For people with chronic gynecological pain conditions, pain can be constant, making everyday activities like sitting, riding a bicycle and even wearing underwear extremely uncomfortable. For many of these people \u2013 most of whom identify as women \u2013 sexual intercourse and routine pelvic exams are unbearable.<\/p>\n
Endometriosis<\/a>\u00a0and\u00a0vulvodynia<\/a>, or chronic genital pain, are common gynecological conditions that can cause severe pain. They each affect about 1 in 10 American women.<\/p>\n Yet many women face skepticism and gaslighting in health care settings when they seek care for this type of pain.<\/p>\n We know this well through our research on\u00a0social cognition<\/a>\u00a0and on\u00a0how people with misunderstood health conditions<\/a>\u00a0manage difficult conversations with their doctors and family, as well as through volunteer work alongside people living with these conditions.<\/p>\n We\u2019ve consistently found that medical gaslighting around chronic gynecological pain is a complex societal problem, fueled by holes in medical research and training.<\/p>\n \u2018It\u2019s all in your head\u2019<\/strong><\/p>\n A 2024 study of patients who went to a clinic for vulvovaginal pain \u2013 pain experienced in the external female genitals and vagina \u2013 found that 45% of these patients had been told that they \u201cjust needed to relax more<\/a>\u201d and 39% were made to feel that they were \u201ccrazy.\u201d A staggering 55% had considered giving up on seeking care.<\/p>\n These results echo what one of us \u2013 Elizabeth Hintz \u2013 found in her 2023 meta-synthesis: Female patients with chronic pain conditions frequently hear this \u201cIt\u2019s all in your head<\/a>\u201d response from doctors.<\/p>\n Another study followed patients in two different major U.S. cities who were seeking care for vulvovaginal pain. The researchers found that most patients saw multiple clinicians but\u00a0never received a diagnosis<\/a>. Given the challenges of seeking medical care, many patients turn to social\u00a0media sources like Reddit for support and information<\/a>.<\/p>\n These studies, among others, illustrate how people with these conditions often spend years going to clinician after clinician seeking care and being told their pain is psychological or perhaps not even real. Given these experiences, why do patients keep seeking care?<\/p>\n \u201cLet me describe the pain that would drive me to try so many different doctors, tests and treatments,\u201d\u00a0a patient with vulvovaginal pain<\/a>\u00a0said to her doctor. For her, sex \u201cis like taking your most sensitive area and trying to rip it apart.\u201d<\/p>\n \u201cI can now wear any pants or underwear that I want with no pain,\u201d said another patient after successful treatment. \u201cI never realized how much of a toll the pain took on my body every day until it was gone.\u201d<\/p>\n Medical gaslighting<\/strong><\/p>\n Many\u00a0patients worldwide experience medical gaslighting<\/a>\u00a0\u2013\u00a0a social phenomenon<\/a>\u00a0where a patient\u2019s health concerns are not given appropriate medical evaluation and are instead downplayed, misattributed or dismissed outright.<\/p>\n Medical gaslighting is rooted in centuries of gender bias in medicine.<\/p>\n Women\u2019s reproductive health issues have long been dismissed as\u00a0psychological or \u201chysterical.\u201d<\/a>\u00a0Genital and pelvic pain especially has been misattributed to psychological rather than biological causes: A century ago, Freudian psychoanalysts\u00a0incorrectly believed that female sexual pain<\/a>\u00a0came from\u00a0psychological complexes like penis envy<\/a>.<\/p>\n These historical views help shed light on why these symptoms are still not taken seriously today.<\/p>\n Consequences of medical gaslighting<\/strong><\/p>\n In addition to the physical toll of untreated pain, medical gaslighting can take\u00a0a psychological toll<\/a>. Women may become\u00a0isolated when other people do not believe their pain<\/a>. Some internalize this disbelief and can begin to\u00a0doubt their own perceptions of pain<\/a>\u00a0and\u00a0even their sanity<\/a>.<\/p>\n This cycle of gaslighting compounds the burden of the pain and might lead to\u00a0long-term psychological effects<\/a>\u00a0like anxiety, depression and post-traumatic stress symptoms. For some, the repeated experience of being dismissed by clinicians\u00a0erodes their sense of trust<\/a>\u00a0in the health care system. They might hesitate to seek medical attention in the future, fearing they will once again be dismissed.