Mélissa Godin and Alexis Doyle
We are raised to think that doctors know the solutions to all of our medical problems. We are taught to see doctors as objective individuals and medical science as a perfect practice. But like anything else, medical science has been shaped by patriarchal norms which has resulted in a sidelining of women’s medical problems and a disregard of women’s pain.
When young women go to the doctor, however, we are not always aware of these biases that are working against us. Not only does our gender and age influence how we are treated, but so does our race, religion, and class position. And yet many of us take doctor’s objectivity for granted, forgetting that they too carry prejudices that influence how they engage with the person sitting on their examination table.
In light of this, we’ve created a guide for young women about what they need to know when they go to the doctor.
You know your body better than anyone else
Adolescence is a time when you start becoming independent from your parents, transitioning away from them making decisions about your health to you making choices about your body.
Although you should have honest and open conversations with your parents about your health and wellbeing, it is important to remember that parents do not necessarily know what is best for your health.
For instance, many doctors have found that parents do not vaccinate their kids against HPV due to fears that this could incite sexual activity despite the fact that HPV is the leading cause of cervical cancer. Likewise, parents often resist putting their daughters on birth control for fear that this could encourage them to become sexual active.
When parents advise you on your health, they carry with them all the ways in which they have been conditioned to think about sex, physical and mental health as well as pain. While you should seek out their advice when you think it is appropriate, you should also do your own research on your health problems and needs. Although your parents may know you well, they do not necessarily know about your substance habits nor about your sex life. You know your body better than anyone else and should feel empowered to make decisions pertaining to your health and wellbeing.
You know your life circumstances better than anyone else, and these circumstances are always medically relevant
For many of us, our teenage years are the first time we seek out medical attention alone, without having our parents in the room. Although this presents an opportunity to raise health concerns that you may not want to discuss with your parents, many of us do not feel comfortable when we are sitting in an examination room with a doctor who is often more than twice our age.
Because women are still underrepresented as authorities in medical research and tend to be interrupted more frequently when they do occupy male-dominated spaces, it is understandable that you may feel less empowered to disagree with your doctor, ask questions, or even share an important part of your medical situation in the first place.
It is important, however, to feel agency in sharing components of your life circumstances that you feel are important to the medical situation at hand.
When it comes to your health, you are, first and foremost, the greatest expert in any medical exam room. Critical components of your life circumstances–ranging from your relationship with others to your cultural context to stressors in your life–cannot be uncovered by medical tests or expertise despite often being critically relevant to your medical situation.
Often times, we do not think that things like bullying, racism, or sexism influence our health and wellbeing. Numerous studies, however, tell us that these life experiences are relevant to our health. A U.S study of 1574 Baltimore residents, for instance, found that those who had experienced racism had higher blood pressure and were more likely to experience kidney failure.
While it is completely normal to feel that there is a power imbalance when you step into a doctor’s office, your role is never confined to that of a listener. Rather, your time with a doctor should be as participatory to the extent that you feel comfortable, fully seen, and fully heard in the complexity that defines each of our lives as women.
Sharing your perspective on your health, informed by your life circumstances and experiences, will help you get the best care you deserve. If you feel that your doctor is not receiving this information with concern and respect, it is completely okay to voice this, by simply saying “I’m worried we are not communicating well. I feel this way because of X. Could we revisit Y?”
Women’s pain and health is under researched and is not a research priority
When entering a doctor’s office, many of us do not know that the current state of medical research and practice is tragically deficient in the arena of women’s health.
In her book, “Doing Harm,” author Maya Dusenbery writes critically of the alarming lack of research in women’s health within the medical establishment. She discusses how medicine as an institution has continued to marginalize topics of research specific to women, in addition to persisting with samples not representative across the axes of gender, race, and class.
