By: Nicole Schanker
Edited by: Stephen Shiwei Wang
Introduction
Gender disparities in pain management and treatment are, unfortunately, the foundation of the U.S. healthcare system. This leads to unequal access to care for half of the U.S. population. In fact, many of these disparities are deeply rooted in the country’s history. Race, gender, and socioeconomic status are all factors that come into play when patients seek medical treatment. The medical community has had significant technological advancements over the past few decades. For gender equality, women are still facing discrimination when seeking medical treatment, with higher rates of discrimination affecting women in marginalized communities.1
For example, researchers at the University of Calgary called Netflix to better represent pain stereotypes: “Researchers analyzed 60 hours of Netflix content, including popular movies such as Spider-Man: Homecoming and TV series such as Stranger Things. Their study found that most of the media depicted pain arising from violence and injuries. They also found that most portrayals of pain involved boys and white people, while there was a lack of representation of pain in girls, gender-diverse people, and individuals with racialized identities”.2
This paper will explore gender disparities within the American medical system’s practice. Specifically, it will address the intersectional disparities in pain management, the lack of gender-specific data in clinical trials, and how medical students play a critical role in reducing these biases and disparities within IUD and pain management. The goal of this paper is to explore how representation, change, and education can improve the quality of care for all patients and how to move toward a more equitable and compassionate healthcare system.
Applying Intersectionality to Address Bias in Pain Management
To start, the intersectionality framework plays a critical role in addressing disparities in pain management. According to the University of British Columbia, “intersectionality is directly tied to oppression… Understanding intersectionality is essential to combating the interwoven prejudices people face in their daily lives.”3 As Kimberlé Crenshaw, American civil rights advocate and law professor explains, “a queer black woman may experience the world on the basis of her sexuality, gender, and race,” which is a “unique experience based on how those identities intersect in her life.”4 She goes on to say that by reflecting on one’s own identities and how they intersect, along with mindfulness, one can become more effective allies for marginalized groups and better articulate one’s own experiences. In the healthcare system, this framework can explore how multiple layers of bias and inequity intersect, and change how patients experience and receive medical treatment.
The Birth of Bias: Unequal Pain Treatment in Early Medicine
In pain management, marginalized populations of women experience unequal treatment, misdiagnosis, and inadequate care. This unequal treatment stems from a “mislabeling” issue. Healthcare providers dismiss women’s reports of pain as emotional or psychotic, so women tend to receive delayed diagnoses, untimely interventions, and inadequate pain relief. J. Marion Sims exemplifies the intersection of gender and race in pain management. In the 1840s, Sims conducted nonconsensual experimental surgeries on enslaved African American women and even received the undeserved title of “father of gynecology.” The enslaved subjects of Sims’ experiments were considered properties, and forced to participate in cruel experimentation, barbarically denied anesthesia. Sims justified this by saying that black women have a higher pain tolerance.5 Without a scientific basis, the claim is based on the intersection of gender and race stereotypes. Subsequent studies that have promoted the fallacy that Black patients feel less pain are based solely on the fact that black patients have historically received less pain medication compared to white patients.6 This false cause fallacy became the backbone for studies to assume that black patients feel less pain.
