I‘d just explained about the nose bleeds, blurred vision, and throbbing pain on one side of my head when my doctor told me, “You’re just studying too hard.” To me, I couldn’t imagine that these symptoms were the result of eye strain and fatigue, especially since they’d persisted for months after taking final exams. But my doctor knew that I’m an anxious high achiever, and was quick to dismiss any physical explanations.
I had an annual eye exam scheduled not long after, so I mentioned my symptoms again. My optometrist wasn’t convinced by my primary doctor’s conclusion, and referred me to a neurologist. Finally, I was diagnosed with chronic migraine. While stress likely had a role in exacerbating my symptoms, putting the blame on studying is a far cry from acknowledging the presence of a serious neurological disorder.
We tend to put a lot of faith in medical professionals, so although it can be upsetting to see them rushing us through an appointment or dismissing our concerns, we often still trust their judgment. Yet scenarios like mine happen so often that there’s actually a term for it.
“Medical gaslighting is when a patient has their symptoms minimized, ignored, or told it’s all in their head, leading them to question themselves,” says Jess Horwitz, chief clinical officer at Tia, a women’s healthcare platform. And it’s not just a dismaying experience—it can be dangerous for patients when it ends up delaying diagnosis and treatment.
Who is most likely to experience medical gaslighting?
While anyone can be gaslit by a medical provider, women and people of color are more commonly misdiagnosed or undertreated. Women typically have to wait longer for a diagnosis and are more likely to be told that they have a mental illness when their symptoms are consistent with heart disease, Horwitz says. A 2021 study also found that women were less likely to be admitted to the ICU than men, despite having more severe illness.
In a 2022 survey of 1000 American women, Tia found that 63 percent had been seen by a doctor who wasn’t listening to their concerns and 48 percent reported having a doctor who had ignored or dismissed their symptoms. Among Black women, these numbers were even higher at 70 and 58 percent, respectively.
One reason for these findings is the long history of women being excluded from scientific and drug research, despite important biological differences, Horwitz explains. “This leads to healthcare providers knowing less about women’s health and having fewer tools to diagnose and treat women,” she adds. A lack of awareness coupled with institutional racism and gender and racial biases contributes to poorer outcomes for marginalized communities.
“Medical gaslighting tends to occur when professionals don’t appreciate cultural differences and aren’t striving to understand symptoms that are outside their cultural frame of reference,” says psychotherapist Michelle Felder, LCSW, founder and CEO of Parenting Pathfinders.
How can you tell if this is happening to you?
Warning signs of medical gaslighting include downplaying your symptoms, interrupting you, or refusing to take your concerns seriously. Another sign is “attributing your symptoms to mental illness without an appropriate workup or mental health care follow-up,” Horwitz says. Rather than giving your condition their full attention, a provider might prematurely rule out physical causes or push back if you request additional testing.
If a provider is questioning the legitimacy of your medical history, it can feel as though your symptoms aren’t “real, a big deal, or serious enough to warrant further investigation,” says Felder. “Simply disagreeing with your healthcare professional doesn’t constitute medical gaslighting. An essential element of this experience is invalidating a patient’s concerns.”
When you hear the term “gaslighting,” you might think of someone who is intentionally trying to manipulate another person. While this can happen in healthcare settings, often medical gaslighting refers to situations where a doctor is “prioritizing certain people as more important than others without even realizing that they’re doing it,” says Gerda Maissel, MD, BCPA, president at My MD Advisor, a private patient advocate company. “Part of it is that they’re moving too fast and not taking time to look at the human being in front of them.”
What can you do to advocate for yourself?
Just because you feel like your doctor isn’t listening doesn’t mean you don’t have options. Here are five ways to take back control of your healthcare.
Ask questions
It might be intimidating to ask questions or push back on medical advice because of the power difference between patients and doctors. Since people are taught to respect their doctor’s knowledge and authority, “they might assume that asking a question will automatically feel like a challenge and sound disrespectful,” Dr. Maissel explains.
If your doctor prescribes a particular medication, make sure to ask about the side effects, other treatment options, and what will happen if you don’t take the medication. When you ask more probing questions like these, “you’re forcing the doctor to slow down and explain why this is the best course of treatment,” Dr. Maissel says. “Doctors expect you to ask questions and the ones who don’t probably aren’t right for you.”
Track your symptoms
Communicating effectively with your provider requires keeping track of your symptoms. For example, you can make notes about your menstrual cycle or take photos to document changes in your skin’s appearance. Presenting a practitioner with this evidence of your symptoms can help make them pay attention.
Don’t skip your annual checkups
Take advantage of regular preventive care. “Annual exams are designed to help you understand your baseline health, so you know when something feels off,” Horwitz explains. “A good provider wants to discuss and understand your health, but ultimately you should be the one driving the conversation.”
Arrive prepared
Whether it’s your first appointment or a follow-up visit, come prepared with topics or questions you wish to discuss and write them down. Since it can be difficult to absorb information when emotions are running high, Dr. Maissel recommends having someone with you like a friend or family member who can listen, ask questions, or take notes. Patient advocates can help with navigating appointments, billing, and insurance. They aren’t usually covered by insurance, but they can save you time and potentially a hospitalization, she adds.
Listen to your gut, and speak up
It’s important to trust your instincts. “Your feelings are valid, and you know your body best,” Felder says. If something doesn’t feel right, she suggests having a direct conversation with your provider by saying:
- “I’m concerned that you aren’t understanding the seriousness of what I’m sharing with you. I would appreciate it if I could have your full attention.”
- “I’m not feeling like my concerns are being heard.”
- “I appreciate your expertise, but the explanations you’ve given don’t seem to address my concerns. Is it possible to get a referral to another specialist? I’d like a second opinion.”
- “What are the next steps that you’re going to take to address my concerns?”
Sometimes doctors don’t know what’s wrong and so they’re not necessarily withholding information from you. If possible, it’s wise to seek a second opinion and be “ready to walk away and find someone new if your provider isn’t taking your concerns seriously,” Horwitz says.
Receiving improper care “can diminish your trust in the medical profession and discourage you from seeking further medical attention,” Felder says. It might be a last resort, but you do have the option of filing a complaint with the appropriate regulatory body that oversees your provider’s practice. When you’re sitting on a cold examination table, having to justify your symptoms should be the last thing on your mind.
