Gender, Ethnicity, Class, and Chronic Pain

Chronic pain is most common among women, those who are poor, minorities, and the elderly. Unfortunately, obtaining appropriate treatment is especially dif- ficult for members of all these groups. (Obtaining proper treatment is also difficult for children because doctors especially fear giving them potentially dangerous medications.)

Women—the majority of those living with chronic pain—are significantly more likely than men to encounter doctors who ascribe their pain to psychiatric causes and prescribe sedatives or psychotherapy rather than effective pain medica- tions. To avoid this fate, women with chronic pain must tread a fine line, striving to appear neither too sick nor too well and neither too assertive nor too passive in order to receive proper treatment and avoid being labeled hysterical or pushy, malingerers, or whiners. Not surprisingly, women consumers have been at the forefront of movements to medicalize chronic fatigue syndrome, multiple chemical sensitivity, fibromyalgia, and other contested illnesses.

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A different set of stereotypes makes it difficult for persons of color to receive proper treatment for pain. Numerous studies have found that doctors routinely dismiss minority patients’ reports of pain on the assumption that such patients are really seeking drugs for recreational purposes.

The same bias limits poorer persons’ access to pain medication. In addition, poorer persons’ pain more often stems from their work. In these cases, however, individuals often have access only to company-employed doctors who have a vested interest in dismissing or downplaying—and thus undertreating—their pain.