Addressing the Modern Challenges of Pain Care
Today, the discrepancy in pain management practices is a symptom of structural biases that even clinical trials couldn’t escape. As Sterne and Smith pointed out, biases are acceptable, but researchers must “identify and assess the potential impact… on the conclusions of the study.”7 While there has been progress since the cruelty faced by women patients in the 1800s, women still face discrimination in the medical world. Structural biases exist not only in the treatment of female patients but also in the selection of populations in studies. According to the National Library of Medicine, “women make up 30% of the gout disease population; however, they make up just 5.3% of gout clinical drug trial participants,” and “female participation in clinical trials has decreased since the 1990s.”8 Further, sexism in clinical trials may become so severe that it compromises patient treatment, resulting in misdiagnoses, improper dosages, and inadequate treatment plans.9
Another example of bias is the absence of female representation in clinical trials for the drugs Thalidomide and Diethylstilbestrol, originally developed as sleeping pills but later found to alleviate nausea. Since pregnant women experience nausea most frequently, the drugs were widely prescribed to expectant mothers around the world throughout the 1950s and 60s to manage morning sickness. However, no clinical trials had been conducted on this population before the approval of the drug as a treatment for nausea. Frances Oldham Kelsey, an American pharmacist and physician working at the Food and Drug Administration, took a brave and unpopular stance, refusing to approve the drugs in the United States due to the lack of clinical trials in pregnant women. Although Kelsey faced backlash from the scientific and pharmaceutical communities, she stood her ground and prevented the distribution of the drug to pregnant women in the U.S.10 The countries that allowed the distribution of the drugs caused devastating consequences, as many babies of mothers who consumed the morning sickness drugs were born with severe birth defects.11
Proposed Solutions and Interventions
Canada implemented two key policies to prevent similar global public health crises in the future. First, the Guidance Document on the Inclusion of Women in Clinical Trials (1997, revised in 2013) ensures that women are adequately represented in medical research by requiring researchers to consider sex and gender differences in study design, data analysis, and reporting. Second, the Health Portfolio Sex and Gender-Based Analysis Policy (2009, updated in 2012) mandates that all health-related research and decision-making processes in Canada incorporate sex and gender-based analysis to address gender disparities in healthcare and improve patient outcomes.12
It is 2025, yet researchers, doctors, and pharmacists still operate with major gaps in knowledge about women’s health as clinical trials continue to fall short of achieving a fifty-fifty participation rate between men and women—a reality that continues to jeopardize patient safety. According to the Association of American Medical Colleges, as of 2019, “women accounted for roughly 40 percent of participants in clinical trials for three of the diseases that most affect women: cancer, cardiovascular disease, and psychiatric disorders, despite representing 51 percent of the U.S. population.”13
The situation is even bleaker for women of color, as clinical trial data often fails to report the intersection of biological sex and race. In fact, “systematic reviews of clinical trials… show significant underrepresentation of women of color”.14 This lack of representation means that medical research often fails to account for how different racial and ethnic groups respond to treatments, leading to disparities in healthcare outcomes. Without adequate data, medications and treatment protocols may be less effective or even harmful for women of color, further exacerbating existing health inequities. Addressing this gap is crucial to ensuring that all patients receive equitable and effective medical care.
Uncovering the Root of Representation Gaps in Medical Education
Many of these discrepancies reflect systemic disparities in medical education. From 2018 to 2019, US medical students severely lacked racial minorities’ representation and women’s gender representation.15 A major consequence of this lack of diversity is pervasive gender bias within medical education. To address this issue, it is essential to reevaluate the medical school admissions process, restructure the current curriculum, and move beyond test scores. The direct implementation is to incorporate diversity and inclusive training as a central component of medical education to create a representative workforce.
Shifting the Narrative: Evolving Representations of Medical Students
According to the British Medical Journal, “gender bias has an overt presence during medical student education”, which has been “too male, too pale… too stale.”16 Medical School students are given simulated patient scenarios and exams called OSCEs, “Objective Structured Clinical Examinations.” The exams aim to test students’ clinical competence in a standardized medical setting. The problem is that the medical settings presented to students in these test cases are not representative of true patient populations.
One female medical student testified to the lack of diversity and representativeness in these settings: “We haven’t seen any patients that aren’t white [and] over forty… [we] need to have that exposure [to demographically diverse patients] from an earlier stage.”17
Another female student reported a slightly different issue: the lack of diversity and representativeness among medical school staff, lecturers, and mentors. She stated: “I can remember the first time we had a Black female lecturer. And that was amazing because that was the only female, black female doctor that I’d seen in the whole year”.18
Representation of diverse doctors is crucial because it helps break down systemic barriers in medicine, inspires future generations, and fosters trust in healthcare among underrepresented communities. When patients see doctors who share their backgrounds, they may feel more understood and receive more culturally competent care. Additionally, increasing diversity in medical education challenges biases and promotes inclusivity within the profession, ultimately leading to better healthcare outcomes for all.
