Starr Mirza started falling for no discernable reason in middle school. She’d see stars, hear a ringing sound, feel tingly, and then pass out. Her parents took her to one doctor and then another.

“They asked me what I had eaten, if I had issues with my weight, if I had a problem with my brother getting better grades in school than I did,” Mirza said. She’s faking it for attention, they seemed to be saying. It took Mirza having a heart attack after a decade of illness to get an accurate diagnosis: a rare heart condition called long QT syndrome.

Marley Hoggatt was similarly dismissed by doctors who asked about her love life and prescribed an antidepressant when she complained about laying on her bathroom floor vomiting from severe migraines multiple times each month.

Two years and lots of ibuprofen later, an internist discovered the problem wasn’t her head, but her neck. She had a herniated disc, two bulging discs, and a pinched nerve.

Until recently, “female hysteria” was doctors’ go-to diagnosis when stumped by a women’s illness. Today, doctors say “emotional” and “psychogenic.”

“Hysteria has been passed down generation by generation,” said Maya Dusenbery, author of Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. “Symptoms aren’t taken seriously, and they’re dismissed as depression or anxiety.”

Up to half of women doctors diagnose with depression are misdiagnosed.

Dusenbery said doctors bring sexist ideas about into their practice, assuming that men are stoic and rational while women are emotional and tend to exaggerate.

“If a doctor doesn’t fully understand what’s going on, it’s a lot easier to put a label on it and say, ‘This is depression,’ instead of saying, ‘We don’t know,’” Carl Erik Fisher, MD, told Cosmopolitan. When women go to their doctors with difficult-to-understand complaints, “They tend to get dismissed as complainers or as ‘psychosomatic.”

“There is inherent bias that makes us undervalue women’s symptoms,” said Dr. Martha Gulati.

One study showed that doctors make women wait longer for pain medication, deny women pain medication, and attribute women’s pain to psychological issues more often than men. Other studies show pain associated with female anatomy is more likely to be dismissed than other types of pain.

Ironically, the assumption than women are unreliable means women actually must exaggerate or misconstrue to get adequate care. “I felt like I had to exaggerate just to make them believe me,” Alicia Jensen said about her severe daily headaches after her concussion.

In 1991 Dr. Bernadine Healy, cardiologist and first female head of NIH, coined the term “Yentl syndrome,” to describe how to get treated women have to convince doctors they’re as sick as men or have the same symptoms a man would have for the same condition.

Another reason doctors are less likely to attribute women’s complaints to illness is that they know a lot less about them. Researchers spend less time and money on illnesses that impact women disproportionately and women are underrepresented in every aspect of medical research.

“Conditions that disproportionately affect women — and exclusively affect women — have often been relegated to the bottom of the research agenda,” Dusenbery told Tonic. One analysis found that erectile dysfunction generated five times the studies as PMS pain, despite a far smaller percentage of the population.

In 1977 researchers began excluding women of childbearing age from clinical trials to avoid harming fetuses. Female rats were excluded from studies due to misconceptions about menstruation. Even male cells are more experimented on than female cells.

Today’s medical school curricula is still based on a 154-pound man, with instructors mostly ignoring sex differences.

Julie Rehmeyer woke up one day unable to walk. A neurologist expecting diagnosed her with chronic fatigue syndrome (CFS). “For him the term clearly meant, ‘Please get out of my office. I have nothing to offer you.’” Rehmeyer said. “No tests, no treatments, no other doctors, not even much sympathy.”

Rehmeyer looked to the literature to find answers. But autoimmune disorders, like many illnesses that primarily affect women, are woefully understudied.

And the little research that does exist is biased against women.

In 1984 near Lake Tahoe 160 people reported crippling fatigue and body pain. The NIH asked Virologist Stephen Straus to look into it. He refused to physically examine a single patient and dismissed the condition as mental, despite the high fevers reported.

“The official CDC diagnosis was hysteria, and that is how the syndrome has been treated by most of the medical community ever since,” writes Jessica Cripsin. Women make up 85% of CFS diagnoses.

The only large, controlled trial for treatments for ME/CFS used shoddy methodology to show that the illness was psychological. Yet despite the study’s obvious errors, doctors and public health agencies are still telling ME/CFS patients to treat their autoimmune disorder with exercise and Cognitive Behavioral Therapy.

Women’s illnesses are understudied because doctors think it’s all in our heads, and doctors think it’s all in our heads in part because our illnesses are understudied.

“Women are not just men with boobs and tubes,” says Dr. Janice Werbinski, a gynecologist and executive director of the Sex and Gender Women’s Health Collaborative. “We can actually harm women by not researching them correctly and knowing the differences.”

Starr Mirza’s heart will never recover from the damage her untreated condition caused. After a dozen heart surgeries and an instance of heart failure she’s more likely than not to need a heart transplant in the future.

Women are 1.5 to 1.7 times more likely to experience an adverse drug reaction than men as a result of gender bias in drug research.

Doctors are seven times more likely to misdiagnose a heart attack when it happens to a woman and discharge her mid-attack. Women whose heart attacks are treated by male physicians are two-to-three times more likely to die.

When Lori Kupetz went to her doctor with “blinding” chest pain her cardiologist insisted she wasn’t having a heart attack. She was prescribed antidepressants. She wound up needing emergency triple-bypass surgery for three blocked arteries.

Despite high fevers and other physical symptoms, one woman’s doctors were so confident that she had depression that they permanently damaged her memory with electroshock therapy before finally diagnosing her with myalgic encephalomyelitis (ME).

Doctors diagnose twice as many women with depression as men. While women might truly suffer from depression more often than men, it’s important for doctors to acknowledge the role medical misogyny plays in false diagnoses in women. How many women are taking SSRIs for undiagnosed, untreated physical illnesses that are wreaking havoc on their bodies and shortening their lives? Until we start taking women seriously and stop gaslighting them, we’ll never know.