“Early on a Wednesday morning, I heard an anguished cry—then silence.
I rushed into the bedroom and watched my wife, Rachel, stumble from the bathroom, doubled over, hugging herself in pain.
‘Something’s wrong,’ she gasped.”
So begins Joe Fassler’s 2015 article in The Atlantic in which Fassler explores the experience responsible for inspiring, “How Doctors Take Women’s Pain Less Seriously:” the trip to the ER with his wife in which her pain – which she categorizes as an eleven on a one-to-ten scale – is dismissed repeatedly by medical professionals in the hospital emergency room.
Sexism’s impact on healthcare access seems rarely addressed in mainstream media or in the healthcare industry; healthcare in the United States is frequently touted as egalitarian and ubiquitous. While socioeconomic status is often regarded for its impact on a person’s access to healthcare, sex and gender rarely warrant the same scrutiny. Additionally, the lack of visibility that too frequently characterizes elderly populations seemingly exacerbates insidious sexism with aging female patients.
Why Are Doctors Hesitant to Listen to Women?
In Fassler’s article, his wife, Rachel, is continuously ignored by her doctors until hours later, she receives a diagnosis:
“Another doctor had told her the mass was her ovary, she said. She had something called ovarian torsion—the fallopian-tube twists, cutting off blood. There was no saving it. They’d have to take it out.”
And while the diagnosis and treatment (surgery) provide a solution, and Rachel begins to mend from the procedure, she reveals to her husband how deeply traumatizing the experience was for her:
“Rachel’s physical scars are healing, and she can go on the long runs she loves, but she’s still grappling with the psychic toll—what she calls “the trauma of not being seen.” She has nightmares, some nights. I wake her up when her limbs start twitching.”
Rachel’s pain being repeatedly ignored is indicative of a very real problem: That women are not considered as reliable or as serious as their male counterparts. As a result, their pain is not taken as seriously as that of their male counterparts.
A particularly disturbing study conducted by Stony Brook University and published in 2007 showed that, although men are more likely to suffer a heart attack, women are 60% more likely to die of a heart attack due to a lack of prompt treatment.
What Do You Do When It Happens to You or a Loved One?
With regard to women in their senior years, ignoring their complaints and self-assessment of their own pain can have particularly negative consequences.
I witnessed this firsthand when I served as a caregiver to my mother during her battle with metastatic terminal cancer, and in this role, I routinely witnessed such consequences. During the frequent trips we took to the emergency room, my mother was consistently labeled pleasant or sweet up until we demanded treatment. Self-advocacy was met with irritation. Questioning medical orders was met with anger. Constructive criticism was met with condescending retorts.
My mother was rarely treated as a reliable source to her own needs and wants. It is important to note that the systemic ageism and sexism we witnessed was not the product of men only. Female doctors, nurses, technicians, caregivers and social workers consistently relied on sexist tropes to categorize care for my mom.
I am too frequently reminded of the visit to the ER – inspired by one of my mother’s permanent radiation-induced ulcers turning green, a sure sign of infection and risk for sepsis – that led to a weeklong stay at the hospital. While hospitalization can be undoubtedly considered a privilege, to my mother and me, it seemed more reminiscent of a prison sentence: doctors refused to answer our simple questions (why can’t we go home) and also failed to provide care, rendering the hospitalization essentially useless.
While she was in the hospital, I provided my mom with the daily wound care therapy I would have otherwise provided at home, simply because there was allegedly no one in the hospital trained to provide this critically important care. When we pointed this out to the medical team and asked to leave, we were met with anger and told that we were being reckless. It wasn’t until my mother said the detainment quality of the stay was making her question suicide that I scolded the doctors for failing to heed our concerns or succeed in providing valuable treatment. It seemed only then that we were taken seriously and discharged.
Meeting Apathy with Aggression
Similarly, we encountered apathy when handling the health insurance company responsible for approving cancer-fighting treatment. When chemotherapy finally failed and my mother’s cancer treatment suddenly hinged on an aggressive drug called Votrient, we were dependent on her insurance company (Tricare) to approve the oncologist’s prescription and send us the bottle of pills. Votrient is notoriously expensive. A month’s supply can easily run past $11,000 without insurance. But it was this drug that would prove capable of extending my mother’s prognosis. Thus, every day we went without it was a day that tumors grew and a day that my mother’s limited time seem to become even more limited.
When I’d call Tricare and ask that they speed their approval process, I was met with canned customer service responses; a different excuse every day. My mom came up with a plan: Have a man call. I was furious that it should even be a consideration for us – that my mom’s life-saving drug be withheld because what we conveyed as urgency would be interpreted as unimportant because we were women. Nevertheless, I listened to her.
The following day – which marked one month of us being put on hold with Votrient because of Tricare’s negligence – I called Tricare and threatened legal action. I explained that we considered the company liable for withholding life-saving treatment and because of this, I would proceed with an attorney.
Votrient arrived at our doorstep that week.
My mom was right. Perhaps I didn’t respond with a man’s voice, but I responded with something frequently characterized as a male virtue: aggression. After spending weeks calmly asking Tricare customer service representatives to help extend my mom’s prognosis, it was this aggression that secured results.
Being a woman and being elderly and still being expected to navigate the healthcare system can be duly taxing as the combined powers of ageism and sexism can frequently impose negative consequences.
The tools below are outlined to help combat these consequences:
#1 – Fassler’s Message: Validate women’s pain
Fassler’s experience with his wife in the ER illustrates a painfully frustrating reality: That pain is not invariably awarded with attention and treatment. In Fassler’s case, he and Rachel had access to medical treatment but were denied treatment because no doctor validated Rachel’s pain until nearly 14 hours into her waiting for treatment.
This was caused by Rachel’s doctors failing to validate her pain, most likely because they failed to interpret her descriptions as reliable due to Rachel’s gender. By listening to and validating women’s pain, women can gain better access to healthcare.
#2 – Avoid Typecasting: Limit stereotypical descriptions for aging women
Too often, older women are defined by words like “cute” and called “sweetheart,” rendering them suddenly void of the decades of rich experience that brought them to a this point in their lives. How many female businesspeople suddenly pass an arbitrary and unspoken milestone and are abruptly transformed from ambitious and intellectual to quirky and adorable.
Combat the compulsion to typecast elderly women by communicating effectively with them. Learning about seniors and their undoubtedly multifaceted lives helps breakdown the stereotypes associated with their age and gender.
#3 – Be an Empowered Bystander: Learn to listen and watch for sexism so that you can advocate on someone’s behalf
Witnessing overt sexism is undoubtedly disturbing but it is nonetheless common. In healthcare, aging women presumably witness sexism far too often. Watching for signs like the seemingly extraordinary lack of visibility that too frequently plagues older women or the subtle patronization that aging women too often encounter can help passersby advocate for victims of sexism.
By continuously educating ourselves on how to help be patient advocates, especially for aging women, we can better equip ourselves with the resources to dismantle systemic sexism.
Erin Corbett is a Care Coordinator at the Griswold office in Alexandria, VA who also enjoys focusing her time on writing about healthcare and homecare Prior to joining Griswold, Erin worked as a caregiver for her mother for nearly three years. She earned a bachelor’s degree in English and public communications, as well as a master’s degree in business administration with a concentration in healthcare management.