The finger of the baby is gone in the doctor's office and the child screams. "Ow! Oh! Oh!"
How many adult Americans think that a young patient suffers will depend on whether they believe the baby is a girl or a boy, according to a study published this month in the Journal of Pediatric Psychology. Those who know the patient in need as "Samuel" will conclude that they are in greater pain than those who know the patient as "Samantha", although Samuel and Samantha are in fact the same 5-year-old whose blond hair, red shirt and gym shorts do not immediately represent male or female characteristics.
A baby finger test was recorded in a short video for 264 adult men and women aged 18 to 75 years. On average, the participants said they were following a boy's reaction to a visit by his preclinical doctor, a scale from 0 (no pain) to 100 (severe pain), like 50.42, while those who were instructed that the patient was a girl rated her pain as 45.90. When scientists controlled explicit gender stereotypes – the belief that boys are stoic – the difference disappeared, suggesting that the prejudices about the willingness of men and women to prevent pain were the belief that this guy was really in the narrow because he was screaming.
The results, which lead author Brian D. Earp described as a "new field of research", contribute to a growing understanding of the gender difference, a topic that was predominantly studied in the context of adults. They add more dimensions to a racial pain assessment survey based on dubious ideas about the biological differences between blacks and whites. They suggest a possible need for repairs of pediatric care courses, where healthcare providers may have the same prejudice that affects the general public.
"Adults have a lot of authority and agencies when they say," That's how I feel. "We are speaking in a variety of ways," he said in an interview for The Washington Post Earp, an associate director of the Yale-Hastings program in ethics and health policy. "But small children and their involvement depend on the judgment of the adults in the room. It is important that the structure of these courts is important for fair health care."
The findings, surprised by the authors of the paper, have reduced the number of female pains due to female participants who were more likely than men to say that the pain of the subject was less serious when she said she was a girl.
"That's a big secret," Earp said. "We're climbing to come up with some reason."
Similar dynamics appeared in the 2014 study, in which the new model is based on a model in which a sample of disproportionately female nursing and psychology students followed the same video as in a recent study and rated Samuel as experiencing more pain than Samantha's identical behavior. The fact that these trainings were healthcare providers among the participants suggests that this is a transition to a healthcare profession. Their answers support the idea that gender prejudices about how children express pain affect those who are "able to decide on health care," Earp said.
"It's a preliminary result, but we're pretty sure it's there," he said.
Leading author of an earlier study, Lindsey Cohen, a professor of psychology at Georgia State University, said in an interview that she had long known if their results, published in the journal Children's Health Care, would remain with men.
It does not seem to be the case. In a new study, the young patient's gender had no effect on the ratings offered by 156 male participants, among the several hundred who viewed the video.
The discovery is in "some kind of tension", writes in the paper, with the findings of related experiments, though not at the central discovery that boys' pain is taken more seriously. For example, a 2008 study found that fathers called pains for their sons higher than their daughters in a high-pressure test, in which the subject immersed his hand in a bowl of ice water. Mothers showed no difference.
So far, research has shown that young children do not notice pain differently due to gender, as the adult population does in terms of both sensitivity and clinical risk. Sex hormones, which are expected to be different, are not found before puberty. Studies on how adults have reached different conclusions about childhood pain are mainly confined to the attitudes of their parents who have a unique advantage.
A new study approaches a wider audience. And the apparent prejudice of the women she studied did not come as a surprise to Cornell's philosopher Kate Manne and "Down Girl: The Logic of Misogyny." She said it was the logical conclusion of women who identified their own pain as less serious.
"Because women have more pressure to be reasonably sympathetic to pain, and because we are inclined to take men's pain more seriously, it makes sense that women are at least as bad, if not worse," Manne said.
The results, though not surprising, were "really sad," she said. "We should be concerned about the fact that everyone else seems to be equal, perceived gender plus a few gender stereotypes enough to respond with little concern to the little girl's pain."
If boys tend to underestimate their own pain, Earp said, there might be good reason to see the same behavior that reflects the more intense pain in a male subject who was convinced: "Boys do not cry out."
Manne, however, pointed out research that questioned the idea that young boys had learned to calm their emotions. Some analysis, on the other hand, found that boys are more likely than girls to show negative emotions in childhood, a pattern that will only change in adolescence.
"It is still possible that we will socialize the boys to be stoic, but this harmful norm does not seem to be powerful," she said. "The results start to look really disturbing, because there is no reason to think that the boy is actually in pain."
Earp said he wanted his next study to introduce a race factor that was explored – revealing "a look at the back of human heads that black people have a stronger skin," he said – but rarely in combination with gender bias, especially in children .
Stark examples have implications, for adults and children, of racial bias assessments of pain. Some of them have been documented by the American Ethical Association magazine. African-Americans and Hispanics have shown lower doses of painkillers than white men. They wait for a long time in the pain medication outpatient clinic. Their painful needs were taken less seriously in hospice care. Although studies have shown that African Americans report greater back pain, doctors see the opposite. Minority and low-income children are experiencing greater difficulty in evaluating and treating pain in the oral cavity.
For Earp, this model suggests that the way adults interpret children's pain can have consequences for their health, raising the question: "What are the real consequences of treating this cognitive distortion?"