Notes on medical misogyny

There is a particular kind of exhaustion that comes from being right.

Not the satisfaction of it. The exhaustion of it. The weight of having to prove, repeatedly, to people with medical degrees and institutional authority, that something is wrong. And that wrong thing deserves to be made right.

I have daughters. They menstruate. One of my daughters has been unwell in a way that is specific to having a female body, and the medical system’s response to that unwellness has been a masterclass in exactly the kind of dismissal that women have been navigating in healthcare for generations.

I want to talk about what I learned in the hours I spent in waiting rooms and ERs and on hold with clinics. Not specifically her story. Or mine. Ours. The one that belongs to female bodies. The one that belongs to every mother who has ever been made to feel like she was overreacting.

The first thing I learned in this phase of being a mother to menstruating children, is that “within normal” is doing a lot of heavy lifting in women’s medicine.

Normal has a range. And there are providers who will find you anywhere in that range and call it fine. What they mean is, you’re not dying. What you mean is, I’m not okay. Those are different things and the gulf between them is where a lot of women and girls live for a very long time.

I watched my child be told, in various ways, to wait. To manage. To come back when things are worse. I kept thinking, if this blood were coming from anywhere else on her body, we would not be having this conversation. The source of the bleeding was the only thing that made it negotiable.

The second thing I learned is that advocacy is a privilege.

I have a background in how to ask questions that are hard to deflect. I know how to say “please document that in her chart” and watch a room shift. I understand enough of the science to know the names of the tests I want and the clinical reasoning behind them. I know not to cry until I am in the car.

Not everyone knows those things. Not everyone has the time, or the language, or background, or the confidence, or the privilege, or the stubborn refusal to be unwilling to leave.

My child got better care because of who I am. That should not be true. It should not matter whether her mother is educated or grew up knowing how to talk to doctors.

The care should be the care.

But it is not. And pretending otherwise helps no one.

The third thing I learned is that my child was watching everything.

She watched me go back to the nursing station at midnight, calmly, for the fourth time. She watched me name what I was seeing without flinching. She watched me stay when they suggested I leave. She watched me use words like “please document that refusal” and “I would like to speak with the charge nurse.”

I do not know yet what she will do with what she saw. She is a child and she is tired and she mostly just wants to be a kid. She is not ready to be an advocate for anything except her own right to rest and comfort in her body.

But I think she knows now, in her body, that her body is worth advocating for. That her pain has clinical language and that clinical language has power. That she is allowed to stay in the room.

I think about all the girls who do not have someone to stay in the room with them. The ones whose mothers did not know the words or were not allowed in at all. The ones who were handed a pad and told to come back when it was worse.

I think about how old this story is.

Periods have been embarrassing for so long that we have forgotten to be angry about it.

There is a long history of menstruation being treated as a private inconvenience rather than a medical reality. Something to manage quietly. Something to not bring up at dinner.

I sat in that ER and I felt all of that history pressing down on me. The accumulated weight of every woman who was told she was being dramatic. Every girl who was handed a pamphlet and sent home. Every mother who was made to feel like she was the problem for not accepting it.

I was not dramatic. My daughter was not dramatic. We were just tired of waiting for a system to catch up to what our bodies already knew.

The last thing I learned is that this is not over.

We have an appointment in a few weeks, a working hypothesis and a partial treatment plan and a lot of questions that still need answers. We have good days and bad days and days when she just wants to sleep in my bed because she is still a child. She is exhausted and she should not have to be this tired.

We are going to be okay. I believe that.

But I am writing this down because I do not want to forget what it felt like to be in that waiting room at midnight, watching my daughter lie quietly and cope, knowing that her composure was being mistaken for stability. Knowing that the average person doesn’t see the bias about where the blood is coming from.

She was not stable. She was just ours. Handling it the way we handle things as a family. As calmly and logically as we can.

I am writing this down for the next mother in that waiting room. The one who does not have the words yet. The one who is wondering if she is overreacting.

You are not overreacting. Go back to the desk. Ask for the charge nurse. Ask them to document the refusal.

Stay in the room.

So how can I sum this up, and what I have learned about what medicine actually says about female bodies.

It says that anemia, transfusion, and hospitalization can be avoided with prompt recognition and treatment.1 It says that one in three girls who end up in hospital with heavy menstrual bleeding have an underlying, diagnosable condition.2 It says that girls are routinely under-screened and that the default assumption is always hormonal, always anovulatory, always something to wait out. It says the average delay to diagnosis for women with bleeding disorders has historically been sixteen years.3

Sixteen years.

THAT is not a normal. That is a generation of women being handed a pad and told to come back when they’re near death or happen to meet a medical professional not jaded by the misogyny in the system.

My daughter is not going to wait sixteen years. I am not going to let her. Not because I have some special power to fix the system, but because I have learned enough of its language to refuse to accept its defaults as her fate.

What I keep thinking about is the girls whose mothers don’t know the words yet. The ones who are in year three or year seven or year twelve of being told this is just how it is. The ones who have started to believe those words.

It is not just how it is. It is how it has been allowed to be. Those are very different things.