Our gendered expectations about the way that men and women should behave can actually have a tangible impact on Americans’ health outcomes, new research conducted by epidemiologists at the Yale School of Public Health suggests.
Previous research has confirmed that women are more likely than men to delay seeking medical care for their health issues, particularly when money is tight, largely because they choose to care for their children before caring for themselves. But on top of that, young women tend to ignore the symptoms of heart disease — and they’re more likely to die because they don’t seek immediate treatment during a heart attack.
Judith Lichtman, an associate professor of epidemiology at Yale, wanted to figure out where that discrepancy comes from. What are the specific barriers standing in the way of women getting treatment for their heart issues? In order to find out, she and her colleagues conducted a small in-depth study that focused on 30 young women between the ages of 35 and 55 who landed in the hospital after having a heart attack.
Many of those women said that they didn’t know what a heart attack felt like, or that their doctors didn’t recognize the signs. Particularly when they occur in women, heart attacks can be signaled by seemingly unrelated symptoms like nausea, shortness of breath, or jaw pain. And health providers still have some gaps in their knowledge about how exactly heart disease affects young women.
But, in an interview with NPR, Lichtman explained that even the women who did recognize the symptoms and suspected they were suffering a heart attack were still hesitant to push for treatment. They didn’t want to seem like they were overreacting or being hypochondriacs. “We need to do a better job of empowering women to share their concerns and symptoms,” Lichtman said.
The finding that some women are too timid to speak up about their medical concerns was particularly interesting to Dr. Jennifer Tremmel, a cardiologist at Stanford University, who pointed out that this is actually a widespread gendered issue for doctors and patients.
“It’s interesting because the whole idea of female hysteria dates back to ancient times,” Tremmel told NPR. “This is an ongoing issue in the medical field, and we all have to empower women patients, so they know that they need to not be so worried about going to the hospital if they’re afraid there’s something wrong.”
The modern-day stereotype that all women are “crazy” and “emotional” can be traced back to the historical notion of female hysteria, which was once considered to be a mental disorder. Women have been being described as hysterical since at least 1600 B.C., when ancient Egyptians attributed hysterics to the misplacement of the uterus. In the 1800s, women who attempted to rebel against the domestic expectations for their gender in the Victorian Age were labeled hysterical and placed in mental asylums.
Although modern medical practice has moved on — “hysteria” was removed from the 1980 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the so-called “bible” of the mental health field — the subtle societal expectations about the ways women should or should not express their emotions have not. Women are still shamed for having emotional reactions and labeled as “crazy” as a way of invalidating their feelings, a dynamic that modern feminists label as “gas lighting.”
According to Robin Stern, who authored the book The Gaslight Effect, women whose feelings are frequently invalidated in this way may have trouble making their own decisions, start constantly second-guessing themselves, or conclude that their concerns aren’t worth articulating because they’re simply being too sensitive.
Delaying medical care isn’t the only potential medical consequence stemming from the reinforcement of gender stereotypes. Previous research has found that young men and women may regulate their behavior in harmful ways when they’re trying to adhere to strict gender roles. Young men may behave physically aggressively or abuse alcohol, while young women may unhealthily restrict their diets.