Why WOMEN'S PAIN is pooh-poohed

WHEN SOMETHING W HURTS AND YOU VISIT YOUR DOCTOR, you expect that if a medicine or procedure exists that could alleviate your pain, the doctor will offer it up.

- GINNY GRAVES

But for a whole host of reasons, that may not happen. Research suggests that healthcare providers are more likely to underestimate pain in women than in men, says Tina Doshi, M.D., an assistant professor of pain medicine at Johns Hopkins University School of Medicine. "Doctors may be less likely to perceive a given [pain] score as the true reflection of a woman's experience,

so an 8 out of 10 from a woman may prompt a different treatment than an 8 out of 10 from a man." This can be the case regardless of the physician's gender and despite studies showing that women are beset by more painful conditions-more headaches, lower-back and neck pain, and painful autoimmune diseasesand report higher pain scores than men with similar ailments. In one study, when participants saw videos of patients in chronic pain, they estimated women's pain, on average, as lower than men's-and judged women as more likely to benefit from psychological treatment and men as more likely to benefit from analgesics. Men and women of color face additional hurdles. Black ER patients were 40% less likely and Hispanic ER patients were 25% less likely than white ones to receive any analgesics for acute pain, found a 2019 review of 14 studies. Those groups were also less likely to receive more powerful opiates.

As you might imagine, being both Black and a woman compounds the problem. "There's this false belief that Black people in general feel less pain than white people," says Elinor Cleghorn, author of Unwell Women: Misdiagnosis and Myth in a Man-Made World. "It comes from a rationalization of slavery and mistreatment of slaves in the 19th century, when Black people were considered less than human. As a result, while white women in pain risk being seen as overwrought, Black women often have to fight to have their pain acknowledged at all."

Stereotypes and subjectivity