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Impact of Gender Norms on Women’s Care Pathways: From Sexist Biases to Medical Violence

Angelina PACE

Although healthcare systems promote equality and universal access to care, women’s care pathways remain permeated by sexist violence rooted in gender stereotypes. These biases can infiltrate everyday clinical encounters and lead to discrimination, loss of trust and, in some cases, medical violence. While research on obstetric and gynecological violence has expanded in recent years, medical violence experienced by women across healthcare settings remains insufficiently explored, particularly from the perspective of primary care.To describe and analyse forms of medical violence linked to gender stereotypes as experienced by women throughout their care pathways.A qualitative study was conducted in 2020-2021 using twenty semi-structured interviews with adult French-speaking women. Participants were recruited via social media and snowball sampling. Interviews explored experiences of care across different medical settings. Data were analysed using a phenomenological thematic approach, with double coding and triangulation to enhance analytical rigor.Analysis led to the development of a “pyramid of medical violence,” ranging from the trivialization of sexism to explicit forms of violence embedded in rape culture. Intermediate levels included derogatory remarks, sexist discrimination in research and clinical practice, reification of patients and deprivation of autonomy. Participants frequently reported a sense of dispossession of their identity, body and healthcare decisions. These experiences were linked to societal injunctions surrounding “femininity,” internalized sexist norms and normative control over reproductive health. Consequences included resignation, avoidance of male healthcare providers and, in some cases, renouncement of medical care. Conversely, some women developed coping strategies based on solidarity, peer support and empowerment.Findings are consistent with existing literature and highlight medical violence as a systemic phenomenon rather than the result of isolated individual behaviors. Limitations include potential selection bias related to voluntary participation, as well as recall and social desirability biases. However, the qualitative design allowed for in-depth exploration of lived experiences that remain largely invisible in clinical practice.Gender stereotypes significantly shape women’s care pathways and can generate forms of medical violence. Raising awareness among healthcare professionals, particularly in general practice, is essential. Integrating training on gender bias, intersectionality and patient participation into healthcare education appears necessary to foster compassionate, trust-based care environments.