The authors ground their analysis in the historical legacy of hysteria, a diagnosis popularised in the early twentieth century that attributed physical symptoms to emotional distress primarily among women. They argue that this diagnostic framework provides essential context for contemporary patterns of dismissal and pathologisation, particularly towards marginalised populations. The term medical gaslighting itself did not appear in the academic literature until 2020, emerging in an account of a woman with long COVID who reported repeated dismissal prior to diagnosis. Since then, the concept has gained recognition in literature on chronic or contested illnesses, yet it still lacks a clear, consistent, and theoretically grounded definition that could guide research, clinical practice, and public understanding.

To construct their definition, the researchers draw on the origins of gaslighting in Patrick Hamilton’s 1938 play Gas Light, which depicts a husband manipulating his wife into doubting her sanity by dimming the gaslights in their home. The term entered academic literature through case studies of involuntary hospitalisation as psychological abuse and has since come to describe a form of psychological abuse in which an individual is manipulated into questioning their own perception of reality. The authors highlight sociologist Paige Sweet’s interviews with forty-three survivors of domestic violence, which demonstrated that gaslighting becomes especially abusive when embedded within social inequities and power dynamics, particularly those related to gender. Sweet conceptualises gaslighting as repeated efforts to construct a surreal environment in which victims are made to feel or appear crazy, thereby undermining their sense of reality, identity, autonomy, and mobility.

Building on this foundation, the researchers examine how medical gaslighting operates within Western medicine’s structural constraints. They cite a qualitative analysis of 334 online survey responses in which respondents with long COVID used the language of medical gaslighting to make sense of their experiences seeking care. Participants described repeated dismissal by medical professionals who were unable or reluctant to recognise their symptoms as real, with physicians invoking biomedical objectivity, including negative diagnostic test results, to discount patients’ subjective symptoms. The authors of that study suggest that medical gaslighting can be understood as a rhetoric of ontological politics, echoing Annemarie Mol’s argument that what counts as real in medicine is inherently political. This framing positions medical gaslighting not merely as an interpersonal failure but as a systemic condition embedded within the epistemology of Western medicine itself.

The researchers emphasise that Western medicine has historically been constructed around a normative body: wealthy, White, able-bodied, heterosexual, cisgender, and endosex male. Although medical gaslighting is not exclusive to marginalised communities, this structural bias systemically disadvantages those outside the norm. They cite interviews with twelve gynaecologists and general practitioners in which women with endometriosis were characterised as hysterical and labelled crazy when they failed to respond to diagnosis or treatment as expected. Miranda Fricker’s concept of epistemic injustice, which describes harm done to someone in their capacity as a knower due to prejudice or limited interpretive resources, provides a useful framework for understanding how implicit biases and power dynamics produce such harm. The authors also highlight the role of intersectionality, noting that while Black women may experience compounded marginalisation within healthcare, White women benefit from racial privilege while still experiencing gender-based disadvantage.

The perspective piece engages critically with alternative framings that have emerged in recent medical literature. Emergency physician Robert Jedick has argued that the term medical gaslighting overlooks physicians’ perspectives and frames patient-provider relationships in conflict, proposing miscommunication as an alternative that better acknowledges the organisational pressures facing medical professionals. The Australian researchers counter that characterising such encounters as miscommunication risks reframing structurally embedded power dynamics as interpersonal misunderstandings, shifting responsibility towards patients seeking recognition of their symptoms. They argue that this reframing may invalidate the lived experiences of those harmed by medical gaslighting, and that the language of medical gaslighting can function as a form of self-advocacy, enabling patients to make sense of their experiences within a medical system that has failed to recognise their legitimacy.

The researchers also address the question of intent, which has divided scholars in the field. Some have distinguished manipulative gaslighting from epistemic gaslighting on the basis of intent, while others have proposed medical invalidation to describe gaslighting-like behaviours that occur without manipulative intent, including those arising from well-meaning clinical practice. The authors argue that patients cannot reasonably be expected to discern the intent of medical professionals, and that introducing additional terminology is unlikely to resolve underlying epistemic tensions when the meaning of the existing term remains contested. They contend that the outcomes of both manipulative and unintentional dismissal are often similar, leading individuals to question or doubt the legitimacy of their concerns, and that a definition of medical gaslighting must recognise that it occurs regardless of intent.

Having surveyed the conceptual landscape, the researchers advance their own definition, which they present as a framework for empirical and clinical inquiry. They define medical gaslighting as a complex phenomenon, understood through psychological and sociological frameworks, in which individuals experience the repeated dismissal and invalidation of their health concerns by medical professionals, healthcare organisations, or the broader medical system, an experience that leads them to question or doubt the legitimacy of their concerns. Influenced by systemic inequities and power dynamics, it occurs regardless of intent and often in the absence of evidence-based care. The authors stress that this definition should continue to evolve as the field progresses, and that it establishes a foundation for academics and medical professionals to identify and address systemic inequities within Western medicine while reinforcing accountability within the medical system.

The researchers argue that such accountability can inform training that prioritises patient-centred care and transparent communication in clinical decision-making, strengthening patient-provider relationships, particularly in the management of chronic or contested illnesses within internal medicine. They distinguish their framing from legal claims of medical negligence, which typically focus on isolated incidents or individual providers, noting that medical gaslighting is more accurately understood as a psychological and institutional process that normalises the devaluation of individuals lacking testimonial power within the medical system. Over time, repeated encounters may generate a documented history of misdiagnoses and ineffective treatments, leading to patients being labelled as psychosomatic or manipulative, with clinical records potentially reflecting the implicit biases of previous providers and leaving patients with limited authority to challenge such assumptions.

Ultimately, the authors call for Western medicine to turn its diagnostic gaze towards medical gaslighting and work to extinguish the systemic inequities that sustain it. They contend that sensationalisation of the term has limited meaningful engagement, leaving insufficient empirical and clinical work to guide practice, and that there is an urgent need to identify and address medical gaslighting within Western medicine to prevent further dismissal and invalidation. By advancing a clear, theoretically grounded definition that affirms the lived experiences of those harmed while establishing a framework for research and clinical inquiry, the researchers aim to ensure that the phenomenon is consistently understood across public, academic, and clinical contexts, transforming a viral term into a rigorous instrument for structural change.

Subject of Research: Medical Gaslighting

Article Title: Defining Medical Gaslighting—To Extinguish It

Article References: Janiszewski, C. M. S., Mosterd, D., Emerson, C., Mikocka-Walus, A., & Grech, L. B. (2026). Defining Medical Gaslighting—To Extinguish It. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10787-8

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10787-8

Keywords: medical gaslighting, patient dismissal, chronic illness, epistemic injustice, healthcare inequities, long COVID, patient-provider communication, systemic bias, internal medicine, medical sociology, Defining, Medical