The urgent need for a healthcare reset

Sara Marsico
Written By Minimax

“When a person is healthy, they’re not in pain. If they are in pain, something’s wrong. Unless you’re a person with a uterus, in that case pain is extremely normalized.” The words of Irene Facheris, an Italian feminist activist, left me thinking about the issue of gender inequality in healthcare, the need for a reset in healthcare, in how people with uteruses are constantly sterotyped which harms their chances of getting appropriate care. Why is there an inherent medical disadvantage in having a uterus, and why isn’t it being addressed more quickly?

The expression gender health gap refers to all those differences in the prevalence of disease, health outcomes, or access to healthcare across genders. It links to the issue of bodies of cisgender male individuals being used as the “default human construction” in the field of healthcare. Basically, men have described the world from their own point of view, and continue doing so, making their personal truth the absolute truth. It’s a prevailing issue in most fields and parts of human life, and healthcare is not excluded from it. Medical misogyny is a real threat, demanding our current medical world to change, reset, for it makes healthcare extremely restrictive to any individual, that is not a cisgender man, hoping to access proper medical care.

Why does such an issue exist in the first place? Evidence can be found all throughout history: medical conditions or illnesses typical of women and afab people were anciently connected to witchcraft, bad luck and something to avoid. Throughout history, for example, periods and menstruating people have been stigmatized around misinformed religious beliefs and labeled as “cursed” and “untouchable”, or, at best, “mystical” - still a harmful label putting a common biological process on a pedestal, not allowing proper research until only recent times. When biology became more meaningful and accurate for medical research (XV century circa), the issue of gender bias in clinical trials arose: the “default” for medical research were always cadavers of cisgender male individuals. Women’s bodies were at the time considered too deviant to make proper calculations due to their frequent hormonal fluctuations, thus they were completely excluded from clinical trials. The problem extended furthermore to diagnose gender bias as well, normalizing “pain” in women and afab people’s lives. Mass invalidation of pain was extremely common, often diagnosing women as “hysterical” or overly emotional over something as “normal” as pain.

There is no repair to the historical prejudices on women’s and afab people’s bodies, since, although some stigmas have been reduced or cancelled thanks to (very) recent research discoveries, there are a lot of stereotypes in the medical field against women and afab people. Although diagnosing hysteria is not as common as it was in the past, often doctors tend to still invalidate symptoms of potential illnesses, saying it’s “normal”, as a person with a uterus, to be in pain. But it’s not. It’s not a “standard requirement for people with a uterus” to be in pain, and this medical misogyny is extremely harmful to those who are attempting to find proper care, and is more common than expected. The pain has to be considered, researched and, when possible, resolved, not invalidated as “normal”, something we need to live with, or even denied as existing at all. I personally heard stories of friends, family members, being invalidated by doctors and only later diagnosed with a disease. The conversation I had a few days ago with my friend Alessandro is only one example of the stories I’ve heard from people close to me. “First of all, I have to say I was lucky, since most of my doctors were women, that believed me. However, I’ve had a few bad experiences with male doctors. When I was 14, I suffered from serious acne, and the doctor visiting me just explained that “girls my age want to be beautiful, but this is a normal stage in life and I should not worry only about appearance”. There are a lot of stereotypes around women or afab people only caring about appearances, even in the medical field, but if the doctor at the time listened to me, maybe I would have been able to mitigate and cure symptoms that are very strong and painful now.”

Gender bias created a lot of ignorance in the medical field, and although incorrect diagnoses sometimes come from stereotypes and misogyny, many times they come from a place of ignorance. Women’s and afab people’s bodies are still, to date, a medical mystery, and many ailments specific to people with a uterus are extremely under-researched, misdiagnosed and mistreated. “Many evident ailments are not known, so doctors will only try to mitigate the effects, because they have no idea what is going on”, tells Alessandro, talking about the difficulty he personally encountered with doctors. One of the most significant examples of under-researched diseases is that of endometriosis, a chronic disease of the female reproductive system in which cells similar to those in the endometrium grow outside the uterus, causing pelvic pain, heavy periods, pain with bowel movements and infertility. The causes of the disease are not known, and although this affects all women and afab people globally, the severe diagnostic delays are not uncommon at all, and primarily caused by poor funding for research and, again, the phenomenon of medical mass invalidation for women and afab people’s pain. It would be revolutionary and save many people if only they were listened to. If only the phrase “it’s normal to be in pain for you, it will go away eventually” was substituted by proper care, proper exams and a proper diagnosis. Because many are examples of people suffering from endometriosis that were diagnosed later than needed, having to suffer months or even years of invalidation, misunderstood suffering, increased risk. Due to endometriosis being related to period pain, it is just too easy for even specialists to classify the symptoms as “something that everyone has to go through''. If someone shows extreme pain, they’re just emotional, they have a lower pain endurance. The Italian transgender writer and activist Majid Capovani talked about his experience with endomitriosis, with excruciating pain and doctors that did not believe him. "I used to live in a lot of pain, visiting many gynecologists to find a solution, and only being told that I needed magnesium and painkillers. I used to take the maximum dosage of painkillers every day, with no results. Later, I discovered I suffered from endometriosis. And if cisgender women have a hard time receiving an official diagnosis, transgender people have it even harder due to the diffuse ignorance and impreparation of the healthcare personell not ready to deal with transgender patients."

There are too many people suffering from endometriosis that never receive a diagnosis, and this is not the only example. Many illnesses specific to people with a uterus are not classified as chronic (like vulvodynia, pudendal neuropathy and fibromyalgia), there are too many barriers to access proper healthcare, and an impellent need for a fight for better sexual health, including both cisgender women and transgender people. Even when diagnosed, there are too many barriers to finding a proper, state-funded, cure. It’s important to rebalance the medical system, to give equal opportunities to everyone, and not only to what has historically been “the default”.

Minimax https://sasse.se
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