The Gender Pain Gap in Medicine: How Doctors Can Do Better

"She's Just Being Dramatic": The Dangerous Myth That Still Haunts Female Patients

Imagine this: a woman walks into a clinic complaining of chronic pain. It’s been ongoing for months, interfering with her sleep, work, and mood. There’s no fracture, no obvious inflammation, and her labs are unremarkable. Her words tumble out, laced with frustration: "I feel tired all the time. My muscles ache. Sometimes it feels like I’m going crazy."

For decades, physicians were conditioned — often unknowingly — to interpret such statements through a biased lens. A bias that whispers: "She's probably exaggerating. Maybe it's anxiety."

Let’s call it what it is: a systemic failure to validate female pain.

And this isn’t just anecdotal. Studies show that women are significantly more likely to be dismissed when reporting pain, more likely to be prescribed sedatives instead of painkillers, and more likely to be told their symptoms are psychosomatic. A 2018 study published in the Journal of Law, Medicine & Ethics found that women wait longer than men to receive analgesics in emergency settings — even when presenting with the same symptoms.

This legacy of dismissal stems from a long history of gender bias in medicine. Words like "hysteria," once a medical diagnosis, are a glaring reminder of this deeply rooted problem. Today, these terms may be gone, but the sentiment remains in subtle, dangerous ways.

The Rise of Fibromyalgia and Stress-Related Pain

Conditions like fibromyalgia, chronic fatigue syndrome (CFS/ME), and stress-induced myofascial pain have helped shift the conversation. These are diagnoses that predominantly affect women and come with a challenging trifecta: invisible symptoms, no definitive diagnostic test, and fluctuating presentation.

Many physicians were not trained adequately to recognize these disorders. Add to that the pressure of time-limited consultations, overflowing clinics, and the lack of concrete biomarkers, and it’s easy to see how dismissiveness happens — not out of cruelty, but exhaustion and systemic gaps.

But here’s the truth: “We don’t have an answer” is not the same as “It’s not real.”

The danger isn’t just about missing a diagnosis. It’s the erosion of trust. When female patients are repeatedly dismissed, they lose faith in the system, delay seeking care, and may even develop medical PTSD. As physicians, we should never allow our limitations to become the burden of our patients.

Why Female Pain is Interpreted Differently

Several factors play into this:

1. Cultural conditioning: Society has long labeled women as emotional and sensitive. This perception seeps into medical practice.
2. Gender data gap in research: Until recently, women were systematically excluded from clinical trials. Many "norms" in physiology and pharmacology are based on male bodies.
3. Communication differences: Women tend to describe symptoms in more narrative and descriptive ways, which can be misread as exaggeration.
4. Hormonal complexity: The interplay of hormones, especially during reproductive years, adds a layer of complexity that some physicians feel ill-equipped to tackle.

How to Do Better: Empathy is a Clinical Skill

Let’s not sugarcoat it — healthcare professionals are tired. Burnout is real. But so is the oath we took to do no harm.

So how do we strike the balance between evidence-based medicine and compassionate listening?

1. Validate First, Diagnose Later

Even if the symptoms seem vague or hard to pin down, always validate the patient's experience. Phrases like “I believe you” or “That sounds really difficult” can go a long way in building rapport.

2. Embrace the Unknown

Medicine isn’t always black and white. Saying “I don’t know, but I’ll work with you to figure it out” is both honest and empowering.

3. Beware the ‘Anxiety Trap’

Anxiety can certainly exacerbate symptoms, but jumping to that conclusion too quickly can shut down further exploration. If anxiety is part of the picture, it should be one piece, not the whole puzzle.

4. Ask, Don’t Assume

Pain scales are helpful, but don’t rely solely on them. Ask open-ended questions like:

• “How does this pain affect your daily life?”
• “What does a bad day look like?”
• “What are your goals for treatment?”

5. Educate Yourself on Female-Centric Conditions

Familiarize yourself with conditions like fibromyalgia, endometriosis, PMDD, and others that are frequently misunderstood or dismissed. The more confident you are in recognizing these, the better you’ll serve your patients.

6. Use Trauma-Informed Care Principles

Assume that many patients, especially women, may have experienced medical or other forms of trauma. Use language that is non-threatening, give them control when possible, and always explain what you’re doing.

7. Make Time for Listening

Yes, your schedule is insane. But even just two minutes of uninterrupted listening can make a patient feel seen. Practice active listening: no typing, no interrupting, just presence.

8. Challenge Your Colleagues Gently

When you hear dismissive comments — “She’s just stressed” or “Another fibromyalgia case” — ask, “What makes you say that?” Sometimes, a gentle challenge can prompt reflection.

Stories from the Frontlines

Dr. Nadia*, an internal medicine specialist, shares: “I used to roll my eyes at fibromyalgia cases in residency. Then I developed it myself. It changed how I practice. Now I take extra time with those patients, because I know how painful it is to be told you’re making it up.”

Or Dr. Ahmed*, a rheumatologist, who began screening every female patient with unexplained pain for fibromyalgia, myofascial pain, and autoimmune markers. “I realized I was missing too much because I was trained to ‘rule out’ instead of ‘look deeper.’”

(*Names changed for anonymity)

These stories aren’t rare — they’re just not told enough.

What About Male Patients?

Great question. Of course, men can and do face dismissal, especially in mental health or chronic fatigue cases. But statistically and experientially, women bear the brunt of pain bias. Addressing that doesn’t negate the needs of male patients — it raises the standard for everyone.

Final Thought (But Not a Conclusion)

We don’t need to be perfect. We just need to be better. Listen. Learn. Lead with empathy. Because healing starts with being heard.