A weekend roundup of sexism in women’s health
Thursday 18 October was World Menopause Day, and I’m very grateful to this week’s guest bloggers, Katie and Jane, for giving an insight into the sexism and stigma that surround women’s health issues during the perimenopause and post-menopausal years.
Make Menopause Matter
Also this week, psychotherapist and menopause expert Diane Danzebrink launched a brilliant new campaign, #MakeMenopauseMatter, calling on the Minister for Women and Equalities, and the Ministers for Health, Work, and Education, to “make comprehensive menopause training a compulsory part of GP education and to expand menopause services throughout the UK.” You can sign Diane’s petition here.
As Diane herself writes:
The result of this lack of education is that far too many women are left to endure menopause symptoms and the long term health effects of falling hormone levels. Women are regularly being misdiagnosed as depressed and prescribed antidepressants when they are in fact perimenopausal. Far too many women are being forced to fund private consultations to access treatment that should be readily available to them via their GP practice.
Many women who experience an early or premature menopause are told they are too young to be menopausal, others are denied first line treatment when they are told they are too old or ineligible due to their lifestyle or health. Those women with complex cases are enduring lengthy waiting lists due to a chronic lack of NHS menopause specialist clinics throughout the UK.
This lack of education and awareness is costing women their health and wellbeing, but it is also costing the NHS. Many women seek repeated appointments with their GPs to attempt to address a host of common menopause symptoms including joint pain, palpitations and anxiety. These women are often incorrectly referred on to secondary care incurring further distress for the individual and further cost for the NHS. Better education and implementation of the 2015 NICE guidelines would result in quicker diagnosis and treatment for women and savings for the NHS.
Women told they’re ‘not thin enough’ for eating disorder treatment
In other news this week, MP Wera Hobhouse told MPs about the following email from her constituent, Lorna, who experienced serious anorexia while studying in Bath:
“My mum was terrified, and didn’t know what to do. Eventually she came with me to my GP and I told him everything. I told him I was petrified of putting on weight, exercising excessively and skipping nearly every meal. His response was ‘Oh, that’ll be your antidepressants.’ He took me off a high dose, there and then. Cold turkey.
Each time, I told him how out of control I felt with my eating. He’d force me onto the scales, shaking and crying, and then tell me my BMI was ‘healthy’ and I didn’t meet the diagnostic criteria. I was devastated. I had opened up and was denied help. I never got diagnosed with anorexia, despite going from a size 16 to a size 8 in less than a year.
I went through the monthly humiliation of being dragged onto scales and told I wasn’t thin enough to be helped yet. And not having that formal diagnosis is hard. When I tell people I was anorexic, they never quite believe me, as even doctors didn’t. I think they always assume I was being dramatic, or ‘it wasn’t that bad then’. Today, I am weight-restored, although struggle with now being overweight.
It took me 3 years to recover. 3 years of misery and obsession. I was dangerously unwell, but not sick enough to get an ounce of support.”
During a Westminster Hall debate on the subject, Hobhouse added: “We cannot ignore the medical failings in Lorna’s story. We need to use them and the figures that prove that Lorna’s experience is not an isolated case… Hope Virgo’s campaign to “Dump the Scales” was also a response to being told that she was not thin enough to receive support. She is calling on the Government properly to implement the eating disorder guidance delivered by clinicians, a call that I strongly echo, along with over 60,000 signatories to her petition.”
From mammograms to nappies: disabled women’s healthcare is a national disgrace
Writing for The Guardian, Frances Ryan explores how: “disabled women in the UK and US are routinely excluded from basic healthcare.
Cancer Research UK last year found that disabled women are a third less likely to participate in screenings for breast cancer than non-disabled women, due to many reasons including lack of accessible transport and the fact that wheelchairs can’t reach the traditional mammogram machines.
We miss out on smear tests for similar reasons – and it can be hard even to get contraception from your GP if you are disabled. This is partly because cultural prejudice means some medical staff still assume disabled women do not have sex or relationships. This month it emerged that thousands of autistic women in the UK are missing out on diagnosis due to gender bias, taking a stark toll on their mental health.
Austerity measures are making access to healthcare even harder, particularly cuts to social care. I have spoken to a number of women with disabilities in recent years whose local councils have suggested they take medication to stop their period or wear adult nappies rather than providing a personal assistant to help them regularly wash and get to the toilet.
Ryan concludes: “This is inhumane, but it is rarely talked about. Whether it is British awkwardness or a wish for privacy, many of us are typically uncomfortable discussing personal healthcare – something that is only increased by sexism that wants to hush away period blood, and ableism that too often ignores disabled lives.”
Autism – why women are under the radar
As Ryan pointed out, the Daily Mail reports that up to 200,000 women and girls in the UK may be living with undiagnosed autism, simply because “most of the research, such as which traits to look out for, has been on men.” Writing for the Daily Mail’s You magazine, Dr Claire Bailey says:
Difficulty communicating, rigid behaviour, narrow interests and being easily overwhelmed by sensations are typical experiences of people with autism spectrum disorder (ASD), but the ‘male’ presentation of the condition is the one we most commonly hear about… Autistic females often don’t fit this picture and, because of that, have been massively overlooked… Unlike men, they are more likely to study ‘normal’ behaviour and mimic it, to avoid being seen as ‘rude’. And being less likely than boys to act out, they tend to be anxious and withdrawn, so don’t get noticed.
Current understanding of autism estimates that it is ten times as likely to affect men than women – but recent research suggests the ratio of men to women with autism is more like 3:1 or even 2:1. And, Dr Bailey adds: “Francesca Happé, a leading professor at King’s College London, has warned that failure to spot the condition in women is taking a stark toll on their mental health.”
Globally: Fighting for women’s health
For a more global perspective, The Conversation: Fighting for women’s health from the BBC’s World Service is well worth a listen.
Two female doctors talk to Kim Chakanetsa about the issues they face in two starkly different places – Somalia and the United States.
Paula Johnson is an American cardiologist who has dedicated her whole career to thinking about health from a woman’s perspective, focusing on the different ways men and women respond to diseases. When Paula learnt that medical research and trials traditionally were only tested on men, she decided she had to fight for the inclusion of women. Paula believes the lack of testing on women, combined with sex differences, can lead to women not receiving effective diagnosis and treatment. Paula thinks that we should be focusing on women’s health and well-being as central to women’s equality.
Deqo Mohamed is a Somali doctor who helps run a 400-bed hospital in a refugee camp west of Mogadishu. It was her mother, the pioneering doctor Hawa Abdi, who opened a small clinic in the 1980s, which became a shelter for thousands of displaced people, the majority of them women and children. Today Deqo oversees a hospital, primary school and women’s education centre. She says she prioritises women’s health because her female patients are often singly caring for their whole family. Deqo believes her gender helps her to connect with her female patients and negotiate with warlords.