By Sherry McAllister, DC

Even in 2021, it can still be difficult for women to stand up for themselves, especially when confronting someone in authority such as a boss, teacher, police officer or physician. Although conflict is never easy, it needs to occur if women feel their concerns are being disregarded.

That is why I’m glad that the International Women’s Day organization named Choose to Challenge as this year’s campaign theme, which urges all people to outwardly challenge gender bias and inequality where they see it to raise awareness and create change.

Although “choosing to challenge” applies to all realms of women’s lives, as a healthcare provider, I hope the campaign inspires women to question the providers in their life when they feel their health goals, or those of a family member or child, are not being achieved.

Historical Gender Bias

Decades of academic studies have documented huge gender disparities in healthcare around the world, with women patients and their concerns being treated far less seriously than those of male patients.

For example, although men and women report cardiovascular-related chest pain at roughly the same rate, men with chest pain were 2.5 times more likely to be referred to a cardiologist than women, according to a 2018 study. Even after adjusting for the patient’s age and cardiovascular disease risk factors, the estimates did not significantly change.

This gender bias in healthcare can have deadly consequences. Analyzing data from the U.K.’s heart attack registry from 2003 to 2013, the University of Leeds concluded that “women in the U.K. were more than twice as likely to die in the 30 days following a heart attack than men.”

Such situations where care concerns may be minimized is of particular importance to women caring for a family member, which is quite common. Two out of three caregivers in the U.S. are women, providing daily or regular support to children, adults or people with chronic illnesses or disabilities. Occasionally, the family member will be reluctant to – or unable—to speak up for themselves, which means that responsibility falls to the caregiver.

Bias Starts Early Across Cultures

Even children seem to face gender-related healthcare bias from adults, according to a 2019 study. Researchers showed videos of boys and girls receiving a finger pinprick to test for iron levels in their blood. More adults perceived the boy as experiencing more pain than the girl despite the same clinical circumstances and identical pain behavior across conditions.

To start correcting these biases in future generations, a parent can respectfully question a healthcare provider’s decision to demonstrate to the girl that this type of behavior is normal and speaking their mind in encouraged. In some cultures, however, obedience to authority regardless of circumstances is still commonplace. A study of South Asian cultures, for example, reported that it is believed that “girls must be socialized to sacrifice their autonomy and freedom for the husband and his family.” Overcoming these cultural gender biases worldwide is part of the #ChoosetoChallenge goal.

#ChoosetoChallenge for Yourself and Others

As a practicing doctor of chiropractic, I have seen far too many women downplay symptoms of fatigue and chronic pain that turned out to be indicative of a larger condition, such as an autoimmune disease. Some may not even have mentioned a health concern. That is a mistake because while healthcare providers are committed to our patients’ overall health (including their quality of life), patients still need to speak up to have their voice heard and respected.  

Patients need to remember that they are in control and should feel empowered to question or decline care if they have concerns. Most providers would be happy to explain the rationale and evidence guiding their decisions and would welcome a discussion of the patient’s healthcare goals.