To some, it may seem as though equality between men and women is nearly perfect. Women have the right to vote, hold powerful and important jobs, and are prevalent in society in ways that they hadn’t been in the past. However, the amount of progress made has cast a shadow over the progress that still needs to come. While topics such as the wage gap in the workplace come up while discussing feminism, the gap in healthcare has received very little attention. Many women don’t even realize that they are not educated on their own health and how dangerous the implications can be. The ugly truth is that in America, diseases in women are under researched, undertreated, underdiagnosed, and undereducated.
When asked about the symptoms of a heart attack, most people will immediately list symptoms such as chest pain or pain and tingling in the left arm, thinking of someone clutching their chest and falling to the ground. They would be correct, if they were referring to the primary symptoms of heart attacks in men. However, heart attacks in women can look very different. What a lot of people don’t know, including a lot of women, is that symptoms of heart attacks in women can include flu type symptoms, such as nausea and vomiting, jaw pain, sleep disturbances and anxiety. According to the Women’s Heart Foundation, “71% of women experience early warning signs of heart attack with sudden onset of extreme weakness that feels like the flu - often with no chest pain at all”. Oftentimes, this leads to both the patient and medical professional to assume that these symptoms are caused by something significantly less serious. A study done in the early 2000s from the New England Journal of Medicine found that women are seven times more likely to be discharged in the middle of having a heart attack because the symptoms are so different than what most associate with a heart attack. The vague nature of heart attack symptoms in women can make it significantly more difficult for physicians to intervene early and treat heart attacks effectively. Moreover, women will also wait longer to seek treatment for a cardiac episode than men will. According to the American College of Cardiology, “more than 70 percent of women in the study took longer than an hour to get to a hospital that could treat them, while less than 30 percent of men took that long.” (“Women Don’t Get to Hospital Fast Enough During Heart Attack”). With that being said, women have a higher risk of death during or post heart attack because most treatments are more effective the earlier they are received. It is the lack of education on both parts, the medical professionals as well as the patients, that accounts for the discrepancy between men and women’s healthcare.
In addition, many women experience dismissal by healthcare professionals in regards to their concerns. One way that this is manifested is through treatment of women's pain- it is often either regarded as psychosomatic or over-exaggerated. One study found that women in pain are much more likely than men to receive prescriptions for sedatives, rather than pain medication, for their ailments. Women with chronic pain are more likely than men to be misdiagnosed with a mental health condition and prescribed psychotropic drugs. Another study found that women are waiting an average of 16 more minutes in US emergency rooms for the same level of abdominal pain. Doctors often see women's pain as psychological due to the fact that many people still have an unconscious view of women as irrational or overemotional. In spite of anyone's believes, women's pain is very real, and should not be underestimated.
Another area of medicine where there is a significant gap is the diagnosing and treatment of mental health disorders. Similar to physiological disorders, mental health conditions can exhibit themselves in a vastly different manner in women. One disorder where this is especially prominent is ADHD, or attention deficit hyperactive disorder. Dr. Steven Hinshaw was one of the first psychologists to research ADHD in females only about fifteen years ago in 2002. Before psychologists started to research girls specifically, they were using the markers found in boys to diagnose girls. While boys typically have more disruptive behaviors, such as hyperactivity or fidgeting, girls tend to have type one ADHD, meaning they are primarily inattentive. Therefore, girls who could sit quietly in class but could not pay attention were silently suffering. The symptoms of ADHD in girls can include daydreaming, disorganization, and forgetfulness, and because these behaviors are less disruptive, they often go unnoticed. A lot of times, girls do not get diagnosed until they are older. Frequently, it takes the lack of routine and structure that college brings or their child being diagnosed for women to get diagnosed themselves. Not only can a late diagnosis cause problems in school, it can also trigger a lot of comorbid disorders, such as anxiety, depression and eating disorders. Girls tend to internalize their symptoms, instead of thinking that their failures could be caused by external factors, they blame themselves and think of their ADHD behaviors as personal failures. Because of this, it is vitally important that teachers and parents are informed of what ADHD can look like in girls, which could save them from a late diagnosis and a lifetime of struggling to function as someone with a perceived neurotypical brain. While ADHD is one of the most researched mental disorders, there is not enough awareness for the ways it can present in women.
The root of the medical gap comes from the distinct lack of research done specifically on females about females. There is a massive gender bias in clinical trials that has been going for decades and only started to be resolved in 1994 with the issuance of a guideline by the US National Institute of Health. Before this guideline, women were frequently left out of early stages of testing new medicine but then were given said medicine in the same capacity that men were. Not only that, but even research done on animals can be biased, using far more male animals or simply not using female animals at all. As most know, there are a lot of significant physiological differences between men and women, and therefore it is highly likely that medications will affect men and women in the same way. After the groundbreaking guideline in 1994, an estimated 80% of prescription drugs were taken off of shelves because of the effects they had on women’s health, which were discovered once women were required to be part of clinical trials. However, this piece of legislation did not fix every problem regarding clinical trial bias. While women were required to be a part of drug trials on humans, they were not being represented in preclinical research. During preclinical research, animals are frequently used to determine whether or not drugs will be safe for humans, and scientists were primarily using only one sex or doing the research on both and not reporting the differences. Female mice were not being used because of their hormone cycles, but male mice were occasionally not being studied because of their tendency to fight each other. Medication was being given to both sexes without an in depth study of the effects that they might have on their specific physiology. In January of 2016, the NIH created a policy that requires NIH grant applications received after January 25th, 2016 be reviewed for how they account for sex in their research. With that being said, there is still an immense amount of research needed to be done in order to account for the lack of equity in research before this policy was invoked.
In conclusion, the medical gap that exists in modern day America can essentially be traced back to a lack of education on women’s health issues. Not only do researchers and medical professionals need to ensure that they are taking these biases into account, but women should be holding themselves accountable for making sure they know how to maintain their health. As a country, we need to do better in raising awareness for how women’s healthcare and the 50% of the population that it represents.