While there have been “modest increases in enrollment among underrepresented groups,” this is not enough to remedy systemic disparities in medical education and the consequences this causes in medical research and practice. Simply increasing medical student diversity would not resolve the problem. It is possible that despite an increase in female medical student representation, the curriculum may not represent the patient or medical student population.
For example, the Health Professional Attitudes Toward the Homeless Inventory (HPATHI) was given to ER doctors, medical students, and residents at a major teaching hospital. “These negative attitudes appear to be more prevalent among faculty than students…”19 This ties back to the discussion that medical schools need to change their curricula. The article reinforces this point: “A future study could examine the development of medical students’ attitudes during their training and into the specialty selection process… Medical students’ attitudes and beliefs about homeless people may be shaped by the attitudes of their teachers, and one of the most common sites for learning about homeless patients is the emergency department…”20
Inconsistent Pain Management Practices: A Critical Examination
A great example of gender disparities in pain management and treatment is the discrepancy between pain management for intrauterine device (IUD) placement and that for the vasectomy procedure. An IUD is a form of contraception that prevents pregnancy. Yale Medicine defines it as a “type of long-acting, reversible contraception (LARC) that provides birth control for three to ten years, depending on the type.” They are “the third most common birth control method used by American women.”21 IUDs are “small, flexible, T-shaped devices are inserted into the uterus through the vagina.” This implantation procedure takes about ten minutes and causes moderate to severe cramping and/or sharp pain that can last hours to a few days afterward.22 CDC approved the administration of pain medications during the IUD insertion to moderate this pain. The pain management treatments vary, including oral pain medication, like Ibuprofen; Lidocaine spray or gel in the cervix; para-cervical block or lidocaine injection in the cervix; or sedation. However, the choice of pain management alternatives is at the discretion of the clinic, and many providers are not willing to administer these medications as “there’s some uncertainty if these pain relief options make patients feel better overall.”23 This uncertainty contradicts half of those studies that backed the CDC recommendation; another half simply suggested that patients are more relieved.
On the other hand, a contraceptive procedure for men – the vasectomy procedure – is inexplicably treated as less controversial when it comes to pain management as compared to the IUD insertion procedure for females. The vasectomy procedure is a reversible means of male sterilization. During the procedure, the male’s vas deferens are cut, sealed, or tied off. After the incision is closed, the patient heals naturally. In some cases, “No stitches are needed because the puncture holes are so small.”24 The procedure takes between 10 to 30 minutes, and the pain is mild, as compared to the moderate to severe pain experienced by women during IUD insertion procedures.25
Analyzing Pain Management Prescription Trends
The American Urological Association (AUA) studies on the topic of pain medication and the use of opioid prescriptions at the time of vasectomy. One study conducted from 2017 to 2018 analyzed 228 patients who “underwent a clinic vasectomy as performed by eight urologists.”26 Of the total patients studied, 102 patients received opioid prescriptions, and 126 received no opioid prescriptions”. The results of this study showed that “opioids, which do not appear to be necessary for men who undergo vasectomy, were associated with persistent use in seven-point-eight percent of patients…”27 Although the study cautioned against the use of opioids for these procedures in the face of the current opioid abuse epidemic, providers are still prescribing these medications for vasectomy procedures at alarming rates.
