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Pain and Prejudice: A Call to Arms for Women and Their Bodies
'Women are in pain, all through their bodies; they're in pain with their periods, and while having sex; they have pelvic pain, migraine, headaches, joint aches, painful bladders, irritable bowels, sore lower backs, muscle pain, vulval pain, vaginal pain, jaw pain, muscle aches. And many are so, so tired ... But women's pain is all too often dismissed, their illnesses misdiagnosed or ignored. In medicine, man is the default human being. Any deviation is atypical, abnormal, deficient.'
Fourteen years after being diagnosed with endometriosis, Gabrielle Jackson couldn't believe how little had changed in the treatment and knowledge of the disease. In 2015, her personal story kick-started a worldwide investigation into the disease by The Guardian; thousands of women got in touch to tell their own stories and many more read and shared the material. What began as one issue led Jackson to explore how women - historically and through to the present day - are under-served by the systems that should keep them happy, healthy and informed about their bodies.
Pain and Prejudice is a vital testament to how social taboos and medical ignorance keep women sick and in anguish. The stark reality is that women's pain is not taken as seriously as men's. Women are more likely to be disbelieved and denied treatment than men, even though women are far more likely to be suffering from chronic pain.
In a potent blend of personal memoir and polemic, Jackson confronts the private concerns and questions women face regarding their health and medical treatment. Pain & Prejudice, finally, explains how we got here, and where we need to go next.
'A major contribution to feminist writing of the 21st century' Caroline de Costa, Professor of Obstetrics and Gynaecology, James Cook University
'Gabrielle Jackson deploys facts to tear away the destructive myths that surround women's health' Lenore Taylor, Editor, Guardian Australia
'This book could not be more timely or important.' Katharine Viner, Editor, The Guardian
Fourteen years after being diagnosed with endometriosis, Gabrielle Jackson couldn't believe how little had changed in the treatment and knowledge of the disease. In 2015, her personal story kick-started a worldwide investigation into the disease by The Guardian; thousands of women got in touch to tell their own stories and many more read and shared the material. What began as one issue led Jackson to explore how women - historically and through to the present day - are under-served by the systems that should keep them happy, healthy and informed about their bodies.
Pain and Prejudice is a vital testament to how social taboos and medical ignorance keep women sick and in anguish. The stark reality is that women's pain is not taken as seriously as men's. Women are more likely to be disbelieved and denied treatment than men, even though women are far more likely to be suffering from chronic pain.
In a potent blend of personal memoir and polemic, Jackson confronts the private concerns and questions women face regarding their health and medical treatment. Pain & Prejudice, finally, explains how we got here, and where we need to go next.
'A major contribution to feminist writing of the 21st century' Caroline de Costa, Professor of Obstetrics and Gynaecology, James Cook University
'Gabrielle Jackson deploys facts to tear away the destructive myths that surround women's health' Lenore Taylor, Editor, Guardian Australia
'This book could not be more timely or important.' Katharine Viner, Editor, The Guardian
321 pages, Kindle Edition
First published September 3, 2019
156 people are currently reading
5334 people want to read
About the author
Gabrielle Jackson
2 books12 followersGabrielle Jackson is an associate news editor at Guardian Australia, and was previously opinion editor there. Before that, she was a senior journalist at The Hoopla. Gabrielle has lived and worked in the USA, UK and Australia as a journalist and copywriter. She currently lives in Sydney and commutes regularly to the Riverina district of New South Wales. Gabrielle was first diagnosed with endometriosis in 2001. In 2015 she was also diagnosed with adenomyosis. After writing about endometriosis for the Guardian 2015, she became interested in how women's pain is treated in modern healthcare systems and has been researching and writing about the topic since then. Gabrielle loves cooking and is a kebab connoisseur. In 2011-2012, she spent eight months travelling from Europe through the Middle East to Asia sampling and researching the history of the kebabs and their journey to the western world. She returned to Australia after being run over by a train in India.
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Displaying 1 - 30 of 145 reviews
May 19, 2024
This is a non-fiction book looking at female pain.
While women tend to live longer than men, women have far less pain-free years. There's little medical research done that relates specifically to women and pain. What there is, is very bikini focused (breasts and reproductive organs).
I flew through this book as this is exactly how I like my nonfiction. An easy breezy narrative (regardless of how heavy the top is), personal and relevant experiences shared, science written in laymen terms with a sprinkling of data.
