Dismissed symptoms, delayed diagnoses, and the quiet harm of bias in women’s healthcare.

The whisper that saved her life

Carolyn Larkin Taylor, MD, had always been the physician, rarely the patient. That changed the day abnormal bleeding appeared. Her gynecologist took it seriously at first, ordering a biopsy that came back normal.

Six months later the symptoms returned, and another biopsy and ultrasound again suggested nothing alarming, only a “benign-looking” polyp. By her next visit, the doctor waved it off as stress.

Taylor left unsettled, a second opinion changed everything.

The new gynecologist reviewed the prior imaging, scheduled a hysteroscopy, and removed the polyp, a standard approach for abnormal uterine bleeding and suspected polyps that aligns with ACOG guidance.

The pathology showed cancer. Within a week, Taylor had a hysterectomy. Because the disease was caught before it spread, her outcome was favorable. For endometrial cancer, the five-year relative survival is about 96 percent when localized, but it falls to about 22 percent with distant spread.

Listening, in this case, was life-saving.

The pattern behind the story

The most dangerous part of Carolyn Larkin Taylor’s cancer wasn’t the tumor. It was being told, again and again, that nothing was wrong.

What happened to Taylor has a name: medical gaslighting, when a clinician minimizes or dismisses symptoms in ways that cause patients to question their own experience.

It is often subtle, more often a tone, but the effects are clear. Large-scale analyses show that women are systematically diagnosed later than men across hundreds of diseases.

A Danish registry study found women were, on average, diagnosed about four years later than men, a finding summarized by the University of Copenhagen’s Center for Protein Research here.

More recently, U.S. claims data also indicate women tend to be older at diagnosis and experience longer diagnostic timelines across conditions (open-access analysis).

The delays are not limited to cancer. In cardiovascular care, women with acute myocardial infarction are less likely to receive guideline-directed therapies and invasive procedures, a gap documented in a scientific statement from the

American Heart Association (Circulation review) and echoed in newer consensus and review literature. Outcomes reflect these inequities: women hospitalized for heart attack are less likely to receive recommended treatments and more likely to die than men, according to the National Institute on Aging’s summary of recent research (NIA research highlight).

Why women’s pain is still doubted

Bias in the recognition and treatment of pain is one driver. Experimental and clinical studies show clinicians underestimate women’s pain more often than men’s.

A 2021 paper in the Journal of Pain found systematic underestimation of women’s pain and a tendency to recommend less aggressive treatment (Journal of Pain study). This is not simply a matter of male physicians versus female physicians; culture, workload, and heuristics affect everyone.

But the net effect is predictable: symptoms that do not fit a tidy template are more likely to be reframed as anxiety or stress.

The same pattern appears in gynecology. Endometriosis, which affects an estimated 1 in 10 women of reproductive age, still takes a median of about seven years to diagnose, despite updated guidelines and growing public awareness. Delays compound suffering, add costs, and chip away at trust.

A clinician becomes the patient

Taylor’s experience illustrates how gaslighting erodes confidence, even for someone fluent in the language of medicine. She describes the way a raised eyebrow or a quick dismissal can make a patient second-guess what they feel.

That is the harm, beyond the missed diagnosis. When a patient begins to doubt their own reality, the threshold for seeking help rises.

There is also evidence that who treats you matters. Analyses of more than half a million heart attack cases found that women had better outcomes when cared for by female physicians, and that male physicians performed better with female patients when they had more exposure to women patients and colleagues (PNAS study abstract).

The mechanism is likely multifactorial, including communication patterns and diagnostic calibration, but the lesson is plain: experience and context shape care.

The takeaway

Taylor’s cancer was caught in time, but only because she listened to the whisper that said, keep going. Her story, told in Whispers of the Mind: A Neurologist’s Memoir, is a reminder that medicine is as much about attention as it is about tests.

For clinicians, the challenge is to cultivate curiosity, especially when the first workup is negative and the symptom story keeps coming back.

For patients, the message is simple and hard won: if your body keeps telling you something is wrong, ask again. And if the answer is a shrug, ask someone else.

References

• American Cancer Society – Endometrial Cancer Survival Rates
• National Cancer Institute SEER – Uterine Cancer Statistics
• ACOG – The Use of Hysteroscopy for the Diagnosis and Treatment of Intrauterine Pathology
• ACOG – Hysteroscopy (Patient FAQ)
• Nature Communications – Population-wide analysis of differences in disease progression patterns in men and women
• University of Copenhagen – Women are diagnosed later than men
• NIH (PMC) – Gender differences in disease diagnosis timing
• Journal of Pain – Gender Biases in Estimation of Others’ Pain (PDF)
• Circulation – Acute Myocardial Infarction in Women (AHA Scientific Statement)
• National Institute on Aging – Women hospitalized for heart attack are less likely to receive treatment
• PNAS – Patient–physician gender concordance and increased mortality among female heart attack patients