Tag Archives: medical

The healthcare gender bias: do men get better medical treatment?

You are walking down the street, minding your own business, when suddenly you see someone collapse to the ground. They are unresponsive, not breathing. Do you perform CPR? No doubt you like to think that you would. But what if the unlucky person was a woman? The question may seem redundant, but unfortunately it is not: a study this month found that women are less likely than men to get CPR from a bystander, and are more likely to die.

The research, funded by the American Heart Association and the National Institutes of Health, found that only 39% of women who have a cardiac arrest in a public place were given CPR, versus 45% of men. Men were 23% more likely to survive and one of the study leaders, Benjamin Abella, speculated that rescuers may worry about moving a woman’s clothing, or touching her breasts. One idea mooted was more realistic-looking practice mannequins to account for the female torso.

It is hard to know what to make of the research, or where to place it in the panoply of ways in which women get short shrift. Medical care – which, at its essence, is about keeping people alive – should, of course, be free of gender bias. Naturally, however, it is not.

This is not to discount the ways in which men fare badly within the system, particularly when it comes to mental health. Race and poverty also feed into bias in healthcare – both huge topics in their own rights. But there is no shortage of ways in which women are discriminated against in medicine. This is evident throughout history, from Aristotle’s distinction between the superior male “form” and inferior female “matter”, to the medieval idea that women (“leaky vessels”) were unbalanced due to their wombs. In antiquity, doctors recommended marriage as a cure for female psychological disorders, and the Victorians had an unfortunate habit of committing women to asylums, regardless of evidence of mental illness. Today, while female GPs outnumber male ones (52% to 48%), 55% of registered medical practitioners are male. And the majority of specialists – 66% – are men.

For patients, the stereotype runs thus: men are less aware of health problems than women, less attuned to symptoms and they don’t visit the doctor as often as women. In other words, men are silent stoics; women hysterical hypochondriacs. There is evidence for this, to an extent – government statistics published in 2010 showed that women were more likely than men to say they were in poor health, but less likely to die over the following five years.

But this does not explain what happens to women when they genuinely need treatment. In 2001, University of Maryland academics Diane Hoffman and Anita Tarzian published The Girl Who Cried Pain, an analysis of the ways gender bias plays out in clinical pain management. They examined several previous studies, including one that indicated women are more likely to be given sedatives for their pain and men given pain medication, and concluded that women were more likely to be inadequately treated by healthcare providers. Several authors attribute this to “a long history within our culture of regarding women’s reasoning capacity as limited”, the paper noted.

‘For so many years I was told the pain was in my head.’


‘For so many years I was told the pain was in my head.’ Photograph: OhhhKaye.co.uk/Kaye Sedgwick-Jones.

In the 16 years since the paper was published, has anything changed? Probably not, says Tarzian, a programme coordinator at the University of Maryland’s school of law. “Every time you think things have changed, you look at the news and you think, ‘Hmm, maybe they haven’t.’ It still happens because that attitude people have towards gender is so inherent it’s hard to even be aware of – it’s subconscious.” Julia Buckley, a freelance journalist, can attest to this. Having had chronic pain since her teens, she was dismissed by doctors, told by a dentist she was “making it up” and, when she asked for physiotherapy on her arm so she could return to work, she was told to wait for a year, because she had already had physio on her leg. “I was gaslighted,” she says. “I don’t think I would have been treated that way if I were a man, and the psychological turmoil I was put through made everything worse.” She was finally diagnosed with Ehlers-Danlos syndrome, an inherited condition that affects connective tissue, five years ago, aged 31, and has written a book about her experiences, Heal Me: In Search of a Cure, which is out in January. “Women need to be pushier, and not revere doctors so much,” she says. “I respect doctors, but they’re not infallible.” Tarzian agrees. The traditional medical system disadvantages women, who, unlike men, are socialised to question themselves, she says: “There’s an extra value for women to trust their instincts.”

Nowhere is this more evident than when it comes to gynaecological conditions, such as endometriosis. One in 10 women suffer from the disease, but it takes, on average, seven to eight years to be diagnosed. Emma Cox, the chief executive of the charity Endometriosis UK, says that unless women with the disease are trying to conceive, they are often overlooked by doctors. “The attitude is that women are there to have babies,” she says.

It took Kaye Sedgwick Jones, a freelance illustrator and designer from Kent, more than 12 years to be diagnosed. In pain and seeking help, she was told by one doctor: “‘It’ll be better when you’ve had a baby’ … which, when you’re 13, is a weird thing to be told,” she says. When she was finally diagnosed, at age 25, her first reaction was “sheer anger. I was livid. For so many years I was told the pain was in my head.”

In September, new guidelines were published by the National Institute for Health and Care Excellence (Nice), in a bid to speed up diagnosis of endometriosis. Nice added that the NHS must “listen to women”.

Sedgwick Jones, now 36, has decided not to have children, although she once wanted them. An earlier diagnosis, she says, could have made a difference. “I wasn’t taken seriously because I was a young woman,” she says. “I can’t imagine why it is still so difficult for a woman to walk into a GP’s office and say: ‘Help me, I’m in pain.’”

Dementia care is another area where women draw the short straw. In 2016, researchers at University College London found that women with dementia receive worse medical treatment than men with the condition. Namely, they make fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men. “We know very clearly what’s happening, but we can’t clearly explain why from that data,” said Dr Claudia Cooper, who led the study. One factor, she says, could be that women, who live longer than men, are more likely to be alone and thus less likely to have a primary carer to help them. “Two-thirds of people over 80 are women,” she says. “But they are the marginalised majority.”

This is a big, unwieldy issue is a discussion that is perhaps too amorphous for some. Health charities the King’s Fund, the Nuffield Trust and the Health Foundation, along with the Royal College of Obstetricians and Gynaecologists, were all approached for comment for this article but failed to provide anyone to talk to.

For Buckley, gender bias in healthcare is an epidemic that needs to be addressed: “People are dying because they are female and doctors are blinded by their gender,” she says. “Don’t assume that women are hysterical. That’s quite basic. Treat everyone as a person.”

The healthcare gender bias: do men get better medical treatment?

