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How Medicine Always Lets Women Down

Even today, research is male-biased

25.09.2021

Most of us have heard words like hysterical, hormonal or menopausal applied to women. It is also common knowledge that women get less medical attention than men, that there are gendered disparities in research, clinical care and treatment. And yet, Unwell Women: Misdiagnosis and Myth in a Man-Made World by British historian Elinor Cleghorn leaves you freshly appalled by the way women have been misunderstood and ill-treated by medical science.

Modern medicine has Western roots, and Cleghorn’s social history is focussed firmly in that world. Social prejudice has passed as biological fact, women’s illnesses and pain, trivialised. In ancient Greece and Rome, it was assumed that women were entirely governed by the whims of the womb, the organ that defined her social purpose.

As centuries rolled on, dismissing all the empirical knowledge of midwives or the testimony of women themselves, physicians kept telling men that women’s maladies stemmed from their dangerous imaginations. There were exceptions – in 1405, Italian writer Christine De Pizan rebelled against this medical misogyny, that women’s bodies were not weak and inferior just because they were different from the male.

As medicine became professionalised, more men studied the female body. But the idea of the ‘hysteric’, which literally means ‘of or from the uterus’ was still held chiefly responsible for any kind of trouble anywhere in a woman’s body. It became a diagnostic dumping ground. Hysteria, of course, is the word for the fits, furies and frenzies that men attribute to women.

Women’s pain was either dismissed as irrational panic, or mystified. White upper-class women’s exquisite sensitivity to pain was seen as a mark of civility – physicians assumed they could cajole them out of it. They were assumed to get breast cancer merely by feeling intense sympathy at another’s pain. Meanwhile, it was assumed that black women feel less pain – an idea that lives on, insidiously.

The book explores the work of Margaret Sanger and Marie Stopes, who did so much to advance reproductive freedom. Stopes wrote a revelatory book on women’s sexuality, given how men were oblivious to their wants and needs, and opened birth control clinics everywhere in Britain.

But both Sanger and Stopes were racist and ableist eugenicists, who saw their mission as a way to stop the wrong kinds of babies, to stop working-class women from rampant breeding, Cleghorn points out. As the 20th century proceeded, women’s health was suddenly dominated by endocrinology, seen as a matter of glands, hormones and secretions.

The fact is, even today, things that specifically afflict women are understudied – chronic conditions like fibromyalgia, endometriosis. There is even less biomedical research on conditions that affect women from specific racial groups, like uterine fibroids.

In a short section at the end, Cleghorn talks of her own experience with lupus, a chronic auto-immune disease that is understudied because 9 out of 10 sufferers are women. Even the variety of menopause experiences is reduced to a few symptoms like hot flashes, night sweats and vaginal dryness – making it hard to support women through nearly a decade of perimenopause.

Medicine and health are a matter of social power, the book underlines. Male bodies have set the standard, and male knowledge has delegitimised unwell women. In a fairer world, medicine must believe our testimonies and solve our medical mysteries with equal care.