Medical Gaslighting

(Part 1 of 3)

I’ve seen more accounts of medical gaslighting on social media and popular news channels lately. And that’s a good thing! We need to bring more awareness to the experiences of patients, especially those who are chronically ill and struggling to be heard and treated. The concept of “medical gaslighting” made a splash a few years ago with a TikTok mocking patients that suffered from medically unexplained symptoms (MUS). There was a subsequent and appropriate backlash with #PatientsAreNotFaking.

Medical gaslighting is nothing new

But let’s be real: Gaslighting in health and medicine is nothing new, it has deep historical roots. And while the internet is filled with first-person stories and forums devoted to speaking out against this abuse, it stubbornly persists.

In the introduction to her book, "“Unwell Women: Misdiagnosis and Myth in a Man-Made World”, the cultural historian Dr. Elinor Cleghorn writes:
“We are taught that medicine is the art of solving our body’s mysteries. And we expect medicine, as a science, to uphold the principles of evidence and impartiality. We want our doctors to listen to us and care for us as people. But we also need their assessments of our pain and fevers, aches and exhaustion, to be free of any prejudice of who we are. We expect, and deserve, fair and ethical treatment regardless of our gender or the color of our skin. But here things get complicated. Medicine carries the burden of its own troublesome history. The history of medicine, of illness, is every bit as social and cultural as it is scientific.”

1944, Film: GASLIGHT, starring Ingrid Bergman

The term “gaslighting” originates from the 1938 play, Gaslight, and its later film adaptation. The story is a psychological thriller set in 1880, in which a man coerces his wife, Paula, to question her perception of reality. The concept of medical gaslighting gained more recognition in psychological research in the 1960s. But the throughline of notions such as “hysteria,” attributed to women in particular, dates back to Ancient Egypt with a description documented in about 1900 BCE. Our usually beloved Hippocrates, (“Let food be thy medicine and medicine be thy food”) coined the term “hysteria” in the 5th century BCE, suspecting that the condition stemmed from movement of the uterus.

Too sensitive. Too much. Too difficult. Overreacting. Reading too much into it. Are you sure? Could be anything, you know. You’re not trying hard enough. I don’t understand what you’re talking about. It’s all in your head. I had that too and it was nothing. Try X, Y, Z (insert handout) and come back to see me in a few months…

These are all gaslighting statements spoken by medical providers to patients. Dismissal. Misdiagnoses. Mystified shrugs. 

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I’ve been there.

​​“You took advantage of every second that I did not love myself.”

― Laura Gentile

My feet were in the cold metal stirrups when she insisted that I go on birth control. My knees were spread wide. The speculum was open inside of me. The light shone between my legs. Her face was parallel with mine, at the opposite end of the exam table.

I’d chosen her because she was my age and had a smart bio. It looked like we could be friends and that she’d understand my situation. We couldn’t. And she didn’t.

It was a day of two exams: this one, and one at the community college, where I was completing all my post-bac, pre-med, pre-reqs. I was up late the previous night studying organic chemistry. The babysitter came early that morning to help my son prepare for school and his carpool. Breakfast was made and set on the table. Lunch (his and mine) was packed. This was the juggle – single parenting, studying for school, working nearly full time from home, and relying on those I could pay when I needed help caring for an adorable redhead. 

Andrea and her son, Gilbert, 2008

I told the doc I’d been widowed for about four years. I relayed the circumstances above. She nodded, looking between a screen with my stats and the naked walls of my vaginal canal. She noted that I was in my early 40s and still fertile. And then she prodded me about birth control. 

“I don’t have time for sex right now. How can I get pregnant?,” I asked her. She answered indignantly and left me with pamphlets for birth control options before switching off the spotlight shining on my early 40-something vulva and exiting the room.

Alone, I swung my legs off the table, wiped the exam goo from my crotch, and quietly removed the paper gown from my naked body. I dressed, grabbed my backpack and the thick notebook I’d been studying in the waiting room, walked to the car that my late husband had purchased for us just weeks before he could no longer drive, and headed to my next exam. 

I never went back to that doctor. 

I never went back to that doctor. I never went on birth control. I also never told anyone this story. These stories (the micro, like this, and the macro, which include far worse offenses) make-up part of our Functional Timelines. One of those Timelines is our trust in what healthcare can do for us. The other is a timeline of how and where we’re able to speak up for ourselves. 

The biggest problem is that you leave these encounters thinking maybe it IS all in your head. You stop trusting your gut, just like Paula in Gaslight. Also of critical note: medical gaslighting is almost always rooted in social inequalities – including race, gender, sexuality, social and economic status, and education. And it’s typically executed in power-laden relationships (when the medical provider is the “god” and not the “guide”).

Again, from Dr. Elinor Cleghorn:

“The discrimination women encounter as medical patients is magnified when they are Black, Asian, Indigenous, Latinx, or ethnically diverse; when their access to health services is restricted; and when they don’t identify with the gender norms medicine ascribes to biological womanhood… In the US, Black, Asian, and other ethnically diverse women face serious barriers to accessing healthcare, treatment, and services, as well as being approved for medical insurance. Structural racism intertwines insidiously with gender bias: 22 percent of Black women in the United States have experienced discrimination when they visited a doctor or a clinic. As a white woman, I risk having my pain written off as hysterical. But a Black woman will often have to fight to have the very existence of her pain acknowledged.”

There’s much more to say, but for now I’ll share that I’m less interested in blaming the provider or even the systems. It’s not because I want to let them off the hook for their offenses, but I tend to be more individualistic in my thinking. Instead of trying to change the embedded structure I wonder what I can do to shift my expectations of both myself and the system. And I wonder how I can invite you to do the same for yourself. In this way, I also hope that we can change the way we do healthcare, precisely because we are more independent, less reliant, and ultimately better partners in getting what we want out of the situation. 

Join me next week to explore the 3 Steps for Moving on after Medical Gaslighting. And if you have a story to tell, I hope to provide you with the opportunity to tell it!