The Trauma Behind Medical Gaslighting, and How It Affects People of Color

Medical Gaslighting BELatina Latinx
Photo: The New York Times.

A few nights ago, on one of those long work days, what had started as a simple muscle contracture turned into a total blockage of my lower back. The pain froze my chest muscles, triggering one of the worst migraines I have ever felt in my life.

As a child of doctors, I have a bad habit of calling Mom and self-diagnosing as soon as possible. Faced with the risk that the sharp pain I was feeling was really kidney stones, I decided to go to the nearest hospital to ask for help.

Living in France, which supposedly has one of the best public health services in the world, I expected nothing less than to be relieved of my pain and to be able to return home in time to take my dog out to pee.

The reality, of course, was different.

Upon arriving at the front desk, a nurse asks me to describe my symptoms. After doing so, the young man dressed in white tells me that I may have a muscle spasm and that the fact that it wasn’t urgent would put me on a waiting list for up to six hours. 

I then decided to contact a private care center which, after repeating the protocol, told me that what I seemed to have was lumbago. Algos = pain; lumbus = back. I felt mocked to my face.

“Take two ibuprofen and courage!” the doctor told me on the phone, with the typical weariness of someone who has been doing the same thing for decades and no longer believes what you tell them.

In short, I was a victim of medical gaslighting.

Recurrent emotional abuse

What happened to me a couple of nights ago is minor compared to what patients of color experience all over the world — especially in the United States.

Medical gaslighting is the behavior of doctors or health professionals who blame a patient’s illness or symptoms on psychological factors or deny the illness and presenting complaints altogether.

It is a form of emotional abuse that persistently denies the facts and the patient’s personal experience, often leading to self-doubt.

The term originates from a 1938 play by Patrick Hamilton, made into a film in 1944 entitled Gaslight. In it, the protagonist engages in psychological warfare on his wife, intending to have her hospitalized for mental instability. He does this by trying to convince his wife that she’s crazy and suffering delusions.

While my last experience with medical gaslighting had to do with a muscle problem, I realized sitting in the waiting room that this is not the first time this has happened to me.

Having a borderline personality, I have been told more than once that the panic I feel in the aisles of the supermarket, or my reluctance to move out of my neighborhood to run errands of any kind is “nonsense,” that this is only in my head, or that I simply lack sleep.

The result is always the same: you accumulate years of self-doubt and begin to question your every thought and feeling.

“Is it real, or am I imagining it?” must be the question I ask myself most times a day.

And I’m not the only one.

As Rachel McKinnon explains in her article entitled “Allies Behaving Badly, Gaslighting as epistemic injustice,” and published in The Routledge Handbook of Epistemic Injustice, people who experience gaslighting often begin to question their own reality or may feel “crazy,” especially if the person subjecting them to gaslighting has more authority or personal power.

McKinnon describes this pattern as the “epistemic injustice circle (of hell).”

“This happens when something such as an identity prejudice based on emotion is treated as a reason to discount a speaker’s testimony, whereby a normal response to this testimonial injustice is to become more emotional (e.g., angry, frustrated, etc.),” she explains.

“But this subsequent emotionality is treated as a further reason to discount the speaker’s testimony,” she adds.

That’s the perfect description of the anger and frustration I felt as I left the hospital unattended because what I was feeling “really isn’t that urgent.”

Lack of trust as a consequence

The result of years of medical mistreatment, especially in communities of color, translates into a troubling lack of trust in health care professionals.

The perfect example of this has been the reluctance of Latino patients to seek help during the COVID-19 pandemic, the distrust of vaccination, or even the outright refusal to seek help for mental health problems.

And no wonder. 

Since the late 1800s, eugenic practices and the use of medicine to modify the traits of populations have made communities of color wary of anyone wearing a white coat. From Nazi genocide to slavery in the United States, physicians have been enemy number one to communities of color and minorities.

The consequences are still being felt today.

A 2016 study found that nearly half of the sample of white medical students believed that Black people had thicker skin than whites, notes Danté Morehead, a community health educator at the Fred Hutchinson Cancer Research Center. This has given rise to normalized beliefs that people of color have greater resistance to pain than white patients, which has shaped medical practices.

“Medical gaslighting, where people of color’s symptoms are ignored or downplayed, leads to further negative health outcomes,” Morehead told Axios. “Not only is this poor-quality care, but by the time it manifests itself, you can be at stage three for cancer.”

Similarly, past atrocities committed in the name of science against Black Americans, Latinos, and Native Americans — such as the Tuskegee syphilis study — “is a huge reason for mistrust,” Namandjé Bumpus, chair of the pharmacology department at Johns Hopkins University School of Medicine, told Axios.

Morehead says she’s heard from many Black women “who just don’t feel comfortable in a clinical setting” because of historical experiments like those from the ‘father of modern gynecology,’ James Marion Sims, who operated on enslaved women without anesthesia.

Suspicion over a trial’s goals or concerns over privacy help lead to low participation in key research, Bumpus says, including vaccine trials. This contributes to low COVID-19 vaccination rates for Black and Hispanic Americans, despite suffering a disproportionate impact from the pandemic.

What is the cure for Medical Gaslighting?

Undoubtedly, and as we’ve repeatedly said, the solution to repairing structural damage such as medical gaslighting is diversity in the workforce. The more physicians of color there are in emergency rooms, the more trust there will be on the part of patients. Common sense tells us that that person understands where we are coming from and handles the language to understand ailments through the idiosyncratic prism.

“If you look at the scientific workforce … there are people missing in that picture,” added Bumpus, the first African American woman to lead a department at the JHU School of Medicine and who’s written about the struggles people of color in the sciences face.

According to the Association of American Medical Colleges (AAMC), an ethnically and culturally diverse nation means changing healthcare needs and increasing ethnic diversity in medical schools and within the physician ranks.

Similarly, research by the AAMC has shown that “healthcare providers who reflect the diversity of our population are more likely to be culturally competent physicians.”

The goal is clear: to provide the best care to a diverse population.