You are walking down the street, minding your own business, when suddenly you see someone collapse to the ground. They are unresponsive, not breathing. Do you perform CPR? No doubt you like to think that you would. But what if the unlucky person was a woman? The question may seem redundant, but unfortunately it is not: a study this month found that women are less likely than men to get CPR from a bystander, and are more likely to die.

The research, funded by the American Heart Association and the National Institutes of Health, found that only 39% of women who have a cardiac arrest in a public place were given CPR, versus 45% of men. Men were 23% more likely to survive and one of the study leaders, Benjamin Abella, speculated that rescuers may worry about moving a woman’s clothing, or touching her breasts. One idea mooted was more realistic-looking practice mannequins to account for the female torso.

It is hard to know what to make of the research, or where to place it in the panoply of ways in which women get short shrift. Medical care – which, at its essence, is about keeping people alive – should, of course, be free of gender bias. Naturally, however, it is not.

This is not to discount the ways in which men fare badly within the system, particularly when it comes to mental health. Race and poverty also feed into bias in healthcare – both huge topics in their own rights. But there is no shortage of ways in which women are discriminated against in medicine. This is evident throughout history, from Aristotle’s distinction between the superior male “form” and inferior female “matter”, to the medieval idea that women (“leaky vessels”) were unbalanced due to their wombs. In antiquity, doctors recommended marriage as a cure for female psychological disorders, and the Victorians had an unfortunate habit of committing women to asylums, regardless of evidence of mental illness. Today, while female GPs outnumber male ones (52% to 48%), 55% of registered medical practitioners are male. And the majority of specialists – 66% – are men.

For patients, the stereotype runs thus: men are less aware of health problems than women, less attuned to symptoms and they don’t visit the doctor as often as women. In other words, men are silent stoics; women hysterical hypochondriacs. There is evidence for this, to an extent – government statistics published in 2010 showed that women were more likely than men to say they were in poor health, but less likely to die over the following five years.

But this does not explain what happens to women when they genuinely need treatment. In 2001, University of Maryland academics Diane Hoffman and Anita Tarzian published The Girl Who Cried Pain, an analysis of the ways gender bias plays out in clinical pain management. They examined several previous studies, including one that indicated women are more likely to be given sedatives for their pain and men given pain medication, and concluded that women were more likely to be inadequately treated by healthcare providers. Several authors attribute this to “a long history within our culture of regarding women’s reasoning capacity as limited”, the paper noted.

‘For so many years I was told the pain was in my head.’


‘For so many years I was told the pain was in my head.’ Photograph: OhhhKaye.co.uk/Kaye Sedgwick-Jones.

In the 16 years since the paper was published, has anything changed? Probably not, says Tarzian, a programme coordinator at the University of Maryland’s school of law. “Every time you think things have changed, you look at the news and you think, ‘Hmm, maybe they haven’t.’ It still happens because that attitude people have towards gender is so inherent it’s hard to even be aware of – it’s subconscious.” Julia Buckley, a freelance journalist, can attest to this. Having had chronic pain since her teens, she was dismissed by doctors, told by a dentist she was “making it up” and, when she asked for physiotherapy on her arm so she could return to work, she was told to wait for a year, because she had already had physio on her leg. “I was gaslighted,” she says. “I don’t think I would have been treated that way if I were a man, and the psychological turmoil I was put through made everything worse.” She was finally diagnosed with Ehlers-Danlos syndrome, an inherited condition that affects connective tissue, five years ago, aged 31, and has written a book about her experiences, Heal Me: In Search of a Cure, which is out in January. “Women need to be pushier, and not revere doctors so much,” she says. “I respect doctors, but they’re not infallible.” Tarzian agrees. The traditional medical system disadvantages women, who, unlike men, are socialised to question themselves, she says: “There’s an extra value for women to trust their instincts.”

Nowhere is this more evident than when it comes to gynaecological conditions, such as endometriosis. One in 10 women suffer from the disease, but it takes, on average, seven to eight years to be diagnosed. Emma Cox, the chief executive of the charity Endometriosis UK, says that unless women with the disease are trying to conceive, they are often overlooked by doctors. “The attitude is that women are there to have babies,” she says.

It took Kaye Sedgwick Jones, a freelance illustrator and designer from Kent, more than 12 years to be diagnosed. In pain and seeking help, she was told by one doctor: “‘It’ll be better when you’ve had a baby’ … which, when you’re 13, is a weird thing to be told,” she says. When she was finally diagnosed, at age 25, her first reaction was “sheer anger. I was livid. For so many years I was told the pain was in my head.”

In September, new guidelines were published by the National Institute for Health and Care Excellence (Nice), in a bid to speed up diagnosis of endometriosis. Nice added that the NHS must “listen to women”.

Sedgwick Jones, now 36, has decided not to have children, although she once wanted them. An earlier diagnosis, she says, could have made a difference. “I wasn’t taken seriously because I was a young woman,” she says. “I can’t imagine why it is still so difficult for a woman to walk into a GP’s office and say: ‘Help me, I’m in pain.’”

Dementia care is another area where women draw the short straw. In 2016, researchers at University College London found that women with dementia receive worse medical treatment than men with the condition. Namely, they make fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men. “We know very clearly what’s happening, but we can’t clearly explain why from that data,” said Dr Claudia Cooper, who led the study. One factor, she says, could be that women, who live longer than men, are more likely to be alone and thus less likely to have a primary carer to help them. “Two-thirds of people over 80 are women,” she says. “But they are the marginalised majority.”

This is a big, unwieldy issue is a discussion that is perhaps too amorphous for some. Health charities the King’s Fund, the Nuffield Trust and the Health Foundation, along with the Royal College of Obstetricians and Gynaecologists, were all approached for comment for this article but failed to provide anyone to talk to.

For Buckley, gender bias in healthcare is an epidemic that needs to be addressed: “People are dying because they are female and doctors are blinded by their gender,” she says. “Don’t assume that women are hysterical. That’s quite basic. Treat everyone as a person.”

The healthcare gender bias: do men get better medical treatment?

You are walking down the street, minding your own business, when suddenly you see someone collapse to the ground. They are unresponsive, not breathing. Do you perform CPR? No doubt you like to think that you would. But what if the unlucky person was a woman? The question may seem redundant, but unfortunately it is not: a study this month found that women are less likely than men to get CPR from a bystander, and are more likely to die.

