Somewhere between yesterday and today, I came across a single statement. Bolded and underlined, the phrase rang clear in the air. A revelation of sorts, finally acknowledging the experiences of modern-day women and their pain throughout the timeline of healthcare.
The sentence read: study finds women experience chronic pain much longer than men.
The study, conducted in 2008, investigated the intertwining worlds of sex, gender and pain, alongside their influence on clinical treatment and diagnosis. In evaluating the management of acute abdominal pain within adults, the study found that women were less likely to receive analgesia and opiates in comparison to men. Along the lines of such trends, the study also disclosed a stark contrast: women waited sixty-five minutes for every forty-nine spent by men in effort to receive adequate and appropriate care, in this case, analgesia.
This work of literature does not stand alone – such findings are supplemented by the diverse voices of countless women. In her memoir, Ask Me About My Uterus, Abby Norman details a similar journey, describing her youth and adulthood as periods plagued by physical disability, impaired functionality, year-after-year of additive treatments and “so-called” solutions – none of which bringing the resolution of relief. This is the experience of some women today. The experience of feeling overlooked, something short of a ghost caught between worlds, always existing in a constant state of searching for answers, for hope, for affirmation. Yet consistently receiving none.
In their path to pain management, these women faced the doubts and skepticism of physician attitudes and trying appointments. A string of conversations, which while varied in words and structure, all begin and end at the same place – synonyms, really, of parameters which corner them in, to make them feel unheard. To make them believe that their reports of pain do not stem from the roots of verity, that this too is a figment of their overheated imagination, or rather, an innate physiological response making them “too sensitive”.
“You’re overthinking it.” As though the only biological reality is that of men and their stresses.
“Have you tried birth control?” As though the health and wellbeing of women falls strictly within the borders of reproductive anatomy.
“A lot of women feel this way.” As though this challenge does not exist once applied to all women.
Unsurprisingly, these phrases and trends paint parallels harshly similar to the ‘World of Women Past’. Stigma and the refusal to recognize women’s pain are themes which date back as far as fifth century B.C., where the use of the term ‘hysteria’ was first coined by Hippocrates. He argued, that unlike epilepsy, which is experienced by men as a disorder of the brain, hysteria manifests in women as female madness. The root cause: a restless and migratory uterus with a predisposition to sickness, especially if deprived of sexual and reproductive desires. Without the widening of the vaginal canal, he argued, toxic fumes can not escape and instead wander throughout the female body eliciting anxiety, tremors, convulsions and paralysis. With the use of this term, began a clockwork of events, manifesting era after era, functioning to deprive women in seeking recognition, affirmation and empowerment for their pain.
In second century A.D., Rome, Claudius Galen’s theories on hysteria were deeply similar to those of Hippocrates. He discouraged sexual abstinence, and prescribes procreation as means of treatment for women’s suffering. Such beliefs prevailed in the Middle Ages where many treatises of the time characterized women as ‘causes’ of their disease, rather than patients. From the 13th century onwards, hysteria began to serve a political role. In unifying Europe under the rule of the Church, mental illnesses and ill-health were increasingly linked to women and sin. Women’s suffering continued to be unacknowledged, and practicing physicians of the time, increasingly linked etiology of disease to illness obtained through the devil. Hysteria, in essence, was thought to only manifest in women – through which the devil stripped women of their forgiving and rationale nature, urging them to commit suicide. Women, especially “hysterical women”, were increasingly punished through exorcisms – a practice which propagated the idea of the ‘woman-witch’, demonological visions whose hysteria was a tell-tale sign of sorcery. Throughout the Renaissance, hysteria was primarily viewed as a mark of femininity.
In the early sixteenth century, physician Thomas Willis proposed a new cause of disease. He argued that perhaps an analysis of the brain and the nervous system, rather than the uterus, was central to understanding hysteria. The implications of such proposals did not influence popular public thought. Within the village of Salem, mental illness in young women was still viewed as ‘hysteria’ and a sign of ‘pacts’ with the devil, a belief which fostered the occurrence of several witch trials. In the eighteenth century, hysteria became gradually associated with the brain prompting physicians to reconsider the etiology and manifestations of the ‘disease’ to one not solely exclusive to women.
In the Victorian Era, the Hippocratic philosophy continued to prevail. Women were encouraged to carry smelling salts on their person. According to Greek philosophies, these salts protected the wandering womb from odour, encouraging it’s return to its ‘original’ place and thus, reinstating consciousness in the ‘hysterical’ woman. Contrary to the perception of mental health, physical maladies, within the Victorian Era, were deeply romanticized, placing great value in female sickness. For instance, attributes of tuberculosis such as thin-body, white pallor and flushed cheeks.
In exploring the perception of women’s pain throughout healthcare, both within the constructs of mental and physical health, it is important to recognize the implications such beliefs hold in accessing adequate care. Such historical trajectories highlight that perhaps modern-day disparities in experience and treatment stem not just from the fact that women have been historically encultured to recognize pain and unease as a natural state of being in efforts to protect social status, social perception of self, self-dignity and their right to optimal quality of life – but also from the enculturation of society to undermine women’s suffering and above all, to view women’s pain from a framework solely based on anatomical difference and gendered stereotypes.