Journal of Pediatric Psychology: Gender Bias in Pediatric Pain Assessment

Ravn

Ravn

Senior Member (Voting Rights)
Gender Bias in Pediatric Pain Assessment
https://academic.oup.com/jpepsy/adv...jpepsy/jsy104/5273626?redirectedFrom=fulltext
Journal of Pediatric Psychology, jsy104, https://doi.org/10.1093/jpepsy/jsy104
Brian D Earp et al, Published: 04 January 2019 (Paywall)
Abstract
Objective

Accurate assessment of pain is central to diagnosis and treatment in healthcare, especially in pediatrics. However, few studies have examined potential biases in adult observer ratings of children’s pain. Cohen, Cobb, & Martin (2014. Gender biases in adult ratings of pediatric pain. Children’s Health Care, 43, 87–95) reported that adult participants rated a child undergoing a medical procedure as feeling more pain when the child was described as a boy as compared to a girl, suggesting a possible gender bias. To confirm, clarify, and extend this finding, we conducted a replication experiment and follow-up study examining the role of explicit gender stereotypes in shaping such asymmetric judgments.

Methods

In an independent, pre-registered, direct replication and extension study with open data and materials (https://osf.io/t73c4/), we showed participants the same video from Cohen et al. (2014), with the child described as a boy or a girl depending on condition. We then asked adults to rate how much pain the child experienced and displayed, how typical the child was in these respects, and how much they agreed with explicit gender stereotypes concerning pain response in boys versus girls.
Results

Similar to Cohen et al. (2014), but with a larger and more demographically diverse sample, we found that the “boy” was rated as experiencing more pain than the “girl” despite identical clinical circumstances and identical pain behavior across conditions. Controlling for explicit gender stereotypes eliminated the effect.

Conclusions

Explicit gender stereotypes—for example, that boys are more stoic or girls are more emotive—may bias adult assessment of children’s pain.
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Could this explain my first experience of being dismissed by the medical profession?

At age 9 I fell off a horse. Complained of a sore arm. Was taken to the doctor who diagnosed bruising, x-ray deemed unnecessary.

Continued complaining the next week or so about arm. Taken back to the doctor. Bruising much reduced, told to “be a big girl”, x-ray again deemed unnecessary.

Continued complaining another week or so. Taken back to the doctor, this time by a friend's mother, one of those scary human bulldozer types. She told the doctor “I know this girl, she's tough as nails. If she says she's sore she is sore. I'm not leaving the clinic till she's had an x-ray”.

Three outcomes. One, with that short statement she had earned my eternal devotion: she alone had seen I had been being a “big girl” all along. Two, I got that x-ray. Three, I was treated for the broken arm I had had all along.
 
Similarly my daughter broke bones in her wrist / arm after a fall in the playground when she was 10. Her knee was a mess and diverted staff attention so it took an hour or so for them to phone after she complained about wrist pain.

OH arrived. Complained that she had been left with another 10 year old over lunch when there was risk of shock. Took to A and E.
Doctor examined, not broken , tissue damage.
After some discussion an x ray was taken , after which the doctor apologized as he realised his examination would have been extremely painful as there were broken bones.

Sometimes telling your children to " be brave" is potentially counterproductive.
 
Moderator note: Merged thread.

Americans take the pain of girls less seriously than that of boys, a new study finds

https://www.washingtonpost.com/nati...less-seriously-than-that-boys-new-study-finds

Washington Post article said:
How much pain adult Americans think the young patient is suffering will depend on whether they believe the child to be a girl or a boy, according to a study published this month in the Journal of Pediatric Psychology. Those who know the distressed patient as “Samuel” will infer that he is in more pain than those who know the patient as “Samantha,” even though Samuel and Samantha are in fact the same 5-year-old, whose shoulder-length blond hair, red T-shirt and gym shorts don’t immediately suggest male or female characteristics.
...
The results, in what lead author Brian D. Earp described as a “new research area,” contribute to growing understanding of sex differences in pain, a topic that has mainly been studied in the context of adults. They add further dimensions to the exploration of pain assessments biased by race, based on dubious notions about biological differences between blacks and whites. And the results suggest a possible need for a course correction in pediatric care, where health-care providers may exhibit the same biases that influence the general public.
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also from that article-

"In a finding that surprised the paper’s authors, the downgrading of female pain was driven by female participants, who were more likely than men to say that the pain of the subject was less severe when told she was a girl."

"In the new study, the gender of the young patient had no effect on assessments offered by 156 male participants, among several hundred who viewed the video."
 
The new study accesses a wider audience. And the apparent biases of the women it surveyed came as no surprise to Kate Manne, a philosopher at Cornell University and the author of “Down Girl: The Logic of Misogyny.” She said it was the logical conclusion of women rating their own pain as less severe.

“Since there’s more pressure on women to be appropriately sympathetic to pain, and since we’re biased in the direction of taking male pain more seriously, it makes sense that women are at least as bad if not worse,” Manne said.
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I was taught from a very young age that expressing pain made me a "naughty" child. I would sometimes be punished or threatened with punishment if I made what my parents thought was "too much fuss" or "made a fuss about nothing". I was accused at various times in childhood and adulthood of being an attention-seeker, a wimp, or a liar by all sorts of people, including doctors.

If girls get that kind of indoctrination from infancy onwards then of course many adult women will assume that those same characteristics apply to other females expressing pain or distress. Anyone with chronic health problems is likely to learn that this is nonsense, eventually. But for those who don't suffer chronic illness nothing is likely to disturb the early indoctrination.

The idea that women complain more about less severe pain is like a meme that carries on throughout societies and cultures all over the world through generation after generation. I don't see it being changed any time soon. Presumably parts of the brain "light up" when people are in pain, and some inventor will invent a gadget to measure pain. When everyone can carry their own pain measurement device around with them and show it to people then maybe people will start to take women's pain as seriously as men's pain.
 
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