Suraya* was 24 when she went to her GP with intractable back pain, fatigue, fever and facial swelling. The doctor prodded her ribcage, poked her face so hard that she left with a black eye – and made his diagnosis.
“He said: ‘Do you like your job?’ He explained that either I didn’t and this was psychosomatic, or I was work-shy.” She sighs, still emotional three decades on. “I loved my job.”
Yet two years later, still no better, she had to leave it, at which stage she was diagnosed with myalgic encephalomyelitis (ME).
It wasn’t ME, though. Nor was it fibromyalgia, which a consultant diagnosed her with at 32, by which point she had a deformed thumb joint and stiffness in her fingers. “I told him it hurt, and he said: ‘Pain is relative. You have to expect some pain as a premenopausal woman.’ I said: ‘What would you say if I was post-menopausal?’ He replied: ‘You’d need to expect some pain as a post-menopausal woman.’”
Six years later, Suraya was diagnosed with rheumatoid arthritis.
To many women with a chronic pain condition, her story will sound familiar. The gender pain gap is real: one study1 in the US found that middle-aged women with heart disease symptoms were twice as likely than men with the same symptoms to be diagnosed with a mental illness; another study2 found that women with acute abdominal pain presenting at emergency rooms were up to 25% less likely than men to be treated with opioid painkillers.
Family and friends aren’t necessarily supportive either – a quarter of women with daily pain feel that it has been ignored by their spouse or partner, according to Nurofen’s Gender Pain Gap Index Report3. “I have to moderate what I share because of the reactions,” says Suraya. “My parents panic, my sibling doesn’t believe it, and my husband doesn’t deal with it very well – at times he doesn’t believe me. It’s unbearable for him so he has to reject the whole idea.”
I’ve experienced similar dismissive treatment by healthcare professionals. At 16 I was told I was “making it up” by the dentist I told about the jaw pain that was impeding my sleep. At 18, the pain spread to my arm and by my 20s it hurt to walk, but by the time a doctor finally listened to my description of my shifting, clicking joints, I was 30. His response? “Part of the ageing process.” Two years later, I was diagnosed with Ehlers-Danlos syndrome, a genetic disorder that affects connective tissue, causing joint dislocations and body-wide pain.
One in six women experience severe pain daily, according to Nurofen’s Gender Pain Gap Index Report, yet more than half of women felt their pain was ignored or dismissed; for those who felt that way, one in four women said no one took their pain seriously. “Part of it is that we’re all used to pain, and most of the time it’s brief, so it’s easy to say: ‘Last time I was in pain I got on with it,’” says Amanda C de C Williams, professor of clinical health psychology at University College London, who has conducted research into how healthcare professionals view women’s pain.
Women have it harder, she says: “There are long-established gender stereotypes that men are brave and don’t complain unless it’s necessary, whereas women complain easily.”
Williams has worked with endometriosis patients, many of whom developed the disease in their teens. “They’re told it’s just period pain, stop making a fuss,” she says.
This could be because it was only made mandatory last year for new doctors to have compulsory women’s health training, but this won’t come into effect until 2024. It’s therefore important to request referral to a specialist, such as a gynaecologist, if you feel your symptoms require a second opinion.
While Williams says there’s no difference in how doctors assess pain among women and men, they are “more likely to psychologise women’s pain. They’re more likely to send a man for investigations, or to tell a woman to think about stress and offer antidepressants.”
Deciding what to wear for medical appointments consumes hours of my life – do I dress up to look like a go-getter in search of a solution, or will I appear too well? If I turn up in trackie bottoms and unwashed hair, will that reflect my pain or render me invisible? “The stereotype women have to avoid is the neurotic, untogether person who’s disbelieved before she opens her mouth,” says Williams, who adds that my wardrobe dilemma is common: “The risk of looking too together versus being written off because you look like a ‘madwoman’.”
There’s a racial bias too. According to a report4 commissioned by the Black Equity Organisation, most black people living in the UK have experienced prejudice from healthcare professionals because of their ethnicity. The report cited particular issues around the experience of black women in maternity care and the prevalence of the ‘Black people don’t feel pain’ trope, which widens the pain gap further for Black women.
“I think when doctors see my name, they think I’ll be a middle-aged Indian or Bangladeshi woman who they’re not really bothered about,” says Suraya, who says she regularly feels “humiliated” by her encounters with medics.
“In our medical system, women don’t get the care we need, it causes trauma, and makes things worse,” she says.
“It doesn’t serve women well. Ultimately I think it’s a reflection of our society.”
*Name has been changed
Julia Buckley is the author of Heal Me: In Search of a Cure
If you want to learn more about the Gender Pain Gap and read the full Gender Pain Gap Index Report commissioned by Nurofen visit nurofen.co.uk/see-my-pain
2 Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain
3 GPG Index Survey References Document (26.08.2022 16.00GMT)
4 Ethnic Inequalities in Healthcare: A Rapid Evidence Review
Nurofen 200mg Tablet for short-term, mild to moderate pain. Contains Ibuprofen. Always read the label. RKT-M-18818
