How to recognize 'medical gaslighting' and better advocate for yourself at your next doctor's appointment
The term "medical gaslighting" may be relatively new, but the practice has been affecting people's health outcomes for decades.
"Medical gaslighting is when concerns about your healthcare are being dismissed, they're not heard and they are minimized," says Stacey E. Rosen, senior vice president for Northwell Health's Katz Institute for Women's Health and co-author of "Heart Smarter for Women — 6 Weeks to a Healthier Heart."
It can be so subtle that you may not even realize if it's happening to you.
Gaslighting, in psychology, refers to a certain kind of manipulation where you are tricked into questioning your own reality.
And in health care, medical gaslighting is pretty common, says Rosen. Especially among certain marginalized groups like women and minorities, including Black and Latino people: Those groups experience medical gaslighting more often.
For folks who belong to more than one of those groups, like Black women, it can be even worse, says Tina Sacks, an associate professor in the school of social welfare at UC Berkeley.
"Women in general in the healthcare space are invalidated because of pervasive misogyny," says Sacks. "And then when you compound that with a profound anti-blackness that runs through all of society, these groups of people are more likely to be dismissed."
Having your health concerns minimized can lead to serious life or death consequences, says Sacks.
Black women historically have the highest maternal mortality rates, and many suspect that is due to institutional racism and a dismissal of their concerns.
If you think you've experienced medical gaslighting or want to be prepared and get ahead of it happening to you, here are a few signs to look out for and tips for advocating for yourself.
It can be difficult to know when gaslighting is happening to you, especially when you're assuming your doctor knows best, says Sacks.
Because care providers have expertise that you may not have, it is very likely that you'll take their word even if they're being dismissive of your symptoms, she says.
"One thing to remember when we go to the doctor is that the provider has specialized knowledge of healthcare and health topics in general, but you know your body," Sacks says, "You do know more than anyone else what is happening to yourself."
Sacks interviewed a Black woman who experienced knee pain for 15 years and was constantly told by physicians that it was as a result of her weight. She later discovered that she had two tumors in her knee.
If persistent symptoms are quickly attributed to weight, stress, anxiety, depression or work overload, Rosen says it is possible that your concerns are being minimized.
Here are a few phrases that could also be indicators of medical gaslighting:
- "It's all in your head."
- "That's normal for your age."
- "I'm sure that's not … " (prior to testing)
- "It's just a little bit of swelling."
To ensure that your concerns are being taken seriously, Rosen advises you take notes before visiting your doctor, and list any changes you've noticed in your health. Come prepared with a list of questions and concerns you hope to discuss during your visit.
Jotting down notes during your appointment can help you follow up on things you don't understand, she adds.
"Empower yourself to be a better advocate for your health care," says Rosen. "We know that health care visits are 15 minutes, so how do you make the most of your 15 minutes?"
Consider bringing another person to the appointment with you, if allowed. This will give you an extra ear and emotional support, says Rosen. Someone who knows you well can help validate your concerns and reiterate them if they're being dismissed.
"Sometimes when there's a second person in the room, that person is another voice [that can say], 'No, she never had complaints like this in the past,' and 'No, this isn't related to stress.' I'm her mother, I'm her sister, I'm her girlfriend," she says.
It can be helpful to find and stick with a primary care physician that you trust. A doctor who is familiar with your medical history may be more understanding of your concerns, Rosen notes.
But at times, the answer could be to switch your physician or get a second opinion, Rosen says.
For visits that you're nervous about, using mindfulness techniques before arriving or while listening to the doctor can help you think more clearly and advocate for yourself if needed, according to Sacks.
A few mindfulness practices she recommends are:
- Finger-tapping exercises
- Chanting in your mind
- Breathing in and out
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