Bias arises sometimes because men have been used as the normative standard in medical research. So a complaint by a woman may be unrecognized due to different symptoms, or may be untreated or treated inappropriately. Many ailments, especially attendant on older women, receive if not unequal treatment, unequal attention. There is also a pervading attitude of many physicians about women's complaints that can lead to misdiagnosis where the woman is perceived as suffering from a psychological rather than physical problem. While the medical profession remains male-dominated, a gender slant in inevitable.
Two recent studies showed that doctors treated women with heart disease less aggressively than they treated men – even though in the women the disease tended to be further advanced. The women were half as likely to undergo cardiac catheterization and much less likely to have bypass surgery or a procedure to unclog blocked arteries. There is also very little good information on treated hypertension in women. A recent review of several major studies found that treatments that work for men may be ineffective or even harmful for white (though not black) women. Women seem to suffer from clinical depression more often than men, but the research on anti-depressants was initially done only with men. Now there is evidence that the effects of some anti-depressants vary during the menstrual cycle, which means that a dosage can be too high at some times and too low at others. Osteoporosis, 90% of whose suffers are women, and general frailty of the elderly are other poorly researched areas.
Medical notes often say more about the medical profession's perception of women than about their actual state of health. Many doctors have inherited a model of mental health that is curiously at odds with their perception of women. Women are socialized to develop certain traits – passivity, self-denial, over-emotionalism – and these are associated with certain psychological conditions, leading to such labels as the "neurotic mother". At the same time, a woman who does not develop these traits will also be seen as odd because her behaviour is inappropriate to her gender, making the assertive woman an "aggressive trouble-maker". Doctors have developed their own euphemisms so that they can talk to each other while the patient is listening: thus for "frequently raised the problem" read "hypochondriac"; "very concerned" equals "obsessive".