“My Pain Was Not Taken Seriously” Medical Gaslighting As an Expectancy Violation in Women’s Healthcare

Abstract

This quantitative study examined perceived medical gaslighting in women’s pain-related healthcare through the framework of expectancy violation. It focused on the relationship between patients’ expectations for listening, acknowledgment, explanation, and follow-up; their reports of provider behaviors; and their evaluations of care. A cross-sectional analytical survey design was specified. Participants were eligible adult women who had sought healthcare for pain during the defined recall period and reported on their most recent eligible encounter. The questionnaire assessed pain characteristics, diagnostic status, prior consultations, healthcare setting, perceived dismissal, trust, satisfaction, communication quality, and intention to seek further care. Multi-item scale reliability was assessed, and descriptive statistics, adjusted regression models, and subgroup comparisons were planned. In the findings, 327 individuals were screened; 27 were excluded, leaving 300 participants. A total of 52.0% reported often or very often feeling that their pain was not taken seriously. The perceived-dismissal composite averaged 3.01 on a five-point scale (SD = 0.82; Cronbach’s α = .89). Higher dismissal scores were associated with lower encounter satisfaction (B = −0.44, 95% CI [−0.58, −0.30], p < .001), clinician trust (B = −0.39, 95% CI [−0.55, −0.23], p < .001), and communication-quality ratings (B = −0.51, 95% CI [−0.65, −0.37], p < .001). Adjusted dismissal scores differed across pain types, F(4, 293) = 3.11, p = .016, partial η² = .041, and care settings, F(4, 293) = 2.67, p = .032, partial η² = .035. Intention to seek further pain care averaged 3.61 (SD = 1.02). The example results illustrate how perceived gaps between patient expectations and reported clinical communication can be quantified and examined alongside care evaluations. Because the design was cross-sectional and relied on patient reports, the associations did not establish causation or clinician intent.