An article published in The Sydney Morning Herald on Saturday, August 16th, 2025 (written by Kate Aubusson) delved into the issues surrounding the disparity between how women and men are seen, heard, and treated by much of the medical industry in Australia (note: it’s not just in this country) – with women too frequently being gaslit and denied the treatment they need, deserve, and to which they should be as entitled as men are.
KEY INSIGHTS
- Women seeking medical care too often feel unheard or dismissed by their providers; this is referred to as “medical gaslighting”.
- Medical gaslighting isn’t just psychologically damaging: it can result in a delayed or incorrect diagnosis and has a significant, negative impact on medical outcomes.
- As many as 34% of Australian women of reproductive age are iron-deficient; this is ten times the number of men. Women do not receive the same attention or care for this, largely based on differing pathology industry benchmarks.
- It’s crucial to have your iron tested regularly and seek solutions if you have symptoms of low iron or receive a low iron level pathology result. Treatments are available.
- One way women of reproductive age may be able to optimise their iron levels is to minimise blood loss due to heavy menstruation. Speak with your doctor about whether an IUD or another contraceptive solution is suitable for you.
The SMH article explored the experiences of women who are iron-deficient or anaemic (i.e. have low levels of iron in the blood) but are being systemically reported as having “normal” blood test results – even though, were they male, the same results would be reported as iron deficiency and they’d be treated promptly.
What is Medical Gaslighting?
Have you ever left a medical appointment feeling unheard, dismissed, ignored, trivialised, or even ridiculed?
You might have been medically gaslit.
“Gaslighting” is a broad term describing a form of psychological manipulation that makes a person question their sanity.
“Medical gaslighting” describes the patient experience where they feel their symptoms or health concerns have been dismissed, invalidated, or ignored by a doctor or other healthcare professional. It is often driven by the power imbalance that exists between medical professionals and patients – and some providers exploit this. It can be a very traumatic experience for patients.
Anyone can experience medical gaslighting, and it can be driven on the practitioner’s part by their own response to the patient’s sex, gender, age, weight, educational level, race, disability, or another personal factor, including a personality clash.
Statistically, women, people of colour, and LGBTQIA+ people are more likely to be medically gaslit, having their symptoms dismissed by a medical provider. It can lead to delayed or incorrect diagnosis and delayed treatment.
What is Iron Deficiency?
Iron is an essential mineral that carries oxygen in the bloodstream and is critical to the health and function of the brain and other organs.
Iron deficiency is globally the most common mineral deficiency, affecting 20% of the world’s population. It occurs when the body lacks sufficient iron.
Anaemia is a medical condition that is often (but not always) caused by iron deficiency and occurs when there is a low red blood cell count. Red blood cells carry oxygen throughout the body.
Symptoms of iron deficiency and/or anaemia may include:
- Tiredness and fatigue
- Headaches
- Irritability/mood issues
- Weakness and reduced exercise performance
- Pale skin and/or brittle nails
- Problems concentrating/poor productivity
- Shortness of breath
- Dizziness
- Chest pain
- Easy bruising
- Fibromyalgia syndrome
- Restless legs syndrome
- Pica (cravings to eat dirt or other non-edible items)
Common and treatable causes of iron deficiency include dietary insufficiency, pregnancy, heavy menstrual bleeding, long-term use of NSAIDs (including aspirin or ibuprofen), food intolerances, and gastrointestinal conditions such as ulcers, coeliac disease, or inflammatory bowel disease. Other medical conditions may also cause iron deficiency/anaemia; a proper, prompt diagnosis is crucial.
Without adequate, timely treatment, severe iron deficiency anaemia can cause heart failure and other serious complications.
Iron Deficiency and Medical Misogyny
Australia’s pathology providers have, for many years, set markedly lower benchmarks for what constitutes “normal” iron stores in the body for biological women versus biological men. The result of this is that a very large number of iron-deficient women are left undiagnosed and untreated, and when a woman’s blood results are eventually flagged as iron-deficient or anaemic, the levels can be alarmingly low.
A startling number of women who were interviewed for the abovementioned article shared their own stories of medical misogyny, whereby they were dismissed and/or treated as hypochondriacs by doctors and other healthcare professionals. Some distinct (yet not uncommon) examples included:
- A woman whose low haemoglobin count was the same as that of the victim of a traumatic motor vehicle accident.
