For decades, a prevailing assumption has held that women enjoy a health advantage over men, living longer and engaging more frequently with healthcare systems. However, a growing body of research, including the work of historian Muriel Salle and physician Catherine Vidal, challenges this notion, revealing systemic biases in medical practices that disadvantage women.
Salle, a specialist in the history of women and medical discourse at Université Claude Bernard Lyon 1, co-authored the book Femmes et santé, encore une affaire d’hommes? (Women and Health, Still a Men’s Affair?) with Vidal. The book argues that medicine has historically been and continues to be, fundamentally designed around the male body, treating women as deviations from the norm. “We think first of health, the body and diseases in the masculine,” Salle points out. “And when we proceed like that, we construct women as exceptions.”
This “masculine-as-default” approach manifests in various ways. A study cited in the research indicates that in emergency room settings, healthcare providers are significantly less likely to assess a woman’s condition as severe compared to a man presenting with identical symptoms – 62% deeming a man’s case grave versus only 49% for a woman. This disparity extends to pharmaceutical development and dosage. Dr. Danielle Hassoun, a gynecologist-obstetrician in Paris, explains that medication dosages for women are often based on studies conducted on men, potentially rendering them inappropriate or ineffective for female patients.
The consequences of this bias can be life-threatening. Women’s experiences of heart attacks, for example, often differ from the “classic” male presentation, with symptoms like nausea, shortness of breath, and fatigue frequently being overlooked. Similarly, reported side effects from medications are often dismissed or downplayed in women.
Even as French women have a higher average life expectancy than men – approximately 85 years compared to 79 – Salle cautions against interpreting this as a clear advantage. The critical metric, she argues, is not total lifespan but “life expectancy in great health.” She notes that women in France experience roughly 20 years of significant health challenges, with their healthy lifespan extending to just over 65 years.
This period of vulnerability is compounded by economic disparities. Women in France, on average, receive approximately 40% less in retirement income than men, leaving them with fewer resources to manage illness and access care. Geographical barriers, such as limited access to healthcare in rural areas, and financial constraints further exacerbate these inequalities, often forcing women to rely on alternative, and often unreimbursed, treatments.
Salle as well highlights a social dimension to healthcare access, noting that factors like ethnicity, socioeconomic status, and language proficiency can deter women from seeking medical attention. “Not being white, not being rich, not being sufficiently francophone, means you are less likely to go to the doctor willingly,” she states.
A recent report by Femme Actuelle magazine attempted to quantify these regional disparities, ranking the 50 largest French cities based on the quality of healthcare services available to women, considering factors like medical density, specialized services, and municipal commitment to gender equality. Surprisingly, Bayonne, the least populated city in the ranking, topped the list. The report attributes Bayonne’s success not to superior infrastructure, but to a culture of attentive listening among its medical professionals. Journalist Sabrina Nadjar, who contributed to the report, observed that “what makes the difference in Bayonne compared to others is that doctors take the time to listen to patients. When you spend time with women listening to them, you arrive at a care plan that is truly extraordinary.” This finding echoes numerous accounts of women whose pain was dismissed as menopause, diabetes went undiagnosed, or heart conditions were misattributed to anxiety.
