Study Highlights Gender Bias in Autoimmune Disease Diagnosis
Women are more likely to have symptoms dismissed as psychological, leading to diagnostic delays and potentially severe health consequences.
A significant portion of women with autoimmune diseases experience diagnostic delays and misdiagnoses, with their symptoms often attributed to psychological factors rather than underlying physical conditions, according to research. A study involving over 6,600 patients with autoimmune diseases found that women were substantially more likely than men to have their symptoms blamed on stress, anxiety, or psychiatric disorders.
These biases in medical assessment can have serious repercussions. One woman, Sarah Bassra, 36, from Nottingham, shared her experience of having her swollen foot dismissed by doctors, only to later suffer a life-threatening blood clot that resulted in permanent lung damage. Bassra recounted that her symptoms, which began in June 2022 with redness and heat in her toes and later swelling in her ankle, were initially diagnosed as plantar fasciitis. Despite her own concerns about a possible blood clot due to recent long-haul flights, her GP reportedly dismissed the idea.
Two months after her initial GP visit, Bassra was hospitalized with a pulmonary embolism, a dangerous blockage in the lung arteries, typically caused by a clot traveling from the leg. Even after this event, she stated that testing for Hughes syndrome (antiphospholipid syndrome or APS), an autoimmune condition that increases clotting risk and for which she had a family history, was delayed. It was only after a second pulmonary embolism in March 2023 that she received appropriate treatment, such as blood-thinning medication.
The study, published in the journal eClinicalMedicine, suggests that gender biases, termed 'medical misogyny' by some experts, persist in healthcare. Autoimmune diseases, where the immune system attacks healthy tissues, can be challenging to diagnose due to vague early symptoms like fatigue, pain, and sleep problems, which can overlap with psychological or hormonal issues. Women were found to have significantly longer delays between symptom onset and diagnosis, sometimes up to two years, and attended more appointments than men. Researchers noted that while psychological explanations can be prematurely given to any patient, females may be particularly vulnerable. Experts emphasize the importance of clinicians remaining open-minded when symptoms are persistent or involve multiple bodily systems, and crucially, listening to patients' concerns.