Analyzing the parallel contraceptive procedures and IUD placement versus the vasectomy procedure, there is a concerning difference in the way the medical community approaches each. Despite studies showing that pain management for the IUD procedure should involve medication, providers often fail to administer it. On the other hand, research suggests that vasectomy patients receive stronger medications than necessary, yet clinics continue to prescribe them.28 This discrepancy is deeply rooted in gender bias, stemming from historical gender discrimination, a lack of female representation in clinical trials, and potential biases in medical training. Historically, female pain has been dismissed as exaggerated or psychological, while male pain is viewed as more urgent and requiring immediate relief.29 This reflects deep-seated gender stereotypes and misogyny. Due to inequalities of gender representation in the medical field, fewer women are treating these patients or educating future doctors about treatment, leading to gaps in knowledge and disparities in care.
The Critical Role of the Emergency Department
The Emergency Department is at the forefront of the U.S. healthcare system. Unfortunately, it also reflects gender disparities in pain management and treatment. The National Library of Medicine’s article, “Sex in Pain Management Decisions,” states that gender disparities in pain management extend across medical practitioners, with both male and female physicians prescribing less pain-relief medications to females than to males, and gender disparities in treatment are not only practiced by physicians but also by nurses.30
Unequal Pain Scores: Understanding Disparities in Pain Management
Studies show that female patients’ pain scores are ten percent less likely to be recorded by nurses.31 A pain score is a numerical rating used to assess the intensity of pain on a standardized scale to evaluate a patient’s discomfort. Pain is often considered objective, so pain scores are necessary to identify patients’ pain levels when they report to the Emergency Departments. At the nurse’s discretion, patients are given forms to self-identify their pain levels: zero meaning no pain at all, and ten corresponding to unbearable pain. The fact that nurses are less likely to administer this method of patient self-identification of pain for women shows that the pain experienced by female patients is taken less seriously. In fact, women often feel that their pain is not taken as seriously as men’s.32 It is also possible that these measurements are complicated by female under-reporting of their pain as compared to men.33 This may be based on females’ fears of being perceived as overly emotional in confirmation of gender stereotypes.
A journal published in Science Journal Translational Medicine states that “centuries-old stereotypes cast women as overly emotional and dramatic,” which has resulted in the presumption that women are “exaggerating their pain”.34 The article studied one hundred nurses at a Missouri hospital. The nurses then wrote scenarios to describe “a patient’s case as well as a [patient-identified] pain rating of nine out of ten”.35 Each nurse then subjectively rated their patient’s pain from zero to one hundred. With a male patient, the average score was eighty. With a female patient, nurses rated lower, averaging seventy-two. In conclusion, disparities persisted regardless of the healthcare provider’s sex.36
Tackling Gender Inequities in Treatment for the Unhoused
Emergency Departments around the country experience a high influx of unsheltered patients. This population has a high rate of chronic medical problems as well as psychiatric disorders. For many of these individuals, the only access to healthcare is through the Emergency Room (ER), and vulnerable populations have significantly higher levels of medical needs. According to Academic Emergency Medicine, women who went to the ER with severe stomach pain had to wait almost thirty-three percent longer than men with the same symptoms.37
The National Center for Biotechnology Information conducted studies on homeless and unstably housed women and their relationship with the Emergency Department (ED). Physical health and pain were strongly correlated with hospital-based health services. Seventy-nine-point-three percent of women in the study reported having at least some degree of activity limitation due to bodily pain. The current study suggests that bodily pain may be associated with both ED visits and hospitalizations in homeless and low-income women”.38
The article goes on to discuss the difference between homeless women and men seeking pain management in the ER. It finds that homeless women visit the ER more frequently for pain management due to sexual and physical violence. “Homelessness puts people at risk for multiple types of violence and other injuries, which may contribute to the high levels of pain seen in this population… ninety-eight-point-seven percent of women experienced moderate to severe pain…”39 So why are women still not receiving adequate pain management in the Emergency Department, even when they seek care after experiencing sexual or physical assault? The answer is systemic bias.
