That moment\u2014quiet, internal and often invisible\u2014is where the real story begins.<\/p>\n
What We\u2019re Actually Talking About<\/p>\n
Medical gaslighting<\/a> refers to situations where a patient\u2019s symptoms are not taken seriously or addressed adequately, leading them to feel dismissed, question their own experience or lose trust in the care process.<\/p>\n But the phrase \u201cmedical gaslighting<\/a>\u201d has become shorthand for these experiences, and experts are increasingly careful with the term.<\/p>\n \u201cIn an effort to be careful about the words I\u2019m using, there is a big difference in gaslighting versus dismissal,\u201d says Dr. Komal Patil-Sisodia<\/a>, an endocrinologist and founder of Eastside Menopause & Metabolism. \u201cGaslighting assumes malicious intent \u2026 most clinicians are not doing this maliciously. Most of us truly want to help people.\u201d<\/p>\n What many patients encounter instead is medical dismissal\u2014a pattern of having symptoms minimized, deprioritized or inadequately investigated.<\/p>\n That distinction matters. Not because the impact is smaller\u2014but because the causes are often systemic: gender bias, gaps in research, limited training<\/a> in midlife women\u2019s health and a long medical history of minimizing women\u2019s symptoms.<\/p>\n And regardless of intent, the body responds the same way. <\/p>\n The Stress Response Doesn\u2019t Differentiate<\/p>\n When a patient feels dismissed or gaslit, the brain doesn\u2019t file it as a minor inconvenience. It registers it as a threat.<\/p>\n \u201cRepeated, stress<\/a>-inducing experiences \u2026 can continuously activate the body\u2019s stress response system, known as the HPA axis,\u201d explains Dr. Haleigh Larson<\/a>, Director of Partnerships at Clair <\/a>Health<\/a>.<\/p>\n The HPA axis\u2014the hypothalamic-pituitary-adrenal system\u2014controls cortisol<\/a>, the body\u2019s primary stress hormone. In healthy conditions, cortisol follows a daily rhythm: high in the morning, tapering off at night.<\/p>\n But chronic stress disrupts that pattern.<\/p>\n \u201cThink of it like a battery,\u201d says Patil-Sisodia. \u201cWe\u2019re fully charged in the morning \u2026 and then plug in at night when we sleep to recharge again. When we are stressed out, we lose that variation.\u201d <\/p>\n The result is a body stuck in a low-grade state of alarm: <\/p>\n Elevated cortisol<\/p>\n Poor sleep<\/p>\n Increased inflammation<\/p>\n Dysregulated blood sugar and blood pressure<\/p>\n Over time, she adds, this \u201caccelerates biological aging\u201d and increases risk for conditions like heart disease<\/a> and diabetes<\/a>. <\/p>\n What\u2019s critical\u2014and often overlooked\u2014is that these physiological changes can begin with something as seemingly routine as a doctor\u2019s visit that ends without clarity. <\/p>\n \u201cEach unresolved appointment is, at minimum, another stressful experience without resolution,\u201d Larson adds.<\/p>\n When Dismissal Starts to Resemble Trauma<\/p>\n Not every frustrating appointment leads to lasting harm. But repetition changes the equation. <\/p>\n \u201cMedical invalidation begins to mirror a trauma response when it becomes repeated, rather than a one-off experience,\u201d Larson explains.<\/p>\n For some patients, especially those already navigating hormonal shifts in perimenopause<\/a> and menopause<\/a>, the threshold is lower.<\/p>\n During this life stage, declining estrogen<\/a> and progesterone affect the brain\u2019s stress-regulation systems.<\/p>\n \u201cGABA is one of the main neurotransmitters \u2026 Think of it as the brake pedal to calm the nervous system,\u201d says Patil-Sisodia. \u201cWhen the hormones drop, it\u2019s like cutting the brakes.\u201d <\/p>\n That biological vulnerability, layered with repeated dismissal, can tip the nervous system into chronic threat mode. <\/p>\n Jessika Fruchter<\/a>, a licensed family and marriage therapist specializing in midlife mental health, sees this pattern often in her clinical work.<\/p>\n \u201cRepeated medical dismissal doesn\u2019t just mirror trauma, it constitutes medical trauma,\u201d she says. \u201cWomen often experience a feeling of powerlessness and anxiety \u2026 and begin to associate medical providers with a threat.\u201d<\/p>\n Clinically, that can look like:<\/p>\n Hypervigilance about bodily sensations<\/p>\n Panic or dread before appointments<\/p>\n Emotional shutdown or avoidance<\/p>\n Persistent anxiety or depressive symptoms<\/p>\n For some, the experience activates deeper beliefs.<\/p>\n \u201cWhen these beliefs become activated\u2014\u2018I\u2019m helpless,\u2019 \u2018I don\u2019t matter\u2019\u2014they can exacerbate symptoms of depression<\/a>, anxiety and PTSD,\u201d says Sofia Chernoff<\/a>, PsyD, of the Beck Institute. <\/p>\n Why Midlife Symptoms Are So Often Dismissed<\/p>\n Perimenopause and menopause create a perfect storm: symptoms that are real, disruptive\u2014and difficult to measure.<\/p>\n \u201cThe most common symptom of perimenopause is \u2018I just don\u2019t feel like myself,\u2019\u201d says Patil-Sisodia. \u201cThat can be hard for clinicians to assess.\u201d<\/p>\n Fatigue, mood changes, brain fog and sleep disruption overlap with multiple conditions. Hormone levels fluctuate daily, making lab results inconsistent. And many providers receive limited formal training in menopause care.<\/p>\n \u201cOnly about 30% of OB-GYN residency programs include menopause education,\u201d Larson notes.<\/p>\n The ambiguity creates a dangerous psychological loop.<\/p>\n \u201cKnowing something feels off \u2026 and then being met with skepticism, can lead to anxiety, self-doubt and a loss of trust,\u201d she says.