Australian women have reported feeling abandoned and shamed by the health care system, with two thirds of women citing experiences of health care related gender bias or discrimination.
The #EndGenderBias survey, conducted by the National Women’s Health Advisory Council, found gender bias in health care had a “far reaching impact on women’s lives” with many women claiming that a delayed diagnosis and treatment led to the progression of their disease and overall, worse health outcomes.
Tasmanian Board Member of the Australian Women’s Health Alliance Heidi La Paglia Reid has been regularly in and out of the health system since she was 15.
Heidi La Paglia Reid said she experienced gender bias and discrimination by the Australian health care system. (Image supplied)
It took Ms La Paglia Reid years to receive a diagnosis after being dismissed by health professionals and believes she was treated differently because she was female.
“Despite now having quite a few diagnoses, it took years for me to get those, and I spent years going to GP’s and even specialists just to get told ‘it’s all in your head’,” Ms La Paglia Reid said.
Another recent survey of Australian women with chronic conditions found women wait an average of four years for a definitive diagnosis and almost half of these women are re-diagnosed at least once.
Of the women re-diagnosed, 32 per cent were originally diagnosed with a psychological condition or medically unexplained physical symptoms.
Ms La Paglia Reid was diagnosed with autism later in her life, in addition to chronic conditions including various psycho-social disabilities such as eating disorders, depression and anxiety, as well as physical conditions such as irritable bowel syndrome (IBS), osteoporosis and chronic pain.
“At times I was told pain around IBS was due to period pain, despite the fact that I had the added complication of not having a period for about a decade – and doctors were never willing to look into that either despite it being a pretty obvious issue,” she said.
However, in addition to her gender, Ms La Paglia Reid said she believes the delayed diagnosis of her conditions was also due to her autism.
“I can communicate and present in ways that are a bit different and may undermine my own conditions in some ways,” Ms La Paglia Reid said.
“For example, I have quite a high pain threshold and even if I am in a considerable amount of pain, when I’m communicating with doctors, I may not explain how debilitating it is.
“If a doctor asks ‘how bad is the pain’ I might say something like ‘I don’t know’ because I don’t know how to explain that kind of thing which is all tied into being autistic and neurodivergent.
“Also, having experienced a multitude of conditions for such a long time, I don’t know anything different.”
The #EndGenderBias survey revealed women disproportionately experience delayed diagnosis, overprescribing of medications, and a failure to properly investigate symptoms due to systemic issues in health care delivery and medical research.
Chair of the Victorian Women’s Health Services Network and CEO of the Multicultural Centre for Women’s Health Dr Adele Murdolo said she was not surprised by the survey’s findings.
“Working in women’s health, you already know that the system is set up not really with women in mind,” Dr Murdolo said.
“It was originally set up for men and not enough has changed to make sure that it’s a system that women can use very easily.
“Almost 70 percent of women’s experiences in our health system are inequitable or making women feel they’re not getting the service they need.”
Over 70 per cent of women reported experiences of bias during the diagnosis and treatment of health conditions, particularly in relation to sexual and reproductive health as well as chronic pain.
“When women [see a health practitioner] for pain or heavy bleeding during their periods, women often report that that’s minimised or not taken seriously and they’re often sent home and told it’s part of the trial of being a woman,” Dr Mudolo said.
“To some extent, pain is a part of life, and we can’t avoid all pain in life, but it is about discrimination and treating women’s pain differently to men’s pain.”
Dr Murdolo said gender bias and discrimination in health care can also be seen in the amount Medicare rebates for internal pelvic ultrasounds compared to scrotal ultrasounds.
“When you have an ultrasound scan, you actually get less of a rebate back for a scan that is a pelvic scan than you would if that same scan was on a scrotum,” Dr Murdolo said.
This is despite internal pelvic ultrasounds requiring more time and expertise.
Source: MBS Online
She said women also experience discrimination when seeing a health practitioner to address issues beyond reproductive or sexual health.
“Women who work in jobs where there is a lot of repetitive strain injury – often those kinds of injuries aren’t really taken seriously,” Dr Murdolo said.
“Women can be seen to be reporting the pain in a way that is not realistic or that it’s just the type of pain that women should withstand.”
Only 38 per cent of the 497 expert stakeholders surveyed as part of the #EndGenderBias report felt women ‘mostly or completely’ have access to safe health care.
Almost half of the expert group (48 per cent) felt ‘only slightly or not at all’ have choice in their health care.
Most of the experts surveyed (70 per cent) felt women were ‘only slightly or not at all’ believed about a health issue.
Dr Murdolo said the health system can begin to better accommodate women’s needs by expanding their opening hours to account for almost a quarter of Australian working women who are employed casually.
“The 8:30am to 5pm [opening hours] that a lot of health services keep can be fine for people who are working in jobs where they can take sick leave,” Dr Murdolo said.
“But if you’re a casual worker then you don’t get sick leave, so you have to make a choice between going to work or getting an issue treated or looked at.”
She believes there needs to be a larger focus on making Australia’s health system and health information more accessible.
“We’d really like to see more of a focus on women’s health being talked about and information being more widely available in multiple formats and multiple languages,” Dr Murdolo said.
“We have to tailor information for different groups of women.
“Twenty five per cent of the women who answered the #EndGenderBias survey had a disability, so I think we really need to look at the different types of systemic changes that we can make to the system to make sure it is more accessible for women with disabilities as well.”
The Australian Labour Government has committed to investing more than $160 million in a tailored women’s health package to address gender bias in the health system, upskill medical professional and improve sexual and reproductive care as part of the 2024-2025 Australian Federal Budget.