I learnt a lot reading this, about my own body, how pain is perceived by the medical profession, and how affected women in particular are when it comes to chronic pain.
The author suffers from stage 5 endometriosis, so while this does look at female pain all over the body, primarily the focus is endometriosis.
Five stars.
While women tend to live longer than men, women have far less pain-free years. There's little medical research done that relates specifically to women and pain. What there is, is very bikini focused (breasts and reproductive organs).
I flew through this book as this is exactly how I like my nonfiction. An easy breezy narrative (regardless of how heavy the top is), personal and relevant experiences shared, science written in laymen terms with a sprinkling of data.
I learnt a lot reading this, about my own body, how pain is perceived by the medical profession, and how affected women in particular are when it comes to chronic pain.
The author suffers from stage 5 endometriosis, so while this does look at female pain all over the body, primarily the focus is endometriosis.
Five stars.
May 21, 2023
I would like to be sitting here stating that the medical system has changed and improved since I last read a book on this topic, but sadly, this is not the case, and speaking completely from experience, in some ways, I think it has gotten worse. This book is about the discrimination against women by the medical industry, and in particular, women's pain caused by these conditions, that are either ignored, wrongly diagnosed, or are wrongly diagnosed with a mental illness.
I have had PMDD (Premenstrual Dysphoric Disorder) for around six years, and during that time, I've not had one doctor or consultant that has taken me seriously in regards to it. I have came into contact with some lovely professionals over the years, but loveliness doesn't give me the help I need. It is true what Jackson states in this book that women are being wrongly diagnosed with anxiety disorders and depression, when actually, they have a horrendous medical condition such as endometriosis, which although is treatable, it can on average take seven years to finally receive that diagnosis. To be frank here, for a condition such as PMDD where 30% of the women with it attempt suicide, I think it is about time medical professionals take it seriously.
This book has obviously been very well researched, but there were only focus on certain conditions which felt slightly repetitive and I would have appreciated a little more focus on PMDD, but there were other conditions and stories from women that I found both interesting and poignant, learning of others personal situations, and even some of those where women have lost their lives due to having no diagnosis, or were just being fobbed off with painkillers for years.
I think it's well past time that medical professionals should be educated about diseases and conditions that are related to women in particular, instead of simply dismissing it as a mental illness. I mean, surely anxiety and depression comes along with feeling poorly for a considerable length of time and years of fighting to be heard?
I'm glad I've read this book, but it has also saddened me thinking about the ignorance of society and the difficult journey's that some women face in the name of health.
I have had PMDD (Premenstrual Dysphoric Disorder) for around six years, and during that time, I've not had one doctor or consultant that has taken me seriously in regards to it. I have came into contact with some lovely professionals over the years, but loveliness doesn't give me the help I need. It is true what Jackson states in this book that women are being wrongly diagnosed with anxiety disorders and depression, when actually, they have a horrendous medical condition such as endometriosis, which although is treatable, it can on average take seven years to finally receive that diagnosis. To be frank here, for a condition such as PMDD where 30% of the women with it attempt suicide, I think it is about time medical professionals take it seriously.
This book has obviously been very well researched, but there were only focus on certain conditions which felt slightly repetitive and I would have appreciated a little more focus on PMDD, but there were other conditions and stories from women that I found both interesting and poignant, learning of others personal situations, and even some of those where women have lost their lives due to having no diagnosis, or were just being fobbed off with painkillers for years.
I think it's well past time that medical professionals should be educated about diseases and conditions that are related to women in particular, instead of simply dismissing it as a mental illness. I mean, surely anxiety and depression comes along with feeling poorly for a considerable length of time and years of fighting to be heard?
I'm glad I've read this book, but it has also saddened me thinking about the ignorance of society and the difficult journey's that some women face in the name of health.
September 9, 2019
This should be a high school text book and compulsory reading for all doctors.
March 23, 2021
“A widespread lack of medical knowledge about women’s health is buoyed by a society that makes a taboo of women discussing their problems, especially those to do with reproductive organs.”
Modern healthcare systems have undergone colossal advancement and development in the last century. From quicker and more accurate diagnoses to personalised care and better patient outcomes, it came as a surprise to long-term endometriosis sufferer and author of this book, Gabrielle Jackson, that very little has changed in the perception, identification and treatment of women’s illnesses by medical professionals. Evidence supports that medical students and specialists alike subconsciously regurgitate covert sexist and misogynistic assumptions about female patients—assumptions that have bled into the field (no pun intended) since the Father of Modern Medicine, Hippocrates [c. 460 - c. 370 BC] and the compilation of the Hippocratic corpus.
