Two patients enter an emergency room, both experiencing chest pains and fearing that it may be a heart attack. One patient is evaluated immediately, and the other is told to wait a bit longer. Both patients were correct to self-diagnose a cardiac episode. While doctors treated the first patient promptly, they told the second patient that their symptoms were a sign of exhaustion or extreme stress. There is only one difference between these two patients: the first is male and the second is female. This hypothetical situation plays out in hospitals across the nation at an alarming rate, as female patients wait 29 percent longer than their male counterparts to be seen for chest pain.
It’s been a year since the Supreme Court overturned the landmark Roe v. Wade case that upheld the right to abortions, sending the U.S. into varying degrees of chaos as the legality of a woman’s autonomy was delegated to state-governing bodies. It’s also been a few weeks since the Food and Drug Administration (FDA) authorized a the first over-the-counter birth control pill. Norgestel alleviates concerns about access to reproductive care in the wake of last year’s Supreme Court decision. With so much unpredictability and confusion surrounding a woman’s status in the healthcare system, female patients are left wondering why their voice is muted in the first place.
It is important to note that this argument is just one small fraction of the discussion of inequities in the healthcare system. I am approaching my evaluation of hysteria from the perspective of a cisgender woman. The experiences of transgender and nonbinary folks with medical professionals are certainly relevant, and far more layered than what cisgender women face. While I recognize this facet of the topic, this article will focus solely on assigned female at birth, female-identifying patients.
The ancient Greeks were among the first to undermine a woman’s credibility in a medical context. The Greeks coined the term “hysteria” to diagnose any seemingly irrational behavior in women. The word itself is derived from the Greek for “uterus” (“hysteron”) because they attributed any condition to a wandering womb. This belief persisted in the medical field through the 20th century. It was as though women were helpless victims to their biology. Any abnormality in their physical or mental health was callously chalked up to their reproductive systems.
According to Dr. Stephanie McNally, an OB/GYN at Northwell Health, many caretakers still blame a woman’s health concerns on her hormones. Drastic fluctuations in emotion are patronizingly labeled as feminine mood swings when they may be signs of bipolar or depressive disorders. Headaches are assumed to be psychosomatic side effects of monthly premenstrual syndrome (PMS) when they could be warnings of neurological diseases like migraines or even brain tumors. Weight gain, fatigue and hot flashes are the supposed tell-tale signs of menopause, but they could also be harbingers of heart disease. The discernible pattern revealed here is the misuse of a woman’s anatomy as a scapegoat for medical problems, even if those problems might be indicative of something less convenient.
The question that arises is whether the consistent misdiagnoses are intentional gaslighting or simply a lack of understanding where proper treatment gets lost in communication between male doctors and their female patients. Over and over again, symptoms of genuine underlying health conditions are written off as a feminine overreaction to pain due to centuries of medical records stating that “the uterus was the “central deciding factor” of a woman’s health. Modern medical society likes to think that it has evolved so drastically from the uneducated cultures of the past. The truth is that “female hysteria” was still considered a legitimate psychological condition well into the 1980s.
As is the case with every feminist issue, the biases and unfair treatment are multiplied for women of color. A 2016 University of Virginia study found that half of white medical students were more likely to underestimate a Black patient’s pain level. Some doctors and nurses reveal their racial biases by assuming that a Black patient experiencing pain is faking it as an elaborate scheme to “score drugs.”
These beliefs are so pervasive that doctors doubted Serena Williams—yes, tennis legend and overall icon Serena Williams—when she expressed worry during the birth of her daughter. Williams, who has a history of blood clots and therefore knows the warning signs, alerted the nurses of her increasing distress, only for the nurse to tell her that her “pain medicine might be making her confused.” Unsurprisingly, she was correct about what was going on in her own body. But because she is a Black woman and faces double the stigma, Williams essentially had to save her own life by standing up for herself—something she never should have had to do in the first place. Doctors must believe women when they explain their alarming symptoms the first time, not after years of pleading. By then, irreversible damage may have been inflicted on the patient or, worse, they may not be alive to communicate their concerns anymore.
When most people hear the word “hysterical” in casual conversation, they probably don’t think twice about it. However, a closer look at the connotations surrounding the word and the targets of that label shed light on a pattern of weaponization. A woman’s reproductive biology and stereotypical emotions are ammunition for doctors to undercut the credibility of her own experience with pain.
While hysteria’s original function was a medical diagnosis, the word has since found broader avenues in which it can damage a woman’s reputation and likability, namely politics. A 2019 Georgetown University study discovered that one in eight people doubt a woman’s “emotional suitability” for politics. This is the kind of thinking that has enabled us to elect 46 men and zero women to lead our country. It all starts with the idea that having a uterus renders you unstable.
The solution to this problem might be easier than it seems. If doctors don’t know how to treat women, then they should study women. A shocking 80 percent of pain studies are conducted on male subjects. Women were only allowed to participate in clinical trials beginning in the 1990s. For centuries, healthcare institutions have based their evaluation of female patients on the anatomies and physiologies of men, and then have the audacity to act perplexed about fatal misdiagnoses. Luckily, though, the growing number of women involved in science and medicine provides a glimmer of hope that women’s needs will be better represented in spaces where they are too often neglected.