Women’s Pain Management in Chronic Disease: Unequal Treatment and Outcomes
When examining gender disparities in pain management, chronic diseases, particularly those that disproportionately impact women and communities of color, are often overlooked by the medical establishment. Sickle Cell Disease (SCD) “affects about 100,000 people in the United States… most of whom are Black”.40 Despite its painful and debilitating nature, many SCD patients are met with “skepticism” or viewed with “suspicion of seeking drugs,” especially in emergency room settings. This reaction cannot be separated from the demographics of those affected. The question becomes: if SCD were a disease primarily affecting white patients, would their pain still be met with the same level of doubt? Historically, the pain of women has been minimized, ignored, or misattributed. Chronic disease pain, like that experienced in SCD or conditions such as endometriosis, fibromyalgia, and lupus, is uniquely complicated: it is often “invisible,” episodic, and easily dismissed as psychological or exaggerated.
This is where chronic illness diverges from acute or more “visible” diseases. It requires long-term validation, nuanced care plans, and a shift away from outdated beliefs about who is “really in pain.” But when the system itself is built on a foundation of racial and gender bias, chronic pain becomes both a medical and sociopolitical issue. SCD isn’t just under-treated because it’s a rare disease; it is under-treated because it exists at the intersection of race, gender, and chronicity. This pattern is not isolated. It’s part of a broader structural failure that continues today.
An associate professor of clinical psychiatry, Dr. Amy Williams, interviewed eleven- to eighteen-year-old patients and concluded that women tend to get worse care for pain, so avoiding biases in treatment is extremely important.41 A similar study enrolled fifty sickle cell patients at similar age ranges with their guardians, and it showed similar results.42
Many women with chronic pain bounce from provider to provider and ultimately end up being referred to mental health services. “Oftentimes, it’s because they don’t have pain that fits neatly into a cookie-cutter category,” says Dr. Robert Duarte, MD, Director of the Pain Institute of Neurology at Long Island Jewish Medical Center. Many symptoms are labeled as “anxiety” or “normal period pain.”43 Women feel defeated and unheard when they seek professional help, only to be told their symptoms are psychological and they are subsequently referred to mental health services.
Ovarian Cancer Pain Treatment for Women
When treating ovarian cancer, many women are dismissed by doctors when they present with pelvic pain, and by the time they are diagnosed, the pain has persisted for too long. Ovarian cancer was once called the “silent killer” because it was believed to have little to no symptoms. Recently, Dr. Robyn Andersen found a high percentage of women reported symptoms. Yet these symptoms are often misdiagnosed or dismissed.44 This issue arises from clinical oversight but reflects a medical policy failure. Developing stronger clinical guidelines for recognizing and validating gynecological symptoms and mandatory training that addresses gender bias in medical and nursing curricula will be necessary.
Significantly, delays in diagnosis are key examples of gender bias: women’s symptoms are too often dismissed, leading to missed opportunities for early intervention and preventable deaths. While the medical system should listen to women, women must feel empowered and encouraged to advocate for themselves. Women know their bodies better than anyone, and by fighting for themselves, their mothers, sisters, and friends, women can create a healthcare system through representation and awareness.
Recent Advancements
Many major health systems are actively working to address these gender disparities. Northwell Health in New York City has been exploring ways to dismantle this issue. In a discussion with specialists at the Katz Institute for Women’s Health—including a cardiologist, gynecologist, pain specialist, and psychologist—experts shared strategies to help women protect themselves from the harmful effects of medical bias. They were asked what patients should do if they felt their providers were “gaslighting” them. One of the most powerful statements came from Dr. Grossman: “Sometimes women feel guilty about getting a second opinion as if they’re betraying their current doctor. But it’s not like cheating on your spouse. You deserve to find a doctor that you can trust—one who genuinely listens to your concerns and delivers the best care possible”.45 Admittedly, while scientific understanding has improved, healthcare delivery lags. As the report states, “We still have many mid-career and senior physicians whose practice of medicine is based on the ‘one-size-fits-all’ approach to diagnosis and treatment. A sex- and gender-based approach to disease management is not even on their radar”.46
Northwell Health, in affiliation with Hofstra’s Medical School, was one of the first institutions to demonstrate that a one-size-fits-all approach to medicine negatively impacts women’s health.47 Their efforts highlight the need for a medical model that fully considers sex- and gender-based differences in diagnosis, treatment, and care.
