Dalila Marra is a medical doctor and graduate of Barts and The London School of Medicine and Dentistry (QMUL). Her interests include gender equity, patient safety and medical education, alongside emergency and acute medicine, trauma, critical care, pre-hospital medicine, surgery, and anaesthesia.

Through The Empowerment Project, Dalila has contributed to inclusion education and initiatives challenging bias in medicine. She delivered the 70kg Man Lecture to 400+ medical students, exploring sex and gender bias in clinical evidence and decision-making.

Dalila is also the Founder and Lead Researcher of The Roselle Project, focusing on melanoma and childhood cancer research and awareness. She has presented research nationally and internationally, including at the European Society for Medical Oncology’s AI and Digital Oncology Congress and the Royal College of Paediatrics and Child Health Conference.

She is pursuing postgraduate studies in medical education and anaesthesia and perioperative medicine, with a commitment to equitable, compassionate, patient-centred care.

Would Medicine Hear Her if She Were Him? Exploring the Gender Pain Gap and the Cost of Being Overlooked

Abstract:

Background:
Gender disparities in pain recognition and management remain a challenge to equitable healthcare. Historical underrepresentation of women in clinical research and gendered assumptions about symptom presentation may influence diagnostic decisions, triage and analgesia provision. In acute care, these disparities raise critical concerns regarding patient safety and health equity.

Methods:
A systematic search of the published literature was conducted to identify studies examining gender differences in pain assessment, diagnostic timelines and acute analgesia provision. Evidence across emergency medicine, cardiovascular care, acute surgery and perioperative practice was reviewed. Findings were synthesised to examine differences in time to diagnosis, time to analgesia, prescribing patterns and associated clinical outcomes between female and male patients. Relevant clinical guidelines and global health reports were also considered to explore implications for clinical practice and healthcare equity.

Results:
Evidence across acute care settings suggests that women may experience challenges in symptom recognition, diagnostic assessment and timely pain relief. These concerns have been reported in cardiovascular presentations and other acute conditions. Research has also identified gender-associated differences in emergency department analgesia prescribing. Potential contributing factors include implicit bias, differences in symptom interpretation and limitations in the evidence informing clinical decision-making. The extent and causes of these disparities vary across clinical contexts.

Conclusion:
Addressing the gender pain gap requires coordinated action across clinical practice, research and medical education. Recommendations include structured pain assessment, equitable triage and analgesia protocols, improved representation in clinical research, and education that helps clinicians recognise and challenge gender bias. Ensuring pain is assessed and managed according to clinical need is essential to patient safety, compassionate care and meaningful progress towards gender equity.