Trichotillomania and the Issue of ‘Medical Misogyny
On Wednesday 23 April 2025, The Financial Times published a report revealing that the average waiting time for an endometriosis diagnosis in the UK has now reached nine years. This figure is not merely a reflection of capacity issues within the healthcare system; it underscores a global issue to appropriately recognise and respond to conditions when they impact female patients.
The article cites clinicians and advocates who describe this prolonged delay in care as “medical misogyny”—a term that, while uncomfortable, accurately reflects the structural inequities faced by many patients. Though endometriosis is a physical health condition, the broader patterns identified in the FT report—diagnostic delays, symptom minimisation, and the burden placed on patients to push for adequate care—mirror the experiences of many individuals - men and women- living with trichotillomania.
Trichotillomania, also known as hair-pulling disorder, is frequently misunderstood or misclassified in clinical settings. As a result, individuals seeking support often encounter fragmented care pathways, limited specialist knowledge, and a lack of recognition of the condition’s impact on mental and physical wellbeing.
These patterns are not anecdotal. They are substantiated by emerging research. In the 2024 study “I have to fight for them to investigate things”: a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness (Zirnsak et al., 2024), researchers conducted in-depth interviews with 20 women managing both physical and mental health conditions. The findings highlight diagnostic overshadowing as a common theme—whereby physical symptoms are attributed to existing mental health diagnoses and therefore not properly investigated. Participants reported being routinely dismissed and required to manage their own care in the absence of coordinated support.
This research aligns closely with the experiences of many in the trichotillomania and broader Body-Focused Repetitive Behaviors (BFRB) community. The lack of informed clinical pathways leads to unnecessary delays in diagnosis, treatment, and long-term support.
While structural reform is essential, individuals are often left to rely on self-advocacy to navigate these gaps in care. This places an undue burden on those already managing chronic conditions, and reinforces inequities across the health system.
The parallels between endometriosis and trichotillomania highlight a broader challenge: improving how health systems recognise, diagnose, and support under-researched and under-prioritised conditions. Addressing this challenge requires a coordinated response from clinicians, policymakers, and research institutions alike.