Medical culture
The highly masculinised culture of the medical field (in both research and workplace settings) has meant clinical studies on pathologies and drug efficacy have historically and exclusively been conducted on the male of a species (rodents, humans). The results of these male-centric studies have been generalised to both genders with a disregard of physiological and anatomical differences between the two. This generalisation has in turn contributed to the ongoing pain and suffering of women, who have either been completely misdiagnosed in the first instance, or have been diagnosed correctly but proffered suboptimal treatment options. For example, when both men and women presented with the same symptoms for heart disease but added a stressful life event to the mix, the final diagnosis for both genders was vastly different. Women were sent home with a diagnosis of mere anxiety whereas the mention of a stressful life event for men served in corroborating his diagnosis of heart disease. The results showed 56% of medical students/residents gave their male patients a diagnosis of heart disease, compared with only 15% for female patients. There are many striking examples like this in the book. She also talks about how female-centred illnesses are severely under-researched:
“Women’s symptoms are not taken seriously because medicine doesn’t know as much about their bodies and health problems. And medicine doesn’t know as much about their bodies and health problems because it doesn’t take their symptoms seriously.”
“PubMed has almost five times as many clinical trials on male sexual pleasure as it has on female sexual pain. And why? Because we live in a culture that sees female pain as normal and male pleasure as a right.”
Now to touch upon workplace culture. Jackson highlights rampant bullying culture (and sexual assault) in medicine, particularly between senior and junior members of staff: “A third of medical trainees experience sexual harassment internationally.” Harassment seldom goes reported due to the hierarchal nature of the field, as for some, progression can be contingent on networking and recommendations from seniors. It unfortunately seems as though women are trapped in a cycle of abuse despite the esteem and respect their careers demand. Depression, anxiety and suicide rates are also high amongst medical professionals including women, which affects patient care.
“In the US, doctors commit suicide at rates higher than any other profession.”
Healthcare systems - Australia, UK, and US
Jackson’s personal anecdotes about her experience with the Australian healthcare system were both harrowing and enlightening. I have an understanding of the UK and US healthcare systems (I work for the former) but I knew next to nothing about the functioning of the Australian healthcare system until I read this book. Australia’s public healthcare system is akin to the UK’s National Healthcare Service (NHS) in that it can be accessed freely or at tax-funded reduced rate via Medicare (which, alongside Medicaid, is also an option for disadvantaged citizens in the US). Australia also provides a private healthcare service that runs in tandem with the public system, much like the UK. The US, however, has no universal healthcare programme. It functions largely via private sector businesses and has an insurance/payment-based healthcare model, with employers funding their employees healthcare as a employment benefit.
Despite the fact that Western healthcare services are the best in the world, they can be highly reductionist—body parts are treated as separate, independent entities from the body and mind at large. This reductionist approach is based on Descartes’ idea of dualism, that the mind and body are two separate entities. It could be argued that due to this approach, illnesses (especially chronic ones) are simply managed as opposed to treated. This differs from Eastern and holistic medicinal approaches that look at the body and mind together as a whole, to determine the best course of treatment.
“Strangely or not, the best predictor of a woman’s sexual wellbeing is her overall wellbeing, which is why those issues—stress, mood, relationships—are not peripheral, it’s because they’re determining factors in whether or not she’s experiencing whatever you want to call sexual wellbeing.”
However, this is understandably a lengthy process. If you live in the UK, you already know how difficult it is to get a GP appointment, and having a surgical procedure is harder still. Most NHS Trusts’ waiting lists for surgical and medical services have become heavily inflated due to COVID-19 and this is exemplified by the rising rate of 52-week breaches across the board.
Healthcare and minorities
As an affluent Western White woman, Jackson acknowledges her privilege. She knows that her experience with healthcare and medical professionals may not be the same as minorities and women of colour. Whether it’s poor prior experience of the healthcare system or cultural/financial factors, people of colour are less likely to receive successful treatment/patient outcomes as their white counterparts.
“It has long been suspected that people of colour are treated negatively by doctors partly because of prejudiced misconceptions about biological differences between black and white people.”