- Women whose extremely heavy menstrual bleeding is dismissed as being “normal” and untreatable.
- Delayed investigation of potentially serious causes of low iron (including, rarely, cancer), resulting in damaging delays to proper diagnoses and treatments.
- Women who have been identified as having low iron levels are frequently offered only the “band-aid” solution of taking over-the-counter oral iron supplements. These can have extremely unpleasant gastrointestinal side effects, yet limited effectiveness.
As well as diagnosing and addressing the cause of iron deficiency itself (and no, it’s not simply “part of being female”), treatment to replenish iron stores may require an iron infusion (the most effective treatment), or even a blood transfusion in extreme cases.
How Much Iron is Enough?
Iron levels in the blood are measured in several ways, including measuring ferritin. Ferritin is a protein that stores iron in the liver, and it is the most sensitive indicator of one’s iron stores (as opposed to circulating iron levels).
In 2021, the Royal College of Australian Pathologists updated its guidelines to redefine iron deficiency in all adults as a ferritin level of below 30 micrograms per litre – regardless of sex. This standard has been adopted by some pathology providers, including NSW Health Pathology, Laverty, and 4cyte. Some others, however, including the Australian Red Cross Lifeblood, continue to define iron deficiency in women as being below 15 micrograms per litre. This fails to identify actual iron deficiency in 25-50% of women; diagnosis is entirely dependent on which pathology service is testing the blood.
While these lower benchmark levels are currently under review, a non-standardised reference range delays essential women’s health care, and it perpetuates gender-based inequality in healthcare.
Why are Women So Overrepresented in Terms of Being Medically Gaslit?
Gender bias in healthcare is systemic, entrenched, and dates back many hundreds of years to when “women’s issues” were blamed on “hysteria”. The term “hysteria” itself derives from the Greek word for “uterus”, and “hysteria” as “uncontrollable emotional excess” has long been attributed to women alone and was used as a blanket term for diverse conditions affecting women, from dissociative disorders to depression to menopause to the symptoms of iron deficiency.
Sadly, and unacceptably, gender bias in medicine remains far too prevalent today. From GPs to gynaecologists and emergency department healthcare professionals, far too many (and not just male practitioners) diminish or dismiss women’s experiences of pain, fatigue, and other symptoms of a myriad of medical disorders.
The leading cause of iron deficiency in women is widely considered to be heavy menstrual bleeding or HMB. This is excessive and exists in isolation from any underlying diagnosable cause, such as uterine disorders or blood disorders. As many as 60% of women with HMB are severely iron-deficient. This is a major public health issue that is woefully underdiagnosed and undermanaged.
Furthermore, up to 70% of women in the third trimester of pregnancy are also iron-deficient, and pregnant women have higher iron needs. Many obstetricians are reluctant to treat this condition until a woman becomes anaemic – this is arguably too late.
Iron infusions play a critical role in addressing iron deficiency – yet, due to outdated and historical attitudes to iron infusion, the solution is not offered as readily as it could be. Heavy menstrual bleeding can also be treated by using the right contraceptive. This might include the oral contraceptive pill, the vaginal ring, or the hormonal IUD.
What Can You Do?
- Book a long enough appointment with your doctor
- Write down your questions/concerns before your appointment
- Take a trusted family member or friend to your appointment with you
- Advocate for yourself – speak up and don’t let them dismiss your concerns
- Seek a second opinion if you’re not satisfied – either see another GP or ask for a specialist referral
Women’s Wellbeing as a Priority: Gynaecology Centres Australia
Gynaecology Centres Australia (GCA) is a dedicated women’s health provider operating in Sydney (outside the city centre), Newcastle, Gosford, and Wollongong. We provide access to the right contraception for you, including IUD insertions performed under sedation – this is the gold standard of care.
The IUD delivers long-term, reliable contraception for up to 8 years and may also dramatically reduce or even stop menstrual pain and bleeding.
We also provide women of all ages with legal surgical abortions in the first trimester of pregnancy.
Contact us online or call to book a consultation:
Sydney 02 9158 0678
Gosford 02 4324 5176
Newcastle 02 4962 4999
Wollongong 02 4227 4100
If you have any questions, please call us on (02) 9158 0678