Arriving "that time of the month": A gendered account of the healthcare of women with premenstrual symptoms.

Abstract

Studies show that healthcare professionals (HP) can be indifferent to women with premenstrual syndromes, a prevalent and potentially disabling condition affecting 2 to 40% of women. The recognition of premenstrual syndromes as a legitimate health problem has been limited, contributing to its underdiagnosis and undertreatment. To uncover some factors accounting for its underdiagnosis and undertreatment and drawing upon gender stereotypes and representations theories, this thesis aimed to investigate: (1) how HP’s gender awareness has been conceptualized, operationalized, and investigated in its relationship to health outcomes and (2) the extent to which HP’s gender awareness could be associated with their representations of women with premenstrual syndromes and their implications for clinical encounters and the doctor-patient relationship. To meet aim 1, a scoping review on gender awareness in health (Study 1) and a psychometric validation of the Nijmegen Gender Awareness in Medicine Scale (N-GAMS.pt; n= 1048 medical students; Study 2) were conducted. To meet aim 2, a quasi-experimental study conducted with 256 medical students (Study 3) and a qualitative study with 32 physicians (Study 4) were conducted. Findings showed that gender awareness is a three-dimensional construct with potential to reduce gender bias, if properly conceptualized and operationalized with a triangulation of measures including the N-GAMS. HP share gendered representations about these women, which potentially contribute for its underdiagnosis and undertreatment. This thesis clarifies the theoretical underpinnings of gender awareness and its relation to HPs representations of women with premenstrual symptoms. It contributes to increase HPs gender awareness hence fostering healthcare equity