Hormonal Hierarchy: Sexism & Racism in Women's Health

Pc: @wearproclaim

In the Hormonal Hierarchy Series, we explore women’s health in America and how the care of our bodies has been, in many ways, put on the back burner. We look at the history of how we got here, what it looks like to be both a woman and a woman of color today and how we can come together to effect change for an empowered, united women’s health future. In Part 1, we look at the State of Women's Health today and the historical disparities that still prevail, and Part 2 takes a look at both sexism and racism in women’s health. Look out for our event recap for the 3rd installment of this series.

We’ve talked about the verifiable difference in the approaches to women’s vs men’s health, and this Part 2 in the Hormonal Hierarchy series explores how these systemic biases have affected the overall state of our healthcare climate and how we can take part in addressing—and combating—the inequalities. Specifically, sexism and racism have been, and still are, prevalent forces against those deemed minorities receiving equitable access to treatment and care. 

Historically | Being non-man or non-white was a medical non-starter.

Sexism in women’s health is, unfortunately, a tale as old as time. Throughout Western medicine, most women’s health issues were classified as “hysteria” with a variety of sexist (and non-research based) interventions recommended, like getting married or the classic being told to calm down. We’re offended too. This dates back thousands of years, from ancient Greek times to formal European medicine to American gynecology. Research shows that, when it came to women’s health issues, there existed a “trust gap,” an implication that their physical symptoms were all in their heads for the sake of attention. Women were often offered antidepressants in lieu of medical experts getting to the bottom of their actual physical symptoms.

These dismissive practices are woven into the history of American gynecology. The slave trade provided American gynecologists with ‘ample bodies’ to perform experimental surgeries and document ‘learnings’ that propelled the field ahead of their European counterparts. Physicians like J. Marion Sims, known as the “father of modern gynecology,” conducted experimental surgeries, without anesthesia, on slave women over and over to perfect his techniques. How could we attribute fatherhood to someone clearly throwing away women’s bodies for the sake of his acclaim? The unattributed contributions of Black and immigrant women to the field that was allegedly built to address their gender’s health issues are staggering. We can thank changemakers like Dr. Deirdre Cooper Owens’ and her book, Medical Bondage, which now gives credit to the subjects’ role in the gynecological advancements we have today.

As advancements were made in the U.S., in the 80's and 90's women were excluded from clinical trials, with treatments for women’s health issues tested on men. Yes, you read that right. This notion, that for decades, the one-size-fits-all in medical trials was “specifically a seventy-kilogram white man, [meant that] women of childbearing age were largely excluded from clinical research, particularly drug studies, altogether.” It also meant that women of color, especially Black women, were even more underrepresented and, with the persistence of privately run trials with internally curated samplings, continue to be so.

Currently | The legacy of bias has left a disparity in modern-day women’s health.

The effects of the aforementioned historical bias in research have led to modern statistics on diseases and conditions being highly prevalent for women, especially Black women. The inherited trauma from slavery runs very prevalently within healthcare. Research shows that “middle-aged African American women are found to be nearly 8 years biologically older than white women, [a finding that] appears to be related to biological alterations caused by environmental exposure to stress and trauma over the life course. Thus, African American women are at an increased risk for negative health outcomes via inheriting such risk from previous generations.”

 Research disparities among diseases highly prevalent in women abound. Women today are 2x more likely to get diagnosed with anxiety and depression and are 250% more likely to be prescribed antidepressants than men. And while cardiovascular disease is the number 1 killer of women, only 33% of cardiovascular clinical trial subjects are female. In addition to the list for all women, Black women are less likely to be prescribed pain medications, are at a higher risk of pregnancy complications, pelvic pain, fibroids, and endometriosis. In a recent study on advanced cervical cancer, only 44.3% of patients received ‘standard of care’ treatment, and those who did not were more likely to be Black. Women, and especially women of color, are being left out of conversations about health and put in danger of serious and even fatal health risks. 

Moving forward | Conversation and Awareness Can Spark Change

We need to educate ourselves on how best to use our privilege to shine a light on this conversation and influence actions for change. Change means that everyone gets the opportunity to live long, abundant lives, without fear that their health issues won’t be taken seriously. It means equitable access to treatment and care. It means not having to fight sexism or racism in the fight for our healthy lives.

Though there’s undoubtedly much work to be done in women’s healthcare, we are proud to collaborate with the Black Women’s Health Imperative to spread more awareness and action to address these inequalities. As the first national nonprofit organization dedicated to protecting and advancing the health and wellness of Black women and girls, we hope commitments like these will change the course of health and wellness for all. We’d love you to join us July 14 for a discussion we’re co-hosting with BWHI to address how we can all make sure that Black and women of color are represented in medical research and can advocate for ourselves when it comes to our health. 

Missed the talk? Join us on Instagram as we will post highlights - and please donate to the BWHI to continue the fight for reproductive justice.

This article was reviewed by Dr. Jessica Ritch.

Dr. Jessica Ritch is a board-certified and fellowship-trained minimally invasive gynecologist who specializes in the management of benign gynecologic conditions such as abnormal bleeding, pelvic pain, fibroids, endometriosis, and polycystic ovarian syndrome. She completed residency training in obstetrics and gynecology at Columbia University, where she was selected as chief resident and received the prestigious AAGL Outstanding Resident in Minimally Invasive Gynecology award.