The research, funded by the American Heart Association and the National Institutes of Health, found that only 39% of women who have a cardiac arrest in a public place were given CPR, versus 45% of men. Men were 23% more likely to survive and one of the study leaders, Benjamin Abella, speculated that rescuers may worry about moving a woman’s clothing, or touching her breasts. One idea mooted was more realistic-looking practice mannequins to account for the female torso.

It is hard to know what to make of the research, or where to place it in the panoply of ways in which women get short shrift. Medical care – which, at its essence, is about keeping people alive – should, of course, be free of gender bias. Naturally, however, it is not.

This is not to discount the ways in which men fare badly within the system, particularly when it comes to mental health. Race and poverty also feed into bias in healthcare – both huge topics in their own rights. But there is no shortage of ways in which women are discriminated against in medicine. This is evident throughout history, from Aristotle’s distinction between the superior male “form” and inferior female “matter”, to the medieval idea that women (“leaky vessels”) were unbalanced due to their wombs. In antiquity, doctors recommended marriage as a cure for female psychological disorders, and the Victorians had an unfortunate habit of committing women to asylums, regardless of evidence of mental illness. Today, while female GPs outnumber male ones (52% to 48%), 55% of registered medical practitioners are male. And the majority of specialists – 66% – are men.

For patients, the stereotype runs thus: men are less aware of health problems than women, less attuned to symptoms and they don’t visit the doctor as often as women. In other words, men are silent stoics; women hysterical hypochondriacs. There is evidence for this, to an extent – government statistics published in 2010 showed that women were more likely than men to say they were in poor health, but less likely to die over the following five years.

But this does not explain what happens to women when they genuinely need treatment. In 2001, University of Maryland academics Diane Hoffman and Anita Tarzian published The Girl Who Cried Pain, an analysis of the ways gender bias plays out in clinical pain management. They examined several previous studies, including one that indicated women are more likely to be given sedatives for their pain and men given pain medication, and concluded that women were more likely to be inadequately treated by healthcare providers. Several authors attribute this to “a long history within our culture of regarding women’s reasoning capacity as limited”, the paper noted.

‘For so many years I was told the pain was in my head.’


‘For so many years I was told the pain was in my head.’ Photograph: OhhhKaye.co.uk/Kaye Sedgwick-Jones.

In the 16 years since the paper was published, has anything changed? Probably not, says Tarzian, a programme coordinator at the University of Maryland’s school of law. “Every time you think things have changed, you look at the news and you think, ‘Hmm, maybe they haven’t.’ It still happens because that attitude people have towards gender is so inherent it’s hard to even be aware of – it’s subconscious.” Julia Buckley, a freelance journalist, can attest to this. Having had chronic pain since her teens, she was dismissed by doctors, told by a dentist she was “making it up” and, when she asked for physiotherapy on her arm so she could return to work, she was told to wait for a year, because she had already had physio on her leg. “I was gaslighted,” she says. “I don’t think I would have been treated that way if I were a man, and the psychological turmoil I was put through made everything worse.” She was finally diagnosed with Ehlers-Danlos syndrome, an inherited condition that affects connective tissue, five years ago, aged 31, and has written a book about her experiences, Heal Me: In Search of a Cure, which is out in January. “Women need to be pushier, and not revere doctors so much,” she says. “I respect doctors, but they’re not infallible.” Tarzian agrees. The traditional medical system disadvantages women, who, unlike men, are socialised to question themselves, she says: “There’s an extra value for women to trust their instincts.”

Nowhere is this more evident than when it comes to gynaecological conditions, such as endometriosis. One in 10 women suffer from the disease, but it takes, on average, seven to eight years to be diagnosed. Emma Cox, the chief executive of the charity Endometriosis UK, says that unless women with the disease are trying to conceive, they are often overlooked by doctors. “The attitude is that women are there to have babies,” she says.

It took Kaye Sedgwick Jones, a freelance illustrator and designer from Kent, more than 12 years to be diagnosed. In pain and seeking help, she was told by one doctor: “‘It’ll be better when you’ve had a baby’ … which, when you’re 13, is a weird thing to be told,” she says. When she was finally diagnosed, at age 25, her first reaction was “sheer anger. I was livid. For so many years I was told the pain was in my head.”

In September, new guidelines were published by the National Institute for Health and Care Excellence (Nice), in a bid to speed up diagnosis of endometriosis. Nice added that the NHS must “listen to women”.

Sedgwick Jones, now 36, has decided not to have children, although she once wanted them. An earlier diagnosis, she says, could have made a difference. “I wasn’t taken seriously because I was a young woman,” she says. “I can’t imagine why it is still so difficult for a woman to walk into a GP’s office and say: ‘Help me, I’m in pain.’”

Dementia care is another area where women draw the short straw. In 2016, researchers at University College London found that women with dementia receive worse medical treatment than men with the condition. Namely, they make fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men. “We know very clearly what’s happening, but we can’t clearly explain why from that data,” said Dr Claudia Cooper, who led the study. One factor, she says, could be that women, who live longer than men, are more likely to be alone and thus less likely to have a primary carer to help them. “Two-thirds of people over 80 are women,” she says. “But they are the marginalised majority.”

This is a big, unwieldy issue is a discussion that is perhaps too amorphous for some. Health charities the King’s Fund, the Nuffield Trust and the Health Foundation, along with the Royal College of Obstetricians and Gynaecologists, were all approached for comment for this article but failed to provide anyone to talk to.

For Buckley, gender bias in healthcare is an epidemic that needs to be addressed: “People are dying because they are female and doctors are blinded by their gender,” she says. “Don’t assume that women are hysterical. That’s quite basic. Treat everyone as a person.”

The healthcare gender bias: do men get better medical treatment?

You are walking down the street, minding your own business, when suddenly you see someone collapse to the ground. They are unresponsive, not breathing. Do you perform CPR? No doubt you like to think that you would. But what if the unlucky person was a woman? The question may seem redundant, but unfortunately it is not: a study this month found that women are less likely than men to get CPR from a bystander, and are more likely to die.

