The words used in the Scally report to describe the treatment of women in the cervical smear scandal come as little surprise to many women who have experienced the healthcare system in Ireland. The report reflects a sexist culture which dismisses women’s voices, as well as an institutionalised misogyny which is unthinkingly reckless with women’s health and women’s lives.
This casual sexism and institutional misogyny is nothing new to us in this country – remember what Brigid McCole and others had to go through to get justice during the Hepatitis C debacle, or the women who had to fight so hard to get justice in the Neary scandal. Remember also the hundreds of women who had symphysiotomies performed on them, without full, informed consent.
Issues with the diagnosis and treatment of endometriosis continue to be problematic within our healthcare system. The stories of how women diagnosed with fatal foetal abnormalities during pregnancy were treated by our health system are well known, their experiences having formed such an important part of the 2018 campaign to repeal the Eighth Amendment.
In 2018, American writer, Abby Norman, published a book entitled Ask Me About My Uterus; A Quest to Make Doctors Believe in Women's Pain. In this well-written pain memoir, Norman, who suffers from endometriosis, describes how difficult it was to get doctors to listen to her. In interviews she spoke not just about sexist doctors, but about the "layers of science and historical precedent that are not just within the healthcare system but in the society around it", all set up to ignore and dismiss women's voices.
Dangerous ethos
This type of sexist, patriarchal ethos is dangerous, not just for women, but for all who are not the archetypal patient, that archetype being male, white and middle class. Within this patriarchal system, misogyny was, and is, often accompanied by institutional racism, homophobia, transphobia, classism and, sometimes, sectarianism.
We need only look back at the 1980s Aids crisis to see how homophobia killed thousands of gay men. It was only after long, hard-fought campaigns, and proof that Aids was not just a “gay” disease, that a real effort was put into providing proper medical care for those affected.
Religious ideologies often make it difficult for females to access proper healthcare
The Irish Medical Organisation (IMO) has produced several position papers which detail the health inequalities caused by bad housing, poverty, social exclusion, unemployment or low-paid employment, all of which “impact significantly on an individual’s health and wellbeing”.
Around the world, religious ideologies often make it difficult for females to access proper healthcare. In our own country, a faith-based ethos in medical practice sometimes means dangerous and / or traumatic outcomes, most obviously in reproductive healthcare.
In a modern healthcare system such as ours, we expect a gender-neutral attitude from medical practitioners. Reports have, however, shown that gender bias exists and that it has a real, lived impact on the healthcare offered to women and girls.
Women in pain
Studies show that women complaining of pain are less likely to be taken seriously than men, while women suffering from heart failure are more often misdiagnosed than men. One report admitted that while 70 per cent of chronic pain sufferers are women, most of the studies on chronic pain are conducted on men or mice. These failures in our system can be dangerous or, indeed, lethal to women who too often receive improper diagnosis or late treatment, as happened in the cervical smear scandal.
We have known of the gender bias in the medical profession for a long time; scandal after scandal, mistreatment after mistreatment of women, report after report have all indicated this. Yet, here we are again, relying on the bravery of women like Vicky Phelan to bring yet more evidence of medical misogyny into the cruel light of day.
Gender bias awareness training of medical students needs to be a core module as part of medical degrees
Having been named so clearly in the Scally report, it is now finally time to tackle and fully expunge sexism and gender bias from within our healthcare system. This could be done, for example, by reactivating the Women’s Health Council, which functioned as “a centre of expertise on women’s health issues . . . to advise the Minister for Health on women’s issues generally”. Any new healthcare plans need to be gender-proofed from their inception. Gender bias awareness training of medical students needs to be a core module as part of medical degrees, and re-training of existing medical professionals in awareness of gender bias is a necessity.
Never again should doctors dismiss a woman’s concern about her health, or disregard her disquiet about the care she is receiving, or withhold her own files from her. Doctors need to hear and heed women. Women need, deserve and demand better from our health service.
Mary McAuliffe is an historian and lecturer in gender studies at UCD.