Conclusion
Pain management has always improved the quality of life for individuals both in and outside the hospital. When pain is left untreated, it leads to slower recovery times, depression, anxiety, post-traumatic stress disorder (PTSD), and opioid addiction. Women’s pain is often dismissed or attributed to psychological causes, such as anxiety or emotional distress, rather than being taken at face value as a physical symptom.
Despite advancements in the medical community, significant disparities still exist in how pain is assessed, treated, and understood, particularly among women. As argued, this bias stems from pervasive gender norms and societal expectations that shape how women’s pain is perceived. The norms, perpetuated by media and cultural stereotypes, contribute to the medical community’s failure to adequately address women’s pain, leading to inequities in healthcare outcomes.
Existing cases all point to the fact that policies need systemic change, specifically with the intersectional approach. The intersectional approach can break down barriers and create a healthcare system that is safe and welcoming for all, but improving medical education and ensuring better representation in clinical trials are prerequisites for achieving this change.
Without these changes, women will continue to be severely mistreated in the medical community and will continue to die at higher rates than men.48 The root of these biases lies in deeply ingrained gender norms and racial prejudices that have shaped how women’s health is perceived and treated throughout history. Addressing these disparities requires reforming medical education to recognize and challenge biases and ensure that clinical research is inclusive of all populations. Without these changes, women, particularly women of color, will continue to receive suboptimal care.
Works Cited
1. “Understanding Health Inclusivity for Women.” 2025. The Economist. The Economist Newspaper. Accessed April 17. https://impact.economist.com/projects/health-inclusivity-index/articles/understanding-health-inclusivity-for-women.
2. Johnston, Kelly. 2024. “Study Finds Netflix Misses the Mark by Trivializing Teenagers’ Pain.” University of Calgary News, April 3, 2024. https://ucalgary.ca/news/study-finds-netflix-misses-mark-trivializing-teenagers-pain.
3. University Of British Columbia. 2021. “Intersectionality: What Is It and Why It Matters.” Vice-President Finance & Operations Portfolio (VPFO). Published March 8. https://vpfo.ubc.ca/2021/03/intersectionality-what-is-it-and-why-it-matters/.
4. Ibid.
5. Weiner, Stacy. 2020. “How We Fail Black Patients in Pain.” AAMC News. Published January 7. https://www.aamc.org/news/how-we-fail-black-patients-pain.
6. University of Virginia. 2020. “Black Americans Are Systematically Under-Treated for Pain. Why?” UVA Frank Batten School of Leadership and Public Policy. Published June 30. https://batten.virginia.edu/about/news/black-americans-are-systematically-under-treated-pain-why.
7. Sterne, J.A.C., G.D. Smith, and D.R. Cox. 2001. “Sifting the Evidence—What’s Wrong with Significance Tests?” BMJ 322 (7280): 226. doi:10.1136/bmj.322.7280.226.
8. Lea Merone, Komla Tsey, Darren Russell, and Cate Nagle. 2022. “Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature.” Women’s Health Reports 3 (1): 49–59. doi:10.1089/WHR.2021.0083.
9. American Medical Women’s Association. 2025. “The Hidden Bias in Medical Research: Gender Inequality in Those Producing the Content.” American Medical Women’s Association (AMWA). Published February 27. https://www.amwa-doc.org/the-hidden-bias-in-medical-research-gender-inequality-in-those-producing-the-content/.
