Gender Bias and Diagnostic Delays in Young Women: A Narrative Review

Gender bias continues to influence diagnostic pathways for young women, contributing to delayed recognition of serious neurological, cardiovascular, autoimmune, and pain-related conditions. Symptoms such as visual disturbances, chest discomfort, fatigue, and multisystem complaints are frequently misattributed to stress, psychosocial factors, or benign causes. This narrative review synthesises existing literature on diagnostic disparities affecting young women across multiple specialities. Evidence highlights longer diagnostic intervals for conditions such as multiple sclerosis, optic neuritis, acute coronary syndromes, lupus, and chronic pain syndromes. Contributing factors include the under-recognition of sex-specific symptom profiles, historical male-centred research models, and cognitive heuristics that disproportionately categorise women's symptoms as functional or anxiety-related. International comparisons reveal narrower diagnostic gaps in Scandinavian systems with structured equity frameworks, whereas data from Australia and other regions demonstrate persistent triage and investigation differences that disadvantage young women. The consequences of delayed diagnosis include irreversible organ damage, increased long-term disease burden, psychological distress, and reduced quality of life. This review emphasises the need for bias-aware clinical assessment, improved education on sex-based differences, and system-level strategies to ensure that young women's symptoms are recognised and investigated promptly. Addressing diagnostic gender bias is essential for improving patient outcomes and achieving equity within modern healthcare.