Autoimmune diseases, where the immune system mistakenly attacks the body's own tissues, disproportionately affect women, who represent 70–80% of cases worldwide. Yet a new study shows that women face significantly longer diagnostic journeys than men, with nearly a third waiting four years or more for a correct diagnosis.
The research, which surveyed more than 6,000 patients across a range of autoimmune conditions, found that while almost half of men receive a diagnosis within a year of symptom onset, most women wait longer: 60.4% of women waited more than a year. The findings point to persistent gender biases in healthcare, according to co-author Shaista Tayabali, who noted that historical biases, limited research on women's health, and sex-biased data feeding machine learning models all contribute.
Dismissed as psychological
One key factor is the tendency for doctors to interpret women's symptoms—such as fatigue, pain, sleep disturbance, or low mood—as psychosomatic or psychiatric, rather than considering an underlying autoimmune condition. The study found that 34% of women reported having their symptoms dismissed as psychosomatic, compared with 22% of men. Women were also nearly 50% more likely to receive a psychiatric misdiagnosis and almost 75% more likely to receive a psychosomatic misdiagnosis.
These delays have serious consequences: untreated autoimmune diseases can progress, causing irreversible damage, and patients often lose trust in the healthcare system. David D'Cruz, a consultant rheumatologist at Guy's Hospital in London, urged clinicians to be open-minded and to consider whether an underlying autoimmune disease might be present, even when symptoms seem psychological.
“This is not about saying that a psychiatric diagnosis is never correct,” D'Cruz added. “People can have both autoimmune and psychiatric conditions, and it is increasingly understood that psychiatric symptoms can be part of an autoimmune disease, especially in diseases like lupus which can directly affect the brain.”
The study's findings resonate across Europe, where healthcare systems vary widely but gender disparities in diagnosis persist. In countries like Spain, where mental health services are stretched, the risk of misattributing physical symptoms to psychological causes may be even higher. Meanwhile, the broader issue of gender bias in medicine is gaining attention, as seen in recent efforts to spotlight women's contributions in art and the recognition of women confronting systemic challenges.
Although labels like “hysteria” are now outdated, Tayabali noted that “as women we still often have a harder time having our symptoms believed and therefore addressed accurately.” The study's authors call for greater awareness among clinicians and for more research into sex differences in autoimmune disease presentation and diagnosis.
For the millions of women across Europe living with conditions such as type 1 diabetes, autoimmune thyroid disease, systemic lupus, and multiple sclerosis, the findings underscore the urgent need for healthcare systems to listen more carefully and to consider autoimmune diseases earlier in the diagnostic process.
