Blog: Hysteria by Different Names: Gender Bias in Patient Care, Gina McGalliard

[Indigophoton]

The blog includes ME as the example par excellence.

“You probably need to be psychiatrically evaluated. Would you be open to that?”

My heart dropped into my stomach. The words were from a neurologist sleep specialist, who I had been seeing regularly for my hard-to-categorize sleep disorder and chronic exhaustion. I knew this meant he was writing me off. Now the motive for those casually dismissive remarks he always managed to sneak in at previous appointments made a lot more sense.

In fact, ME/CFS provides the ultimate case study in what happens when a particular medical condition has the unlucky combination of being both poorly understood and being composed of primarily female sufferers. Despite the immense suffering it causes, ME/CFS has been so badly ridiculed it’s been described as “yuppie flu” by the media and a “culturally-sanctioned flight into illness” by “feminist” writer Elaine Showalter. Government health agencies recommended both psychotherapy to combat patients’ “false illness beliefs” and graded exercise therapy, which actually should be contraindicated because the primary indication of the disease is post-exertional malaise. The hallmark study for this advice? A study in the prestigious Lancet journal that turned out to be not just sloppy but fraudulent:researchers drastically lowered their two outcome measures for success, weakening them so drastically that a subject could score lower than at the beginning of the trial and count as “recovered.”

These massive flaws were revealed only after a contentious court battle and freedom of information request. Horrifyingly, when patients first began voiced their criticisms, rather than defending their work on its merits the researchers claimed they were being harassed by unhinged mentally unstable patients (a convenient tale given that the trial set out to prove the disease itself was psychiatric) and under oath researchers admitted these allegations were false. After the raw data was released and analyzed in accordance for original outcome measures, only a small minority had made slight improvements.

http://www.ginamcgalliard.com/hysteria-by-different-names-gender-bias-in-patient-care/

 

[Invisible Woman]

Of course we're all aware of the stigma and lack of treatment for the more disabling conditions, but the type of attitudes discussed also have huge financial implications for women. I mean the luckier ones who manage to carry on having some sort of life.

There will be so many cases where women will be given some mental health diagnosis, until they are finally diagnosed with an autoimmune condition or whatever. Then they have both diagnosis on their health records, the previous is rarely, if ever in the UK at least, removed.

This can affect employment prospects, cost of life and health insurance etc., etc..

How is that not doing harm?

 

[Sean]

Excellent blog.

When I talk to physicians about the practice of using supposed psychosomatic illness as a fallback, they tend to get a tad defensive. Some seem to actually believe they’re not harming patients by using psychological maladies as a catch-all for anything they can’t easily figure out or treat—they just need to find the right euphemism. “Well, I think it’s in how it’s presented,” a doctor might say in a thoughtful, conciliatory tone that implies he or she is the unbiased mediator in this unfortunate doctor/patient communication mishap. According to this mollifying theory, the problem isn’t sexism, or doctors who are willing to sacrifice the well-being of patients to protect their pride, or the fact that the theory of psychogenic illness is inherently disprovable, or even that certain symptoms carry a deep-set cultural bias against them, such as our can-do workaholic American culture being predisposed to view fatigue and sleep problems as laziness. No, the whole thing is just a big misunderstanding. We’ll clear it up as soon as we find those magic words and “present” it better.

Good explanations and effective therapies tend to sell themselves. If the concern becomes how to sell it, how to find the right 'marketing strategy', then you probably don't have a good explanation nor effective therapy.

The degree to which marketing becomes the primary concern is a good index of how invalid the explanation and therapy are.