Why don’t we take women’s pain seriously?

Since the age of eight, Melbourne influencer Keely B has been sick. Over time, she’s collected diagnoses and disabilities, battled particularly bad flare-ups and dismissive healthcare professionals. In the middle of one health crisis, a doctor turned to her and said: “You’ve experienced a lot of pain in your life, so some extra pain won’t be a worry.”

After the loss of her mum (a nurse who advocated for her), Keely’s experience with medical treatments spiralled downwards. “I spent many appointments crying as I was so frustrated that my words weren’t being heard, and my tears of frustration and exhaustion only added to (doctors) not believing or listening to me,” she tells Harper’s Bazaar, adding that she believes this negligence led to her depression. 

Meg Croydon was 22 years old when her monthly flu-like symptoms rapidly got more severe. She faced debilitating nausea, sore throats, chronic fatigue symptoms, body aches, and pain for weeks. At best, she was given antibiotic prescriptions without any answers. At worst? “I was told many times that my symptoms didn’t exist and that it may have been psychological,” she tells me.

The 30-year-old Kuku Yalanji woman knows she isn’t alone. “I don’t know a single woman whose life isn’t impacted by unexplained pain or an experience with significant and ongoing health trauma.”

Alarmingly, two in three Australian women report feeling discriminated against in the medical system. A survey of almost 3,000 women, conducted by the National Women’s Health Advisory Council last year, found that most women experience gender bias, particularly in the diagnosis and treatment stages. The findings read painfully like a cliché medical daytime drama: Women sharing that they’re inadequately offered paracetamol and hot water bottles, that they’re stereotyped as ‘hysterical’ or a ‘drama queen’, and even questioned whether they were faking their pain.

It’s this textbook medical misogyny that’s led the Victorian Government to create an Inquiry into Women’s Pain, investigating and challenging the ways women and girls receive healthcare. Through a survey that’s asking Victorian women and girls to share their lived experiences with pain and pain management, this research will help shape the future of the health system. “It’s time we stopped treating women’s health like some kind of niche issue. We deserve to have our pain believed and relieved,” Premier Jacinta Allan said when announcing the Inquiry.

“I think it’s a pretty bold but long overdue move,” disability advocate Hannah Diviney tells me. “The majority of (people assigned female at birth (AFAB)) don’t have pleasant experiences with their periods or with menstruation,” she says, reflecting the recent statistics that around half of Victorian women report period-related conditions affect their health and wellbeing. “The fact that women are typically not believed or have to spend much longer proving or justifying their pain and their own awareness of their body is terrifying.”

Four in 10 Victorian women live with chronic pain, so why aren’t we taking pain seriously? Dr Angela Chia, pain medicine specialist and the director of Pain Matrix, was one of the invited speakers on the expert panel which informed the Inquiry. “There’s a lack of understanding from both sides—the healthcare provider as well as the patient receiving care. (We need to) acknowledge there is a problem,” she tells me.

Keely admits she’s neglected to report at least five instances of gender discrimination because of how deeply rooted it is in the medical system. “I just have to carry on and take it as I want to receive medical care. I worry that if I report what I experience in my appointments too many times, I will be believed less than I already (am),” she says.

In the wake of her mum’s death, Keely observed her treatment team become “very slack”, feeling as if she was close to being lost in the system. After her dad wrote a very strongly worded email, she was suddenly able to access the support she’d been chasing. “I realised after this that they’d listen to me if I had a man with me. I began to bring my partner to appointments. The validation I felt once I had someone else witness the gaslighting I was experiencing sent me spiralling,” she continues.

Of course, misogyny doesn’t exist in a vacuum. AFAB people often have multiple, interconnecting identities that impact how they’re able to move in the world. Classism, racism, and sexism are rife within the medical institution. Medical research has traditionally excluded the consideration of women. Diviney points to how neurodivergent literature has a huge gender gap of knowledge, where on average, it takes six years longer to diagnose autism in girls and women than in males. “We still have a long way to go for a lot of people to actually consider women as people and not just a means to reproduction.”

Chia points to how, two years ago, cultural competency was added to her medical body’s mandatory continuous medical education. “The more you learn, the more you realise, oh, that’s why we (need to learn),” she says. 

For Croydon, healthcare’s lack of affordability is her biggest accessibility barrier; her 30th birthday present from her mum was footing the bill of a doctor’s appointment. Coupled with full-time work’s stringent leave policies (in the past, she’s been fired from jobs for calling in sick) she’s unable to care for herself holistically and consistently.

As a First Nations woman, her cultural beliefs around health and wellness aren’t aligned with Australia’s mainstream medical model. “I believe medical gender bias is an outcome in a wider dysfunctioning colonial and capitalist system,” Croydon shares. 

“For me, an equitable medical landscape includes systems which prioritise women’s wellbeing, including reform and access to affordable housing, responsibly and ethically farmed food, access to free healthcare including dental, birthing (and) childcare community support, flexible and shorter working weeks (and) paid period leave.”

April Hélène-Horton, body acceptance and fat positivity advocate, has firsthand experience with fatphobic discrimination. “As a child, I was subjected to direct and indirect medical misogyny and fatphobia,” she tells Harper’s Bazaar. “Being the fat child of a mother who was also plus-size meant we were both constantly expected to either apologise for my body or commit to changing it as a way to access healthcare.”

Hélène-Horton suggests a comprehensive approach to inclusivity as a way to combat this prejudice. “Gender equity, authentic diversity, and cultural safety are the keys to balancing the bias in most industries,” she says.

Chia’s professional advice for patients with unmanaged pain revolves around therapeutic alliance, the relationship between a healthcare professional and their patient. “I actually urge patients to not forget to have a good GP. Having someone who can advocate for you medically will be a useful long-term therapeutic relationship,” she adds.

Most weeks, Keely visits the hospital for treatments and leaves with more positive days than negative. But the pain of previous bad memories leave their mark. “Those bad experiences are always with me and I go into every appointment with them in the back of my mind, worried it could happen again.”

“Unfortunately, most women don’t realise that they are not receiving the care they deserve, simply because they are a woman,” she adds. “Once I realised what I was experiencing, being able to label it helped me to be able to report it, (and) ask for change in my medical team and treatments.”

The Hippocratic oath is one of the oldest binding documents in history. Still widely sworn by physicians today, the 2,400-year-old text has been revised with the Declarations of Geneva to fit our modern-day standards. It wasn’t until 1994 that gender was added to the decree, stating: “I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, or social standing to intervene between my duty and my patient.” 

It’s been 30 years since this amendment, and it seems we’ve still got a long way to go.

This article originally appeared in Harpers's Bazaar Australia. 

Lead image: Pexels

Also read: How office gossip can be detrimental to your career

Also read: Ten podcasts you should get hooked onto right now