[Perception of gender aspects in the relationship between doctors and patients in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)]

Abstract

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) affects women more than twice as often as men. Since they often report a problematic doctor–patient (DP) relationship , gender aspects are to be analysed here which, from the point of view of the women concerned, could have an influence on the DP relationship. Methods: As part of an exploratory qualitative survey, 544 medically diagnosed ME/CFS sufferers (> 20 years.; 455 women, 89 men) were asked in writing about their experiences regarding their DP relationships. The questionnaire was structured in the same way as a focused guideline interview. A qualitative content analysis of the data was then carried out according to Mayring. In addition, individual details were quantified and statistically examined with regard to gender-specific differences. Results: Female participants described, that doctors attributed certain characteristics (emotional, hypersensitive, anxious) and behaviour (describe non-specific symptoms, exaggerate) to them. They were “difficult” patients whose symptoms are emotional and therefore psychological. More often than men, women felt that they were not being taken seriously. Their perceptions and their credibility were being questioned. In their questionnaires, they mentioned symptoms significantly more often than men, which doctors usually classify as nonspecific and subjective. Conclusions: Gender-related appearance/behaviour of physicians often occurs in diseases with “subjective”,“unspecific” symptoms. Emotional symptom descriptions then lead to the perception of those affected being questioned and a mental disorder being assumed. In the future, in the context of making a diagnosis for ME/CFS, this pigeonhole thinking should be replaced by a systemic consideration of possible pathophysiological processes that includes the entire organism before a psychosomatic diagnosis is made. In addition, during medical school the special importance of gender sensitivity with regard to the DP relationship should be pointed out again and again.