“Another 2016 study found that a substantial number of white medical students and registrars believed false stereotypes that black people have a thicker skin than white people, the nerve endings are less sensitive, and that their blood coagulates more quickly than white peoples.”
This doesn’t go to say that all medical professionals across the board will allow biases to dictate how they perceive women and people of colour. Indeed, Jackson mentions those doctors and specialists that have helped her manage her endometriosis and other surgeries and she is ever grateful to them. What this book does do is give an explanation as to why some individuals may have a poor experience within the field, and it is largely due to historic practices and culture.
Conclusion
It would be dishonest to write this book off as a self-pitying feminist work. As a woman of colour (and faith) with a background in science and healthcare (if you couldn’t tell from my rambling review thus far) this work has been both liberating and empowering. There were a couple of bits I didn’t necessarily agree with, however this is due to my personal religious beliefs. My faith shapes my worldview and beliefs on gender and sexuality. To be specific, my points of contention are regarding Jackson’s remarks about female masturbation as a necessity and a healthy way to explore one’s body/sexuality. This apparently combats the patriarchal society that perceives women’s self-pleasure as dirty. That’s an interesting endeavour to advocate considering pornography addition is on the rise with women and pornography in general objectifies women (and men), leading to masturbation addiction and increased rates of infertility. I also disagree with her hailing the 1960/70s sexual revolution which perceived increased sexual agency/freedom [i.e out of wedlock] a woman’s “right” and something that should be encouraged. That being said, she does criticise the movement due to the rise of sexual assault and harassment: “[...]the truth of the sexual revolution: it freed men to feel comfortable with their fantasies of sexual dominance without uprooting the culture that shames women and people of all genders and lower social classes both for enjoying sex and for speaking out about sexual violence.”
I highly recommend giving this a read, especially if you work in healthcare.
“It’s everything from our cultural backgrounds, which haven’t been pro-women; it’s the fact that women’s pain is pain you can’t see; the fact that our society in general doesn’t listen to women; it’s the fact that pain symptoms are described [by women] in ways that men don’t appreciate; it’s the non-prioritising of issues of importance to women, and that covers the undervaluing of gynaecology compared to other specialities”
4/5 ⭐️⭐️⭐️⭐️
Modern healthcare systems have undergone colossal advancement and development in the last century. From quicker and more accurate diagnoses to personalised care and better patient outcomes, it came as a surprise to long-term endometriosis sufferer and author of this book, Gabrielle Jackson, that very little has changed in the perception, identification and treatment of women’s illnesses by medical professionals. Evidence supports that medical students and specialists alike subconsciously regurgitate covert sexist and misogynistic assumptions about female patients—assumptions that have bled into the field (no pun intended) since the Father of Modern Medicine, Hippocrates [c. 460 - c. 370 BC] and the compilation of the Hippocratic corpus.
Medical culture
The highly masculinised culture of the medical field (in both research and workplace settings) has meant clinical studies on pathologies and drug efficacy have historically and exclusively been conducted on the male of a species (rodents, humans). The results of these male-centric studies have been generalised to both genders with a disregard of physiological and anatomical differences between the two. This generalisation has in turn contributed to the ongoing pain and suffering of women, who have either been completely misdiagnosed in the first instance, or have been diagnosed correctly but proffered suboptimal treatment options. For example, when both men and women presented with the same symptoms for heart disease but added a stressful life event to the mix, the final diagnosis for both genders was vastly different. Women were sent home with a diagnosis of mere anxiety whereas the mention of a stressful life event for men served in corroborating his diagnosis of heart disease. The results showed 56% of medical students/residents gave their male patients a diagnosis of heart disease, compared with only 15% for female patients. There are many striking examples like this in the book. She also talks about how female-centred illnesses are severely under-researched:
“Women’s symptoms are not taken seriously because medicine doesn’t know as much about their bodies and health problems. And medicine doesn’t know as much about their bodies and health problems because it doesn’t take their symptoms seriously.”
“PubMed has almost five times as many clinical trials on male sexual pleasure as it has on female sexual pain. And why? Because we live in a culture that sees female pain as normal and male pleasure as a right.”
Now to touch upon workplace culture. Jackson highlights rampant bullying culture (and sexual assault) in medicine, particularly between senior and junior members of staff: “A third of medical trainees experience sexual harassment internationally.” Harassment seldom goes reported due to the hierarchal nature of the field, as for some, progression can be contingent on networking and recommendations from seniors. It unfortunately seems as though women are trapped in a cycle of abuse despite the esteem and respect their careers demand. Depression, anxiety and suicide rates are also high amongst medical professionals including women, which affects patient care.
