Medical Gaslighting in Vulvovaginal Disorders: When Patients Aren’t Heard

Living with a vulvovaginal disorder or chronic pelvic pain can be challenging enough without feeling dismissed or unheard by your healthcare providers. Unfortunately, a new study highlights just how common negative healthcare experiences may be for people seeking care for vulvovaginal conditions.

This study was the first to specifically quantify experiences of medical gaslighting among people with vulvovaginal disorders.

What Is Medical Gaslighting?

The authors describe medical gaslighting as a form of epistemic injustice, meaning that a person’s knowledge or understanding of their own experience is unfairly dismissed or devalued.

The study defines medical gaslighting as:

“An act that invalidates a patient’s genuine clinical concern without proper medical evaluation, because of physician ignorance, implicit bias, or medical paternalism.”

For patients with vulvovaginal disorders, this can be particularly harmful. Symptoms such as vulvar pain, vaginal pain, painful intercourse, burning, pelvic pain, or pain during an examination can be difficult to diagnose and may not always have obvious physical findings.

“You Just Need to Relax”

Two of the most frequently reported experiences in the study included patients being told that they needed to relax more and being told that their physical examination findings were normal despite experiencing pain during the examination.

These experiences can leave patients questioning their own symptoms.

When someone is experiencing pain, the absence of an obvious physical finding does not automatically mean that their pain is not real. Pain is complex and can involve the nervous system, muscles, connective tissue, hormonal factors, previous experiences, and other biological and psychosocial factors.

Patients deserve to have their symptoms investigated and their concerns taken seriously.

Lack of Clinician Knowledge Can Become a Barrier to Care

One of the most highly reported barriers to care in the survey was lack of clinician knowledge.

Patients also identified clinicians not listening or being dismissive as concerning behaviors.

This is especially important in vulvovaginal and pelvic health, where conditions can be complex, overlapping, and sometimes difficult to diagnose. Patients may see multiple healthcare providers before receiving an explanation for their symptoms.

The study found that 52.8% of patients considered stopping care altogether because of negative healthcare experiences.

Even more concerning, patients who had seen a greater number of clinicians in the past reported higher levels of distress and more frequent experiences of medical gaslighting.

Why Listening Matters

Healthcare providers may not always have an immediate explanation for a patient’s symptoms. But uncertainty does not have to mean dismissal.

Listening carefully, asking thoughtful questions, performing an appropriate evaluation, acknowledging pain, and communicating what is known — and what still needs to be investigated — can make an enormous difference in a patient’s experience of care.

For patients experiencing vulvovaginal disorders or pelvic pain, being believed is an important part of feeling safe enough to continue seeking care.

Although this study has limitations, including the use of a survey that was not statistically standardized, it provides an important starting point for understanding medical gaslighting in vulvovaginal healthcare.

Future research can help identify best practices for clinicians and healthcare systems to reduce dismissive and harmful behaviors and create more patient-centered care.

Your pain deserves to be evaluated, your concerns deserve to be heard, and you deserve care that takes your experience seriously.

Article referenced:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833711