Last week on Loveline, Dr. Drew Pinsky insinuated that a man’s fiancée who suffered from a variety of pelvic disorders, like endometriosis and irritable bowel syndrome, really needed to see a trauma specialist rather than her doctors because she had been the victim of sexual abuse as a child—these disorders somehow weren’t “real” but were manifestations of psychological trauma. Maybe even psychosomatic, though he seems to hedge on this point.
First and foremost, even if they were a direct result of her trauma, it doesn’t make them any less “real.” Millions of women have been victims of sexual assault and abuse; millions of men have been victims of sexual assault and abuse. Physical manifestations of psychological trauma are still physiological because the brain and body are not separate entities. Dr. Drew should know better.
The issue that arises, though, isn’t a debate over where these disorders come from. It’s how women are treated when we talk about our health problems. In the case of endometriosis, symptoms can include severe cramping and heavy bleeding. Some women may have relatively minor symptoms. Some women have truly debilitating symptoms. Pain can be constant at a low level and then spike on bad days. Stress can certainly exacerbate symptoms. They can experience dysmenorrhea and anemia; it can lead to infertility. For some women, the only ultimate cure is a hysterectomy. It’s not phantom pain, as any woman who has seen the photos of her surgery can testify—the tissue is real, and it’s not where it’s supposed to be. No one really knows why.
When young women who suffer from miserable periods first talk to their health care professionals, they are often told that these kinds of periods are “normal” in young women, that they should regulate. I’ve heard of women advised to get pregnant to get some relief. We are often made to feel as though we are somehow being “weak”—every woman menstruates and periods hurt, you’re just being a whiner. A wus. You’re seeking attention. You’re using this as an excuse to skip school or work. Some doctors have even told young women, “well, it’s probably endometriosis, but there’s no way to tell, so ….” Well, there are ways to diagnose this disease, and some treatments. But the woman who hears this gem gets the message loud and clear—your suffering doesn’t matter. Buck up. Rub some dirt on it.
Our doctors are providing us a service. Their job is not to brush off our concerns and charge us a copay for it. Their job is to help us find out what is wrong. Approaching women’s health complaints with an attitude of polite disbelief, or as though they are only manifestations of emotional instability, a modern-day case of the vapors, can not only make women feel like idiots, it can cost women their health, their fertility, and their lives. They owe us better. We owe ourselves better. If your doctor doesn’t take you seriously, find a new one. Advocate for yourself. And hold doctors accountable for failing to provide the care you need.