Medical Gaslighting
“Gaslighting” is an increasingly popular term—perhaps to the point of overuse—but what does it actually mean?
It comes from the 1938 play Gas Light, in which an abusive husband attempts to drive his wife insane by convincing her that the things she is experiencing are not real. In particular the dimming of their home’s gas light. It is an insidious form of abuse, and, unfortunately, a version of it also exists in the medical field.
The American Journal of Medicine defines “medical gaslighting” as “an act that invalidates a patient's genuine clinical concern without proper medical evaluation, because of physician ignorance, implicit bias, or medical paternalism.” It is distinct from other forms of gaslighting, in that it is often unintentional. Most doctors do not set out to gaslight their patients, but the effects are still devastating. Delayed diagnoses, misdiagnoses, and, in the worst cases, long term illness and death can all arise from medical gaslighting. Implicit bias means that women and people of color are far more likely to be subjected to this than men.
Too often, a woman will go to her doctor reporting symptoms, only to be dismissed out of hand. Her chest pain is simply anxiety. Her fatigue would lift if she lost a little weight. Her muscle pain can be managed with some Advil. No proper testing is done, and patients are left without solutions. It’s no wonder women and minorities are up to 30% more likely to be misdiagnosed than their white male counterparts. And it takes women longer to get diagnosed than men on average, meaning women suffer more. Even when they are diagnosed, recovery may take longer than if the problem was caught quickly.
Medical gaslighting also has deeply harmful psychological effects. We are taught to trust doctors. They train for years to understand the body in ways the average layperson doesn’t. So when an expert tells you that your symptoms are “nothing to worry about” or “all in your head” who do you believe? The doctor or yourself? Can you trust your reality when someone tells you you are experiencing it wrong?
Sounds a lot like the dilemma faced by the heroine of Gas Light.
It’s a double edged sword that leaves women sick, exhausted, and drained. There are countless stories of women going from doctor to doctor, seeking relief and only finding more gaslighting. Hopefully they finally find someone who believes them before their symptoms become too severe to ignore. Sometimes, in the most tragic cases, medical gaslighting ends in a patient’s death.
And gaslighting in the medical field doesn’t just affect patients. Female doctors often face pushback from male colleagues. Their diagnoses or treatment plans are questioned, which not only erodes the confidence of women and racialized practitioners, it means their patients get worse care. We desperately need more diversity in the medical field, not less, but the patriarchal power structures within it facilitate this type of interaction. It is especially concerning as recent studies indicate that patients treated by female doctors may have better outcomes than those treated by men. This improvement is notably larger for female patients treated by female doctors.
Medical gaslighting is something many women experience when they go to the doctor. Which is why practitioners need to be taught to listen to their patients. Medical studies must take women and their bodies into account. Both patients and practitioners need to be empowered to correct this, because women’s pain is real. It is not all in your head.
