Chapter 11: Emotion and Gender

INTRODUCTION

Women and men differ in how they feel, express, and manage emotions,¹ and these gender differences also affect clinical practice. Female physicians expressing concern, being considerate, and talking about feelings with patients do not get the same credit for their patient-centered communication as do male physicians.² Female patients expressing fear are less likely to obtain the necessary treatment for anxiety disorder because they are perceived as “hysterical.”³ A priori assumptions, often unconscious, such as implicit stereotypes affect how we treat women and men and such stereotypes also affect social interactions in the medical domain. While missing an emotional cue in an interaction at work (e.g., not noticing that my colleague is sad) might not hamper work performance much, missing emotional cues in patients might have detrimental effects (e.g., missing cues of sadness or despair resulting in a patient’s suicide).

The present chapter applies a gender lens on the discussion about how medical caretakers and patients feel and express emotions, how they read emotions in others, and how they manage their own emotions. Gender is a social and individual construct. It has to be noted, however, that almost all the literature on the topic assumes that participants are cisgender; that is, they self-identify with the gender assigned to them at birth. In most studies, participants self-declare their gender but are given only two choices without the possibility to indicate alternative, nonbinary genders or their sexual orientation, neither of which we are able to address in this chapter. Only very recently has the research community started to look at different conceptions of gender and sexual orientation.^4,5

When talking about gender differences, we do not mean that all women are like this and all men are like that. We talk about gender differences if in a study the authors report statistically significant differences between women and men. This always means that there is still substantial heterogeneity in the population and that when we encounter one single individual and we only know their gender, we do not know where in the distribution this person stands. This attention to gender heterogeneity is highly relevant for the medical practice and means that if I, as a clinician, have a hypothesis about a person and their emotions based on knowing whether they are a man or a woman (e.g., knowing that research shows that women express sadness more easily than men), I need to put this hypothesis to test in the actual interaction with the patient (maybe this man does not show me his sadness because men tend to hide sadness more than women do or maybe this man is simply not sad).

We review research related to the general population, to patients, or to different healthcare providers such as medical doctors, advanced practice providers, physical and occupational therapists, physician assistants, medical assistants, or genetic counselors. However, most research on emotions in healthcare looking at ...