The term “gaslighting” can be traced back to Patrick Hamilton’s 1938 play Gas Light (adapted into films in 1940 and 1944), in which a devious husband manipulates his wife into believing that she is losing her mind by repeatedly invalidating her experiences, including her perception that the gas lights in their house are dimming.
Scholarly interest in the concept of gaslighting has ballooned in recent years. While there is broad agreement that gaslighting involves causing someone to doubt their own experiences, memory or perhaps interpretation of events, views diverge on what else is required. Does gaslighting require (malicious) intent, or can it also be unintentional? Does the target have to experience psychological harm as a result? Does the gaslighter have to be another person, or can one also be gaslit by oneself or the society at large? The jury is still out on these questions.
As debates over gaslighting have progressed, attention has also turned to its manifestations in medical contexts; the term “medical gaslighting” is now used to describe some situations where patients’ concerns and perspectives are dismissed or invalidated by medical providers. The term has seen mainstreaming in recent years, which is unsurprising, given how common patient experiences of dismissal and invalidation are, especially among marginalized populations and patients with difficult-to-explain symptoms.
There is substantial agreement that medical gaslighting is a real phenomenon that can result in a variety of harms, including diagnostic and treatment delays, loss of faith in the medical system, and feelings of isolation and hopelessness. However, some worry that the current usage of the term is overextended, with patients labeling all kinds of negatively valenced encounters with providers as instances of medical gaslighting. Avoiding such overextended usage is important for two reasons. First, the term is often used to assign blame, so we want to make sure that the concept tracks genuine blameworthiness. Second, if the term is to play a useful role in helping individuals understand and communicate their experiences, we want it to pick out a unique phenomenon, not a vague constellation of issues in medical practice.
Some have argued that “medical gaslighting” is a misnomer because providers are rarely driven by malevolence when they downplay patient perspectives. But on the assumption that medical gaslighting doesn’t require malicious intent but can involve unwarranted invalidation of experiences or concerns, perhaps in a way that shakes patients’ confidence in their own judgment, it seems common enough to warrant philosophical investigation. One question we should investigate is what we can be medically gaslit about.
Let’s start with two examples that I think many of us would agree on. A doctor telling a patient that their pain is not real would in most ordinary circumstances constitute medical gaslighting. But if a doctor refused a patient’s request for antibiotics, after appropriate testing showed no evidence of a bacterial infection, then that would not constitute medical gaslighting, even if the patient insists that they have such an infection.
In the clearest examples of medical gaslighting, such as in the first case above, providers invalidate patients’ experiences of symptoms, or the seriousness of those symptoms. Patients frequently report being told that their pain is in their head, that their dizziness is just anxiety, or that their fatigue can’t really be that bad. By contrast, in the antibiotics case, the provider takes the patient’s concern seriously and investigates it, and only afterwards concludes that the concern is unsubstantiated, with good reason. This case shows that mere disagreement is not enough for medical gaslighting.
Many agree that invalidating patients’ symptom experiences constitutes medical gaslighting, but it has been proposed that, in general, dismissing patients’ claims about the causes of those symptoms does not. One argument for this claim goes as follows: medical gaslighting occurs only when patients are forced to doubt things over which they have relevant authority and patients in general do not have this kind of authority over what is causing their symptoms.
I am not so sure. Claims about specific disease mechanisms might lie beyond the kind of epistemic authority patients generally have, but broader claims, such as “my symptoms are not entirely psychologically caused” or “there is something physically wrong with me,” plausibly fall within this authority, at least in some cases. Many putative instances of medical gaslighting involve these kinds of claims, often made by chronically ill people.
I suspect that patients with chronic illnesses might have a particularly strong claim to having the relevant authority, in virtue of lived experience of their illness spanning months or years or even decades. My hunch is that patients’ awareness of symptom patterns and their covariation with various other factors often ground these claims. For example, chronically ill people tend to notice if environmental conditions (heat, cold, pressure changes), behaviors (exercise, certain movements, sitting), dietary factors, or medications are correlated with changes in symptom severity. In fact, many actively track such correlations in the hope of avoiding triggers. They can of course be mistaken about what is affecting their symptoms, but this doesn’t mean that they in general lack the relevant expertise. Infallibility would be too high a bar.
So the idea is that many chronically ill individuals have not only first-personal access to their symptom experiences but also access to sufficiently reliable evidence—acquired through long-standing lived experience of their illness—that justifies their broad causal claims. This idea requires a careful defense, of course, as does the idea that dismissing such claims can constitute medical gaslighting. But we should at least take these possibilities seriously to avoid dismissing genuine epistemic expertise that patients bring to the table. Patients are often labeled as “chronic complainers” or “heartsink patients” if they insist that there is something physically wrong when providers think otherwise. But the history of medicine should make us suspicious of the idea that providers are always epistemically superior to patients; many symptoms and conditions that providers in the past confidently classed as psychologically caused are now understood to have identifiable biological causes.
Tiina Rosenqvist
Tiina Carita Rosenqvist is an assistant professor of philosophy at Rowan University. Her research focuses on philosophy of perception and philosophy of medicine. Recent work includes “Engineering the concept of pain for clinical practice” (forthcoming) and “Women’s pain and psychogenic diagnoses” (with Sara Purinton, 2026).
