’re struggling with being dismissed or gaslit and unsure how to advocate for yourself or set boundaries, working with a mom therapist can help. Book a FREE 15 minute virtual consult today!

‍This post includes links to outside resources we endorse–if you make a purchase we might receive a commission at no extra cost to you. As an Amazon Associate I earn from qualifying purchases.

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Tags:

Women's Health, Menopause, Hormonal Health

Stage:

Postpartum, Motherhood

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OUR GUEST

Dr. Karen Tang
MD and author

KAREN TANG, MD, MPH is a board-certified gynecologist and minimally invasive gynecologic surgeon who is an internationally recognized leader in reproductive health. She received her medical degree and masters in public health at Columbia University, and trained in obstetrics and gynecology at Beth Israel Deaconess Medical Center / Harvard Medical School. As @KarenTangMD on TikTok, Instagram, and YouTube, she reaches millions of viewers each month with her educational videos about period health, pelvic pain, and reproductive rights.

Erica Djossa
Erica Djossa
PMH-C | Founder of Momwell
Erica is the founder of Momwell, providing educational resources and virtual therapy for moms. She is a mom of three boys and a registered psychotherapist. Erica’s work has been featured in the Toronto Star, Breakfast Television, Scary Mommy, Medium, Pop Sugar, and Romper. how they want it.
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