In the last year of being ill, I have discovered a disturbing pattern between the sharing of my mental health situation, and the disparagement – bordering on disbelief – by doctors of my physical symptoms. 

This was particularly apparent during my most recent visit to hospital, when the attending physician insisted my pain was being caused by a panic attack, and that I simply needed to calm down. As I said in this post, I know very well what a panic attack feels like. I was not experiencing one.

The tension between the accurate medical treatment of women and (mostly male) practitioners is not new.

This image, from an article in the Daily Mail about the Trans-Allegheny Lunatic Asylum, is particularly revealing.

“Imaginary female trouble,” “menstrual deranged,” “and “uterine derangement” may seem almost amusing now, but they paint an accurate and chilling picture of the charges leveled against women, and used as applicable reason for a life of imprisonment.

“‘In 1872 … if [a woman’s] husband had a mistress or if she had inherited money … he could bring her here,’ a guide at the former asylum told the Los Angeles Times.

‘He could sign her in and leave her until he decided to come back and get her – or until she died, whichever came first.’

Women’s health issues were also seemingly neglected under a catch all of lunacy. ‘Imaginary female trouble’, ‘suppression of menses’ – which could be the case of being pregnant out of wedlock, or caused by an eating disorder or other illness – and hysteria.

The weaker sex, as women were defined at the time the asylum first opened, also meant a strong attitude could land them in trouble, with ‘nymphomania’ and ‘seduction and disappointment’ reasons for admission.”

The word hysterical, which is and always has been exclusively applied to women, in fact comes from the Greek ὑστέρα “hystera” – uterus.

You can see that the use of it peaked around the early 20th century – but it hasn’t declined that much, certainly not as much as you would think. It’s not a nice word. It’s not a medically accurate word. It’s a word that is used to completely undermine female experience.

You might remember my posts last year about my friend whose doctors not only did not believe she was pregnant and diagnosed an “hysterical pregnancy” (yes, this term is still used), but also refused to remove her contraception or refer her to someone who would. Why was she treated like this? Because she has Bipolar Disorder. She was explicitly told that she shouldn’t have children, due to her mental illness. This despite the fact she is already a mother, and is doing a fantastic job.

I’ve been told that my Chronic Fatigue, my IBS, my constant pain, my insomnia, my weight loss, my RSL – are all caused by my depression and anxiety disorders.

As I’ve said before, I am happy that doctors recognise how much mental illness can effect someone physically. I think it make sense to explore, with the patient, how it might be manifesting.

But there’s a very big difference between recognising the influence of mental illness in exacerbating physical symptoms – and believing it is the sole cause.

I find it hard to believe, had I been a man at the hospital that day, that the doctor would have told me I was hyperventilating, and that anxiety was the only reason for my pain.

While researching this post, I found this article, amazingly, in Time magazine: It’s Not Just Sexism, Women Do Suffer More From Mental Illness. (Trigger warning for bullshit). Of course, it’s written by – who would have guessed it – two men, who, whilst trying to defend themselves against accusations of sexism, reinforce the very tropes they’re arguing against. It’s a very odd piece.

For once, I did read the comments, and while many of them are throw-up-in-your-mouth MRAs, there’s a couple of level-headed women who explain calmly that the data the writers are using to back up their claim that women suffer more from mental illness than men, is from self-identified surveys. And it is well-known that women admit, and seek help for, mental illness far more than men do. So the data is irreparably skewed.

(It made my laugh quite hard that the article finishes with the line: “let’s end the discrimination, inequality, and downright misogyny that seem to be triggering profound psychological distress in so many women.” IRONY MUCH).

I also discovered this very interesting article on medical sexism towards women with Fibromyaglia, an illness that mainly effects women. The experience it describes is uncomfortably similar to my own.

“The total number of fibromyalgia patients worldwide is jaw-dropping and the situation is much worsened by the medical profession’s failure to adequately diagnose and sympathetically treat this virtual epidemic, displaying a medical sexism that’s hard to miss even if you’re not looking closely. The sexism I see is the result of a male-dominated healthcare system dealing with a condition that simply doesn’t follow the rules we learned in medical school.

Fibromyalgia gets its start in a biochemically susceptible woman after a lengthy period of stress. Making matters much worse is that even after the initial stressors recede, her fibro pain persists. This occurs because of the stress of the pain itself combined with an unhelpful, unsympathetic, and sometimes overtly hostile medical profession.”

What we have here is a doctor who has been running a pain clinic for 17 years, estimates having diagnosed 1600 people during that period, and who declares that the stress of sexist medical treatment makes women’s health worse.

Finally, my wonderful friend Chris Miller shared this excerpt from one of his essays, entitled “Biomedicine has low self-esteem so it picks on ladies and queers.” Very apt.

“The idea that all illness can be traced back to a measurable, quantifiable cause has been strong enough that illnesses and therefore treatments have been found to account for behaviours disapproved of by social elites.

While this tendency brought us vibrators, it also introduced lobotomies, ovariotomies, dangerous electro-shock therapy, the “rest” cure and the over-use of sedatives and mood-balancers like Valium and Nembutal, immortalised in the 1966 Rolling Stone’s song “Mother’s Little Helper” (Joralemon, 2010; Hedges, 1973; Jagger et al., 2003). All were intended to cure what were often entirely normal behaviours. Researchers still seek to isolate the genetic markers for traits such as homosexuality (Blue, December 13 2012), while intersex and transgender conditions are still highly medicalised (Barnes, 2001). Mental illness is now attributed to brain chemistry, and in the first half of the 1990s the second most sold drug in the world was an antidepressant (Queijo, 2010).”

So basically, the tendency to treat women by imprisonment, surgery, and what amounted to sexual abuse, has been replaced by a need to medicate us. By attributing our valid expression of emotion, and/or our physical and unrelated symptoms, to mental illness, doctors can feel comfortable either providing expensive drugs with lamentable side effects, or providing nothing at all.

I think – I hope – that we’ve moved on just a little bit from diagnoses of “imaginary female trouble” – but when I hear the words “hysterical pregnancy,” “hyperventilation,” and “anxiety disorder” being used as an excuse not to provide women with the medical care they seek, I really do wonder.

Image: Second half of “Reasons for Admission to the Trans-Allegheny Lunatic Asylum“ (of special note: “Women trouble,” “Desertion by Husband” and “Female disease.”)

EDIT:

After I shared this post, I found a few more relevant articles – and some of you sent me some, so thank you. A friend has suggested a project pulling together a paper on this topic, which would be based on statistics but also the massive amount of anecdotal evidence we both have – from experience, and from talking to others. So if you have any other relevant information or links, or would like to share your experience, you can email me (address is under the Media tab) or comment below.

When Doctors Discriminate. Are medical professionals biased against the mentally ill? This extremely well-referenced article seems to prove it so.

Iron Deficiency and Women’s Health – according to Dr Kate Clancy, women’s iron deficiency is so often blamed on their periods, that doctors don’t check for more serious causes, like internal bleeding. A study showed that 86% of women who were actually given an endoscopy after presenting with iron deficiency, actually had a gastrointestinal disease.

Sexism in Women’s Medical Care – This is an older study which has to be accessed via an academic database, but WOW. Here’s the intro:

I’d love to see today’s stats pitched against these – this was written in 1979. I know for a fact the stories haven’t changed, and women remain the biggest group of helathcare consumers. Does our “modern” Western medical profession reflect this? Or are our “serious, treatable problems” still progressing to “irreversible damage or death while a woman is trying to convince her doctor that her problems are not all in her head”?

As I said above, I’m hoping to do some more research around this topid. So do get in touch and share if you have anything to add.