“He told me my pain was in my head”: Testimonial injustice in patient-physician relationships

Abstract

Women living with chronic pain are more likely than men to experience pain dismissal, receive nonspecific diagnostics, receive fewer follow-ups, have their condition undertreated, and be told that it results from a psychological condition. This is particularly concerning for adolescent girls living with scoliosis, who, given the progressive nature of their condition, require timely diagnosis to allow for less invasive treatment options to be explored. This population is also significantly more likely to have their condition progress to a curve angle where treatment such as bracing or spinal fusion surgery is required, both of which are associated with chronic pain. However, timely diagnosis depends on clinicians taking patients’ testimony regarding their health concerns seriously and investigating their claims. This presentation will dive into the gender gap in care for adolescent girls living with chronic pain caused by scoliosis, focusing on their experiences of pain dismissal and its negative short and long-term effects. Leveraging the concept of intersectionality, the authors argue that adolescent girls may suffer a testimonial injustice when their pain is dismissed by clinicians. This presentation will also explore gender-specific peer support groups as a possible mitigating factor to testimonial injustice and other negative outcomes from chronic pain and pain dismissal. The researchers interviewed members from scoliosis peer support group Curvy Girls using open-ended questions, gathering narrative data about their experiences that was subsequently analyzed using an applied philosophical hermeneutics approach, along with intersectionality and testimonial injustice as part of their framework.