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Misogyny In Medicine: Why Are Women’s Health Issues Ignored and Misdiagnosed In India?

Disha Bijolia

“Women are born with pain built in. It’s our physical destiny: period pains, sore boobs, childbirth, you know. We carry it within ourselves throughout our lives, men don’t. They have to seek it out, they invent all these gods and demons and things just so they can feel guilty about things, which is something we do very well on our own.”

Taken from Belinda’s monologue in the bar scene on Fleabag, a highly revered BBC show, these lines captured women’s pain so profoundly that the LA Times called it ‘The Best Three Minutes of TV Ever’. The scene's impact was due to its personal nature; straight from the mouth of a woman who is happy to finally go through menopause. The frustration and pain of living with a uterus are always brushed under the dismissive rug of 'natural' processes. Disasters also happen to be natural but that logic doesn’t seem to stop people from being compassionate with their victims. The argument is only used to undermine women’s suffering.

As if the wage gap wasn’t enough, women around the world are also dealing with the pain gap. Best explained in Anushay Hossain’s book, 'The Pain Gap: How Sexism and Racism in Healthcare Kill Women', the misogyny that has invaded the healthcare system often lets serious health issues in women go undiagnosed and ignored. Its origins lie in 1900 BCE when hysteria, a name derived from the Greek word, ‘hystera’ meaning uterus, was considered a psychological disorder that only afflicted women. It wasn’t removed as a medical diagnosis from the Diagnostic and Statistical Manual until 1980. Women in the 18th century had to undergo lobotomies for expressing emotions that society didn’t consider normal. This ignorance still remains in the medical community.

Female patients are continuously gaslighted about their physical and mental health. From menstrual and maternal care to cardiovascular diseases, more often than not women's symptoms are not taken seriously by healthcare professionals; whether it’s heart disease labeled as anxiety, an auto-immune disorder attributed to depression, or ovarian cysts chalked up to normal period pain. Despite the fact that 70% of chronic pain is experienced by women, nearly 80% of pain studies are conducted on males or on male mice. In one study, when medical students and clinicians saw videos of patients in chronic pain, they estimated women’s pain, on average, as lower than men’s — and were more likely to recommend psychological treatment to women and analgesics to men.

Recently there has been a rise in awareness about endometriosis across the internet. This has come as a result of years of misdiagnosis in women where symptoms of severe pain were brushed off as period cramps by doctors. Women suffering from this disease lead a troubled life due to severe pain, fatigue, backache, depression and anxiety. Left untreated, endometriosis can even cause infertility and increase the risk of certain cancers but this discovery has only come to light in the last few years which shows the harrowing state of healthcare information and resources available to women.

Cardiovascular diseases are another problem among women. The ignorance about it affects women with heart ailments in three ways: misdiagnosis, lack of awareness of the rising risks among young women, and inability to recognise the symptoms of heart attacks. In 2016, Sakshi Sudrik from Mumbai started experiencing a strange heaviness in her chest along with slight back pain. The neighbourhood doctor dismissed the symptoms and sent her home with pills for acidity. A few days later, Sakshi was rushed to the hospital after she started getting electric-like shocks in her arms during her evening walk. She was diagnosed with a 90% blockage in the coronary arteries. Timely surgery saved her from a heart attack. It makes you wonder if the situation would've been handled in the same way if it were a man in Sakhshi’s place.

There are evident gender disparities in cardiovascular diseases in India. A gender bias study led by Dr. Prafulla Kerkar says, “This could be related to the greater importance of the society to men's health such as a tendency to preferentially spend resources on men's health care who are usually the sole source of household income”. Such misogynistic narratives have become a dangerous threat to women’s health across the country. While it’s worse for women in rural regions, where stigma inhibits discourse and action on sexual and menstrual health, women in urban areas aren’t as educated as they should be either. This is partly due to lack of information but mostly because of patriarchal precedence to undermine their struggles because of their gender.

Apart from physical well-being, the toll women’s reproductive systems take on their mental health is also ignored. There are no support groups for women going through menopause. While women anticipate freedom from this monthly torture with excitement, society devalues a woman that cannot bear a child anymore. The trans community faces a whole other aspect of aggressions where their femininity is questioned. Our decisions to not go through pregnancy are ignored and undermined, and the effects of the relentless menstrual cycle on our mental health are misunderstood and made fun of.

It reflects in ignorant questions women are asked like “Is it that time of the month?” Although menstrual cycles are an annoying and stressful period of the month for a woman, this is not when we go through the hormonal mood swings men joke about. PMS literally means Pre-menstrual Syndrome. The fatigue, food cravings, tender breasts and mood swings happen weeks before the bleeding starts. Women know this. In our lowest times, we wonder if our lives are really that bad or if Aunt Flo is about to arrive. It has always vexed me how men miss such an obvious detail evident in the name of the condition itself.

At my physical a few years ago, I was denied a pap smear by a woman at the reception of my doctor's office. I still find it absurd. She told me pap smears are for married women only. Her ignorance caught me by surprise. A part of me wanted to be crude and inform her of my highly active sex life but I chose to walk away. I haven’t had a pap smear since, or rather, ever.

Women are really the brunt of everything; shame that makes us uncomfortable in talking about our sexual health and outright dismissal when we do. Our pain is ignored and used as a weapon against us. A typically Brown notion that I find highly misogynistic is that women are strong. Not because of our wills or ambitions, but just on the basis of our ability and expectation to shut up and endure suffering. The misdiagnoses and misinformation about our health symptoms are linked to our emotional state which would never happen for a man. The system we depend on is biased and untrained to actually help us. It’s diseased with misogyny and the only antidote is equality. When feminists protest for fair-pay and more opportunities for women, this is what we fight for; to disintegrate misogynistic beliefs and to allow women to hold professional spaces in medicine and healthcare so that our issues are finally understood and addressed.

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