“I Just Want to Feel Safe Going to a Doctor”: Experiences of Female Patients with Chronic Conditions in Australia

Abstract

Background: The androcentric history of medicine and medical research has led to an ongoing sex and gender gap in health research and education. Sex and gender gaps in research and education may translate into real-life health inequities for women. This study aimed to explore the experiences of female patients with chronic health conditions in the Australian health system, considering existing sex and gender gaps in medicine. Methods: This qualitative study used semistructured in-depth interviews with a sample of adult women with chronic conditions in Australia. Thematic analysis was undertaken, guided by Braun and Clarke. Software NVivoX64 assisted in the management of the data. Coding was performed before grouping into subthemes and central themes. To allow for potential researcher biases, the principal researcher engaged in the practice of reflexivity, including the writing of detailed notes during analysis. Results: Twenty adult Australian women with chronic conditions were interviewed. Diagnoses were varied and included Ehlers–Danlos syndrome, chronic fatigue syndrome, functional neurological disorder, and inflammatory bowel disease. Four central themes emerged: diagnostic difficulties; spectrum of health care experiences; understanding medical complexity; and coping with symptoms. Conclusions: Women with chronic conditions in Australia report pain, fatigue, and suffering that significantly impacts upon their daily lives. There was a shared experience of feeling that the pain and suffering of women was dismissed or not taken seriously. Many women expressed trauma because of their experiences in health care and often this led to a fear of accessing health services. The participants highlighted a need for more knowledge, understanding, and empathy from health care practitioners.

“I have to fight for them to investigate things”: a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness

“…Experiencing medical gaslighting can lead to women suppressing emotion in clinical settings out of fear of being stigmatised and dismissed ( 35 ), using comprehensive self-management and communication strategies, and self-advocacy in an effort to get needs met and avoid further inequity ( 15 , 34–36 ), feeling that symptoms must need to be severe in order to warrant seeking medical care ( 36 ), and feelings of grief and loss from years spent undiagnosed and untreated ( 37 , 38 ). Due to medical gaslighting, women may also distrust, fear and avoid health services ( 17 , 32 , 34 , 39 ), and under-report their symptoms ( 40 ). This can increase vulnerability to illness, for example via delayed diagnosis ( 16 , 38 ), and worsening symptoms ( 15 , 17 ).…”

“…Women may experience multiple, intersecting discrimination that increase risk of medical gaslighting (i.e., sexism, racism, ableism, ageism, sizeism) ( 16 , 19 , 32 , 34 ). For example, their gender and age leading to perceived lack of credibility, dismissal, and misdiagnosis ( 32 , 34 ), or women’s intersections of gender, race, or weight may lead to stigmatising health experiences based on these characteristics ( 19 , 34 ). Co-diagnosis of a mental and physical health condition can increase the likelihood that women will be stigmatised and dismissed as imagining or fabricating somatic symptoms ( 32 ).…”

“…For example, their gender and age leading to perceived lack of credibility, dismissal, and misdiagnosis (32,34), or women's intersections of gender, race, or weight may lead to stigmatising health experiences based on these characteristics (19,34). Co-diagnosis of a mental and physical health condition can increase the likelihood that women will be stigmatised and dismissed as imagining or fabricating somatic symptoms (32). These gendered inequalities in healthcare outcomes have historical precedent.…”

Representation of Women and Women's Health in Australian Medical School Course Outlines, Curriculum Requirements, and Selected Core Clinical Textbooks

“… 14 Combined, this simultaneous gender blindness and social preconceptions of women can have adverse impacts on the experiences of women patients. 15 , 16 …”

Factors affecting women’s decision between uterine-preserving versus hysterectomy-based surgery for pelvic organ prolapse

“…This paucity of evidence reflects the continued devaluation of research and women’s experiences to inform women’s reproductive health. There is significant evidence indicating that women’ symptoms and experiences in healthcare are often ignored, trivialized, or dismissed by physicians, 18 – 20 termed “medical gaslighting,” 21 and this experience has been documented in treatment-seeking for POP. 22 Furthermore, although surgical expertise plays a role in determining surgical treatment for POP, 8 many surgeons do not have the training or expertise to perform uterine-preserving procedures 10 resulting in a perpetuation of the historical hysterectomy-based approach to POP surgery and limiting women’s bodily autonomy and informed choice in treatment-seeking.…”