Messy Misdiagnoses and Medical Misogyny

On Oct. 1, “Science Magazine” published a special issue on women’s health for the first time in the publication’s history. Beyond studies in sex-differentiated reproductive health and gynecology, the journal detailed fundamental biological discrepancies, denoting a gap in women’s health-specific research. Almost every organ functions differently in the female body than in the male, yet many sweeping medical generalizations have historically stemmed from predominantly male datasets. As highlighted by Senior Editor Yevgeniya Nusinovich, chronic pain disorders and autoimmune diseases are among the areas that remain understudied while disproportionately impacting women.

Actress Christina Applegate is only one such example. In 2021, she was diagnosed with multiple sclerosis, an autoimmune condition and neurodegenerative disease impacting the brain and spinal cord. However, on Oct. 20, she revealed that MS was a misdiagnosis, leaving her with more questions than when she began.

“You don’t get misdiagnosed and all of a sudden [you’re] better. I haven’t gotten better. If anything, I’ve gotten worse in some ways,” Applegate said to Jamie Lynn Sigler on their podcast, “MeSsy.”

Dr. Tanuja Chitnis, the Chief of the Division of Neurology at Mass General Brigham and Professor of Neurology at Harvard Medical School, is a multiple sclerosis specialist who has made breakthroughs in research. She provided insight into Applegate’s potential situation and the broader implications for women’s health.

According to Dr. Chitnis, there are several reasons why women may be predisposed to autoimmune disorders like MS. “Most autoimmune diseases are female predominant, and the ratios range from three to one in MS and Crohn’s disease and other similar diseases, to nine to one in diseases like lupus,” Chitnis said in an interview with the “Harvard Independent.” She attributed these ratios to estrogen’s pro-inflammatory effect on immune cells, for example, and to X-chromosome genes related to the immune system. MS, in particular, is expressed after puberty and can be less active after menopause, suggesting a potential hormonal link.

Dr. Marwa Kaisey, a neurologist at Cedars-Sinai Medical Center in Los Angeles, spoke on Applegate’s podcast and later to “CBS News.” She outlined how there is no consistent test to diagnose MS, leaving doctors with an adapting checklist instead. “These criteria change every seven or eight years as we get new technology and new information about the disease that allows us to refine them,” Kaisey explained.

Chitnis echoed Kaisey’s statements, discussing disorders that coincide with parts of the MS diagnosis criteria. MOGAD, or myelin oligodendrocyte glycoprotein antibody disease, can look similar on brain scans. “There are lesions in the brain, and in this case, we do, for the most part, we can detect an antibody to something called MOG,” Chitnis added.

Neuromyelitis optica, lupus, Sjögren’s syndrome, and occasionally rheumatoid arthritis can also present with brain and spinal cord degeneration. In fact, Applegate herself is now undergoing testing for many of these conditions. Symptoms of MS can also result from rare chronic infections, tumors, long-COVID fatigue, and myalgic encephalomyelitis/chronic fatigue syndrome. However, ME/CFS does not present with the MRI lesions, Chitnis explained.

Extensive research has been done to understand better the risk genes and causes of MS, specifically related to the Epstein-Barr virus and how EBV infection precedes MS onset. This progress has been important to the field, especially in exploring blood-based biomarkers, but Chitnis said more work remains. “Every disease is understudied until we truly have a cure and optimal treatments for it,” Chitnis said.

Chitnis explained the history and necessity of treatment, given the potential of medical misogyny and marginalization of women with MS. “This is a lifelong disease, and once someone is diagnosed, then we need to start disease-modifying treatment right away,” said Chitnis. “There has been a historical tradition of not being as aggressive with treatment for women who, on the converse side, might have a more inflammatory form of the disease, so that in a way is a form of misogyny.”

In July 2026, comedian Kylie Vincent spoke to “People Magazine” about her MS diagnosis after a male doctor initially dismissed her symptoms as a urinary tract infection (UTI). She explained how, in the seven months since her diagnosis, she is still not on disease-modifying treatment and how the medication would essentially dictate whether or not she would use a wheelchair. She was treated with antibiotics for a UTI for a week and felt a complete lack of trust. Her not yet being on disease-modifying treatment reflects the non-aggressive approach Chitnis described.

Chitnis also detailed that with fatigue and depression as symptoms of MS, the physicality and severity of the condition have gone underrecognized in the past, presumably related to the psychosomatic excusal of women’s symptoms. A 2026 University of Cambridge study found that “Women with autoimmune diseases are 74% more likely than men to be told that their symptoms are psychological or psychosomatic,” which in turn prolongs proper diagnosis and treatment. This phenomenon stems from historical sexism: terms like hysteria were commonly used to label unexplainable symptoms experienced by women, attributing illness to expressive emotional responses.

Journalist Katie Couric, founder of Katie Couric Media, discussed this connection at the Female Quotient Health Summit on Oct. 14. Her upcoming documentary, “HORMONAL!,” focuses on the systemic misogyny that female patients face. “Why, for centuries, have women been marginalized, misdiagnosed, and gaslit?” Couric posed at the panel.

She furthered her complaints with statistics. “Women weren’t required to be in clinical trials until 1993 … women take an average of four years longer than men to be diagnosed with a disease,” she said. This prolonged state of uncertainty subjects women to worsening physical and mental symptoms without treatment, making it more difficult to manage challenging day-to-day conditions.

Couric’s statements imply a link between the lack of research in women’s health and the likelihood of successful diagnosis. Chitnis is determined to see this change, starting with MS. “I do think that we are very close to having a blood test for MS, to having even preventative treatments or strategies launched in the next ten years for MS,” Chitnis said.

As Applegate continues on her journey for answers, Chitnis is hopeful for improvements in differential diagnoses. “If we learn a lot about MS, we’re going to learn a lot about lupus and rheumatoid arthritis and Crohn’s disease, and this is all going to impact many, many autoimmune diseases,” Chitnis concluded.

Sucheta Srikanth ’29 (suchetasrikanth@college.harvard.edu) is comping the “Harvard Independent” and impatiently waits for a cure.