A sixteen-year-old patient visited her doctor after experiencing extreme abdominal pain, finding blood in her urine, and running a fever. Her doctor asked about her sex life, whether she used tampons or pads, her home life, then prescribed her antidepressants before sending her home. She was finally given generic antibiotics for her kidney infection two days later, but because she had entered early-stage sepsis, they weren’t strong enough and she had to be hospitalized.

As shocking as this story may seem, instances where women are misdiagnosed or their physical pain is written off are exceedingly common. A 2008 study found that women who went to the emergency room (ER) with severe stomach pain had to wait almost 33% longer than men with the same symptoms. A 2018 study found that research papers referred to chronic pain differently based on gender: they used terms like “brave” and “stoic” for men but “emotional” and “hysterical” for women. Notably, papers with both male and female authors were included in this study. Numerous studies have been conducted across the healthcare industry, and they’ve all come up with the same problem.

This widespread disparity is both a result of how medical research is conducted and how medical professionals are trained. Caroline Criado-Perez writes in her book, Invisible Women: Exposing Data Bias in a World Designed for Men: “Historically it’s been assumed that there wasn’t anything fundamentally different between male and female bodies other than size and reproductive function, and so for years medical education has been focused on a male ‘norm’, with everything that falls outside that designated ‘atypical’ or even ‘abnormal’.” As Criado-Perez says, the typical human in anatomy was a ~150lb man, and the female body was seen simply as a “variation.” Research in the past few decades has shown us that there are many more differences between the sexes—including the heart, lungs, immune system, cells, and even the body’s response to stress. However, women (and female mice) are still very often underrepresented or completely excluded in studies and clinical trials. Criado-Perez explains an example from 2014 in which only 20% of participants of trials for a CRT-D, a type of defibrillator, were women. Because there were so few women in each study, separating the data based on sex didn’t show anything significant. But when researchers combined sex-disaggregated data from all the trials, they found that the threshold used to determine whether a patient needed the device was higher for men than women; in short, many women who should’ve been given CRT-Ds were subject to avoidable heart failure and early death. All because women were being treated using research done on men. If science doesn’t have a good enough understanding of the female body as a whole, how can we be surprised that misdiagnosis and misunderstanding of pain is so common?

In addition, gender bias disproportionately affects women of color—specifically Black women. To this day, half of medical trainees surveyed in 2016 believed that Black people are less sensitive to pain, have thicker skin, or have fewer nerve endings. A 2019 study showed that doctors were less likely to identify pain in the facial expressions of Black patients. The quality of care they receive reflects this devaluation of pain on account of both race and gender. In 2021, the maternal mortality rate for Black patients was 2.6 times higher than that of White patients.

Pain is the human body’s way of signaling a problem. But too often for women, no one—not even the doctor—knows which problem. Lack of knowledge about women’s health has life-threatening consequences for women everywhere. This Women’s History Month, take the time to reflect on where women face inequities, especially invisible ones. An answer could be staring you right in the face the next time you read some statistics—how representative of women is the study? Or it could be in the more subtle form of doubt in a woman’s claims about her own body. Ignoring the impact of gender bias in healthcare means allowing half the world’s population to receive poorer treatment. If we as a society start listening to women, we can get closer to making the world more equitable and avoid a lot of pain, trauma, and death.