What is medical gaslighting and how can it be addressed?

Medical Gaslighting: Definition and Solutions

Medical gaslighting occurs when healthcare providers invalidate, dismiss, or question patients' reported symptoms and lived experiences, causing patients to doubt their own reality and potentially leading to delayed diagnosis, inadequate treatment, and significant psychological harm. 1

What Medical Gaslighting Is

Medical gaslighting represents behaviors that invalidate or call into question a patient's ability to judge their own lived experience in healthcare settings 1. This phenomenon manifests when physicians discount, doubt, question, second-guess, or deny patients' medical complaints and suffering 2.

A critical distinction exists regarding intent: Medical gaslighting should be conceptualized on a continuum, with the term "medical invalidation" proposed for unintentional dismissive behaviors, while reserving "medical gaslighting" for more deliberate actions 1. Many instances occur unintentionally but still result in severe ramifications 2.

Common Manifestations

Patients experience medical gaslighting through:

• Invalidation of their illness and symptoms 2
• Providers appearing uninformed or rushing visits 2
• Blaming, stigmatizing, or misunderstanding their condition 2
• Refusing to discuss pain or provide appropriate information 2
• Failing to maintain eye contact, listen actively, or show sensitivity 2

Who Is Most Affected

Medical gaslighting disproportionately impacts marginalized populations, particularly women, transgender, intersex, queer, and racialized individuals—collectively termed "bio-Others"—due to deeply embedded ideologies within western healthcare systems. 3

Specific documented impacts include:

• In vulvovaginal care, 41.6% of patients were told to "just relax more," 20.6% were referred to psychiatry without medical treatment, and 39.4% were made to feel "crazy" (the most distressing behavior, rated 7.39/10 on distress scales) 4
• Black women experience anti-Black medical gaslighting through privileging of medical knowledge over patient reports and stereotype-driven dismissive encounters 5
• 52.8% of vulvovaginal patients considered ceasing care entirely because their concerns were not addressed 4

Root Causes

The perpetuation of medical gaslighting stems from three interconnected levels 1:

Patient factors:

• Difficulty articulating symptoms in medicalized language 1

Provider factors:

• Lack of knowledge about specific conditions 4
• Implicit biases and stereotypes 5
• Time pressures and rushed encounters 2

Systemic factors:

• Structural and epistemic biases embedded in healthcare 5
• Ideological structures of western medicine that marginalize certain embodied experiences 3

Ethical Violations

Medical gaslighting constitutes serious infringements of core bioethical principles: 2

• Violates beneficence (duty to benefit patients) 2
• Breaches non-maleficence (duty to do no harm) 2
• Undermines patient autonomy 2
• Creates distributive injustice in healthcare access 2

How to Address Medical Gaslighting

For Healthcare Providers

Adopt a trauma-informed, biopsychosocial approach that prioritizes active listening and validation of patient experiences. 4

Specific actions include:

• Maintain eye contact and demonstrate active listening behaviors 2
• Avoid rushing patient encounters 2
• Acknowledge gaps in your own knowledge rather than dismissing unfamiliar presentations 4
• Recognize that lack of objective findings does not invalidate subjective suffering 1
• Address implicit biases through ongoing education, particularly regarding stereotypes about marginalized populations 5

For Healthcare Systems

Implement structural changes that foster a culture of listening and humanize the illness experience: 5

• Provide education about implicit ethical aspects of dismissive medicine 2
• Develop validated instruments to quantify and monitor patient experiences 4
• Create opportunities for recovery when medical invalidation occurs 1
• Modify policies to systematically address and prevent dismissive behaviors 2

For Patients

Recognize that feeling dismissed or doubted represents a breakdown in the provider-patient relationship, not a reflection of the validity of your symptoms. 1

• Consider seeking second opinions when concerns are repeatedly dismissed 4
• Document your experiences and symptoms objectively 4
• Advocate for referrals to specialists when appropriate 4

Critical Pitfalls to Avoid

Never assume that absence of objective findings means absence of disease or that psychological factors negate physical symptoms. 1 The most common mistake is conflating "I cannot find the cause" with "there is no cause" or "this is all in your head" 4. This distinction is particularly important given that 247 patient quotations specifically cited lack of clinician knowledge as a primary theme in their negative experiences 4.