To begin, I ask if you would like to outline your professional biography and Fondazione Onda.
Francesca Merzagora, founder and president of Fondazione Onda ETS a national Observatory established almost two decades ago with the intent of promoting gender medicine and facilitating access to diagnosis and treatment predominantly for the female gender.
How does gender bias extend within the world of medicine and care towards and patients?
Gender bias within the world of medicine and care manifests itself in various ways, negatively affecting all patients. Here are the main critical issues:
- Underestimation of women’s pain: women’s pain experiences receive less consideration from men. There are studies that have shown that pain reported by women is often regarded as “exaggerated” or “emotional” by health professionals, resulting in the prescription of less aggressive treatments or the attribution of symptoms to psychological factors.
- Late diagnosis in women: many diseases, such as heart disease, are diagnosed later in women than in men. Female symptoms may differ from male symptoms, but research historically has been centered more on men, leading to misdiagnoses or delayed diagnoses. This is especially true for diseases such as heart attacks or autoimmune conditions.
- Differences in medical research: for a long time, clinical trials have been conducted predominantly on men, leading to a lack of specific data on women’s medical responses to drugs and therapies. This limits the understanding of how certain diseases manifest and respond to treatments in women, contributing to less effective treatments.
- Underreported “women’s” diseases: conditions such as endometriosis, fibromyalgia, and polycystic ovary syndrome, which primarily affect women, are often overlooked or downplayed, despite their strong impact on quality of life. These conditions can take years to be correctly diagnosed, and patients often feel invalidated in their symptoms.
- Cultural norms related to masculinity: In contrast, men often avoid seeking medical care for mental or physical health problems so as not to appear vulnerable or “weak,” due to cultural expectations related to their masculine role. This can lead to delayed diagnosis or failure to treat serious problems.
- Reproductive health and motherhood: The focus on women’s reproductive health often obscures other important aspects of their overall health. Women may be considered primarily according to their ability to procreate, with less attention paid to their overall health. At the same time, problems such as postpartum depression may be underestimated or inadequately treated.
- Access to care: there are economic and social barriers that can affect access to health services, and these barriers tend to affect women more, especially in more vulnerable socioeconomic settings.
This gender bias not only perpetuates inequalities, but also limits the health system’s ability to provide personalized and effective care to all patients, regardless of their gender. Combating these inequalities requires a change in medical education, research, and clinical practice.
Would you like to recall an Onda Foundation project where gender bias EMERGED strong?
A significant project of Fondazione Onda in which strong gender bias emerged is “Gender Stereotypes in Health Care: a Cultural Pathway.” This study, conducted in hospitals in Lombardy, highlighted four main stereotypes: violence (especially verbal) against healthcare workers, perceived insecurity in the workplace, maternity seen as an obstacle to women’s professional development, and contractual inequality between men and women.
One of the critical issues highlighted is the differential treatment that women experience in health care, not only as patients but also as professionals. The research showed how female health workers face gender barriers, which include discrimination related to their careers, with motherhood often seen as a hindrance to their opportunities for advancement. In addition, verbal violence emerged as one of the most common issues.
This initiative led to the drafting of a Manifesto with recommendations addressed to institutions, hospitals and scientific societies to promote more inclusive and gender-friendly practices for both patients and health care workers.
Istud’s studies showed that even when the topic to be analyzed was the approach to a disease more prevalent in men, there were more female narratives than male narratives; did the Onda Foundation find the same results or did other evidence emerge?
I agree women have a much more open attitude toward sharing their experiences and writing.
The Pink Stamps are a wonderful idea of ONDA: what impact do they have on the care and reception of women in the pathways dedicated to them?
The Bollino Rosa is the recognition given to Italian hospitals that have a diagnostic and therapeutic approach oriented to the female gender. it is a highly appreciated recognition by hospitals, there are currently 361 hospitals awarded with this recognition, which is a concrete example of the application of gender medicine in healthcare. The value of the Bollino Rosa is also linked to the participation of these hospitals in initiatives organized by the Fondazione Onda: on days dedicated to certain diseases these hospitals open the door to the population and offer free informative diagnostic therapeutic services, thus bringing patients closer to earlier diagnoses and better treatments.
Too often feminine narratives of caregivers, what could be proposed to institutions?
Narratives about the role of the caregiver are often feminine, reflecting a reality in which women assume most of the caregiving responsibilities, whether for children, the elderly, or the sick. However, this limited view does not fully recognize the contribution of male caregivers and reinforces gender stereotypes that see caregiving as almost exclusively a female responsibility. To promote a more equitable and balanced view of the caregiver’s role, several initiatives could be proposed to institutions.
Institutions should promote public campaigns that recognize the role of male caregivers, valuing their contributions and encouraging a more equitable distribution of caregiving responsibilities. It is essential to break the stereotype that caregiving is a “female” task and normalize male involvement. Legislation should be promoted to encourage parental and caregiving leave that is equally distributed among parents. In some countries, parental leave has been structured to encourage fathers to care for their children as well, with specific resources devoted exclusively to them. This would not only balance caregiving roles but also reinforce the recognition of caregiving as a shared responsibility.
Economic support and training for all caregivers: caregiving is often associated with economic difficulties, as many women reduce their working hours or leave their jobs to take on the role of caregiver. Institutions should provide affordable financial support for all caregivers, regardless of gender, and organize training courses to ensure that everyone involved in caring for sick or elderly people is properly trained.
Integration of male caregiving into health and social policies: health and social policies should explicitly recognize male caregivers, providing them with psychological support, training, and opportunities for discussion with other caregivers to prevent them from feeling isolated or unrecognized in their role. Corporate incentives for shared caregiving. Companies can be encouraged, through tax incentives, to promote internal policies that promote a balance between work and caregiving for all employees, male and female.
This could include hourly flexibility, smart working and specific support for workers who are also caregivers. These initiatives aim to change the social perception of caregiving, not just as a “woman’s” task, but as a shared responsibility that needs to be supported and recognized by all sectors of society