Is Medical Gaslighting Delaying Autoimmune Disease Diagnosis in Women?

If you're told your symptoms are “all in your head” when something is physically wrong, it can leave you feeling dismissed and filled with self-doubt. In a new international study of adults with autoimmune diseases, researchers found that this scenario was more likely for women — an especially notable conclusion because autoimmune conditions typically occur more often in women than in men.

“We already knew that many autoimmune diseases can take many years to diagnose, so our most worrying and novel finding was the very high reports of these types of misdiagnoses, and the gender differences,” says the lead author, Melanie Sloan, PhD, an assistant research professor of public health and primary care at the University of Cambridge and Norwich Medical School at the University of East Anglia in England.

Women Waited Longer and Were More Often Told Symptoms Were Psychological

For the new study, researchers surveyed more than 6,600 adults with autoimmune diseases, including lupus, autoimmune thyroid disease, and rheumatoid arthritis, between December 2024 and March 2025.

The information gathered included how long it took participants to receive a diagnosis, how many doctor visits were required, and whether their symptoms had been misdiagnosed. Most participants were women, and about 70 percent lived in the United Kingdom.

About 50 percent of men reported receiving their diagnosis within the first year after symptoms started, compared with 40 percent of women. Women were also more likely to report:

• Having their symptoms attributed to a mental health condition (43 percent of women versus 33 percent of men)
• Having their symptoms labeled psychosomatic (34 percent versus 22 percent)
• Waiting four years or more for a diagnosis (32 percent versus 26 percent)
• Seeing a clinician 11 or more times before diagnosis (26 percent versus 18 percent)

These gender differences in mental health and psychosomatic misdiagnoses held up after researchers accounted for age, type of disease, where people lived, and household finances. But women and men were about equally likely to report being misdiagnosed with a different physical disease.

Do the Findings Point to Medical Gaslighting?

Medical gaslighting could also look like a provider suggesting that you’ve misunderstood your own body, that your symptoms are insignificant, or that the cause is not medical, but instead psychiatric or behavioral, says Dr. Shapiro, who researches medical gaslighting.

The findings of this new study stand out because autoimmune diseases are more common in women. In theory, she says, that fact should lead doctors to suspect these conditions less often in men. “And yet men waited less time for an accurate diagnosis than women, required fewer trips to the physician in order to achieve an accurate diagnosis, and were less likely to be dismissed as presenting with a psychiatric or behavioral disorder,” says Shapiro.

Why Autoimmune Diseases Are Easy to Miss

Many of these conditions start with symptoms that are common in people without autoimmune disease: fatigue, pain, poor sleep, and low mood. Some diseases have no visible signs or definitive diagnostic blood markers. When test results don’t point to a clear answer, medical providers may instead attribute symptoms to psychological causes, according to the study authors.

But just because these conditions are challenging to diagnose doesn’t make that assumption right, says Sloan. “Patients shouldn’t receive a psychosomatic or psychiatric diagnosis simply because there are no objective test results, or because the doctor does not yet have another explanation for their symptoms,” she says.

Why Might Women’s Symptoms Be Dismissed More Often?

This study wasn’t designed to explain why women had these experiences more often than men, says Sloan, but possible explanations include:

• Hormonal Changes Physical transitions such as menopause can cause symptoms that then interact with autoimmune disease, making the cause of symptoms in women harder to pin down, says Sloan.
• A Past Anxiety Diagnosis Women in the study were more likely than men to have been diagnosed with anxiety, which may lead a doctor to view later symptoms through a psychiatric lens, the authors wrote.
• Lingering Bias Medicine has historically portrayed women as less credible, more “emotional” reporters of their symptoms, and those biases may persist, said the authors.

Men can face the opposite problem, because healthcare providers may be less likely to consider autoimmune disease in their case, says Sloan. One male patient her team interviewed was told by his doctor, “You can’t have lupus because you’re not a woman and don’t have a rash.”

Strengths and Limitations of the Study

Patients, nonprofits, and clinicians helped design the survey, and the study was large and drew participants from several countries. But the results rely on people’s memories of past events, and misdiagnoses reflect the patient’s point of view; a doctor may see some of those experiences differently.

People volunteered online, so those with difficult experiences may have been more likely to take part. Most participants were white and lived in the United Kingdom, so the results may not reflect care in the United States, and there were relatively few men.

What to Do if You Suspect Medical Gaslighting

If you feel like your concerns are being dismissed or attributed to your emotions and not your body, it’s natural to feel upset, says Shapiro.

Still, don’t hesitate to speak up or ask more questions, says Shapiro, and definitely don’t give up seeking answers. “You know your own body and are an important part of the diagnostic process,” she says.

She recommends the following steps if you think you’re experiencing medical gaslighting.

• Keep a record. A symptom list or diary, plus photos of any visible symptoms, can help you and your doctor work together toward a diagnosis, says Sloan. Many autoimmune symptoms are invisible, but that doesn’t make them any less real, she adds.
• Ask your doctor to explain their thinking. Ask why they’re considering a particular diagnosis and share your own view if you see things differently, says Sloan.
• Say how you feel. If you think a provider hasn’t taken your concerns seriously, it’s appropriate to tell them, says Shapiro. Sloan has heard from several patients who told their doctors they’d been upset by the word “psychosomatic,” and almost all of those doctors apologized and explained that it hadn’t been their intention.
• Ask whether your sex or gender is a factor. Sex and gender can be relevant to the diagnosis and treatment of some diseases, says Shapiro. “It is absolutely reasonable, then, for a patient to ask whether their sex or gender is being considered by the provider in their diagnostic process, and how this information is relevant,” she says. “Patients should maintain a respectful engagement and avoid sounding accusatory. Giving providers the benefit of the doubt is always the best way to begin,” she adds.
• Bring someone with you. A support person can share observations, help you remember what was said, and offer reassurance if you feel dismissed, says Shapiro.
• Consider another opinion. Seek out a second opinion if you’re still concerned, says Sloan. If you can’t switch providers, which can be a real burden and isn’t possible for everyone, bring a short written list of your concerns and briefly explain that you didn’t feel heard at your last visit, says Shapiro.

“It is also important to remember that mental health conditions are common, real, and important to talk about and treat correctly,” says Sloan.