In a study published in the Journal of Pediatric Psychology, Brian Earp and his colleagues found that the perceived gender of a child influences an adult’s evaluation of that child’s pain.
Brian Earp, the associate director of the Yale-Hastings Program in Ethics and Health Policy and the lead author of the study, stressed the importance of examining biases in pediatric pain assessment.
A model proposed by the authors provides a general framework for an adult’s assessment of a child’s pain. The authors contend that once an adult notices that a child is in pain, they may discount, augment or accept the child’s level of pain based on factors in the environment and the adult’s own perceptions. Earp said that this model is especially pertinent in a clinical setting, according to the Washington Post.
“Adults have a lot of authority and agency in saying, ‘This is how I feel.’ We express ourselves in nuanced ways,” Earp said. “But young children and how they’re attended to depends on the judgments of adults in the room. Understanding the structure of those judgments is important for equitable health care.”
The study expands on a previous one conducted by Lindsey Cohen and colleagues in 2014. In that study, the participants were 183 undergraduates, 154 of whom were female.
One of the aims of the recent study was to make the results more generalizable. The authors of the study recruited adults using Amazon’s Mechanical Turk (MTurk). MTurk is a crowdsourcing platform which is routinely used to connect social scientists to participants for an experiment or a survey.
Since the study was conducted entirely online as opposed to the laboratory, the participants’ attention levels, degree of seriousness and other parameters were vetted.
The final sample consisted of 264 adults: Roughly half were women of different races and ethnicities, and their ages ranged from 18 to 75.
To test for biases, participants were shown a video then asked to answer survey questions.
In the video, participants saw a 5-year-old child whose gender was ambiguous — the child had shoulder-length blonde hair and wore a red T-shirt and gym shorts. The child’s finger was pricked while they said an audible “Ow!” The child was described as a boy, “Samuel,” to some participants and as a girl, “Samantha,” to others.
The participants were then asked to rate the child’s experience of pain and display of pain on a scale of 0 to 100 with 100 being “severe pain.” They were also asked to rank the child’s response to that of a typical boy or girl and how much they agreed with explicit gender stereotypes surrounding pain response.
The average rating of the participants who were told that the child was a boy was 50.42 while the rating of those who were told that the child was a girl was 45.90. In other words, participants ranked the actual pain higher when they were led to believe that it was experienced by a boy.
The difference between the perception of the girl’s and the boy’s pain was larger in the responses among female participants; male participants tended to rate the perceptions of pain more closely.
But, when the researchers controlled for explicit biases, like a cultural belief that boys are more stoic while girls are more sensitive, the difference of the ratings between the two genders disappeared. Joshua Monrad, a co-author of the study, was struck by the result.
“An interesting result in our findings was that the implicit bias effect was related to people’s explicit beliefs about gender stereotypes,” Monrad said in an interview with the Yale Daily News. “So a way to combat biases would be to have more honest conversations about the stereotypes that we hold and that we perpetuate regarding the experiences of children of different genders.”
According to the Washington Post, future Earp would like to study the combined effects of racial and gender bias among children in the future.