When we talk about the problems women encounter in seeking healthcare, we focus almost solely on reproductive rights and contraception. With the US government systematically restricting access to both, this is a crucial discussion.
But the discourse around this needs a shift in language and a stretch in focus. We need to recognise that these problems are often a symptom of a more general contempt for women in pain, and acknowledge that reproductive health does not always equate to women’s health. There are trans women whose biology means they need neither of those things, and they remain just as failed by healthcare systems.
Ideas about pain and gender embedded in the public consciousness are odd. It is almost on auto pilot that we instruct those in pain to ‘man up’, yet perceptions about what it is to have a female body mean a contradictory assumption that women have some innate ability to cope with suffering.
Research has backed this up to some extent, as there are parts of the female assigned reproductive system that suggest those with this biology should experience significantly more pain than those with a male assigned reproductive system. But when tests were launched into how individuals express pain, the difference was only slight, suggesting that women tend to minimise their pain when they express it. (the conducted research seemed to focus only on cis people)
These findings are complicated further when we look at the facts about how women in pain are treated. In the US, women wait an average of 65 minutes to be seen when dealing with acute abdominal pain, while men wait just 49 minutes. Women are also more likely to be given sedatives to ease their pain, while men are given narcotics. In other words, men expressing pain is understood as pain, while women expressing pain is interpreted as anxiety.
So, we have a situation in which those with assigned female reproductive systems are experiencing more pain, but expressing less. Simultaneously, doctors are acting as if it were the other way around, treating those they assume have female assigned biology as if their distress is less legitimate.
These facts show that the problems with how we respond to women’s pain transcend biological explanation. Rather, they is born from cultural assumptions. It seems obvious that having a vagina is not what makes others disregard your suffering; a nurse or doctor who decides how long you’re going to be waiting when you walk in to A&E probably hasn’t seen your genitals. Trans women would likely be treated with the same contempt, and probably then some. Misogyny and transphobia often walk hand in hand.
It is how someone’s gender is perceived (based on a set of performative aspects, rather than their biology) that dictates how we respond to them. We associate feminine with female, and apparently female with hysterical.
The notion that women are prone to overreaction is steeped in history – it is the residue of centuries in which women, and only women, were diagnosed with ‘Hysteria’, an umbrella term thought to explain symptoms such as emotional outbursts and nervousness. While this might seem unthinkable now, it is far too easy to draw connections between this diagnosis and the present and frequent prescription of sedatives to women expressing pain
The recent focus on encouraging men to speak out when they are struggling will hopefully retain the momentum it is gaining, but that doesn’t mean we should stop thinking about women. When it comes to physical pain, it seems that women are not speaking out as much as we’d like to assume, and speaking out can only do so much when the world is refusing to listen.
Image: Xu Suye