What is the "Pain Gap"?

Introduction to the Gap: 

70% of chronic pain patients are biologically female yet 80% of medications are tested only on males. This is just one example of the pain gap. The pain gap is gender inequality in healthcare. Women are being misdiagnosed, mistreated, and doubted when they go to doctors.  

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More precisely, the pain gap is biased against women or those assigned female at birth and how their pain or illness is treated. Until the 1986 policy by the National Institutes of Health, women were frequently excluded from clinical trials.  It wasn't until 1993 that the NIH Revitalization Act was passed, which required women to be included in clinical studies. This act also required that experimental treatments analyze whether the medications or experients effected men or women differently. Before this, medication that had never tested on women, was given to women. This disregard led to women frequently having side effects to medication that was not accounted for in the clinical studies. This is just one display of the pain gap and how it effects women/those assigned female at birth. 

Women face disproportionate bias in every phase of health care. Along with the bias that is shown in clinical studies, women face this bias in the doctors office too. Some studies suggest that women feel more intense pain than men. Women also make up a signifigantly higher portion of patients with chronic illness. Despite this, women are frequently told they are exaggerating and that they are overdramatic about their pain. For many women, going to the doctor means having to be over prepared for disbelief. They have to fear that their symptoms will be brushed off as anxiety or weight problems. Women are not taken seriously in health care and this is a dangerous problem.  

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When doctors doubt women's pain, they can misdiagnose or mistreat their pain. Studies show that women can have different heart attack symptoms than men. Because of the systimatic bias, if a woman comes in having a heart attack, they may not catch it in time and it may not be treated. There are many issues that, if not treated, are serious or fatal. Unless doctors start trusting women with their pain, many women will have medical problems far into the future. 

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What can we do about the pain gap? 

The pain gap is built off of a systimatic bias. The pain gap will not go away completely without a complete change to the system. But there are ways to help at an individual level. While you cannot change how people perceive your pain, you can make people aware of their bias. When you go to the doctor for surgeries or procedures set up a pain treatment plan and let the doctor know about your concerns. It's also helpful to have someone who can advocate for you if you are unable to advocate for yourself. Inform your doctors and other women you know about the pain gap so more people can help prevent it. The pain gap is bias and when more people are aware of their bias they can change it. This will not work for everyone. There will still be dissimissive doctors. But learning what to do when this happens could save your life. 

But how do you identify bias? 

Bias takes many forms. In these cases it may be saying something like, "Oh, shes just being hysterical!" or "It can't hurt that bad!" Or it could be more subtle like, "Are you sure your pain is a 7?" But no matter what, these biases are dangerous. While some people will eaggerate their pain, its better to assume they are not. A doctor may spot these biases by trying to catch themselves if they think someone is exaggerating or overstating their pain. Think about how you think. If you see someone in pain, don't assume that they are exaggerating their pain, trust them to know how they feel. As a patient, if your doctor is hesitant when you state your pain level or says that it can't be that bad then those are clear signs that they are being biased.​ Remember: It's okay to ask questions and advocate! It is your doctors job to listen to your needs. And you do deserve to get help.