10. Waggoner, Miranda R., and Anne Drapkin Lyerly. 2022. “Clinical Trials in Pregnancy and the ‘Shadows of Thalidomide’: Revisiting the Legacy of Frances Kelsey.” Contemporary Clinical Trials 119 (August). doi:10.1016/j.cct.2022.106806.
11. Dana-Farber Cancer Institute. 2018. “After 60 Years, Scientists Uncover How Thalidomide Produced Birth Defects.” Dana-Farber Cancer Institute. Published August 1. https://www.dana-farber.org/newsroom/news-releases/2018/after-60-years-scientists-uncover-how-thalidomide-produced-birth-defects.
12. Alla Yakerson. 2019. “Women in Clinical Trials: A Review of Policy Development and Health Equity in the Canadian Context.” International Journal for Equity in Health 18 (1): 1–8. doi:10.1186/s12939-019-0954-x.
13. Weiner, Stacy. 2024. “Why We Know So Little About Women’s Health.” AAMC News. Published March 26. https://www.aamc.org/news/why-we-know-so-little-about-women-s-health.
14. Ibid.
15. Boyle, Patrick. 2019. “More Women Than Men Are Enrolled in Medical School.” AAMC News. Published December 9. https://www.aamc.org/news/more-women-men-are-enrolled-medical-school.
16. Megan E L Brown, Gabrielle M Finn, George E G Hunt, and Ffion Hughes. 2020. “‘Too Male, Too Pale, Too Stale’: A Qualitative Exploration of Student Experiences of Gender Bias within Medical Education.” BMJ Open 10 (8). doi:10.1136/bmjopen-2020-039092.
17. Ibid.
18. Ibid.
19. Fine, A.G., T. Zhang, and S.W. Hwang. 2013. “Attitudes towards Homeless People among Emergency Department Teachers and Learners: A Cross-Sectional Study of Medical Students and Emergency Physicians.” BMC Medical Education 13 (1). doi:10.1186/1472-6920-13-112.
20. Ibid.
21. MacMillan, Carrie. 2024. “What Women Should Know About Intrauterine Devices (IUDs).” Yale Medicine. Published August 13. https://www.yalemedicine.org/news/intrauterine-devices-iud.
22. Ibid.
23. Bartz, Deborah. 2024. “IUD Insertion Pain Relief: What You Need to Know.” Mass General Brigham. Published October 22. https://www.massgeneralbrigham.org/en/about/newsroom/articles/iud-insertion-pain.
24. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). 2022. “How Is a Vasectomy Done?” NICHD. Last reviewed February 18. https://www.nichd.nih.gov/health/topics/vasectomy/conditioninfo/done.
25. Bartz, Deborah. 2024. “IUD Insertion Pain Relief: What You Need to Know.” Mass General Brigham. Published October 22. https://www.massgeneralbrigham.org/en/about/newsroom/articles/iud-insertion-pain.
26. Barham, D.W., L.P. McMann, J.E. Musser, J.Q. Schisler, R.W. Speir, S.P. Olcese, J.R. Sterbis, T.M. E-Nunu, and G.B. Stackhouse. 2019. “Routine Prescription of Opioids for Post-Vasectomy Pain Control Associated with Persistent Use.” Journal of Urology 202 (4): 806–10. doi:10.1097/JU.0000000000000304.
27. Ibid.
28. Ibid.
29. eClinicalMedicine. 2024. “Gendered Pain: A Call for Recognition and Health Equity.” EClinicalMedicine 69 (102558-). doi:10.1016/j.eclinm.2024.102558.
30. Guzikevits, Mika, Tom Gordon-Hecker, David Rekhtman, Shaden Salameh, Salomon Israele, Moses Shayo, David Gozal, Anat Perry, Alex Gileles-Hillel, and Shoham Choshen-Hillel. 2024. “Sex Bias in Pain Management Decisions.” PNAS Proceedings of the National Academy of Sciences of the United States of America 121 (33): 1–7. doi:10.1073/pnas.2401331121.