In the U.S., it was not until the year 1993 that a law was passed that made it a requirement that women are included in NIH-funded research. Additionally, it was in this same law that it became a legal requirement for minority representation in the body of NIH-funded research. As a result, the body of medical research informing medical training and practice worldwide is massively biased–resulting in a problematic lack of data on medical phenomena specific to or experienced differently by women and other people whose identities differ from caucasian males.
Unfortunately, a study conducted in 2015 found that clinical trials in the U.S. today persist in their lack of representation of the current diversity of America. This means that doctors sometimes lack information and training about women and other minority groups’ health.
It also means that men’s health problems continue to receive more funding and research attention than women’s health issues. For instance, five times as many studies are conducted on erectile dysfunction (ED) than on premenstrual syndrome (PMS) despite the fact that only 19 percent of men experience ED while 90 percent of women experience PMS. Likewise, women health problems such as endometriosis continue to be under researched and underdiagnosed. Historically speaking, medical research in the realm of obstetrics & gynecology (OB/GYN) has been significantly underfunded, even among countries like the United States, which has a relatively high public budget for medical research and the NIH–the largest public funder of biomedical research worldwide.
As a result, the medical establishment and possibly by extension, your doctor, has a limited understanding about women specific health problems: the medical establishment is not always prepared to tackle health issues that women may face over the duration of their lives. This includes contraception, premenstrual syndrome, sexually-transmitted infection prevention, safe birthing, menopause, and female-specific cancers such as ovarian and cervical cancer which demand more study and discussion.
When consulting your doctor, you should bear in mind the limitations of medical science in the arena of women’s health.
Remember that medical solutions are not necessarily bulletproof, especially for women whose health has received less attention within medical research. It may take some experimenting with different treatment strategies before finding one that is right for you. This is particularly true of birth control or antidepressants which women respond to differently.
Being confident in your own expertise and being informed about the persisting imbalances in medical care across genders and other intersectional aspects of identity is important not only for your time in the doctor’s office, but also in your life beyond the doctor’s office in which you pursue your goals of well-being.
Women’s pain is systematically marginalized and underestimated
Women often have patronizing experiences within the medical establishment, due to the belief that women have lower pain thresholds than men.
In Lucia Osborne-Crowley’s article, “‘Doctors thought I was exaggerating, lying or just weak’: Endometriosis & the politics of female pain” she discusses that for years she suffered from extreme pain due to undiagnosed endometriosis but her doctors did not believe her.
Unfortunately, Osborne-Crowley’s experience is not unique: studies have found that women wait significantly longer to receive analgesic medication in hospital settings when they report pain, as compared to men. Women also wait longer to receive critical diagnoses, especially for autoimmune disease, which is significantly more common among women than men. These delays in acknowledgement of pain and diagnoses are experienced even more substantially by women of color and economically disadvantaged women. As a result, women report that they are taken more seriously when they attend their medical appointments accompanied by a man.
When entering a doctor’s office, it is important to remember that you
know how much pain you are in. Although some doctors may question your pain, asking questions such as “is it really that bad?” you are the only one who knows how you are feeling. Do not be afraid to speak up, reiterating your symptoms and demanding that they be taken seriously.
What we should remember
Navigating medical spaces is tricky and endlessly frustrating for women, particular for women of colour as well as transgender, economically marginalized, or disabled women.
Understanding how far the medical establishment–and our culture at large–has to go regarding women’s health is important for every young woman to know. A doctor’s office does not exist outside the parameters of patriarchy. It is embedded within it. Although your health is inherently personal, it is also necessarily political.
Mélissa Godin and Alexis Doyle are currently both Rhodes Scholars at Oxford University. Godin is a freelance journalist focussing on gender and I’ve been published in Teen Vogue, TIME Magazine, the San Francisco Chronicle, and the Chicago Tribune. Alexis is an upcoming Knight Henessey scholar and is due to commence medical school later this year. Doyle has a Masters in Medical Anthropology and is currently completing a Masters in Public Policy. She focusses on women’s health issues and will be working in Jackson, Mississippi implementing a reproductive health program for the state.