Is There a Gender Self-Advocacy Gap? An Empiric Investigation Into the Gender Pain Gap
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ORIGINAL RESEARCH
Is There a Gender Self-Advocacy Gap? An Empiric Investigation Into the Gender Pain Gap Sara K. Kolmes
&
Kyle R. Boerstler
Received: 24 October 2019 / Accepted: 15 July 2020 # Journal of Bioethical Inquiry Pty Ltd. 2020
Abstract There are documented differences in the efficacy of medical treatment for pain for men and women. Women are less likely to have their pain controlled and receive less treatment than men. We are investigating one possible explanation for this gender pain gap: that there is a difference in how women and men report their pain to physicians, and so there is a difference in how physicians understand their pain. This paper describes an exploratory study into gendered attitudes towards reporting uncontrolled pain to a physician. This exploratory study provided subjects with a vignette describing a situation in which their pain is not being treated adequately and asked them questions about their attitudes towards selfadvocacy and the strategies they would likely use to express themselves. We found that women scored higher than men on measures of patient likelihood to self-advocate. Women also reported intending to use more varied self-advocacy strategies than men. This suggests it is unlikely that patient’s communication styles are to blame for the gender pain gap. Keywords Bioethics . Pain management . Gender . Gender pain gap . Empirical . Patient self-advocacy S. K. Kolmes (*) Georgetown University, 215 New North Hall, 37th and O, NW, Washington, DC 20057, USA e-mail: [email protected] K. R. Boerstler Florida State University, 151 Dodd Hall, Florida State University, Tallahassee, FL 32306, USA e-mail: [email protected]
Introduction and Motivation There are documented differences in the outcomes of pain related conditions between men and women.1 In treatment of some chronic pain conditions, women have a lower chance of positive outcomes of treatment, measured in terms of self-report of manageable pain levels or a decrease in disability (Payne 2004; Green and HartJohnson 2010; Stavropoulos and Hastie 2007; Greenspan et al. 2007; Jonsdottir, Jonsdottir, and Gunnarsdottir 2015a; Jonsdottir et al. 2015b; Samulowitz et al. 2018; Weisse et al. 2001). This does not seem to be due to gender differences in responses to pain treatment. There are no gender differences in reported pain experience in experimental conditions in which controlled pain was induced (Greenspan et al. 2007). It is possible that the gender pain gap is a result of differences in how pain treatment is prescribed. Standardizing pain treatment has been shown to increase the effectiveness of pain treatment for women (Uri et al. 2015), suggesting that pain treatment between genders is not currently standardized. The origins of these gender discrepancies in pain treatment are not clear (Schulman et al. 1999; Hawker et al. 2000; Harden et al. 2015; DiCecco, Patel, and Upshur 2002; Payne 1 There are very little data on pain treatment for nonbinary people. This is a gap in the literature which we will not address dir
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