31. Ibid.
32. University of Miami. 2021. “Women’s Pain Not Taken as Seriously as Men’s Pain.” Science Daily. Published April 6. https://www.sciencedaily.com/releases/2021/04/210406164124.htm.
33. Bernardes, Sónia F., Anke Samulowitz, Kai Karos, and Jeffrey S. Mogil. 2024. “Sex/Gender Biases in Pain Research and Clinical Practice.” International Association for the Study of Pain (IASP). https://www.iasp-pain.org/resources/fact-sheets/sex-gender-biases-in-pain-research-and-clinical-practice/.
34. Guglielmi, Giorgia. 2019. “Emergency Rooms Are Less Likely to Give Female Patients Pain Medication.” Science. Published April 4. https://www.science.org/content/article/emergency-rooms-are-less-likely-give-female-patients-pain-medication.
35. Ibid.
36. Ibid.
37. Chen, Esther H., Frances S. Shofer, Anthony J. Dean, Judd E. Hollander, William G. Baxt, Jennifer L. Robey, Keara L. Sease, and Angela M. Mills. 2008. “Gender Disparity in Analgesic Treatment of Emergency Department Patients with Acute Abdominal Pain.” Academic Emergency Medicine 15 (5): 414–18. https://doi.org/10.1111/j.1553-2712.2008.00100.x.
38. Linnstaedt, Sarah D., Timothy F. Platts-Mills, James R. Miner, Andrey V. Bortsov, Basmah Safdar, Polly Bijur, Alex Rosenau, et al. 2014. “Gender Differences in Acute and Chronic Pain in the Emergency Department: Results of the 2014 Academic Emergency Medicine Consensus Conference Pain Section.” Academic Emergency Medicine 21 (12): 1421–30. doi:10.1111/acem.12529.
39. Ibid.
40. King, Bobby. 2021. “Painful Bias.” Indiana University School of Medicine Magazine. Published May 26. https://medicine.iu.edu/magazine/painful-bias.
41. Ibid.
42. Gates, Laura. 2020. “IU School of Medicine Psychologist Studies Injustice in Treatment of Youth with Sickle Cell Disease.” Indiana University School of Medicine. Published November 10. https://medicine.iu.edu/blogs/research-updates/iu-school-of-medicine-psychologist-studies-injustice-in-treatment-of-youth-with-sickle-cell-disease.
43. Northwell Health. n.d. “Gaslighting in Women’s Health.” Katz Institute for Women’s Health. https://www.northwell.edu/katz-institute-for-womens-health/articles/gaslighting-in-womens-health.
44. Mapes, Diane. 2018. “Squelching Ovarian Cancer: The Not-So-Silent Killer.” Fred Hutch News Service. Published September 17. https://www.fredhutch.org/en/news/center-news/2018/09/squelching-ovarian-cancer-the-not-so-silent-killer.html.
45. Northwell Health. n.d. “Gaslighting in Women’s Health.” Katz Institute for Women’s Health. https://www.northwell.edu/katz-institute-for-womens-health/articles/gaslighting-in-womens-health.
46. Ibid.
47. Ibid.
48. Jean-Pierre, Phoebe. 2022. “Medical Error and Vulnerable Communities.” Boston University Law Review 102 (1): 327–92. https://research-ebsco-com.proxy.library.cornell.edu/linkprocessor/plink?id=cef3d47b-ded9-3d29-88d6-d73a985af585.
Author Bio
Nicole Schanker is an MHA candidate with nearly a decade of experience in hospital-based settings, including emergency trauma social work, behavioral health, and patient advocacy. As a proud social worker, Nicole has dedicated her career to advancing healthcare equity for underserved populations and supporting patients through complex medical challenges. She is currently pursuing her second master’s degree in Health Administration to deepen her leadership in healthcare advocacy and advance meaningful improvements in access and equity across health systems.
