Gender biases in estimation of others’ pain, 2021, Zhang L et al

This paper appears to me to be largely re-inventing the wheel. This effect of estimating pain to be less in women than in men has been demonstrated before. There is also an assumption that women believe themselves to be in great pain more readily than men because they are more likely to be attention-seeking and mentally ill.

How this affects a woman in severe pain because of a dangerous physical problem is described very well in this article written by the woman's husband :

https://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/

 

To perhaps be guilty of mansplaining, I think it is important we demonstrate as much as possible the gender biases of the medical profession to ensure better management of conditions that impact on woman more than men and also to avoid the harms caused by MUS misdiagnoses.

As a man I believe I have been better treated by the doctors I have come into contact with than most/many? women with ME are treated, but in contrast I have suffered equally in the lack of research and the mischaracterisation of our condition as a psychiatric condition that has resulted from it impacting on more women than men.

So though not Earth shattering these studies are still important.

[corrected typos]

 

@Peter Trewhitt i will take your mansplaining any time, thank you for your words. I suspect that men have access to more medicine and more tests, and in fact it would make for a good retrospective, chart review study, if we only had that to worry about.

What is fascinating is that increasingly we read research about sex differences in the biology of ME, as highlighted by the work on this post this week end (of course, larger study and replication is needed).

What is devastating is that this is still going on in 2021 and entire diseases are involved.

 

I don't understand how anyone knew how much pain there really was.
I am not aware of any valid way to compare one person's pain with another - the scales we use are designed to compare one person's pain with that person's pain at another time.
This looks a bit like PACE - finding what you set out to find - but actually much less effect than everyone might have expected simply from the sort of bias likely to have crept in.

 

Exactly.

When it comes to BPS codswallop then someone showing no objective signs of improved function are believed when they say they are recovered but not when they they say they feel worse.

Similarly, if someone says their pain levels improved that's great but we tend to be less supportive & believing when the pain goes above & lasts longer than some arbitrary point. An arbitrary measurement of a subjective experience at that.

Surely, what matters here is that the pain is preventing the person from functioning and is interfering with their life?

 

For anyone who stops and thinks for a moment that is completely the wrong way around. Sure men typically played sports that were more violent & where injury was more likely.

On the other hand women generally weren't supposed to go around discussing or whinging about *ahem "women's trouble" *.

So women, even those with bad period pain, were supposed to.just get one with it despite being in pain for several days or even one week out of four.

Of course for those susceptible to the hormone headache which can occur just before, during or after a period that can be an extra day or two of pain too.

Unless you were incapacitated by it, you were supposed to just carry on.

Women have been conditioned for generations not to make a fuss about pain & to carry on without showing it.

As for women being quicker to seek help - until very recently a woman who worked was also still largely responsible for the bulk of the household chores & making sure the children were fed, watered and in school on time. They couldn't afford to be sick because, as often as not, there was no one else to do it all for them. Seeking help earlier than men could just as easily be through a sense of duty to their family as anything else.

 

The main thrust of the paper (have only read the abstract) seems to be about the perceivers' judgements. I wonder why they didn't go digital instead of using actual patients and trying to do the impossible, i.e. somehow measure and match "true" levels of pain and facial expressiveness?

Start with a computer-generated androgynous face and overlay it with various levels and types of pain expression. Give half of the pictures stereotypical male features like a mustache and the other half stereotypical female features like a feminine hairdo. Then ask perceivers to rate how much pain they think the digital person is in. This should give a somewhat clearer picture of any specific gender effect (at least until such time as gender diversity has made visual male-female distinction too hit & miss, by which time we may no longer need studies such as this).

Similar studies have also been done on perceivers' judgement of pain in people of different colour, with predictable results.

Point 2) appears to me the more significant finding though it only restates what others have already found. But until the situation has changed I guess it has to be restated over and over again, basically saying each time that "see, it's still a problem".

 

Staying straight-faced and still when in pain can be taught, up to a point, if you start early enough.

 

Yep. I stood on a fire ants nest, wearing a pair of flip flops one day. I was stood there for a good 5 minutes as a neighbour wanted to talk to me about something really important.

I was in pain anyway and feeling lots of stinging on my feet & lower legs. My neighbour didn't notice a thing, my husband didn't notice a thing.

I only stayed there because I am so used to getting random stinging and burning sensations that it didn't occur to me I was being stung or bitten.

It hurt but obviously I masked the pain from expression well. When you are used to pain you get quite good at hiding it.

 

" I masked the pain from expression well. When you are used to pain you get quite good at hiding it. " so clearly stated by invisible woman . this i think is a major problem with chronic pain i hate being asked every five minutes if i am okay and would of course do my best to hide any outward signs of discomfort . then their is the predator and prey response we know full well that some people will and do take advantage of others who show any sign of perceived weakness .