“Women are in pain,” writes Gabrielle Jackson in Pain and Prejudice.

“They’re in pain with their periods, and while having sex; they have pelvic pain, migraines, headaches, joint aches, painful bladders, irritable bowels, sore lower backs… But women’s pain is all too often dismissed, their illnesses misdiagnosed or ignored.”

First printed in 2019, Jackson’s ebook — subtitled a “call to arms for women and their bodies” — captured her frustration at how little progress had been made on the remedy of endometriosis after her personal prognosis 14 years earlier.

“I was so angry when I wrote the book,” Jackson says.

“And it was so exhausting. When you’ve got a chronic illness, sometimes full-time work is all you can do, and I was writing the book on top of my full-time job. And there were times when I really thought it wasn’t worth it.”

In the years since, Jackson has stepped again her advocacy, specializing in her “day job” as Guardian Australia’s head of multimedia whereas she recovers some vitality.

An announcement made within the final week, nonetheless, has her feeling reinvigorated.

On Thursday, Ged Kearney, Assistant Minister for Health and Aged Care, introduced that the federal government would be establishing a Women’s Health Advisory Council to tackle “medical misogyny” within healthcare systems.

The council, which Kearney will chair, brings collectively specialists — and people with lived expertise — to offer recommendation and suggestions to the federal government on all issues ladies’s well being.

In her speech, Kearney thanked Jackson and others who’ve advocated for motion, acknowledging that the “system is stacked against them”.

“There’s no conspiracy in a basement somewhere. It’s just that society, the world, simply everything is built around men. And the good thing that’s happening is that we’re starting to get a small body of evidence to show what women have known for centuries.”

Stats present ladies at elevated threat of dying

That small physique of proof is more and more extra alarming — and the discrepancies aren’t simply related to gynaecological points.

A current examine Australian and New Zealand information confirmed that women are approximately 1.5 times more likely to die in ICU after heart surgery than men.

Yet research additionally present that ladies complaining of signs in keeping with coronary heart illness are twice as likely to be diagnosed with mental illness compared to men with identical symptoms.

We now know that ladies current with totally different signs of heart-attack than males (for instance being much less more likely to complain of chest ache), however doctors routinely recognise only those symptoms that men most commonly experience.

A 2021 study from the U.S., in the meantime, discovered that ailments which primarily have an effect on ladies are vastly underfunded relative to illness burden, whereas these primarily affecting males are over funded by a ratio of two:1.

And trans ladies face a raft of unique barriers to accessing adequate health care, together with insufficient coaching and stigma on the a part of medical doctors and specialists. 

The stats are proof of what ladies have been saying all alongside: that they face a spread of “poorer health outcomes” comparative to males.

“It feels like I’ve put my shoulder up against a massive juggernaut and I’m trying to steer it in another direction,” Kearney says.

“I’m not going to pretend that life is going to be different tomorrow, but I hope this can be the start of systematic change at the policy level.”

More analysis, gendered tips wanted

Dr Sarah White, CEO of Jean Hailes for Women’s Health, is without doubt one of the specialists who has been invited onto the nationwide advisory council.

She has a variety of options for the place the council can begin attending to work.

“So much medical research has studied males and then generalised those findings to females,” she says.

“As a society, none of us seems to have a problem understanding that we need paediatric research and children’s hospitals.

This is an issue raised by Jackson in Pain and Prejudice. She points out that while 70 per cent of those who live with chronic pain are women, 80 per cent of pain studies are conducted on men or male mice.

This means that women are often prescribed drugs (and at dosages) that may not be appropriate for them.

“The Therapeutic Goods Administration (TGA) mustn’t approve medicines until there’s enough information round high quality, security and efficacy for women and men individually,” Dr White says.

“We additionally want totally different remedy tips and public consciousness campaigns. If you take a look at one thing like menopause, it impacts 50 per cent of the inhabitants, and of these, 10 per cent can have signs that actually influence their capacity to work, reside, examine and play. But we nonetheless do not have anyplace close to sufficient analysis on it.”

The Labor government has undertaken some preliminary, related measures to address some of the issues raised by Dr White.

This contains the announcement that it’s going to fund 16 dedicated Endometriosis and Pelvic Pain Clinics across the country, whereas in October Health Minister Mark Butler introduced that the NHMRC would set targets to award equal numbers of Investigator Grants to women and men to handle gendered inequities in analysis funding.

Kearney says this measure is one step towards addressing knowledge gaps, given women are more likely to study issues relevant to women’s health.

While White welcomes both initiatives, she says she would like to see the government go further by promising targeted funding for issues that overwhelmingly affect women and gender diverse people:

“We want to verify there’s equality of funding for situations like endometriosis and menopause, and maybe even extra funding, to make up for injustices up to now.”

Women’s voices ‘have not been heard’

Tackling gender inequality in the healthcare system also requires addressing the underlying issue of how women are treated when they present to doctors.

“When we do our work as ladies’s well being providers and ask ladies what’s lacking from medical care, repeatedly they are saying ‘we’re not being heard’,” Tricia Currie, head of the Victorian Women’s Health Council and CEO of Women’s Health Loddon Mallee, says.

“There’s unconscious bias within the health care system which is why it is important that we have structures around decision-makers that ensure governments are hearing from women, and diverse women, about not only what the issues are but what some of the potential solutions are.”

It’s a problem Dr Mariam Tokhi feels passionately about. She is a GP at Utopia, a refugee and asylum seeker well being centre in Hoppers Crossing.

Tokhi has a diploma in obstetrics and gynaecology, and lately accomplished a qualification in narrative remedy.

“As doctors and health care workers, we get a lot of training in statistics and biosciences,” she says.

“But what I see is that when we meet people every day, we are hearing stories, and we really need to get some training and skills in how to listen, and how to show up for patients.” 

Medical mannequin wants overhaul: GP

Tokhi argues that addressing the various points with ladies’s well being care requires a re-think of the medical mannequin.

“The way Medicare is set up, the way our hospitals are designed, all of those things have been done with a particular lens, and it has mostly been set up by white, wealthy men,” Tokhi says.

“With general practice, the system is set up to incentivise fast care. So GPs, especially if you’re bulk billing, make the most money if you see someone every six minutes.

“There is a penalty for spending extra time with sufferers. And we have to query that — why is quick seen nearly as good? Fast favours a hyper-masculine, terse and laconic type of communication.

These points are solely amplified, she says, when ladies face different types of drawback, together with these from numerous cultural and decrease socio-economic backgrounds.