Medical misogyny, gaslighting doctors make it tough for long COVID-affected women

Up to 20 percent of people infected with COVID-19 may develop long COVID, a condition where individuals continue to experience persistent symptoms or develop new symptoms after recovering from acute COVID-19. For middle-aged women, long COVID is a difficult enough condition to endure as it is without having to put up with gaslighting having their symptoms diminished or dismissed by doctors when they seek treatment. One study of women seeking medical attention for long COVID revealed the impact of medical misogyny and gaslighting on middle-aged women's confidence and wellbeing as they accessed medical support for their long COVID symptoms.

"GPs weren't helpful at all, not at all and said: 'Are you sure it's not anxiety?'" one woman in her late 50s told researchers. "I've never suffered from anxiety, and I still don't." Another woman, aged 50, found doctor appointments to be invalidating: "The doctors cannot help you. They make you worse because they make your stress worse by saying it's in your head."

Long COVID usually develops three months after the initial infection. Symptoms such as fatigue, shortness of breath, cognitive dysfunction and around 200 others, last at least two months. There are no specific treatments or vaccines. The research came about because there was a gap in knowledge of how women who developed long COVID during the first wave of COVID-19 in March 2020  were managing their symptoms.

Nine women, eight from England and one from Poland discussed their medical care, which they reported as mostly being negative. Medical gaslighting is the process of diminishing or dismissing the physical or mental health symptoms of a patient by a healthcare provider. A patient may be told their symptoms are in their head or given a vague explanation leaving them without a treatment plan or diagnosis. The women reported being mistreated when attempting to ask for medical support for their long COVID symptoms. They also felt their health concerns were not being prioritised or taken seriously.

One woman who had attended a long COVID clinic said she noticed sexist, ageist and discriminatory assumptions were made about her being a woman over 40  with healthcare providers assuming her symptoms were due to menopause.

Hysteria and women's health
Her experience is an example of gaslighting which can involve doctors telling a patient their symptoms are in their head, giving a vague explanation, and leaving them without a treatment plan or diagnosis. Gaslighting can also lead to genuine symptoms and diagnoses being overlooked because medical staff dismisses women as emotional, dramatic and "hysterical".

There is a long history of women's health care being classified as hysteria although the diagnosis has now been replaced with "medically unexplained symptoms". This label has been applied to unexplainable and chronic health conditions in women's health care such as chronic fatigue syndrome and long COVID. Some research papers point to medical misogyny as they highlight the many ways in which women who experience pain are often viewed by the medical establishment as hysterical, malingerers, not helping themselves to get better or fabricating the pain.

One woman in the study pointed to language used in scientific research as an example of these sexist assumptions. "You have some people who are studying long COVID, usually, unfortunately from the psychological side, will start talking about things like neurasthenia or hysteria, said the woman, in her late 40s. This is very misogynist language."

Eliminating misogyny
Eliminating medical misogyny and medical gaslighting is no small feat, but there are some obvious places to start. As medical research is mostly based on male biology in clinical studies, researchers can play a key role by including more women in their studies.

Offering mindfulness interventions may support women with long COVID. While not a cure, mindfulness can play a role in helping sufferers manage debilitating symptoms including fatigue and unrefreshing sleep. Crucially, doctors can also commit to listening to female patients. Women know their bodies and when something feels off. It can be empowering for a woman to trust their instinct and to advocate for their health and to ask for a second opinion when necessary.

This research suggests all healthcare providers need to validate women's health concerns when they are trying to access care for long COVID. This would reduce discrimination and misogynistic practices, as well as help women access the support they need.