It is common knowledge that women or those born with a uterus face some of the most hardship in hospitals. I’m not talking about the trauma associated with childbirth — those with a uterus go more undiagnosed than men, resulting in years of painful symptoms in addition to death. According to a recent study1 of 6.9 million Danish people, “women on average were diagnosed when they were about four years older than the age at which the conditions were recognized in men.”
Those born with a uterus are going to be more in touch with their bodies. We learn about periods in school in the fifth grade, for crying out loud! We have to be in tune with our bodies because there are always so many changes happening. Those with a uterus basically go through several “puberties” throughout life, in a way; our first period, our period worsening in high school, maybe the adjustment after going on birth control, how our cycles change if we bear children, pre-menopause, menopause, post menopause... The point is, hormones want to control the way we feel, hormones change a lot throughout our entire lives and we have to be in tune with what they’re doing to us physically, mentally and emotionally.
So, now that I’ve gotten that straightened out, know this: You’re not crazy. You know your body. If something is wrong, something is likely wrong. You are not being dramatic. If you’re in moderate or unbearable pain, you are valid. The first step is to know that much. Don’t let people who don’t know your body try and squash you for responding to its cries.
Pep talk over. The remainder of this piece will dive into some communication techniques specific to the doctor’s office.
The running theme here is to be firm but not aggressive, informed but not a know-it-all, patient but not passive, and totally detail-oriented. Yes, I know, it’s a bit overwhelming. It’s no secret that people nitpick women’s speech. Sexism in the doctor’s office is a common problem women face. While you shouldn’t have to worry about sounding aggressive or hysterical when you’re already in uncomfortable pain, this is just the world we live in today.
Come prepared with facts; dates, times, routines, bodily functions and food and beverage intake. People looking to fix a problem (which medical providers are) respond better when emotion is taken out of the equation.
When you do a math problem, it isn’t productive to think about how seven might feel when being subtracted from twelve. Even when talking about your emotions, state them as facts, such as “Symptoms of a depressive low increased to a manic high for two weeks, before plummeting back to the low in addition to suicidal thoughts of hurting myself but not others. No plan or attempt was made to hurt myself.”
Ramble as little as possible and consider coming prepared with a speech. You might sound like a robot, but medical providers respond well to facts. This communication technique matches the way they have to report their findings.
The following scenario describes symptoms of a heart attack. Women die of heart attacks more often than men, according to research2. Women are often in a constant state of some kind of pain or discomfort, and are therefore calmer when experiencing a heart attack or other health issues. We are easily overlooked because of this.
“Pain in my left arm began around 11 AM. Gradual numbness happened from there. My arm was completely numb by 11:15 AM. I have not experienced this before, however, I have had an ongoing migraine for three days in a row. I drink six cups of water per day and have been eating regular meals. On the scale of painless to childbirth, my current pain levels are at an 8/10.”
I’m not saying to act more like you’re in pain when you’re in pain. (Then, you’ll just look dramatic, unfortunately). Instead, state where your pain is on a scale of one to ten, after describing what one and ten mean to you. One could mean “Essentially painless” while ten could be personal to you “When my appendix burst.” This way the provider is made aware of your experience with pain and your personal threshold.
If I could go back in time, I would tell the provider who told me to “stop believing everything you read on the internet and get off of internet forums,” something like “I was doing as my previous doctor asked and going to trusted sources , not forums, while researching birth control I’ve put in my body. After going on this birth control, I developed various symptoms I have not experienced before. I take offense to your assumption and find your bedside manner inappropriate.”
In this way, my response would be stating facts without arguing, in addition to stating my discomfort, which is something providers appreciate (at least in the long run).
I respect the medical staff and all they go through on a daily basis; however, we need to stop telling ourselves that those in the medical field are better than everybody else or allowed to be arrogant and dismissive. While ambitious people, medical providers are just that — people. People make mistakes and sometimes allow their bias to disrupt the way they see patients. If a provider is being rude to you, call them out in a productive way. They need to adjust their bedside manner for all their patients because that’s part of their job.
Just because a certain treatment worked for someone else, that doesn’t mean it will work for you. I hated my Mirena IUD. I had a medical assistant tell me she loved her Mirena, so my symptoms were likely not related to mine. Excuse me… what!?
There can be a disconnect between male providers and female patients. I’ve had negative experiences with both male and female providers, but male providers have accused me of not being in as much pain as I claimed because they could “just tell.” Or, because “sex is just uncomfortable for women, that’s the way it is.” This is where you must stand your ground. Remember — not by being aggressive, but by being firm.
“You aren’t in my body right now. I assure you, I am in a lot of pain. I do not have a dramatic response to pain. I need a referral for a specialist now.”
There’s no “Please? Please can you refer me to a specialist?” It’s a firm “I need a referral to the specialist now.” At the end of the day, medical providers need to take precautionary measures in order to cover their own tracks. Using the method of stating versus asking or begging will go further.
Medical staff and providers want to help patients. They went through a lot of school and are required to keep up on newfound research. Despite stigmas and stereotypes associated with gender at the doctor’s office, at the core, they do want to help. Sometimes, they just require a nudge in order for women to really be seen.
1. NBC News, Women are diagnosed years later than men for same diseases, study finds, March 25, 2019, https://www.nbcnews.com/health/health-news/women-are-diagnosed-years-later-men-same-diseases-study-finds-n987216
2.Cedars Sinai, Time: Women Die From Heart Attacks More Often Than Men. Here's Why & What Doctors Are Doing About It, April 5, 2019. https://www.cedars-sinai.org/newsroom/time-women-die-from-heart-attacks-more-often-than-men-heres-why--and-what-doctors-are-doing-about-it/