Women have been saying for years that something feels different when they seek medical care. Now, a new review suggests there may be measurable differences in what happens after they walk through the door.
Researchers at the University of St Andrews examined 41 studies covering areas from heart disease and emergency care to surgery and kidney medicine. In 33 of 38 studies based on patient records, men and women received significantly different treatment.
The finding does not prove that doctors are deliberately treating women worse. But the consistent differences are hard to overlook.
The Pattern Was Bigger Than One Specialty
The researchers searched more than 1,100 records before narrowing their review to 41 peer-reviewed studies published between 2018 and 2023.
Most were based on existing medical records. And the pattern was remarkably consistent: women were often less likely to receive invasive or intensive treatment than men with similar clinical characteristics.
Among 38 retrospective studies, 33 found a statistically significant difference in treatment.
The researchers then looked at the 29 studies that had used statistical models to account for other measured differences between patients. Twenty-five still found a significant treatment difference.
Miriam Veenhuizen, an honorary lecturer at the University of St Andrews and co-author of the review, said: “While the direction of the findings was not a surprise the consistency was.”
The differences appeared across specialties rather than in one isolated corner of medicine.
Heart Care Is One Place the Gap Shows Up
Some of the clearest examples involved cardiovascular treatment.
Women with myocardial infarction, heart failure or supraventricular tachycardia were more likely to receive medication instead of procedures such as coronary intervention, ablation or bypass surgery in the studies included in the review.
Women with atherosclerotic disease were also less likely to receive lipid-lowering treatment in the reviewed research.
Other studies point in the same direction. A 2024 systematic review covering 19 studies found that women were less likely to receive several cardiovascular tests, including ECGs, cardiac enzyme testing, exercise testing and coronary angiography. Women were also less likely to be referred to cardiologists or admitted to hospital in the studies reviewed.
One U.S. emergency-department study involving patients with non-traumatic chest pain found that women were 20% less likely to receive a troponin test and 36% less likely to be admitted to a specialized unit, even after adjustment for other factors.
Symptoms can complicate the picture, too. A 2020 meta-analysis of 27 studies found that women with acute coronary syndrome had greater odds of reporting back pain, nausea or vomiting, and shortness of breath. Chest pain remained common among both women and men.
Related: 10 Medical Myths That Can Seriously Harm Your Health
Then There’s the Question of Pain
Pain may be where the issue feels most personal.
The new review included studies showing that women were less likely to receive opioid pain treatment in emergency settings.
A 2008 U.S. study of patients with acute abdominal pain found that women were less likely than men to receive any pain medication or an opioid despite reporting similar pain scores. After researchers adjusted for age, race, triage category, and pain score, women were still 13% to 25% less likely to receive opioids.
And the issue has not disappeared.
A 2024 international analysis found that women waited about 30 minutes longer than men to be seen for pain and were less likely to receive pain relief for the same complaints.
The researchers found the pattern regardless of whether the clinician was a man or a woman.
That finding makes the issue harder to reduce to a story about one type of doctor or one type of interaction.
“Too Many Women’s Health Issues Are Still Dismissed”
Image Credit: peopleimages12 via 123RF
The frustration is not limited to research papers.
Dr. Charmaine Griffiths, chief executive of the British Heart Foundation, said: “Too many women’s health issues are still dismissed, or poorly treated.”
In England, the government’s renewed Women’s Health Strategy has also put medical misogyny into the policy conversation.
Health and Social Care Secretary Wes Streeting said: “Women’s voices must be central to delivering effective, respectful and empathetic care.”
Streeting also said women’s pain had too often been treated as an inconvenience and their symptoms as an overreaction.
Those comments are political and advocacy statements rather than findings from the St Andrews review. But they show how the issue has moved beyond individual patient complaints into a wider debate about how women experience the health system.
Is Every Difference Medical Misogyny?
“Medical misogyny” has become a powerful phrase for describing women’s experiences of being dismissed, stereotyped, or not taken seriously in health care.
But the new review does not establish that every difference it identified was caused by misogyny.
A patient’s treatment can be influenced by preferences, access to care, disease severity, other medical conditions, and clinical judgment. Some of those factors may not be fully captured in a medical record.
The authors also found that many of the studies had gaps in the information available about patients. Seventeen of the retrospective studies did not report ethnicity, while 13 did not include information about comorbid conditions.
The authors say better prospective research is needed to separate those explanations.
O’Malley, who co-led the review, offered a practical takeaway for clinicians: “For clinicians, the findings are a prompt to check whether treatment is being offered on clinical grounds rather than assumption.”
That may be the most important distinction in the entire paper. The issue is not whether men and women should receive identical care in every circumstance. It is whether differences in care are based on the patient’s medical situation or on assumptions that have little to do with it.
There Is a Surprising Gap in the Research
Between 2018 and 2023, they identified 551 papers examining gender differences in professional opportunities within health care.
Only 41 examined measurable differences in patient care.
That gap makes it harder to understand how widespread treatment differences are, why they occur, and what can be done about them.
It also comes against a backdrop of limited sex-specific research. The National Academies found that women’s health research accounted for an average of 8.8% of NIH research-grant spending from fiscal years 2013 through 2023.
The figure does not mean only 8.8% of medical research involved women. It refers specifically to research classified as women’s health research. Still, it adds another piece to the question of how much medical evidence is designed to capture differences between male and female patients.
What Women Can Do When Something Feels Wrong
The findings aren’t a reason to assume that a doctor who disagrees with you is dismissing you because you’re a woman.
But patients can ask for clarity.
Why isn’t a particular test being recommended? What other possibilities are being considered? If medication is being chosen instead of a procedure, why? What should happen if the symptoms don’t improve?
Those questions can make a medical appointment more of a conversation than a one-way decision.
And when a problem persists or an explanation doesn’t make sense, seeking another medical opinion can be reasonable.
The bigger issue, though, cannot be solved by asking patients to advocate harder for themselves.
Veenhuizen said the pattern across specialties was what stood out to her. The next step is figuring out why it happens and whether the differences reflect clinical need, patient choice, access to care, or bias.
For women who have spent years wondering whether they were imagining the difference, that is an important question to keep asking.
Have you ever felt that you had to work harder than expected to have a medical symptom taken seriously?
More Articles You Might Be Interested In:
The post Medical Misogyny May Be Changing the Care Women Receive, New Review Finds appeared first on FODMAP Everyday.