New research has found that women’s pain is often underestimated and under-treated as a result of existing gender biases. Beliefs about women’s sensitivity to pain, their willingness to report it and their capacity to endure it result in both men and women underestimating women’s pain and overestimating men’s pain.
The results of a new study published in the Journal of Pain found that an individual’s pain-related gender stereotypes predicted pain estimation biases. As a result, women were judged as more likely to benefit from psychotherapy, while men were prescribed more pain relief medicine.
In the experiment, lay participants viewed facial video clips of men and women in chronic shoulder pain and estimated patients’ pain intensity. Participants’ estimations were compared to patients’ self-reported pain and pain facial expressiveness. A follow up experiment showed that stereotypes drove their judgements. Men’s pain was considered higher by participants who believed that the typical man endured pain better than the typical woman. Women’s pain was also estimated lower by those who thought women were more likely to report pain than men.
Differences in female and male experience of pain
Consultant Ophthalmic Surgeon and advisor to MAPS, Bina Parmer, discusses how men and women experience pain differently.
“Pain happens when neural sensors in skin, muscles, joints or organs register a potentially harmful sensation, such as heat or tissue damage. These signals are sent to the cerebral cortex, which interprets pain. Pain is a symptom that can have a significant impact on a person’s quality of life, general functioning and employability.
“There are multiple biological and psychosocial factors that contribute to an individual’s interpretation of pain. Oestrogen, for example, is found to contribute to a higher level of pain than testosterone, which protects against pain. Depression and anxiety are higher in women than men, and both can be associated with lower pain sensitivity. Similarly, of the twenty per cent of people worldwide who experience chronic pain, the majority are women.
“It is established that differences exist between the way men and women experience pain, however, the specific underlying mechanisms are far from clear. Hormones, sociocultural beliefs about masculinity and femininity and culture-related variability are thought to be a few of the reasons behind it.”
Considerations for expert witnesses
Medical expert witnesses and their instructing solicitors must both be mindful to avoid unconscious bias and this new research provides a useful prompt to guard against any pre-existing beliefs that could influence expert opinion.
Miss Parmer added: “At present, there is no specific regime that is gender-tailored for the treatment of pain, however, treatment must be individualised. When assessing medico-legal reports, how many experts would consider this when formulating their final opinion and prognosis? Having a holistic approach, with a helicopter view of all relevant factors that influence a client, is key.”