Women with autoimmune conditions are far more likely than men to be told their illness is psychiatric or “all in their head”, according to new research from the University of Cambridge and the University of East Anglia published in Lancet eClinicalMedicine and reported by The Guardian. The study, covering more than 6,600 people with autoimmune conditions, puts hard numbers on an experience many women describe anecdotally: not being believed.
The misdiagnosis gap
After adjusting for age, disease group, continent and household finances, women were 46% more likely than men to report a psychiatric misdiagnosis and 74% more likely to report a psychosomatic one — symptoms labelled as triggered or worsened by stress or anxiety. In raw terms, 43% of women said they had been told their condition had a psychiatric cause, compared with 33% of men; 34% of women had their symptoms called psychosomatic, against 22% of men.
Autoimmune conditions affect around one in ten people globally, with symptoms that can include fatigue, muscle pain and rashes — presentations that are easy to wave away early on, and costly to miss. The diseases in the study included autoimmune thyroid disease (Hashimoto’s and Graves’), which affected almost a quarter of the women surveyed, and systemic lupus, affecting one in seven women; among men, rheumatoid arthritis, vasculitis and antiphospholipid syndrome were most common.
Years, not months
The gap shows up in the calendar. The most frequently reported time to a correct diagnosis was under three months for men — but one to two years for women, who also reported going through more consultations before getting an answer. Every extra month matters: autoimmune diseases damage the body progressively, and treatment delayed is damage accumulated.
Lead author Melanie Sloan, a public-health researcher at Cambridge and UEA, warned that the harm from misdiagnosis can be very long lasting — eroding patients’ trust in doctors and their own self-esteem — and urged clinicians not to reach for psychological explanations too soon, especially with women. Co-author and patient Shaista Tayabali noted that although the word “hysteria” has largely disappeared from medicine, the pattern behind it has not: women still struggle more to have their symptoms believed.
A pattern medicine keeps rediscovering
The findings land in a wider conversation about whose symptoms get taken seriously. We recently examined how errors in AI chatbot medical advice can be nearly impossible to trace — a different failure mode, but the same underlying theme: the road to a correct diagnosis is full of points where a patient can be quietly diverted. And as our coverage of France’s record West Nile virus season showed, health systems under pressure fall back on familiar assumptions — precisely when atypical presentations get missed.
What needs to change
The study’s prescription is systemic rather than personal: training that reflects how these diseases present in women, structured second looks when a “psychological” label is applied but symptoms persist, and a culture that treats a patient’s persistence as evidence rather than attitude. For the women in this research, the validation may be the headline in itself: the dismissal was real, it was measurable — and it was not in their heads, even when that is exactly where they were told the problem was.