The research, funded by the American Heart Association and the National Institutes of Health, found that only 39% of women who have a cardiac arrest in a public place were given CPR, versus 45% of men. Men were 23% more likely to survive and one of the study leaders, Benjamin Abella, speculated that rescuers may worry about moving a woman’s clothing, or touching her breasts. One idea mooted was more realistic-looking practice mannequins to account for the female torso.

It is hard to know what to make of the research, or where to place it in the panoply of ways in which women get short shrift. Medical care – which, at its essence, is about keeping people alive – should, of course, be free of gender bias. Naturally, however, it is not.

This is not to discount the ways in which men fare badly within the system, particularly when it comes to mental health. Race and poverty also feed into bias in healthcare – both huge topics in their own rights. But there is no shortage of ways in which women are discriminated against in medicine. This is evident throughout history, from Aristotle’s distinction between the superior male “form” and inferior female “matter”, to the medieval idea that women (“leaky vessels”) were unbalanced due to their wombs. In antiquity, doctors recommended marriage as a cure for female psychological disorders, and the Victorians had an unfortunate habit of committing women to asylums, regardless of evidence of mental illness. Today, while female GPs outnumber male ones (52% to 48%), 55% of registered medical practitioners are male. And the majority of specialists – 66% – are men.

For patients, the stereotype runs thus: men are less aware of health problems than women, less attuned to symptoms and they don’t visit the doctor as often as women. In other words, men are silent stoics; women hysterical hypochondriacs. There is evidence for this, to an extent – government statistics published in 2010 showed that women were more likely than men to say they were in poor health, but less likely to die over the following five years.

But this does not explain what happens to women when they genuinely need treatment. In 2001, University of Maryland academics Diane Hoffman and Anita Tarzian published The Girl Who Cried Pain, an analysis of the ways gender bias plays out in clinical pain management. They examined several previous studies, including one that indicated women are more likely to be given sedatives for their pain and men given pain medication, and concluded that women were more likely to be inadequately treated by healthcare providers. Several authors attribute this to “a long history within our culture of regarding women’s reasoning capacity as limited”, the paper noted.

‘For so many years I was told the pain was in my head.’


‘For so many years I was told the pain was in my head.’ Photograph: OhhhKaye.co.uk/Kaye Sedgwick-Jones.

In the 16 years since the paper was published, has anything changed? Probably not, says Tarzian, a programme coordinator at the University of Maryland’s school of law. “Every time you think things have changed, you look at the news and you think, ‘Hmm, maybe they haven’t.’ It still happens because that attitude people have towards gender is so inherent it’s hard to even be aware of – it’s subconscious.” Julia Buckley, a freelance journalist, can attest to this. Having had chronic pain since her teens, she was dismissed by doctors, told by a dentist she was “making it up” and, when she asked for physiotherapy on her arm so she could return to work, she was told to wait for a year, because she had already had physio on her leg. “I was gaslighted,” she says. “I don’t think I would have been treated that way if I were a man, and the psychological turmoil I was put through made everything worse.” She was finally diagnosed with Ehlers-Danlos syndrome, an inherited condition that affects connective tissue, five years ago, aged 31, and has written a book about her experiences, Heal Me: In Search of a Cure, which is out in January. “Women need to be pushier, and not revere doctors so much,” she says. “I respect doctors, but they’re not infallible.” Tarzian agrees. The traditional medical system disadvantages women, who, unlike men, are socialised to question themselves, she says: “There’s an extra value for women to trust their instincts.”

Nowhere is this more evident than when it comes to gynaecological conditions, such as endometriosis. One in 10 women suffer from the disease, but it takes, on average, seven to eight years to be diagnosed. Emma Cox, the chief executive of the charity Endometriosis UK, says that unless women with the disease are trying to conceive, they are often overlooked by doctors. “The attitude is that women are there to have babies,” she says.

It took Kaye Sedgwick Jones, a freelance illustrator and designer from Kent, more than 12 years to be diagnosed. In pain and seeking help, she was told by one doctor: “‘It’ll be better when you’ve had a baby’ … which, when you’re 13, is a weird thing to be told,” she says. When she was finally diagnosed, at age 25, her first reaction was “sheer anger. I was livid. For so many years I was told the pain was in my head.”

In September, new guidelines were published by the National Institute for Health and Care Excellence (Nice), in a bid to speed up diagnosis of endometriosis. Nice added that the NHS must “listen to women”.

Sedgwick Jones, now 36, has decided not to have children, although she once wanted them. An earlier diagnosis, she says, could have made a difference. “I wasn’t taken seriously because I was a young woman,” she says. “I can’t imagine why it is still so difficult for a woman to walk into a GP’s office and say: ‘Help me, I’m in pain.’”

Dementia care is another area where women draw the short straw. In 2016, researchers at University College London found that women with dementia receive worse medical treatment than men with the condition. Namely, they make fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men. “We know very clearly what’s happening, but we can’t clearly explain why from that data,” said Dr Claudia Cooper, who led the study. One factor, she says, could be that women, who live longer than men, are more likely to be alone and thus less likely to have a primary carer to help them. “Two-thirds of people over 80 are women,” she says. “But they are the marginalised majority.”

This is a big, unwieldy issue is a discussion that is perhaps too amorphous for some. Health charities the King’s Fund, the Nuffield Trust and the Health Foundation, along with the Royal College of Obstetricians and Gynaecologists, were all approached for comment for this article but failed to provide anyone to talk to.

For Buckley, gender bias in healthcare is an epidemic that needs to be addressed: “People are dying because they are female and doctors are blinded by their gender,” she says. “Don’t assume that women are hysterical. That’s quite basic. Treat everyone as a person.”

The healthcare gender bias: do men get better medical treatment?

You are walking down the street, minding your own business, when suddenly you see someone collapse to the ground. They are unresponsive, not breathing. Do you perform CPR? No doubt you like to think that you would. But what if the unlucky person was a woman? The question may seem redundant, but unfortunately it is not: a study this month found that women are less likely than men to get CPR from a bystander, and are more likely to die.

The research, funded by the American Heart Association and the National Institutes of Health, found that only 39% of women who have a cardiac arrest in a public place were given CPR, versus 45% of men. Men were 23% more likely to survive and one of the study leaders, Benjamin Abella, speculated that rescuers may worry about moving a woman’s clothing, or touching her breasts. One idea mooted was more realistic-looking practice mannequins to account for the female torso.

