What is ‘self-advocacy’ and why is it important in healthcare?

This page is section 2 of 5 of FTWW’s My Voice Counts Self-Advocacy Toolkit.

What is self-advocacy?

Self-advocacy is where a person has the ability to understand, communicate, and assert their own needs, rights, and interests.

It enables us to make informed decisions about the things that matter to us and enables us to take more control of our lives. It is especially important in healthcare where we need to explain our symptoms and what will help us to have the best outcomes possible.

Why is self-advocacy important for women in healthcare settings?

It’s very important that women have the skills to advocate for themselves in healthcare settings because evidence suggests that we are more likely than men to experience diagnostic delays and gender prejudices which can make it more difficult for us to get the treatment we need. These are often described as ‘gender health inequities’. For example, in Wales, evidence shows that it takes 26 GP appointments and almost 10 years to get a diagnosis of endometriosis, a condition as common in women as diabetes or asthma (Source: Endometriosis care in Wales, Endometriosis Task and Finish Group).

Studies also show that women have to make more appointments than men to get a diagnosis of the same condition, for example, coronary heart disease, where it’s reported that GPs feel much more confident diagnosing this in men than in women. Similarly, with colorectal cancer, data shows that women tend to wait longer than men after first noticing symptoms and then need more visits to the doctor to get a diagnosis (Source: Do men consult less than women?, BMJ). And when it comes to pain management in emergency settings, evidence shows that men are more likely to receive pain relief, with women being offered sedatives instead.

We are also more likely than men to live with chronic illness and disability as we age. Accessing the right support early on can help to prevent our health getting worse and impacting different aspects of our lives, such as staying in education or work, maintaining relationships, and financial security.

Why speaking up about your health can be difficult

You might find self-advocacy in healthcare settings challenging for the following reasons:

1. You’re poorly – if you are tired, in pain, or experiencing problems concentrating or thinking clearly, this can make it much harder to clearly explain your symptoms and their impact on you

2. There are communication differences or challenges – if you don’t speak English as a first language, have additional learning needs, or are neurodivergent, you may find it more difficult to find the words you need to explain your issues. You may also find it more difficult to focus on the things the doctor needs to know to help you

3. There may be power imbalances – the doctor is often seen as the person with the scientific and clinical knowledge that you as a patient don’t have, so you may feel anxious about how they view you and your experience. Also, the GP will usually be the person who has the power to refer you on for further investigations or treatment, so you might feel as though you have to convince them to take you seriously and act on your concerns.