“In the US, doctors commit suicide at rates higher than any other profession.”
Healthcare systems - Australia, UK, and US
Jackson’s personal anecdotes about her experience with the Australian healthcare system were both harrowing and enlightening. I have an understanding of the UK and US healthcare systems (I work for the former) but I knew next to nothing about the functioning of the Australian healthcare system until I read this book. Australia’s public healthcare system is akin to the UK’s National Healthcare Service (NHS) in that it can be accessed freely or at tax-funded reduced rate via Medicare (which, alongside Medicaid, is also an option for disadvantaged citizens in the US). Australia also provides a private healthcare service that runs in tandem with the public system, much like the UK. The US, however, has no universal healthcare programme. It functions largely via private sector businesses and has an insurance/payment-based healthcare model, with employers funding their employees healthcare as a employment benefit.
Despite the fact that Western healthcare services are the best in the world, they can be highly reductionist—body parts are treated as separate, independent entities from the body and mind at large. This reductionist approach is based on Descartes’ idea of dualism, that the mind and body are two separate entities. It could be argued that due to this approach, illnesses (especially chronic ones) are simply managed as opposed to treated. This differs from Eastern and holistic medicinal approaches that look at the body and mind together as a whole, to determine the best course of treatment.
“Strangely or not, the best predictor of a woman’s sexual wellbeing is her overall wellbeing, which is why those issues—stress, mood, relationships—are not peripheral, it’s because they’re determining factors in whether or not she’s experiencing whatever you want to call sexual wellbeing.”
However, this is understandably a lengthy process. If you live in the UK, you already know how difficult it is to get a GP appointment, and having a surgical procedure is harder still. Most NHS Trusts’ waiting lists for surgical and medical services have become heavily inflated due to COVID-19 and this is exemplified by the rising rate of 52-week breaches across the board.
Healthcare and minorities
As an affluent Western White woman, Jackson acknowledges her privilege. She knows that her experience with healthcare and medical professionals may not be the same as minorities and women of colour. Whether it’s poor prior experience of the healthcare system or cultural/financial factors, people of colour are less likely to receive successful treatment/patient outcomes as their white counterparts.
“It has long been suspected that people of colour are treated negatively by doctors partly because of prejudiced misconceptions about biological differences between black and white people.”
“Another 2016 study found that a substantial number of white medical students and registrars believed false stereotypes that black people have a thicker skin than white people, the nerve endings are less sensitive, and that their blood coagulates more quickly than white peoples.”
This doesn’t go to say that all medical professionals across the board will allow biases to dictate how they perceive women and people of colour. Indeed, Jackson mentions those doctors and specialists that have helped her manage her endometriosis and other surgeries and she is ever grateful to them. What this book does do is give an explanation as to why some individuals may have a poor experience within the field, and it is largely due to historic practices and culture.
Conclusion
It would be dishonest to write this book off as a self-pitying feminist work. As a woman of colour (and faith) with a background in science and healthcare (if you couldn’t tell from my rambling review thus far) this work has been both liberating and empowering. There were a couple of bits I didn’t necessarily agree with, however this is due to my personal religious beliefs. My faith shapes my worldview and beliefs on gender and sexuality. To be specific, my points of contention are regarding Jackson’s remarks about female masturbation as a necessity and a healthy way to explore one’s body/sexuality. This apparently combats the patriarchal society that perceives women’s self-pleasure as dirty. That’s an interesting endeavour to advocate considering pornography addition is on the rise with women and pornography in general objectifies women (and men), leading to masturbation addiction and increased rates of infertility. I also disagree with her hailing the 1960/70s sexual revolution which perceived increased sexual agency/freedom [i.e out of wedlock] a woman’s “right” and something that should be encouraged. That being said, she does criticise the movement due to the rise of sexual assault and harassment: “[...]the truth of the sexual revolution: it freed men to feel comfortable with their fantasies of sexual dominance without uprooting the culture that shames women and people of all genders and lower social classes both for enjoying sex and for speaking out about sexual violence.”
I highly recommend giving this a read, especially if you work in healthcare.