It is hard to know what to make of the research, or where to place it in the panoply of ways in which women get short shrift. Medical care – which, at its essence, is about keeping people alive – should, of course, be free of gender bias. Naturally, however, it is not.

This is not to discount the ways in which men fare badly within the system, particularly when it comes to mental health. Race and poverty also feed into bias in healthcare – both huge topics in their own rights. But there is no shortage of ways in which women are discriminated against in medicine. This is evident throughout history, from Aristotle’s distinction between the superior male “form” and inferior female “matter”, to the medieval idea that women (“leaky vessels”) were unbalanced due to their wombs. In antiquity, doctors recommended marriage as a cure for female psychological disorders, and the Victorians had an unfortunate habit of committing women to asylums, regardless of evidence of mental illness. Today, while female GPs outnumber male ones (52% to 48%), 55% of registered medical practitioners are male. And the majority of specialists – 66% – are men.

For patients, the stereotype runs thus: men are less aware of health problems than women, less attuned to symptoms and they don’t visit the doctor as often as women. In other words, men are silent stoics; women hysterical hypochondriacs. There is evidence for this, to an extent – government statistics published in 2010 showed that women were more likely than men to say they were in poor health, but less likely to die over the following five years.

But this does not explain what happens to women when they genuinely need treatment. In 2001, University of Maryland academics Diane Hoffman and Anita Tarzian published The Girl Who Cried Pain, an analysis of the ways gender bias plays out in clinical pain management. They examined several previous studies, including one that indicated women are more likely to be given sedatives for their pain and men given pain medication, and concluded that women were more likely to be inadequately treated by healthcare providers. Several authors attribute this to “a long history within our culture of regarding women’s reasoning capacity as limited”, the paper noted.

‘For so many years I was told the pain was in my head.’


‘For so many years I was told the pain was in my head.’ Photograph: OhhhKaye.co.uk/Kaye Sedgwick-Jones.

In the 16 years since the paper was published, has anything changed? Probably not, says Tarzian, a programme coordinator at the University of Maryland’s school of law. “Every time you think things have changed, you look at the news and you think, ‘Hmm, maybe they haven’t.’ It still happens because that attitude people have towards gender is so inherent it’s hard to even be aware of – it’s subconscious.” Julia Buckley, a freelance journalist, can attest to this. Having had chronic pain since her teens, she was dismissed by doctors, told by a dentist she was “making it up” and, when she asked for physiotherapy on her arm so she could return to work, she was told to wait for a year, because she had already had physio on her leg. “I was gaslighted,” she says. “I don’t think I would have been treated that way if I were a man, and the psychological turmoil I was put through made everything worse.” She was finally diagnosed with Ehlers-Danlos syndrome, an inherited condition that affects connective tissue, five years ago, aged 31, and has written a book about her experiences, Heal Me: In Search of a Cure, which is out in January. “Women need to be pushier, and not revere doctors so much,” she says. “I respect doctors, but they’re not infallible.” Tarzian agrees. The traditional medical system disadvantages women, who, unlike men, are socialised to question themselves, she says: “There’s an extra value for women to trust their instincts.”

Nowhere is this more evident than when it comes to gynaecological conditions, such as endometriosis. One in 10 women suffer from the disease, but it takes, on average, seven to eight years to be diagnosed. Emma Cox, the chief executive of the charity Endometriosis UK, says that unless women with the disease are trying to conceive, they are often overlooked by doctors. “The attitude is that women are there to have babies,” she says.

It took Kaye Sedgwick Jones, a freelance illustrator and designer from Kent, more than 12 years to be diagnosed. In pain and seeking help, she was told by one doctor: “‘It’ll be better when you’ve had a baby’ … which, when you’re 13, is a weird thing to be told,” she says. When she was finally diagnosed, at age 25, her first reaction was “sheer anger. I was livid. For so many years I was told the pain was in my head.”

In September, new guidelines were published by the National Institute for Health and Care Excellence (Nice), in a bid to speed up diagnosis of endometriosis. Nice added that the NHS must “listen to women”.

Sedgwick Jones, now 36, has decided not to have children, although she once wanted them. An earlier diagnosis, she says, could have made a difference. “I wasn’t taken seriously because I was a young woman,” she says. “I can’t imagine why it is still so difficult for a woman to walk into a GP’s office and say: ‘Help me, I’m in pain.’”

Dementia care is another area where women draw the short straw. In 2016, researchers at University College London found that women with dementia receive worse medical treatment than men with the condition. Namely, they make fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men. “We know very clearly what’s happening, but we can’t clearly explain why from that data,” said Dr Claudia Cooper, who led the study. One factor, she says, could be that women, who live longer than men, are more likely to be alone and thus less likely to have a primary carer to help them. “Two-thirds of people over 80 are women,” she says. “But they are the marginalised majority.”

This is a big, unwieldy issue is a discussion that is perhaps too amorphous for some. Health charities the King’s Fund, the Nuffield Trust and the Health Foundation, along with the Royal College of Obstetricians and Gynaecologists, were all approached for comment for this article but failed to provide anyone to talk to.

For Buckley, gender bias in healthcare is an epidemic that needs to be addressed: “People are dying because they are female and doctors are blinded by their gender,” she says. “Don’t assume that women are hysterical. That’s quite basic. Treat everyone as a person.”

The healthcare gender bias: do men get better medical treatment?

You are walking down the street, minding your own business, when suddenly you see someone collapse to the ground. They are unresponsive, not breathing. Do you perform CPR? No doubt you like to think that you would. But what if the unlucky person was a woman? The question may seem redundant, but unfortunately it is not: a study this month found that women are less likely than men to get CPR from a bystander, and are more likely to die.

The research, funded by the American Heart Association and the National Institutes of Health, found that only 39% of women who have a cardiac arrest in a public place were given CPR, versus 45% of men. Men were 23% more likely to survive and one of the study leaders, Benjamin Abella, speculated that rescuers may worry about moving a woman’s clothing, or touching her breasts. One idea mooted was more realistic-looking practice mannequins to account for the female torso.

