Editorial
Ignored and dismissed, women raise voices against medical misogyny
Nine months ago, The Age published the first articles in an investigation into medical misogyny, exposing the shameful cost, damage and insults inflicted on women by the institutionalisation of treating one human differently whenever they sought care and treatment.
More than 2000 women have shared their disturbing encounters with the medical system as part of an investigation into medical misogyny.Credit: Marija Ercogovac
The ingrained systemic bias is individual-based, medical process-based and government-based, and our investigation prompted more than 2000 women to respond to a survey callout. There was a national outpouring of grief and frustration. Women described their feelings of being gaslit and dismissed, or being told their pain was “all in their heads”.
Today, we continue the series with a three-part investigation focusing on personal accounts of medical misogyny.
Among their stories, more than 50 women with debilitating iron deficiency or anaemia said they were treated as hypochondriacs or had their symptoms dismissed by healthcare professionals, while others have been incorrectly admitted to mental health wards or had cancer diagnoses missed.
Other women described their heavy menstrual bleeding being written off as a normal, untreatable part of womanhood, and experiencing damaging delays in investigating serious underlying causes of their low iron. Iron is an essential mineral for organ function, from carrying oxygen in red blood cells to supporting immune and brain health.
The stories are stark but the women, doctors and experts who have spoken out are not seeking to lay blame at the feet of clinicians but rather lay bare entrenched, structural problems disadvantaging women in a health system that historically evolved to reflect the needs of men.
For instance, systemic gender bias in healthcare systems can be traced back centuries, long before iron deficiency was believed to cause “hysteria” in women of the 16th century. But our investigation found some of Australia’s biggest pathology providers have for years set a significantly lower benchmark for what they consider “normal” iron stores in females compared with males, leaving a huge proportion of iron-deficient women undiagnosed and untreated.
As the haematologist and clinician researcher Professor Nada Hamad told our reporter: “The fact that there is a difference in what is considered iron-deficient between men and women is insane.”
“It’s sexist. There’s no way around it,” said one pathology service employee not authorised to speak publicly.
But shining a light on such outrageous inconsistencies can right egregious wrongs: our investigation prompted the laboratory heads of pathology providers to convene an emergency meeting, and those still upholding the practice gave assurances they would be overhauled.
But other anomalies continue unchecked. A storm is gathering over the brevity of GP visits that work against complex health problems, and some doctors say the Medicare system gives them insufficient time and funding to manage complex women’s healthcare issues. Further, a contentious debate is playing out in clinics, laboratories and medical journals between clinicians and researchers who are raising the alarm about untreated iron deficiency in women and their colleagues who don’t believe it’s an issue worth treating.
The reality is that 90 per cent of patients needing iron infusions are women and no Medicare subsidy exists, and private treatment can cost up to $700 a visit.
There is a pressing need for such treatment. Iron infusion is recognised as the most effective treatment for replenishing iron. But estimates suggest as many as 70 per cent of pregnant women in their third trimester are iron-deficient, while other studies have found up to 60 per cent of women with heavy menstrual bleeding have severe iron deficiency, and half have not seen a doctor about it. No underlying cause (such as polyps, fibroids, adenomyosis, or uterine or blood disorders) is found in about half of the cases investigated. Defined as excessive menstrual blood loss that interferes with the woman’s physical, emotional, social and/or material quality of life, occurring alone or with other symptoms, it affects about one in four women of reproductive age.
In response to questions, Federal Health Minister Mark Butler said he had asked the Medical Services Advisory Committee to look at a Medicare item for iron infusions in general practice. “The Albanese government is tackling sex and gender bias in the health system and improving health outcomes, particularly for women at greater risk of poor health,” Butler said in a statement.
Women have struggled through history to be treated as the equal of men. Everything has had to be fought for, from being allowed to vote to being allowed to take part in the workforce, and despite such reforms, we now see the blunt and brutal truth that medical misogyny is continuing to condemn half the population to poor treatment. That must change.
Our investigation and stories promoted wider awareness and hopefully created conditions for change. But the voices of women telling their stories of lived experience must surely hasten an end to the health system’s deeply embedded gender bias.
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