It's not just you: Why Self Advocacy in the Health Care Setting can be HARD

We’re often told to “advocate for ourselves” in medical settings — to speak up, ask questions, and make sure we’re heard. But for many people, that’s easier said than done.The reality is, even the most capable, educated, or confident person can feel small in an exam room. Power dynamics, time pressure, and past experiences of being dismissed can make self-advocacy feel intimidating or even unsafe.

In this post, we’ll explore why self-advocacy in healthcare is so challenging, how the system unintentionally makes it harder, and what small steps you can take to begin feeling more grounded, informed, and empowered in your care.

Power Dynamics in Healthcare

Healthcare still operates in a hierarchy. The provider is viewed as the expert, and the patient — even a well-informed one — can feel like a subordinate.

Add time pressure, rushed appointments, and medical jargon, and the dynamic becomes even more one-sided. In that environment, it’s easy to lose confidence or second-guess yourself, especially if your questions are brushed aside or your symptoms minimized.

The key to shifting this balance is preparation. Writing down your top concerns, bringing a support person, or even practicing what you want to say beforehand can help you stay grounded and focused when emotions rise.

Cognitive Overload and Emotional Stress

When your brain is juggling symptoms, medical jargon, multiple opinions, and the emotional weight of being unwell, it can slip into overload. That cognitive fatigue makes it hard to think clearly or recall details in the moment — especially when emotions are high.

Slowing down, grounding your body, and breaking big questions into smaller steps can help you regain clarity. Advocacy requires bandwidth, and protecting that mental space is part of caring for yourself.

Mismatched Communication Styles

Sometimes the problem isn’t that your provider doesn’t care — it’s that you’re simply not speaking the same language.

Everyone has a natural communication style. Some people are factual and direct; others express themselves through emotion, intuition, or story. When your provider’s style doesn’t align with yours, messages can easily get lost in translation.

Recognizing these mismatches can take the pressure off both sides. It’s not about blame — it’s about awareness. Learning how you communicate best, and how your provider tends to communicate, can transform the interaction.

Communication in healthcare is more than sharing information—it’s ensuring shared understanding. I help clients develop skills to clearly express their needs and also to confirm what’s been understood. That includes learning how to ask providers to restate, rephrase, or clarify information when something doesn’t make sense. These small but powerful strategies help ensure your providers hear what you mean, not just what you say. Learn more about how to recognize if a provider is a good fit for you.

Gender, Racial, and Cultural Factors

Self-advocacy isn’t experienced equally. How someone is perceived — by gender, race, or culture — can shape whether they’re heard, believed, or dismissed.

Women are more likely to have symptoms labeled as stress or anxiety. People of color often face longer waits for diagnosis and fewer referrals for care. Language differences, cultural communication styles, and implicit bias can all make speaking up even more exhausting.

When you’ve been repeatedly unheard, advocating for yourself isn’t just a skill — it’s an act of courage. Recognizing these systemic barriers reminds us that true empowerment isn’t only personal; it’s collective. Change begins when both patients and providers learn to slow down, listen, and seek understanding beyond assumptions.

Medical Gaslighting

When you’ve been dismissed, minimized, or misdiagnosed in the past, every new appointment can carry echoes of that experience. Even if the current provider is compassionate, your body remembers what it felt like to be unseen or unheard.

This kind of medical trauma can show up as anxiety before visits, emotional shutdown during conversations, or difficulty trusting new information. It’s a protective response — your nervous system trying to keep you safe from more disappointment or harm.

Acknowledging this history is the first step toward rebuilding trust. Self-advocacy doesn’t mean forcing confidence you don’t feel; it means honoring your past experiences while learning tools that help you stay grounded, prepared, and supported as you move forward in care.

Closing Thoughts: You're not the Problem

If you’ve struggled to speak up, second-guessed yourself after appointments, or left feeling unheard — you’re not alone, and you’re not doing anything wrong. The difficulty of self-advocacy isn’t a personal flaw; it’s a reflection of a system that often asks people to be clear, calm, and confident in moments when they’re scared, exhausted, or unwell.

Learning to advocate for yourself isn’t about becoming louder or tougher — it’s about finding steadiness, clarity, and tools that help you stay centered even in difficult conversations. With awareness, preparation, and support, your voice can carry more power and calm than you may realize.

You deserve care that listens and collaboration that respects your perspective. And while the system may not change overnight, you can change how you move through it — with confidence, compassion, and the grounded sense that you belong in every discussion about your health.