It is hard to know what to make of the research, or where to place it in the panoply of ways in which women get short shrift. Medical care – which, at its essence, is about keeping people alive – should, of course, be free of gender bias. Naturally, however, it is not.

This is not to discount the ways in which men fare badly within the system, particularly when it comes to mental health. Race and poverty also feed into bias in healthcare – both huge topics in their own rights. But there is no shortage of ways in which women are discriminated against in medicine. This is evident throughout history, from Aristotle’s distinction between the superior male “form” and inferior female “matter”, to the medieval idea that women (“leaky vessels”) were unbalanced due to their wombs. In antiquity, doctors recommended marriage as a cure for female psychological disorders, and the Victorians had an unfortunate habit of committing women to asylums, regardless of evidence of mental illness. Today, while female GPs outnumber male ones (52% to 48%), 55% of registered medical practitioners are male. And the majority of specialists – 66% – are men.

For patients, the stereotype runs thus: men are less aware of health problems than women, less attuned to symptoms and they don’t visit the doctor as often as women. In other words, men are silent stoics; women hysterical hypochondriacs. There is evidence for this, to an extent – government statistics published in 2010 showed that women were more likely than men to say they were in poor health, but less likely to die over the following five years.

But this does not square away what happens to women when they genuinely need treatment. In 2001, University of Maryland academics Diane Hoffman and Anita Tarzian published The Girl Who Cried Pain, an analysis of the ways gender bias plays out in clinical pain management. They examined several previous studies, including one that indicated women are more likely to be given sedatives for their pain and men given pain medication, and concluded that women were more likely to be inadequately treated by healthcare providers. Several authors attribute this to “a long history within our culture of regarding women’s reasoning capacity as limited”, the paper noted.

‘For so many years I was told the pain was in my head.’


‘For so many years I was told the pain was in my head.’ Photograph: OhhhKaye.co.uk/Kaye Sedgwick-Jones.

In the 16 years since the paper was published, has anything changed? Probably not, says Tarzian, a programme coordinator at the University of Maryland’s school of law. “Every time you think things have changed, you look at the news and you think, ‘Hmm, maybe they haven’t.’ It still happens because that attitude people have towards gender is so inherent it’s hard to even be aware of – it’s subconscious.” Julia Buckley, a freelance journalist, can attest to this. Having had chronic pain since her teens, she was dismissed by doctors, told by a dentist she was “making it up” and, when she asked for physiotherapy on her arm so she could return to work, she was told to wait for a year, because she had already had physio on her leg. “I was gaslighted,” she says. “I don’t think I would have been treated that way if I were a man, and the psychological turmoil I was put through made everything worse.” She was finally diagnosed with Ehlers-Danlos syndrome, an inherited condition that affects connective tissue, five years ago, aged 31, and has written a book about her experiences, Heal Me: In Search of a Cure, which is out in January. “Women need to be pushier, and not revere doctors so much,” she says. “I respect doctors, but they’re not infallible.” Tarzian agrees. The traditional medical system disadvantages women, who, unlike men, are socialised to question themselves, she says: “There’s an extra value for women to trust their instincts.”

Nowhere is this more evident than when it comes to gynaecological conditions, such as endometriosis. One in 10 women suffer from the disease, but it takes, on average, seven to eight years to be diagnosed. Emma Cox, the chief executive of the charity Endometriosis UK, says that unless women with the disease are trying to conceive, they are often overlooked by doctors. “The attitude is that women are there to have babies,” she says.

It took Kaye Sedgwick Jones, a freelance illustrator and designer from Kent, more than 12 years to be diagnosed. In pain and seeking help, she was told by one doctor: “‘It’ll be better when you’ve had a baby’ … which, when you’re 13, is a weird thing to be told,” she says. When she was finally diagnosed, at age 25, her first reaction was “sheer anger. I was livid. For so many years I was told the pain was in my head.”

In September, new guidelines were published by the National Institute for Health and Care Excellence (Nice), in a bid to speed up diagnosis. Nice added that the NHS must “listen to women”.

Sedgwick Jones, now 36, has decided not to have children, although she once wanted them. An earlier diagnosis, she says, could have made a difference. “I wasn’t taken seriously because I was a young woman,” she says. “I can’t imagine why it is still so difficult for a woman to walk into a GP’s office and say: ‘Help me, I’m in pain.’”

Dementia care is another area where women draw the short straw. In 2016, researchers at University College London found that women with dementia receive worse medical treatment than men with the condition. Namely, they make fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men. “We know very clearly what’s happening, but we can’t clearly explain why from that data,” said Dr Claudia Cooper, who led the study. One factor, she says, could be that women, who live longer than men, are more likely to be alone and thus less likely to have a primary carer to help them. “Two-thirds of people over 80 are women,” she says. “But they are the marginalised majority.”

This is a big, unwieldy issue is a discussion that is perhaps too amorphous for some. Health charities the King’s Fund, the Nuffield Trust and the Health Foundation, along with the Royal College of Obstetricians and Gynaecologists, were all approached for comment for this article but failed to provide anyone to talk to.

For Buckley, gender bias in healthcare is an epidemic that needs to be addressed: “People are dying because they are female and doctors are blinded by their gender,” she says. “Don’t assume that women are hysterical. That’s quite basic. Treat everyone as a person.”

Hospitals in crisis in Uganda as Middle Eastern countries poach medical staff

The failure to stop a brain drain of almost 2,000 of its best doctors and nurses is exacerbating Uganda’s healthcare crisis, reflecting a growing problem across east Africa, say healthcare workers.

At least 1,963 medics are being recruited to work at one hospital alone in Libya, as Middle Eastern countries turn to the region for highly qualified workers to fill their own vacancies, which have increased amid political instability and migration.

Nurses, laboratory technicians and doctors in different fields are being recruited from public health facilities, private hospitals and the not-for-profit sector, with no clear government plan to mitigate the impact on the domestic health sector, medical workers say.

“This one [Libyan] deal, if executed, will worsen the shortage of health workers, undermining service delivery and the investment by donors to the health sector,” said a statement from the Uganda Civil Society HIV Prevention Advocacy Coalition.

