Health inequalities

How even the treatment of women’s health discriminates against them

The invisibility of women’s experiences has led to gender biases and discrimination in healthcare

PROFESSOR COLIN BERRY can pin- point the exact moment he began to realise just how much the profession he has dedicated his career to discriminates against women.

The year was 2018 and, as he and colleagues analysed the results of a year-long cardiology study, they stumbled upon very significant – and until then undetected – sex-based differences that were putting women’s lives at risk.

It was, the University of Glasgow academic says, “a watershed moment”.

“If you imagine a tree, the trunk and the main branches are the heart’s blood vessels,” Berry, who is also a consultant cardiologist at the Golden Jubilee and Queen Elizabeth hospitals, explains.

“You can see them in a coronary angiogram, but there are a multitude of smaller vessels you can’t see, but what you can’t see you don’t know.

“New technology used in the study allowed us to measure the function of those vessels and when we analysed the results it was literally a watershed moment.

“Of the patients who had angina but no blockages in their arteries the vast majority were women, and here’s the rub: those are the patients who get told ‘it’s a great result, you don’t have any blockages, you can go home’.”

In other words, women have been sent home to potentially die because a diagnostic test designed around the way heart disease presents in men did not pick up on their symptoms.

Ultimately it was advances in technology that led to the breakthrough Berry describes, but he says the study highlighted that the way medicine is taught and the fact cardiology is such a male-dominated branch of the profession have led to women’s justified health concerns being dismissed.

“We are educated to believe that angina and heart attacks are caused by blocked arteries,” he says.

“Unfortunately there’s also a bias with male doctors when they are talking to female patients, especially when they realise what they’re looking at doesn’t make sense – how can this woman have angina when she doesn’t have blocked coronary arteries?

“They say things like ‘it must be in your head or to do with your weight’ or give other, frankly sexist, reasons.”

It is a characterisation that is easily recognisable to Emma Ritch, executive director of feminist membership organisation Engender.

Like Berry, Ritch is a member of the Scottish Government’s Women’s Health Group, a panel set up in the 2019-20 session to find ways of tackling women’s health inequalities. Also like Berry, she believes many of those inequalities exist because findings about men are used to make assumptions about women, while a tendency to stereotype women’s experiences exacerbates the situation.