<\/p>\n Over time, patients begin to internalize the uncertainty. <\/p>\n \u201cThey may start to question if their symptoms are \u2018all in their head,\u2019\u201d Fruchter adds. <\/p>\n The Downstream Effects: Anxiety, Avoidance and Mistrust <\/p>\n Research<\/a> increasingly shows that repeated dismissal produces four major categories of harm, according to Patil-Sisodia:<\/p>\n Psychological distress: anxiety, depression, shame<\/p>\n Healthcare-related anxiety and trauma<\/p>\n Avoidance of care<\/p>\n Delayed diagnosis and treatment<\/p>\n That avoidance can take different forms. <\/p>\n Some patients stop going to doctors altogether. Others do the opposite\u2014seeking multiple opinions, searching for answers, unable to settle the uncertainty.<\/p>\n \u201cBoth of these outcomes are harmful,\u201d Patil-Sisodia says.<\/p>\n Larson sees similar patterns.<\/p>\n \u201cHealth anxiety, hypervigilance and care avoidance are some of the most common outcomes,\u201d she says. \u201cOver time, patients may begin to internalize that disbelief.\u201d<\/p>\n The damage extends beyond the healthcare system.<\/p>\n \u201cInvalidation \u2026 can lead to loss of trust in themselves,\u201d says Chernoff. \u201cThat can confirm beliefs like \u2018I\u2019m not to be trusted.\u2019\u201d<\/p>\n For Margaret Quinlan<\/a>, Ph.D. a professor of health communications who experienced early menopause<\/a> herself, that internal shift is deeply personal.<\/p>\n \u201cI felt like I failed my body,\u201d she says. \u201cEven the term \u2018premature ovarian failure\u2019 personalizes a biological process and blames the individual.\u201d<\/p>\n She adds that even with academic expertise, navigating the system was disorienting.<\/p>\n \u201cYes, I study women\u2019s health \u2026 and this is still difficult for me,\u201d she says. \u201cThat tells you how complex and overwhelming this can be.\u201d <\/p>\n Rebuilding Agency\u2014What Actually Helps <\/p>\n Repairing the psychological impact of medical dismissal requires both individual strategies and systemic change.<\/p>\n On the patient side, experts emphasize restoring a sense of agency.<\/p>\n That can start with something simple: preparation.<\/p>\n \u201cI encourage clients to develop a list of questions and \u2018interview providers\u2019 before establishing care,\u201d Fruchter says. \u201cMost women forget that technically medical providers work for them.\u201d<\/p>\n Larson suggests shifting how symptoms are communicated.<\/p>\n \u201cFraming symptoms in terms of functional impact \u2026 helps move the interaction from subjective dismissal to problem-solving,\u201d she says.<\/p>\n For example: documenting patterns in sleep, mood or cognition over time\u2014and clearly stating how they affect daily life.<\/p>\n Support systems matter, too.<\/p>\n \u201cTake a friend, loved one or family member to appointments,\u201d Chernoff advises. \u201cThey can help advocate.\u201d<\/p>\n And when the psychological toll is already present, it deserves direct care. <\/p>\n \u201cIf health anxiety, trauma or depression symptoms are popping up, individuals should take these as seriously as physical symptoms,\u201d she adds. <\/p>\n What Providers Must Do Differently <\/p>\n Experts are equally clear: the burden cannot fall solely on patients. <\/p>\n Trauma-informed care offers a framework for change. <\/p>\n \u201cIt follows six principles: safety, trust, collaboration, empowerment, peer support and cultural sensitivity,\u201d says Patil-Sisodia. <\/p>\n In practice, that can look like: <\/p>\n Listening without interruption<\/p>\n Validating symptoms\u2014even when the cause is unclear<\/p>\n Offering options, not dead ends<\/p>\n Clearly outlining next steps and follow-up <\/p>\n \u201cProviders should normalize symptoms without minimizing them,\u201d Larson says. \u201cPairing validation with action \u2026 helps rebuild trust.\u201d <\/p>\n After the Appointment Ends <\/p>\n The psychological impact of medical dismissal doesn\u2019t happen in the exam room. It happens afterward\u2014in the quiet moments where patients decide what to believe about their bodies. <\/p>\n Quinlan\u2019s work now focuses on changing that narrative.<\/p>\n \u201cMy hope is that women feel less alone and more confident advocating for their health needs,\u201d she says.<\/p>\n Because the goal isn\u2019t just better appointments. It\u2019s restoring something more fundamental: the ability to trust what your body is telling you\u2014and to know it deserves to be taken seriously.<\/p>\n","protected":false},"excerpt":{"rendered":"She leaves the appointment with more questions than answers. Her labs are \u201cnormal.\u201d Her symptoms\u2014fatigue, brain fog, anxiety…\n","protected":false},"author":2,"featured_media":677826,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[520,64,63,326675,137,500,41788,158778,519],"class_list":["post-677825","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-anxiety","tag-au","tag-australia","tag-gaslighting","tag-health","tag-healthcare","tag-medical-gaslighting","tag-menopause-symptoms","tag-stress"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/677825","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=677825"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/677825\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/677826"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=677825"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=677825"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=677825"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"Female](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/05\/AdobeStock_222222234.jpeg\")
<\/a> <\/p>\n