A recent study has concluded that a patient’s pain response may be perceived differently by others based on their gender.
The findings were published in Journal of Pain last month and show that the same amount of pain expressed in male and female patients causes observers to see female patients’ pain as less intense. They also considered female patients more likely to benefit from psychotherapy rather than medication as opposed to men. This displays a noticeable patient gender bias that could lead to inequalities in treatments.
“If the stereotype is to think women are more expressive than men, perhaps ‘overly’ expressive, then the tendency will be to discount women’s pain behaviors,” said Elizabeth Losin, assistant professor of psychology and director of the Social and Cultural Neuroscience lab at the University of Miami in a statement. “The flip side of this stereotype is that men are perceived to be stoic, so when a man makes an intense pain facial expression, you think, ‘Oh my, he must be dying!’ The result of this gender stereotype about pain expression is that each unit of increased pain expression from a man is thought to represent a higher increase in his pain experience than that same increase in pain expression by a woman.”
Researchers conducted two experiments for the study.
In the first, 50 participants were asked to view different videos of male and female patients with shoulder pain as they performed a series of range of motion exercises. They did these exercises with their injured and uninjured shoulders. Researchers obtained footage from a database of videos of patients with real shoulder injuries and with varying pain levels. Patients’ self-reported discomfort levels when moving their shoulders was also pulled from the database.
Ultimately, the study found that female patients were seen as being in less pain than male patients who reported and displayed just as much pain. Researchers concluded such perceptions were explained in part by gender-related stereotypes based on patients’ questionnaires about the topic.
In the future, Losin the researchers on her team hope this study serves as a step in pointing out and addressing gender inequalities in health care.
“I think one critical piece of information that could be conveyed in medical curricula is that people, even those with medical training in other studies, have been found to have consistent demographic biases in how they assess the pain of male and female patients and that these biases impact treatment decisions,” Losin said. “Critically, our results demonstrate that these gender biases are not necessarily accurate. Women are not necessarily more expressive than men, and thus their pain expression should not be discounted.”
The study also comes after reports of medical professionals failing to take the pain of Black patients seriously.
Janice A. Sabin, Ph.D., is a research associate professor, biomedical informatics and medical education at the University of Washington. She has written about the science of implicit bias to health care disparities for the Association of American Medical Colleges. Her research has shown that half of white medical trainees believe myths about how Black people experience pain that can cause disparities in treatment.
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