The girl who cried pain: a bias against women in the treatment of pain.

There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country.' There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed and treated for their pain. One particularly troublesome study indicated that women are more likely to be given sedatives for their pain and men to be given pain medication.^ Speculation as to why this difference might exist has included the following: Women complain more than men; women are not accurate reporters of their pain; men are more stoic so that when they do complain of pain, "it's real"; and women are better able to tolerate pain or have better coping skills than men. In this article, we report on the biological studies that have looked at differences in how men and women report and experience pain to determine if there is sufficient evidence to show that gender^ differences in pain perception have biological origins. We then explore the influence of cognition and emotions on pain perception and how socialized gender differences may influence the way men and women perceive pain. Next, we review the literature on how men and women are diagnosed and treated for their pain to determine whether differences exist here as well. Finally, we discuss some of the underlying assumptions re-