Medicine may appear as an infallible and objective science, but deeply ingrained within its foundations is a blindness to differences. It's this very blindness that threatens women's health.
Women make up 51 percent of the entire population, yet modern medicine is largely based on data collected from men. The phenomenon known as the gender health gap is not “just” social inequality, but a critical failure of the healthcare system, costing women their lives. It repeatedly shows that women are being sidelined.
According to the McKinsey Health Institute report, women live on average 25 percent more time in poor health compared to men. And it's definitely not because they're more fragile, but because the system is historically designed for the well-being of men.
The Year Women Disappeared from Science
To understand why the system still fails today, we need to go back to 1977. That year, the American Food and Drug Administration (FDA) recommended excluding women of reproductive age from early clinical studies. Wondering why? Doctors were afraid women's hormonal cycles would interfere with results. So, for 20 years, medications and diagnostic processes were primarily tested on 70-kilo men.
Women were viewed as "smaller versions of men," ignoring crucial biological differences in metabolism and genetics.
One of the harshest examples of the system's failure was the sleep medication Zolpidem (Ambien). It took 20 years of widespread use for the FDA to realize women metabolize the drug much more slowly. They still had dangerous levels of the drug in their blood in the morning, leading to a massive increase in car accidents. Only a few years later was the recommended dosage for women halved. Diagnosis and treatment without consideration of gender isn’t objective; it’s just dangerous.
While men with such symptoms would receive a full evaluation, women are too often sent to a therapist, as if their pain can’t be real.
Welcome to the World of Medical Gaslighting
Unfortunately, most of us are familiar with this. You go to a doctor with chronic pain, extreme fatigue, or periods so painful you can't function for days, and you leave with them telling you it's normal and hormones are to blame. They suggest more rest or, in case of menstruation, just starting hormonal contraception.
While men with such symptoms would receive a full evaluation, women are too often sent to a therapist, as if their pain can’t be real.
This is classic gaslighting. Except now, instead of an ex with narcissistic tendencies, it’s a professional you're seeking help from. They deny your feelings and symptoms until you start believing that nothing is actually wrong and it’s all in your head.
One of the most shocking manifestations of the gender gap is how medicine approaches pain. Studies show it starts right in the ER waiting room. Women wait on average 30 minutes longer for pain relief than men. And it's not just about the wait but also the strength of the medication.
While men are more regularly prescribed strong analgesics for postoperative pain, women statistically receive sedatives for calming. As if women's pain isn’t a biological signal but an expression of anxiety.
A Heart Attack That Doesn’t Look Like the Movies
In 1991, cardiologist Bernadine Healy introduced the term Yentl syndrome. She used it to describe situations where women are correctly diagnosed and treated only when their symptoms start to resemble those of men.
Needless to say, this is completely off. In some cases, it’s downright critical. Take a heart attack. While men experience chest pain and left-arm cramps, women often show symptoms like extreme nausea, jaw or shoulder blade pain, and unexplained shortness of breath.
And because these symptoms don’t fit the male model, doctors often mistake them for panic attacks or digestive issues. Women are thus 50 percent more likely to receive a misdiagnosis following a heart attack.
Endometriosis: “But periods are supposed to hurt, right?”
If there’s one diagnosis symbolizing the failure of modern medicine for women, it's endometriosis. It affects one in ten women, but it’s only started gaining attention in recent years.
What is endometriosis? Imagine having tissue similar to the uterine lining growing where it shouldn’t be, like on the ovaries, intestines, or even lungs. This causes inflammation, adhesions, and pain, which patients equate to being cut with a knife. Pain so intense that women can’t even walk.
The diagnosis for this condition takes seven to ten years. Years of pain and just getting by before women finally hear the correct diagnosis. The biggest barrier slowing down the process is the belief that pain is just part of menstruation. A gynecologist might suggest just taking some ibuprofen and toughing it out, as if there's no alternative for dealing with the pain. This approach condemns women to a life of chronic pain.
If something “just” hurts, you can wait years for a diagnosis. But if a condition limits your partner’s comfort, suddenly it's a study topic.
The height of absurdity is that for decades scientific interest in endometriosis focused not on how much the patient suffers just by existing, but on how her condition affects men. Because again, why bother with alleviating the pain of a woman collapsing on her bathroom floor when we can discuss how endometriosis is tough for men because it affects their sex life?
Can a woman suffer, but medicine only cares about her suffering if it’s inconvenient for men?
This is a prime example of how even in the 21st century, the value of women’s health is reduced merely to reproductive abilities and sexual availability. If something “just” hurts, you can wait years for a diagnosis. But if a condition limits your partner’s comfort, suddenly it's a study topic.
Neurodiversity: Masking as a Survival Strategy
While boys are evaluated for ADHD and autism at the elementary level, girls often aren’t diagnosed until adulthood. Why? Because diagnostic criteria were based on observing energetic, hyperactive boys.
ADHD in boys often shows up as "fidgetiness." They run around the classroom, interrupt, and make noise. In girls, hyperactivity is often internal. Instead of running around, they frequently daydream. They don’t disrupt but are very talkative and perfectionists. Since women are raised to be good and not cause problems, they learn to mask their symptoms perfectly. Their surroundings have no idea what's happening inside or how exhausted they are.
Autistic girls often have highly developed social imitation skills. They watch others, learning gestures, expressions, and tone of voice like a movie script. Instead of being diagnosed with autism or ADHD, women in adulthood might be labeled with borderline personality disorder, bipolar disorder, anxiety disorder, or depression. Only the effects of life with masking are treated, while medicine ignores the root cause.
21st-century medicine cannot afford to overlook half the population. Women need a healthcare system that acknowledges their existence.
Change Must Come From All Sides
The gender gap in diagnosis isn’t just a series of isolated unfortunate events. It’s a failure of a system that considered women's bodies too complicated. When a gynecologist trivializes a patient’s endometriosis pain and a psychiatrist overlooks ADHD in a teenage girl because she's not loud enough, it’s not an individual error. It’s the result of an educational system teaching about the human body based on a male model.
What can we do about it? Change needs to come from both sides. We can’t just hope heart medication will work just as well for women; we need to know for sure.
We also have a role to play. We need to learn to stand up for our pain. If you feel your diagnosis is underestimated, seek a second opinion. Ask, "What else could this be?" or “Would you note in my record that you refuse to conduct this test?” 21st-century medicine cannot afford to overlook half the population. Women need a healthcare system that acknowledges their existence.
