Discrimination Against Singles in the Health Care System
It's time to shine a light on anti-singles bias in medical care.
Posted March 21, 2018
[Bella’s intro: All people should be treated fairly, in all domains, regardless of their marital status, relationship status, or any other status. It is a matter of justice. In the health care system, it is also a matter of your well-being, and maybe even your life. Unfortunately, singlism is pervasive in that domain, as it is in so many others. I am very grateful to Joan DelFattore, who is writing about this issue for her new book, for offering a preview here as well as an invitation to readers to share their own stories.]
When Singlism Wears a White Coat: Discrimination Against Single People in the Health Care System
Guest Post by Joan DelFattore
In an episode of the television show Private Practice, a man is dying in the hospital with a friend lying beside him and another friend standing nearby. And all the time, they're talking about how sad it is that he's dying alone, because there's no spouse. As Bella DePaulo points out in Single with Attitude, "The usual perversion of the word 'alone' is in play: If you have two old friends with you, one actually in bed with you and holding you in his arms, you have died alone. By this taken-for-granted definition, friends are not people. Unless there is a spouse present, you have died alone."
That scene illustrates what sociologists call cultural invisibility, meaning that in our couples-centered culture, even the closest relationships with friends, neighbors, co-workers, and extended family may seem less significant than they really are. Unfortunately, health care providers in real life may share that bias, despite numerous studies showing that the quality of relationships matters more than whether they fit specific categories. In a recent TEDx talk, "Sick While Single? Don't Die of Discrimination," I describe my own experience with an oncologist who assumed that without a spouse, I couldn't possibly have the support necessary to handle powerful chemotherapy. Research shows that that’s not unusual: marital status can affect medical decisions in ways that patients might not even recognize.
Not surprisingly, the belief that women, in particular, are meant to be married is especially noticeable in sex-related health care. A recent New York Times review of books about women's health starts with two stories that make that point: a cancer patient's preference for a mastectomy is questioned because she isn't married, and an eleven-year-old girl is advised that her endometriosis will improve when (not if) she has children. And just this morning, my Facebook feed included yet another protest about doctors refusing to tie the tubes of unmarried women, even in their thirties, because of the insistence that some day they, or their future husbands, will want children.
Less deadly, but nonetheless serious, are the actions of health care workers other than doctors. In All the Single Ladies, Rebecca Traister writes about a woman who fell on a dance floor and was driven to an urgent care center by a friend, but had to see the doctor alone because the staff wouldn't let the friend accompany her. I had a similar experience myself, when an emergency room nurse insisted that only immediate family could drive me home. I later learned that that requirement wasn't official hospital policy, and indeed couldn't be, because federal law recognizes the right of competent adults to choose our own caregivers. My guess is that something similar might have happened to the woman in Traister's story, with poorly trained staff making up rules based on their own social beliefs.
That's not to say that institutional policies are never at fault, as indifference to the needs of single patients may cause unnecessary inconvenience, expense, and delays. Regular readers of Living Single may remember a guest post in which Cathy Goodwin, Ph.D., drew attention to rules and restrictions about when patients need drivers, who those drivers have to be, and how long they have to stay. Despite the increasing number of Americans living alone, Dr. Goodwin wrote, "the medical world remains firmly rooted in the 1950s, when people got married and one spouse stayed home to take care of the kids, who were then available to help their aging parents.”
Amazingly, in a nation where almost half the adult population is widowed, divorced, or never-married, lifestyle-based inequity in health care not only exists, but isn't getting anywhere near the attention it deserves. So that's one of the things I’m writing about in my new book, which deals with what's important about the identity of woman when the answer doesn't revolve around wife, mother, or romantic partner. I've already told bits and pieces of my own story here, as well as at Psych Central, KevinMD , and the Washington Post, among others. But I think it's important for this book to create a space in which other people's voices, not just mine, can be heard.
If anything in this article rings a bell with you -- if you're thinking, Oh, yeah, something like that happened to me, or to a friend of mine -- I hope you'll take a moment either to post a comment or to email me, Joan DelFattore, at email@example.com. Nothing you say will be published without your consent, and it'll be up to you whether I use your real name.
The problems I've described here aren't happening because doctors and health care workers are bad people. They're happening because anti-single bias is so common that it passes for normal thinking, and the solution isn't blame, but education. Our stories need to be heard -- and this is a chance to make that happen.
[From Bella, again: Thank-you, Joan, for sharing this! Can't wait to read your book.]
About the Author:
Joan DelFattore is a professor emerita of English and legal studies at the University of Delaware. Her publications include three books with Yale University Press as well as dozens of articles. She's currently writing about being a lifelong single-by-choice, including dealing with singlism in medical care. Her articles have appeared at the Washington Post and KevinMD, among others, and she gave a TEDx talk, "Sick While Single? Don't Die of Discrimination."