by Hannah Shewan Stevens
Medically Reviewed by:
Bethany Juby, PsyD
by Hannah Shewan Stevens
Medically Reviewed by:
Bethany Juby, PsyD
Medical gaslighting wreaks havoc on chronically ill people’s self-esteem and overall well-being. Learning to recognize it and self-advocate can help stem the tide.
Gaslighting affects interpersonal relationships, and it crops up in medical practice as well.
Patients are supposed to feel safe with medical professionals because they diagnose and treat conditions that would remain a mystery, even with the help of Dr. Google.
Sadly, many patients’ needs are dismissed or minimized through medical gaslighting. Occurrences seem to increase when doctors encounter conditions they know little about, if the patient is a member of a marginalized group, or if the condition has symptoms that can be invisible, like psoriatic arthritis.
“Medical gaslighting is when a doctor or other medical health professional disregards or ignores a patient’s description of their symptoms, questions, or concerns,” says licensed clinical social worker Iris Waichler, MSW, LCSW. “They may falsely assume their concerns are inappropriate, not really associated with a medical condition, or they may falsely assume that they have a psychological disorder.”
“While it’s evident that healthcare has been prioritizing reactive rather than preventive approaches to patients’ medical concerns, it’s crucial to recognize that the root cause of this issue lies in the general lack of research on women’s health,” says Sylvia Kang, CEO and co-founder of Mira.
Ashley Couto, a freelance journalist in Montreal who was diagnosed with psoriatic arthritis as a young child, has experienced medical gaslighting in a myriad of ways.
“Weight-related medical gaslighting has happened to me a lot,” she explains. “Doctors dismiss my pain as a result of my weight without considering the systemic factors or thinking about my mental health.”
Couto also has difficulty convincing technicians not to take blood from specific points on her body due to having deep, thin veins that collapse easily.
“You might be thinking, ‘Just refuse,’” she adds. “The problem is that when I do this — if I say the words ‘I refuse’ or ‘I’m not letting you draw my blood in that location’ — I’m always told that I’m being difficult or that I need to calm down, even though I’m not raising my voice.”
Chronically sick and disabled people spend more time with doctors than the average person, meaning that they’re especially vulnerable to medical gaslighting. The long-term impact of repetitive gaslighting is demoralizing.
“It’s incredibly discouraging,” says Couto. “I am vocal with my primary care practitioners, but in many instances where I’m meeting someone new, I’m too exhausted from years of standing up for myself.”
“I was diagnosed with my condition at the age of 18 months,” she continues. “I don’t remember not being sick. My entire life has been me fighting the medical system, and it’s exhausting.”
“Medical gaslighting can lead patients to feel a lack of empowerment and trust in themselves, a sense of confusion, isolation, and feeling uncomfortable and sometimes scared,” says licensed mental health counselor Maggie Holland, MA, MHP, LMHC. “It can also lead patients to comply with treatment options they aren’t comfortable with because they don’t feel confident in advocating for themselves any longer.”
The erosion of trust between doctor and patient inflicted by medical gaslighting makes securing long-term treatment a trial. Couto requires regular contact with her medical team, but the process hasn’t gotten easier.
“It makes the system inhospitable, and I’m still privileged,” says Couto. “I’m a cisgender, white patient. Doctors are more likely to believe my reports of pain. Everything I’ve discussed compounds for people who identify as trans or beyond the binary and people of color.”
Studies have found that women face longer waits to be diagnosed with conditions like heart disease, are less likely to be offered appropriate pain medications, and are treated less aggressively for traumatic brain injury.
People of color are vulnerable to receiving an overall poorer quality of healthcare. Racial bias may result in doctors under-prescribing pain medications to black patients, which also impacts their quality of care.
Medical gaslighting can exacerbate the poorer quality healthcare marginalized people often receive.
“Patients may also dismiss their own needs and concerns over time as a result of being gaslit and learning that perhaps their own experience is less valid,” says medical social worker Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C.
Aside from the mental impact, medical gaslighting threatens patients’ physical health, too.
“Medical gaslighting can mean that a provider misses important symptom information that may prevent them from treating the full issue, or even miss an important diagnosis altogether,” explains Holland.
“Not having important symptoms and diagnoses treated can lead to the presenting issue getting worse or even developing additional issues if left untreated.”
Self-advocacy is the best shield against medical gaslighting. Patients armed with knowledge of the medical system as well as their condition(s) will be better equipped to resist and report mistreatment.
“Educate yourself about your medical condition,” says Waichler. “Practice responses you feel comfortable saying in response to inappropriate comments or minimization of your wishes or questions. This will empower you and help you feel better prepared when medical gaslighting occurs.”
Don’t be afraid to switch care providers. Offending a doctor by leaving their care is inconsequential compared to protecting your well-being.
“Keep a paper trail or take notes of what you feel your experiences are with your condition, your symptoms, and the conversations you have had,” says Saxena. “Also, document the recommendations and treatment options presented.”
Your loved ones are the second-best defense against medical gaslighting. Form a team to help, and don’t be afraid to call them off the bench when you need assistance.
“It can be helpful to have a family member or friend be there with you to act as a patient advocate,” adds Waichler. “It can certainly be beneficial to have that additional support and to have them as a witness to verify the doctor’s gaslighting behavior if a complaint needs to be filed.”
Doctors and nurses need to take responsibility for recognizing and calling out medical gaslighting.
“Clinicians should take patients’ concerns seriously and listen to their experiences,” says Dr. Hana Patel, a general practitioner and medico-legal expert witness based in the United Kingdom. “It is important for healthcare workers to be aware of their own biases and to avoid making assumptions about a patient’s symptoms based on their gender, race, or medical history.”
It starts with creating a culture centered on active listening. Too often, patients get dismissed because they try to set boundaries or they get gaslit due to ingrained biases or a lack of knowledge.
Medically reviewed on January 19, 2024
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About the author
Hannah Shewan Stevens
Hannah Shewan Stevens is a freelance journalist, speaker, press officer, and newly qualified sex educator. She typically writes about health, disability, sex, and relationships. After working for press agencies and producing digital video content, she’s now focused on feature writing and on best practices for reporting on disability. Follow her on Twitter.