The routine attribution of abdominal pain from conditions like appendicitis or gastrointestinal disease to gynecological problems can also delay or complicate the diagnostic process. A 2008 study published in the journal Academic Emergency Medicine, designed to gauge gender disparities among emergency room patients complaining of abdominal pain, found that even after adjusting for race, class and triage assessment, women were still 13 to 25 percent less likely than men to receive high-strength “opioid” pain medication. Those who did get opioid pain relievers waited an average of 16 minutes longer to receive them.

Conditions like fibromyalgia or chronic fatigue syndrome, for which definitive causes have not been identified and concrete diagnostic tests are not available, illustrate the problems associated with the perceived reliability of the female patient as narrator of her pain. Women are more likely to receive diagnoses of many of these more nebulous conditions — fibromyalgia, which affects about six million patients in the United States, is nine times more likely to be diagnosed in women than in men — and this discrepancy surely contributes to the widespread skepticism that still exists over the legitimacy of these disorders.

I AM a sufferer of pain and chronic disease. Like many, I’ve had physical symptoms (in my case, respiratory problems and infections) explained away as emotional. My freshman year in college, I was in the emergency room, flanked by machines and struggling to breathe while doctors lobbed questions at me: Why wasn’t I responding to the medication the way they expected I would? Was I just too anxious? Could I not handle stress, and was that making me sick?

I was 23 before I was given a correct diagnosis of a rare genetic lung disease called primary ciliary dyskinesia. I’d been sick since birth, but long diagnostic journeys are occupational hazards of living with conditions doctors don’t often see. Still, my journey was unnecessarily protracted by my doctors’ dismissal of my symptoms as those of a neurotic young woman.

For all the medical advances of the past few decades, we still know shockingly little about pain and how to control it. Sex-based research is a crucial part of understanding not just the underlying mechanisms of pain, but the most effective ways to treat it for men and women alike. The Institute of Medicine report found gaps in research, particularly in terms of effective treatments, as well as in the oversight of pain research. The report recommended that these problems be addressed and that strategies to resolve them be implemented by 2015.

Among those improvements must be a renewed focus on discovering why women respond differently to some drugs and diseases, as well as an emphasis on training physicians to better diagnose and manage women’s pain. A report by the Campaign to End Chronic Pain in Women found that inadequate physician training in diagnosing and treating just six pain disorders that affect women either exclusively or predominantly, including fibromyalgia and chronic fatigue syndrome, added as much as $80 billion a year to America’s health care bills.

Part of the reason the diagnosis and treatment of women’s pain lag so much is simply the pace of medical research itself, which is slow to move from publication to clinical practice. Unfortunately, if anything, changes in assumptions about gender evolve even more slowly.