Why Do We Ignore Women’s Pain?

Welcome back to this week’s edition of The Bendy Bulletin.

Today, we’re diving into a question that affects far too many of us - why is women’s pain so often ignored? Whether it’s being dismissed in the ER, misdiagnosed for years, or told it’s “just anxiety,” women frequently face barriers to being believed and properly treated.

As someone who lives with chronic pain and works with patients navigating complex connective tissue disorders like Ehlers-Danlos Syndromes (EDS) and Hypermobility Spectrum Disorders (HSD), I’ve seen firsthand how gender bias can delay diagnosis, derail care, and erode trust. In this edition, we’re unpacking the history, science, and systems behind this ongoing problem - and what we can do to change it.

While this newsletter focuses on women, it’s important to note that anyone who isn’t a cisgender man - including (but not limited to) nonbinary individuals and transgender people - may face similar or compounded barriers to being believed and properly treated.

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Why Do We Ignore Women’s Pain?

Pain is inherently subjective, but evidence shows that when women report pain, they are more likely to be dismissed, told it’s “just anxiety,” or prescribed sedation instead of effective treatment. As a physician who has both experienced chronic pain and treated countless women, I want to shine light on this troubling pattern - and why it persists.

1. Biased Baselines: Research on Men, Applied to Women

Historically, medical research has centered on male bodies. In fact, 80% of pain studies have relied on male participants - whether mice or humans - even though 70% of chronic pain sufferers are women.¹ This skewed baseline means physicians often misjudge women’s pain thresholds, appropriate dosing, and healing timelines.

2. Gendered Stereotypes: Emotional, Hysterical, Hypersensitive

There’s a well-documented stereotype that women are “emotional” or exaggerating their pain. A 2018 literature review described men as “brave” and women as “emotional” in the context of chronic pain.² These biases push clinicians to view women’s pain as psychosomatic, prompting unnecessary psychological referrals rather than proper treatment. Studies also show that women patients have to work harder to make the symptoms socially visible, real, and physical when consulting a doctor.³

3. Diagnostic Delays and Treatment Gaps

Studies across multiple conditions consistently show that women wait longer than men for diagnoses - even when presenting with similar symptoms.⁴ After surgery or during acute pain episodes, women are less likely to receive opioid medications and more likely to be prescribed sedatives or antidepressants.⁵

4. Cultural Disbelief: The Medical Gaslight

Medical gaslighting - when a patient’s symptoms are dismissed, minimized, or attributed to psychological causes without proper evaluation - can significantly increase physical pain. It triggers a stress response that activates the body’s fight-or-flight system, increasing levels of cortisol and other inflammatory mediators. This heightened stress state can amplify pain perception through central sensitization, a process where the nervous system becomes more reactive to pain signals. Over time, the lack of validation and support can erode trust, worsen mental health, and lead to avoidance of care - all of which contribute to greater pain, disability, and suffering.

Being dismissed doesn't just hurt emotionally - it actually makes physical pain worse.

Women are frequently told that their pain is “just part of being a woman.” One patient was worried because she’d noticed chest pressure and trouble maintaining endurance during regular exercise. Both her gynecologist and internist told her not to worry - that it was just a combination of perimenopausal symptoms and the stress of a high-powered job with long working hours.

It turns out that she had plaque in some of her arteries. Her symptoms weren’t due to hormones and anxiety - they were caused by hypertension and early coronary heart disease.⁶ This kind of medical gaslighting - well-documented and deeply harmful - costs patients both time and trust.