“It’s everything from our cultural backgrounds, which haven’t been pro-women; it’s the fact that women’s pain is pain you can’t see; the fact that our society in general doesn’t listen to women; it’s the fact that pain symptoms are described [by women] in ways that men don’t appreciate; it’s the non-prioritising of issues of importance to women, and that covers the undervaluing of gynaecology compared to other specialities”
4/5 ⭐️⭐️⭐️⭐️
December 22, 2019
‘I have a disease that I know nothing about.’
I picked this book up because I saw a reference to Gabrielle Jackson’s diagnosis of endometriosis. I was diagnosed with endometriosis in 1980, and I wondered what might have changed since then.
‘Endometriosis has been known as the ‘silent disease’, but that isn’t because women don’t want to talk about it.’
I quickly learned that while endometriosis was Ms Jackson’s starting point, her book is more broadly about women’s pain and suffering, and how that is treated (or not treated). Ms Jackson points to a lack of education about how our bodies work, and the social taboos and stigmas that prevent many of us from talking about our genitals, sex life, pain and reproductive processes. As she points out, many women do not know the names of parts of their anatomy. So how can women accurately describe the location of pain when they can’t identify where it is? Add to that the fact that in medicine the male is the default human being, then it is easy to see how women’s concerns can be overlooked and (or) ignored. Writing this, I am reminded that many women experience different symptoms of heart attack from men and consequently can be mistakenly diagnosed. Or, sometimes tragically, not diagnosed at all.
So I kept reading, becoming more and more uncomfortable. I remembered, too, that I’d had many of the symptoms of endometriosis for at least ten years before diagnosis.
‘We need to know what is normal as opposed to what is common.’
Women are more likely to suffer from chronic pain than men, and less likely to receive effective treatment. I can relate to this, and I know several other women who can as well. How often are men described as being ‘hysterical’?
This book is a blend of personal memoir, and presentation of reasons why women’s pain has been ignored. There are also some hopeful signs of a better understanding. But then I read about the earning differential between male and female doctors, that female doctors often take more time with their patients (which disadvantages them fee wise because of the way Medicare provides a greater benefit for some consultations than others). One outcome noted:
‘In 2018, an inner-Melbourne medical practice kicked off a media storm when it put up a sign announcing female GPs would be charging more than male GPs because women’s health issues take longer to deal with than men’s, and women tend to self-select female doctors.’
So, what are the answers? Surely the Australian health system is capable of recognising that then insertion of an IUD is more complex than a standard consultation? Surely the Australian health system is capable of recognising that biology can have an impact on medical issues? And, if you suffer from an autoimmune condition (as women do, more frequently than men), you’ll find some interesting information here.
I’d recommend this book to most of my friends (male and female). Many women my age and older will be acutely aware of the social taboos and stigmas, that leave us with euphemisms and vague descriptions of ‘down there’. I’d like to think that younger women are more knowledgeable, but I wonder.
Where to from here?
I’ll leave the last word to Ms Jackson:
‘Pain isn’t killing us, but it is denying us our full humanity. Refusing to understand this fact of life for women is tearing opportunities from our grasp. And I say, enough.’
Jennifer Cameron-Smith
I picked this book up because I saw a reference to Gabrielle Jackson’s diagnosis of endometriosis. I was diagnosed with endometriosis in 1980, and I wondered what might have changed since then.
‘Endometriosis has been known as the ‘silent disease’, but that isn’t because women don’t want to talk about it.’
I quickly learned that while endometriosis was Ms Jackson’s starting point, her book is more broadly about women’s pain and suffering, and how that is treated (or not treated). Ms Jackson points to a lack of education about how our bodies work, and the social taboos and stigmas that prevent many of us from talking about our genitals, sex life, pain and reproductive processes. As she points out, many women do not know the names of parts of their anatomy. So how can women accurately describe the location of pain when they can’t identify where it is? Add to that the fact that in medicine the male is the default human being, then it is easy to see how women’s concerns can be overlooked and (or) ignored. Writing this, I am reminded that many women experience different symptoms of heart attack from men and consequently can be mistakenly diagnosed. Or, sometimes tragically, not diagnosed at all.
So I kept reading, becoming more and more uncomfortable. I remembered, too, that I’d had many of the symptoms of endometriosis for at least ten years before diagnosis.
‘We need to know what is normal as opposed to what is common.’
Women are more likely to suffer from chronic pain than men, and less likely to receive effective treatment. I can relate to this, and I know several other women who can as well. How often are men described as being ‘hysterical’?