The coalition, a group of workers and patients, wants a temporary halt to recruitment, to allow urgent discussions at government level. “This deal will make the health crisis worse in Uganda – actively facilitating export of critical cadres of health workers will accelerate suffering and death,” said Asia Russell, executive director of the Health Global Access Project (Health Gap). “The government is refusing to increase production, retention and motivation of health workers in order to save lives.”

Dona Anyona, of the health system advocacy partnership at Amref Health Africa, said: “It’s not the right move, given the understaffing and its resultant impact on healthcare service provision.

“Besides, it’s not a good return on investment, given the fact that training a health worker is a costly venture and most health workers are educated using public funds – and at the end of the day the citizens who meet the costs of this education do not benefit from their services.”

Uganda continues to face a severe shortage of critical health workers, according to the health ministry. The national health system performs poorly and staff encounter challenges with accommodation and transport, not to mention months without pay.

On top of that, health facilities lack adequate medicines and proper equipment. Just 69% of health posts are filled (pdf) according to figures for 2015. In 2013, the doctor-to-patient ratio was estimated at 1:24,725, with a nurse-to-patient ratio of 1:11,000. The World Health Organization (WHO) recommends one physician per 1,000 people.

Although the Institute of Public Policy Research Uganda, a thinktank, sued the government in 2014 to stop the loss of 263 health workers to Trinidad and Tobago, that court case is still pending, and some 3,000 medics left the country between March and June this year alone, according to estimates from activists.

The brain drain of health workers from east Africa is caused by local private recruitment agencies that broker deals mainly with Arab countries – arrangements it is difficult to prevent.

“As a government, we can’t stop health workers from going to work abroad if they want to. Since we have free movement of labour in Uganda, there is no reason as to why we can stop them from going,” said health minister Sarah Achieng Opendi.

“We also can’t absorb all [these workers] in our health government system because of the wage bill and [limits on staff levels]. We tried to put a system to bond health worker students who complete studies on government sponsorship. But it doesn’t work – they took us to court. The case is still pending.”

Every year, at least 320 medical students graduate from Ugandan universities, more than in any east African nation. But public hospitals are very short staffed.

“Uganda’s health worker crisis is caused by multiple factors. The government refuses to provide adequate pay, health workers are not deployed to the areas where they are most needed, and many lack the tools and support to do their jobs effectively,” said Russell.

The medical brain drain is not restricted to Uganda – but common across sub-Saharan Africa. A 2011 study found, for example, that 77% of physicians who had trained in Liberia were working in the US.

Meanwhile, HIV activists have criticised the labour ministry for allowing recruitment agencies to insist that applicants undergo an HIV test, which is against Ugandan law on the workplace.

“Mandatory HIV testing deprives someone of their rights to privacy and dignity, and also those taken through the test and found HIV positive are denied the opportunity to work. Despite the fact that they meet the qualifications, their right to equal opportunity is denied,” said Dorah Kiconco, of the Uganda Network on Law, Ethics and HIV–Aids. “This is wrong on all fronts. HIV does not make someone incapable of doing what they can do.”

Cheers! Drinking’s good for us again – but can the medical hype be trusted? | Simon Jenkins

That’s OK then. A pint a day keeps the doctor away. A pint of beer, that is. Yes, it used to be a pint of milk, but that was before milk was bad for you. Go to work on an egg was the same. Now it is our old friend alcohol that is back in favour. Seven pints of beer, or a bottle and a half of wine, dramatically cut whether you get type 2 diabetes. It’s official. Danish scientists say so, and who are we to quarrel?

What should the ordinary reader make of the daily stream of stories bursting from the swing-doors of medical research, usually followed by a request for more research cash? The biggest headlines go to anyone who can stand previous advice on its head. Vitamins are good for you, or totally useless. Exercise is good for your heart, or might kill you, depending on who you are. Carbohydrates are good if complex, bad if not. Cholesterol also comes in “good” and “bad” varieties. As for the microbiome theory, it offers a whole new cornucopia of horrors and delights.

Some things are getting better. Time was when “surveys show …” was preliminary to pure advertising copy. Peddlers of cigarettes, fats, cereals and stout all used pseudo-science to claim health-giving properties for their wares. They probably killed hundreds of thousands. Advertising regulation and scientific peer review have done something to curb such woes.


Peddlers of cigarettes, fats, cereals and stout all used pseudo-science to claim health-giving properties.

The new menace is self-diagnosis. Doctors claim that a majority of patients investigate their symptoms online, arriving at the surgery demanding not diagnosis, but prescriptions. Burgeoning health columns in the media have a similar effect.

Huge profits can be made by drug companies from claiming to postpone the approach of death. Big pharma is like the medieval papacy, selling indulgences to reduce time spent in purgatory. Its long campaign against cancer immunology – to protect its lucrative chemotherapy patents – was a scandal of similar proportions. So, too, is the continued condemnation of medicinal cannabis.

Increased knowledge about health must be a good thing. Increased regulation of such knowledge is essential, though not if dominated by big pharma, as it still is. As yet, there is no regulation of the internet hypochondria, which allows scare-mongering and quackery to encircle the world unbridled in seconds.

The wisest response remains the old alliance of sceptic and epicurean. Trust nothing at first sight. Test everything against the evidence. The good things in life are best taken in moderation. But what makes you happy cannot be all bad, whatever the doctor says.

Stem cell therapies: medical experts call for strict international rules

Medical and legal experts from around the world have united to call for more stringent regulation of stem cell therapies to prevent people pursuing unproven and potentially deadly treatments overseas.

In a perspective piece for the US journal Science Translational Medicine, 15 experts from countries including the UK, the US, Canada, Belgium, Italy and Japan wrote that national efforts alone would not be enough to counter an industry offering unproven treatments to vulnerable patients.

“Stem cell-based interventions are classified under diverse and potentially incompatible national regulatory frameworks,” the authors wrote.

“Approaches for international regulation not only need to develop consistent rules over the commercialisation of medical practices and products but also need to give them teeth by developing cross-border partnerships for compliance.”

Stem cells found in bone marrow and umbilical cord blood have long been used to successfully treat blood cancers including leukaemia and some immune diseases. But those are among the few proven treatments. Legitimate and ethics-approved clinical trials by academic centres are also occurring, exploring the potential of stem cells to treat a wider range of diseases.

