Medical Gaslighting in Women’s Health: How to Advocate for Yourself

Ann Cutbill Lenane, a prominent New York-based realtor and leader of Wise and Wonderful Women, recently had horrible pain in her back, vomiting and shortness of breath. If it wasn’t for her constant advocating for herself, she might not still be here. Lenane was a victim of all too common occurrence, medical gaslighting. Like most people, especially women, Lenane struggled to make sense of a life-threatening and confusing situation.

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Medical gaslighting occurs when a doctor or other healthcare professional denies a person is having a medical issue when in fact they are or makes a medical emergency a psychological one instead. This could manifest as a doctor shrugging off the need for cancer-related medical testing despite concerning family history or being unconcerned that your blood pressure is high for you because it’s within the normal range.

One of the areas where women most often experience medical gaslighting is related to their heart health. Starting in 1984 – 40 years ago – more women died of heart disease than men. Among the reasons for this is that signs of heart disease and heart attacks often look different in these two genders.

A study was conducted where a man and woman entered an emergency department reciting the same script of symptoms to healthcare staff and the man began testing for a heart attack while the woman was sent home with the notion she was likely anxious or stressed.

When treating cardiac ailments, timing is key. The faster a physician can identify and begin treatment, the better a person’s outcome will be. Gaslighting could be the difference, as it nearly was in the case of Lenane, between life and death. This painful reality inspired Lenane, and her cardiologist, Dr. Suzanne Steinbaum, who helped her navigate her medical experience from afar, to hold an event with Wise and Wonderful earlier this week.

Dr. Steinbaum, founder and CEO of Adesso and a preventive cardiologist for more than 20 years, shared at the event that 59 percent of women with cardiac issues are medically gaslit. Women with heart issues also have a 30 percent longer wait for medical care than their male counterparts and often don’t know what they are experiencing because they don’t believe heart disease will happen to them, especially at a young age. Medical gaslighting can actually encourage women with a false sense of security, making it even more dangerous.

Why The Medical Gaslighting?

There are a series of reasons that women with heart ailments can experience medical gaslighting. One sixth of the National Institute of Health’s budget is used to study cardiovascular disease and, of that, two percent goes toward women’s heart disease, Dr. Steinbaum said. This is after 40 years of women dying from heart disease more often than men. One in three women will die of cardiovascular disease; it’s the number one killer of women.

Add to that the fact that it takes about 20 years for clinical research to become ingrained in medical practice, Dr. Steinbaum explained. While this research is being published and incorporated into medical education, in some cases next-generation physicians will be mentored and directed by doctors with outdated beliefs that heart attack signs are universal for men and women, i.e. the feeling of an elephant sitting on a person’s chest and pain down their left arm. That defines male heart attack symptoms quite well, but for women, symptoms can include: pain in the back, neck, or jaw; shortness of breath; nausea; fatigue; or other symptoms. Microvascular disease for women is a unique issue that must be treated with the woman in mind, Dr. Steinbaum stated.

“Women present differently when they get heart disease. Risk assessment and addressing all the barriers to diagnosis and access to care are critical.” as reported by JACC.

These can be symptoms women ignore because who isn’t fatigued? Working endless hours, trying to fit in time to exercise, having some level of a social life, and perhaps maintaining your family responsibilities is exhausting.

An additional factor that casts women, who more often have issues with their microvasculature, aside is the stereotype of the “anxious woman.”

To help combat this, Dr. Steinbaum encourages women to learn what’s going on with their heart health and become their best advocate, much like her patient, Lenane did during her recent health scare, as she told those at the event about her traumatizing experience with medical gaslighting.

At one point, frustrated with the attending physician’s dismissal of the serious nature of her symptoms, Lenane called Dr. Steinbaum and put her on the phone with the other physician. Her continued self-advocacy quite possibly saved her life, both agreed.

At one point the physician expressed rage that Lenane had taken the initiative to have Dr. Steinbaum on the call.

“‘You had no right to have your doctor listen to our conversation,’ she told me,” Lenane said. “The sad fact is that this just didn’t happen to me… women are subjected to medical gaslighting, all day, every day, in every country around the world, and it needs to @#%$$ stop.”

Advocate For Yourself

As Dr. Steinbaum encouraged the Wise and Wonderful Women, don’t feel as if you’re being a burden by asking for medical care. Emergency department physicians are paid by their shift, so they are there whether a patient comes in or not, Dr. Steinbaum noted.

“You’re not bothering them; you’re not disturbing the system,” she said at the event. “That’s their job; you might as well show up.”

When it comes to the heart, it’s better to be wrong and “waste” medical staff’s time than to be horribly right and do nothing about it.

If you’re experiencing shortness of breath going up the stairs to your office even though you’re a runner and in great shape, that’s a sign that something could be wrong. If your blood pressure is unusually high or low for yourself, take notice. If you have a wearable and your heart rate is off, there is some kind of an issue.

“Heart rate is one of the most sensitive signs something is going on,” Dr. Steinbaum said.