"How can I prove I am sick enough?"
For years I was told by medical professionals that my struggles with food and anxiety were “normal”, that I just had to be “strong”, and that I would “grow out of it”.
A few years later, I was diagnosed with anorexia nervosa and generalised anxiety disorder and prescribed anxiety medication.
We are always told to listen to medical professionals. Doctors are paid some of the highest salaries. Medicine, particularly in South Asian communities, is a “prestigious” degree, and the entry score in university is ridiculously high.
So, of course, when a doctor tells you your struggles are not real, you would believe them; your family would trust them.
I was gaslit to believe it was all in my head and that it was just about flicking a switch. Just turn it off, why don’t you?
Medical gaslighting is a term used to describe doctors or medical practitioners who blame a patient's illness or symptoms on psychological factors or deny a patient's condition entirely, for example, incorrectly telling patients they are not sick.
I was finally diagnosed with anorexia and anxiety in my last year of high school because my academic life was falling apart. That was enough for my doctor to see I needed help.
But even then, my GP, who was also South Asian, said he did not want to diagnose me because it would become official and part of my medical history. It would “affect my employability”. As if a mental illness had not already stopped me from completing the basic tasks in my day-to-day life already.
Being a South Asian man, my GP liked to use our culture, our one commonality, as a way to dismiss my eating disorder. Perhaps this is because there was no training on how mental illness can manifest in South Asians. Or maybe this is because his cultural stigmas crept into his work.
Being prescribed anxiety medication required me to break down in my doctor’s office after being told I should be “stronger” and that “we all have struggles.”
The thing is, I completely believed every word my professionals told me.
When seeing my first psychologist and dealing with an unhealthy relationship with exercise, I was told to exercise if I was too stressed.
I remember my doctor finally filling out the form for my eating disorder and having to check a box regarding the severity of my eating disorder. He did not tick the top box, and his nonchalant attitude towards my struggles made me feel like an imposter in my own struggles.
My mind immediately went to, “how can I prove I am sick enough”.
Much of this was also layered by cultural stigma and societal ideals of who can have an eating disorder and what an eating disorder looks like. A diagnosis is not the driving factor in whether you are sick or not. However, when you are a brown girl who does not fit societal ideals of what an eating disorder looks like, it can make or break you.
Film and TV make it seem like only those who are thin, white, and beautiful per Eurocentric ideals can have an eating disorder. I never thought someone like me could have an eating disorder.
The more I was made to feel like my struggles were not real, the further I went to prove I was sick, that I did need help.
The saddest thing is that my experiences, compared to others, are the tip of the iceberg. Women are far more likely to be misdiagnosed than men, particularly regarding mental illness, autism, ADHD and endometriosis. In 2022 digital platform Liv surveyed 2,000 adult women across England, Wales, Northern Ireland and Scotland regarding misdiagnosis. The survey found that 57% of those women feel medically misdiagnosed simply because of their sex, and 29% do not think they have received the correct diagnosis.
Women of colour are also disproportionately affected by medical gaslighting. This became clear in speaking to Raisa Islam, a Bangladeshi-Australian, PhD student and lecturer for medicine at UNSW. Islam is completing her PhD on medical inequity regarding families with autistic children in low socioeconomic and culturally diverse areas. She draws on her personal experience and empirical data in calling for culturally competent support.
Islam states that despite having a high risk of mental health issues, women of colour struggle with accessing services. In cases where they have access, it is common for women of colour to face “medical gas lighting or just culturally inappropriate advice from mental healthcare professionals”. Islam says that women of colour are more likely to experience financial disadvantages.
Islam says, “Women of colour experience issues that white therapists just are not equipped to handle, making culturally competent service so important.”
Jess Harwood | Supplied
I also spoke with Jess Harwood, a South Asian Australian, about her journey in being diagnosed with endometriosis. It took Jess more than 13 years to be diagnosed with endometriosis. The average is 9. “I fell through the cracks for a few reasons,” she shares.
Jess was told by GPs “that periods could be painful” and that she should try birth control, but further investigation was not suggested.
She also discussed the complexities of confronting her privilege when her mum and aunties had struggled to set up their new life in a new country while she was “bowled over by pain” despite her significant privileges.
It was only after hearing experiences of other women her age that Jess “pushed for a diagnosis and exploratory surgery which removed seven endo adhesions.”
Several reports also highlight that medical gaslighting is common for women in particular as they are viewed as too emotional and a medical mystery because most of the research conducted in health care is based on men. This lack of data significantly affects misdiagnosis in communities of colour as studies about young, mostly healthy, and white men generally do not fully apply to women and people of colour. Many health professionals carry implicit racial bias by dismissing the patient’s overall information and downgrading their pain's scope and quality.
Our healthcare system needs cultural and gender competency at the heart of its training. Surely, in the years of studying doctors undertake, they can fit a section that will be truly life-changing for their patients.