5. Intersectional Factors Amplify the Problem

Women of color face an added layer of bias. Studies have found racial and ethnic disparities in pain perception, assessment, and treatment were found in all settings (postoperative, emergency room) and across all types of pain (acute, cancer, chronic nonmalignant, and experimental).⁷ 

Women with connective tissue disorders - like Ehlers-Danlos Syndromes (EDS) and Hypermobility Spectrum Disorders (HSD) - frequently encounter medical skepticism. An especially troubling aspect of this skepticism is the accusation of Munchausen by Proxy, or “medical kidnapping,” where parents seeking medical care for their children are accused of fabricating or inducing symptoms. One mother, Beata Kowalski, was accused of Munchausen by Proxy after seeking treatment for her daughter’s complex regional pain syndrome (CRPS).⁸

Recommended Viewing: Complicated

If you’ve ever been turned away, not believed, or know someone with a complex illness - Complicated is essential viewing. This film highlights mothers accused of Munchausen by proxy when advocating for their children. Their persistence, love, and bravery save lives. 

A powerful exposé of children with complex illnesses and the systems that fail them, this documentary shines a light on the devastating consequences of medical gaslighting. Through investigative depth and personal storytelling, filmmaker Andrew Abrahams and co-producer Donna Sullivan deliver both a heartbreaking wake-up call and a rallying cry for change.

Donna, a fierce advocate for those with EDS, also serves as a board member for TCAPP (The Coalition Against Pediatric Pain). Check out their programs and resources if your child is suffering.  

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Sources:

1. Harvard Health Publishing. Women and pain: Disparities in experience and treatment. Harvard Health Blog. https://www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562

2. Samulowitz D, et al. "Brave Men" and "Emotional Women": A Theory-Guided Literature Review on Gender Bias in Health Care. Int J Equity Health. 2018;17(1):152.https://onlinelibrary.wiley.com/doi/full/10.1155/2018/6358624

3. Werner A, Malterud K. It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors. https://pubmed.ncbi.nlm.nih.gov/12927471/

4. Sun TY, Hardin J, Nieva HR, Natarajan K, Cheng RF, Ryan P, Elhadad N. Large-scale characterization of gender differences in diagnosis prevalence and time to diagnosis. https://pmc.ncbi.nlm.nih.gov/articles/PMC10592987/

5. Hoffmann DE, Tarzian AJ. The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain. J Law Med Ethics. https://pubmed.ncbi.nlm.nih.gov/11521267/

6. Northwell Health – Katz Institute for Women’s Health. “Gaslighting in Women’s Health: No, It’s Not Just in Your Head.” https://www.northwell.edu/katz-institute-for-womens-health/articles/gaslighting-in-womens-health

7. Green CR, et al. The unequal burden of pain: confronting racial and ethnic disparities in pain. Pain Med. 2003;4(3):277–294. https://pubmed.ncbi.nlm.nih.gov/12974827/

8. The EDS Clinic. “Is Ehlers‑Danlos Syndrome a Scam?” Updated October 2024, The EDS Clinic, https://www.eds.clinic/articles/ehlers-danlos-syndrome-scam

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LAST THURSDAY, JUNE 26th: Dr. Theoharis Theoharides on Rethinking Mast Cell Activation

We were thrilled to welcome Dr. Theoharis Theoharides back to the podcast to continue an important conversation on mast cells and why language matters. In this episode, he explains why calling it mast cell activation - not mast cell activation syndrome - could be the key to getting more patients the care they deserve. You’ll learn why normal lab results, like tryptase levels, shouldn’t stand in the way of treatment - and how to advocate for yourself when the data doesn’t match your symptoms. Dr. Pradeep Chopra joins as guest cohost for this must-hear episode.

THIS THURSDAY, JULY 3rd: Voice and Swallowing Issues in EDS with Stacey Menton

This week, we’re joined by Mayo Clinic speech-language pathologist Stacey Menton for a powerful episode on voice, breathing, swallowing, and cough issues in people with Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD). These symptoms are more common than many realize - but too often, they’re dismissed because patients “seem fine” or “don’t sound that bad.”

Well that’s all for this week; thank you so much for reading and supporting this newsletter. Talk to you soon, Bendy Buddies!

Yours in Health,

Dr. Bluestein