But some doctors are directly offering to the general public stem cell treatments for diseases still under clinical trial or for which no evidence exists and for which the safety and efficacy is as yet unproven.

Deaths as a result of stem cell treatments have already occurred. In 2013 Sheila Drysdale died in a New South Wales nursing home after undergoing an unproven liposuction stem-cell therapy at a western Sydney clinic. Following Drysldale’s death, her doctor, Ralph Bright, gave a statement to police in which he claimed that stem-cell treatment could improve “comorbidities” and that stem cells could move from joints to other parts of the body to “improve disease in distant sites including lungs and brain, vision, mentation and pain”.

In his report into Drysdale’s death, the coroner Hugh Dillon wrote that he could not “say what motivated Dr Bright to perform this unproven, dubious procedure on Sheila Drysdale”.

“But regardless of his motivation, Dr Bright’s performance as a medical practitioner was, for the reasons outlined above, poor and resulted in Sheila Drysdale’s death.”

The Medical Council of NSW investigated Bright and placed a number of restrictions on his right to practice. Bright is still authorised to practise stem cell therapy for patients with osteoarthritis or who are taking part in research studies approved by an ethics committee. He is also still allowed to treat patients returning for remaining injections of stored cells.

In 2013 a Queensland woman, Kellie van Meurs, died when she travelled to Russia to undergo stem-cell treatment for a rare neurological disorder. She died of a heart attack as a result.

Australia’s drug regulator, the Therapeutic Goods Administration, last year sought feedback on the regulation of autologous stem-cell therapies but is yet to publish those submissions. A TGA spokeswoman said the Administration was still examining the options for changes to the legislation to reflect public and industry views. The TGA currently considers autologous treatments, which involve treating someone with their own tissue or cells, to be a therapeutic good and, therefore, does not regulate them. Stem cells used for medical practice and therapeutic purposes are covered by different regulatory frameworks.

Associate Professor Megan Munsie, a University of Melbourne stem cell scientist and a co-author of the paper, said: “The idea that stem cells are magical holds court in the community, along with this idea the advances in treatment are being held up by red tape.”

Unethical health practitioners exploited this, she said, along with the vulnerability of patients with difficult-to-treat or incurable conditions.

“There is a precedent for international regulation of this industry because regulations already exist around drugs – the way they are manufactured,” she said.

“This could be extended to the regulation to the stem cell and tissue-based therapies. This international stance would then force or encourage stronger local regulations.”

There have been successful efforts by scientists to push back against unscrupulous doctors. In Italy scientists and regulators highlighted the unproven yet government-subsidised treatments being offered by the entrepreneur Davide Vannoni and fought to stop him. He was convicted of criminal charges but the sentence was later suspended.

Stem cell therapies: medical experts call for strict international rules

Medical and legal experts from around the world have united to call for more stringent regulation of stem cell therapies to prevent people pursuing unproven and potentially deadly treatments overseas.

In a perspective piece for the US journal Science Translational Medicine, 15 experts from countries including the UK, the US, Canada, Belgium, Italy and Japan wrote that national efforts alone would not be enough to counter an industry offering unproven treatments to vulnerable patients.

“Stem cell-based interventions are classified under diverse and potentially incompatible national regulatory frameworks,” the authors wrote.

“Approaches for international regulation not only need to develop consistent rules over the commercialisation of medical practices and products but also need to give them teeth by developing cross-border partnerships for compliance.”

Stem cells found in bone marrow and umbilical cord blood have long been used to successfully treat blood cancers including leukaemia and some immune diseases. But those are among the few proven treatments. Legitimate and ethics-approved clinical trials by academic centres are also occurring, exploring the potential of stem cells to treat a wider range of diseases.

But some doctors are directly offering to the general public stem cell treatments for diseases still under clinical trial or for which no evidence exists and for which the safety and efficacy is as yet unproven.

Deaths as a result of stem cell treatments have already occurred. In 2013 Sheila Drysdale died in a New South Wales nursing home after undergoing an unproven liposuction stem-cell therapy at a western Sydney clinic. Following Drysldale’s death, her doctor, Ralph Bright, gave a statement to police in which he claimed that stem-cell treatment could improve “comorbidities” and that stem cells could move from joints to other parts of the body to “improve disease in distant sites including lungs and brain, vision, mentation and pain”.

In his report into Drysdale’s death, the coroner Hugh Dillon wrote that he could not “say what motivated Dr Bright to perform this unproven, dubious procedure on Sheila Drysdale”.

“But regardless of his motivation, Dr Bright’s performance as a medical practitioner was, for the reasons outlined above, poor and resulted in Sheila Drysdale’s death.”

The Medical Council of NSW investigated Bright and placed a number of restrictions on his right to practice. Bright is still authorised to practise stem cell therapy for patients with osteoarthritis or who are taking part in research studies approved by an ethics committee. He is also still allowed to treat patients returning for remaining injections of stored cells.

In 2013 a Queensland woman, Kellie van Meurs, died when she travelled to Russia to undergo stem-cell treatment for a rare neurological disorder. She died of a heart attack as a result.

Australia’s drug regulator, the Therapeutic Goods Administration, last year sought feedback on the regulation of autologous stem-cell therapies but is yet to publish those submissions. The TGA now considers autologous treatments, which involve treating someone with their own tissue or cells, to be a therapeutic good and, therefore, does not regulate them. Stem cells used for medical practice and therapeutic purposes are covered by different regulatory frameworks.

Associate Professor Megan Munsie, a University of Melbourne stem cell scientist and a co-author of the paper, said: “The idea that stem cells are magical holds court in the community, along with this idea the advances in treatment are being held up by red tape.”

Unethical health practitioners exploited this, she said, along with the vulnerability of patients with difficult-to-treat or incurable conditions.

“There is a precedent for international regulation of this industry because regulations already exist around drugs – the way they are manufactured,” she said.

“This could be extended to the regulation to the stem cell and tissue-based therapies. This international stance would then force or encourage stronger local regulations.”

There have been successful efforts by scientists to push back against unscrupulous doctors. In Italy scientists and regulators highlighted the unproven yet government-subsidised treatments being offered by the entrepreneur Davide Vannoni and fought to stop him. He was convicted of criminal charges but the sentence was later suspended.