<\/p>\n Although some chronic gynecological pain conditions like\u00a0endometriosis<\/a>\u00a0are\u00a0gaining public attention<\/a>\u00a0and becoming better understood, these dynamics persist.<\/p>\n A funding crisis<\/strong><\/p>\n Part of the reason for the misunderstanding surrounding chronic gynecological pain conditions is the lack of research on them. A January 2025 report from the National Academies found that research on\u00a0diseases disproportionately affecting women were underfunded<\/a>\u00a0compared with diseases disproportionately affecting men.<\/p>\n This problem has gotten worse over time. The proportion of funding from the National Institutes of Health spent on women\u2019s health has actually\u00a0declined over the past decade<\/a>. Despite these known disparities, in April 2025 the Trump administration threatened to end funding for the Women\u2019s Health Initiative,\u00a0a long-running women\u2019s health research program<\/a>, further worsening the problem.<\/p>\n Without sustained federal funding for women\u2019s health research, conditions like endometriosis and vulvodynia will remain poorly understood, leaving clinicians in the dark and patients stranded.<\/p>\n Disparities in care<\/strong><\/p>\n As hard as it is for any female patient to have their pain believed and treated,\u00a0gaining recognition for chronic pain<\/a>\u00a0is even harder for those who face discrimination based on class or race.<\/p>\n One 2016 study found that half of the white medical students surveyed\u00a0endorsed at least one false belief<\/a>\u00a0about biological differences between Black and white patients, such as that Black people have physically thicker skin or less sensitive nerve endings than white people. The medical students and residents who endorsed these false beliefs also underestimated Black patients\u2019 pain and offered them less accurate treatment recommendations.<\/p>\n Studies show that\u00a0women are more likely to develop chronic pain conditions<\/a>\u00a0and report\u00a0more frequent and severe pain<\/a>\u00a0than men. But women are\u00a0perceived as more emotional<\/a>\u00a0and thus less reliable in describing their pain than men. Consequently, female patients who describe the same symptoms as male patients are judged to be in less pain and are\u00a0less likely to be offered pain relief<\/a>, even in\u00a0emergency settings and with female clinicians<\/a>. Compared to male patients, female patients are more likely to be prescribed\u00a0psychological care instead of pain medicine<\/a>.<\/p>\n These lingering erroneous beliefs about gender and race are key reasons patients\u2019 pain is dismissed, misunderstood and ignored. The very real-life consequences for patients include delayed diagnosis, treatment and\u00a0even death<\/a>.<\/p>\n Practical steps to disrupt medical gaslighting<\/strong><\/p>\n Correcting these problems will require a shift in clinical training, so as to challenge biased views about pain in women and racial minorities and to educate clinicians about common pain conditions like vulvodynia. Research suggests that medical training needs to teach students to better listen to patients\u2019 lived experiences and\u00a0admit when an answer isn\u2019t known<\/a>.<\/p>\n In the meantime, people navigating the health care system can take practical steps when encountering dismissive care.<\/p>\n They can educate themselves about chronic gynecological pain conditions by reading books like \u201cWhen Sex Hurts: Understanding and Healing Pelvic Pain<\/a>\u201d or educational information from trusted sources like the\u00a0International Society for the Study of Women\u2019s Sexual Health<\/a>, the\u00a0International Pelvic Pain Society<\/a>\u00a0and the\u00a0International Society for the Study of Vulvovaginal Disease<\/a>.<\/p>\n Although these steps do not address the roots of medical gaslighting, they can empower patients to better understand the medical conditions that could cause their symptoms, helping to counteract the effects of gaslighting.<\/p>\n If someone you know has experienced medical gaslighting and would like support, there are resources available.<\/p>\n Organizations like\u00a0The Endometriosis Association<\/a>\u00a0and the\u00a0National Vulvodynia Association<\/a>\u00a0offer support networks and information \u2013 like how to\u00a0find knowledgeable providers<\/a>. Additionally, connecting with patient advocacy groups like\u00a0Tight Lipped<\/a>\u00a0can provide opportunities for patients to engage in changing the health care system.<\/p>\n <\/p>\n