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      “Brave Men” and “Emotional Women”: A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain

      review-article
      1 , , 2 , 2 , 1
      Pain Research & Management
      Hindawi

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          Abstract

          Background

          Despite the large body of research on sex differences in pain, there is a lack of knowledge about the influence of gender in the patient-provider encounter. The purpose of this study was to review literature on gendered norms about men and women with pain and gender bias in the treatment of pain. The second aim was to analyze the results guided by the theoretical concepts of hegemonic masculinity and andronormativity.

          Methods

          A literature search of databases was conducted. A total of 77 articles met the inclusion criteria. The included articles were analyzed qualitatively, with an integrative approach.

          Results

          The included studies demonstrated a variety of gendered norms about men's and women's experience and expression of pain, their identity, lifestyle, and coping style. Gender bias in pain treatment was identified, as part of the patient-provider encounter and the professional's treatment decisions. It was discussed how gendered norms are consolidated by hegemonic masculinity and andronormativity.

          Conclusions

          Awareness about gendered norms is important, both in research and clinical practice, in order to counteract gender bias in health care and to support health-care professionals in providing more equitable care that is more capable to meet the need of all patients, men and women.

          Related collections

          Most cited references89

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          Studying sex and gender differences in pain and analgesia: a consensus report.

          In September 2006, members of the Sex, Gender and Pain Special Interest Group of the International Association for the Study of Pain met to discuss the following: (1) what is known about sex and gender differences in pain and analgesia; (2) what are the "best practice" guidelines for pain research with respect to sex and gender; and (3) what are the crucial questions to address in the near future? The resulting consensus presented herein includes input from basic science, clinical and psychosocial pain researchers, as well as from recognized experts in sexual differentiation and reproductive endocrinology. We intend this document to serve as a utilitarian and thought-provoking guide for future research on sex and gender differences in pain and analgesia, both for those currently working in this field as well as those still wondering, "Do I really need to study females?"
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            • Article: not found

            Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression.

            Consultation rates and help-seeking patterns in men are consistently lower than in women, especially in the case of emotional problems and depressive symptoms. Empirical evidence shows that low treatment rates for men cannot be explained by better health, but must be attributed to a discrepancy between perception of need and help-seeking behavior. It is argued that social norms of traditional masculinity make help-seeking more difficult because of the inhibition of emotional expressiveness influencing symptom perception of depression. Other medical and social factors which produce further barriers to help-seeking are also examined. Lines of future research are proposed to investigate the links between changing masculinity and its impact on expressiveness and on the occurrence and presentation of depressive symptoms in men.
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              • Article: not found

              'It's caveman stuff, but that is to a certain extent how guys still operate': men's accounts of masculinity and help seeking.

              It is often assumed that men are reluctant to seek medical care. However, despite growing interest in masculinity and men's health, few studies have focussed on men's experiences of consultation in relation to their constructions of masculinity. Those that have are largely based on men with diseases of the male body (testicular and prostate cancer) or those which have been stereotyped as male (coronary heart disease). This paper presents discussions and experiences of help seeking and its relation to, and implications for, the practice of masculinity amongst a diversity of men in Scotland, as articulated in focus group discussions. The discussions did indeed suggest a widespread endorsement of a 'hegemonic' view that men 'should' be reluctant to seek help, particularly amongst younger men. However, they also included instances which questioned or went against this apparent reluctance to seek help. These were themselves linked with masculinity: help seeking was more quickly embraced when it was perceived as a means to preserve or restore another, more valued, enactment of masculinity (e.g. working as a fire-fighter, or maintaining sexual performance or function). Few other studies have emphasised how men negotiate deviations from the hegemonic view of help-seeking.

                Author and article information

                Contributors
                Journal
                Pain Res Manag
                Pain Res Manag
                PRM
                Pain Research & Management
                Hindawi
                1203-6765
                1918-1523
                2018
                25 February 2018
                : 2018
                : 6358624
                Affiliations
                1Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg SE-405 30, Sweden
                2Centre for Healthcare Improvment, Division of Service Management and Logistics, Department of Technology Management and Economics, Chalmers University of Technology, Göteborg SE-412 96, Sweden
                Author notes

                Academic Editor: Parisa Gazerani

                Author information
                http://orcid.org/0000-0001-6494-6119
                Article
                10.1155/2018/6358624
                5845507
                29682130
                f21c8383-4347-4439-b2be-a4b4b867e24e
                Copyright © 2018 Anke Samulowitz et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 October 2017
                : 13 January 2018
                : 21 January 2018
                Categories
                Review Article

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