“Are you sure you’re not just getting your period?”: The History of Gendered Medical Bias
Last Halloween, my partner and I drove from Nebraska to Illinois to see our friends for the week. I had recently had my gallbladder removed and was newly diagnosed with a relatively severe food allergy. The United States was still in the peak of the Covid-19 pandemic, and I was thrilled to get a change of scenery and create a new “bubble” for a few days. So thrilled, in fact, that I slipped on my new, strict diet and ate something I wasn’t supposed to. I didn’t think too much of it until the next morning when there was the clear symptom that everyone knows isn’t a good sign: blood. I had to leave my friends and get taken to the emergency room, where I waited for hours and had my arm painfully poked and prodded to get an IV into my stubborn veins, just for the doctor to ask me: “Are you sure you’re not just getting your period?”
I am far from the first person with a uterus to be asked this question by a medical provider. As Caroline Reilly writes: “In the ER we’re asked, ‘Are you sure it’s not that time of the month?’ When we complain to our parents, or peers, or doctors that our cramps are debilitating, we’re handed painkillers and heating pads but rarely answers. We’re told that periods are supposed to hurt. We’re told that symptoms like nausea, headaches, and debilitating abdominal pain are all just part of the ride. We’re told that everything looks ‘normal.’” As Reilly makes clear, the medical system’s tendency to blame any pain on the reproductive system does not mean that relief will be given. Instead, it is an easy way to write off pain: these things are “supposed” to hurt – that’s just the way it is.
Taking a look at the history of medicine shows us how this came to be, “just the way it is.” In her piece, “Natural Facts: A Historical Perspective on Science and Sexuality,” Ludmilla Jordanova argues that medical literature from the Enlightenment forward is central to common conceptions of both gender roles and sexuality. As Jordanova explains throughout the piece, medical literature “employed a language fraught with sexual metaphor, and systematically examined the natural facts of sexuality” (158). Within these metaphors, the dichotomies of man/woman and culture/nature were also at play. She writes that these sexual metaphors that medical literature used “were clearly expressed in designating nature as a woman to be unveiled, unclothed and penetrated by masculine science” (158).
Jordanova’s most interesting example of the sexualization of medicine is her description of a German drawing (included above), “The dissection of a young, beautiful woman directed by J. Ch. G. Lucae (1814-1885) in order to determine the ideal female proportions,” made in 1864 by J.H. Hasselhorst. As Jordanova describes it: "A group of men stand around the table on which a female corpse is lying. She has long hair and well-defined breasts. One of the men has begun the dissection and is working on her thorax. He is holding up a sheet of skin, the part which covers her breast, as if it were a thin article of clothing so delicate and fine is its texture. The corpse is being undressed scientifically, the constituent parts of the body are being displayed for scrutiny and analysis" (165). While this is an apt description of the piece for Jordanova’s purposes, I think she interestingly leaves out a few important aspects of it. For example, the lighting hits the woman in a way that makes her look angelic – it almost acts as a halo around her. Additionally, there is evidence throughout the image that she is not the first, and probably not the last woman that these men would dissect in this way. There is a skeleton of a woman in the left background (significantly only shown from the pelvis down), and there are skulls lining a shelf in the right side of the background. Finally, Jordanova does not mention the seeming desire in each of these men’s eyes and glances. All of their gazes go directly to the woman’s breasts, and although she has a cloth on top of her, it only covers her legs and none of the more “private” parts of her body. All of this additional information only adds to Jordanova’s overall argument: “It is almost as if women in their sexually stereotyped roles were made kin to all living objects brought under the penetrating enquiry of male reason” (165).
Jordanova’s discussion of medicine as it connects to gender and sexuality connects to Barbara Ehrenreich and Deirdre English’s book For Her Own Good: Two Centuries of the Experts’ Advice to Women, originally published in 1978, but then revised and republished in 2005. Ehrenreich and English explain that in the nineteenth century this conflation of sexuality and medicine was completely tied up in “The Woman Question,” and that “[w]oman’s body, with its autonomous rhythms and generative possibilities, appears to the masculinist vision as a ‘frontier,’ another part of the natural world to be explored and mined” (23).
What Ehrenreich and English also make clear in their work, which Jordanova does not mention, are the real, tangible effects that this medical ideology had on women. They describe the “dictatorship of the ovaries” that nineteenth century doctors believed in: “According to this ‘psychology of the ovary’ woman’s entire personality was directed by the ovaries, and any abnormalities, from irritability to insanity, could be traced to some ovarian disease. Dr. Bliss added, with unbecoming spitefulness, that ‘the influence of the ovaries over the mind is displayed in woman’s artfulness and dissimulation’” (133). The connection between female sickness and reproductive organs led to an onslaught of unnecessary medical procedures, such as sticking leeches onto women’s cervixes, injecting milk into the uterus, and cauterizing the cervix (135-6). The most popular “solution” to these female medical problems, though, was removal of the ovaries: “The most common form of surgical intervention in the female personality was ovariotomy, removal of the ovaries – or ‘female castration.’ In 1906 a leading gynecological surgeon estimated that there were 150,000 women in the United States who had lost their ovaries under the knife” (136). Clearly, this ideology had effects not only on perceptions of women’s sexualities, but also on their physical bodies.
This history is in the air every time a woman enters a doctor’s office. Even in 2021, stereotypes and misinformation about women’s bodies which stem from the nineteenth century and earlier cause women to be misdiagnosed and not believed. About an hour after they finally got the IV to stay in my arm, they took it out again without administering anything. We didn’t know what was happening, but it wasn’t “bad enough” to do any testing. They sent me home in pain and bleeding. Part of my experience is of course colored by the fact that I was being seen at a packed hospital at the height of a global pandemic, but even outside of those circumstances, women are treated like this every day in hospitals across the world. And that is only accounting for the women privileged enough to seek medical care. We need to grapple with the sexist, racist, classist, and homophobic medical system in order to ensure that all people receive the care that they deserve.
Citations not linked
Ehrenreich, Barbara and Deirdre English. For Her Own Good: Two Centuries of the Expert's Advice to Women. 1978. Anchor Books, 2005.
Jordanova, Ludmilla. "Natural Facts: A Historical Perspective on Science and Sexuality." Feminist Theory and the Body, edited by Janet Price and Margaret Shildrick. Routledge, 1999, pp. 157-68.