This book is a blend of personal memoir, and presentation of reasons why women’s pain has been ignored. There are also some hopeful signs of a better understanding. But then I read about the earning differential between male and female doctors, that female doctors often take more time with their patients (which disadvantages them fee wise because of the way Medicare provides a greater benefit for some consultations than others). One outcome noted:
‘In 2018, an inner-Melbourne medical practice kicked off a media storm when it put up a sign announcing female GPs would be charging more than male GPs because women’s health issues take longer to deal with than men’s, and women tend to self-select female doctors.’
So, what are the answers? Surely the Australian health system is capable of recognising that then insertion of an IUD is more complex than a standard consultation? Surely the Australian health system is capable of recognising that biology can have an impact on medical issues? And, if you suffer from an autoimmune condition (as women do, more frequently than men), you’ll find some interesting information here.
I’d recommend this book to most of my friends (male and female). Many women my age and older will be acutely aware of the social taboos and stigmas, that leave us with euphemisms and vague descriptions of ‘down there’. I’d like to think that younger women are more knowledgeable, but I wonder.
Where to from here?
I’ll leave the last word to Ms Jackson:
‘Pain isn’t killing us, but it is denying us our full humanity. Refusing to understand this fact of life for women is tearing opportunities from our grasp. And I say, enough.’
Jennifer Cameron-Smith
September 20, 2019
Journalist Gabrielle Jackson was first diagnosed with endometriosis in 2001 and after writing about her experiences in The Guardian in 2015, and subsequently being overwhelmed with emails from other women who had suffered similar experiences, she focussed her interest on how women’s pain is treated in our modern healthcare systems. The result is her non-fiction book Pain and Prejudice (Allen and Unwin 2019), a brilliant and powerful examination of how the pain and suffering of women are treated in our own culture and around the world, how little is known about ‘women’s illnesses’, the bias towards male-centred medical research, and the continuing myth of ‘hysterical’ women labelled as such because their symptoms and pain cannot be explained.
In a seamless blend of memoir and investigative journalism, Jackson confronts this issue from the historical to the modern, with a rigorous and intellectual interrogation of medical culture and practice, peppered with plenty of real-life anecdotes and examples from her own experience and from women she has met in the course of her work.
Labelled ‘the silent disease’ because nobody knows how to talk about it, or wants to talk about it, endometriosis is only the tip of the iceberg. Jackson explores the ten chronic pain conditions that most specifically or often affect women, including Chronic Fatigue Syndrome, Chronic Migraine, Chronic Tension-Type Headache, Interstitial Cystitis, Fibromyalgia, Irritable Bowel Syndrome, Vulvodynia, Temporo-mandibular Disorders, Chronic Low Back Pain and Endometriosis, and investigates how these debilitating conditions frequently overlap and are often misdiagnosed or even ignored. She discusses the lost opportunities, lost employment or school days, the failed relationships and general ill health suffered by women as a result of this failure to recognise and effectively treat women’s health. She argues that ‘for most of human history, the widespread idea that a woman is inherently irrational and brimming with uncontrollable emotions and bodily functions has justified her subordination’ and she laments the lack of knowledge around female body parts and their functions, even the incorrect language commonly used – often by women themselves! She reveals numerous examples of how women’s pain – throughout history – has been minimalised, trivialised, ignored or mistreated.
Covering everything from Aboriginal women’s health to the #MeToo movement, Jackson talks about how ‘racism, poverty, violence, trauma, abuse and stress all contribute to poor health, and women suffer disproportionately in many of these areas’, and discusses the links between anxiety and depression and poor physical health.
But it’s not all doom and gloom. Jackson summarises her investigation by exploring the advances made in women’s health, and highlights some of the promising research and funding opportunities. Perhaps most importantly, Pain and Prejudice opens a frank and open discourse about women and their bodies, and urges everyone – men, women and medical professionals – to have informed conversations with each other and to vigilantly pursue improved women’s health.
In a seamless blend of memoir and investigative journalism, Jackson confronts this issue from the historical to the modern, with a rigorous and intellectual interrogation of medical culture and practice, peppered with plenty of real-life anecdotes and examples from her own experience and from women she has met in the course of her work.
Labelled ‘the silent disease’ because nobody knows how to talk about it, or wants to talk about it, endometriosis is only the tip of the iceberg. Jackson explores the ten chronic pain conditions that most specifically or often affect women, including Chronic Fatigue Syndrome, Chronic Migraine, Chronic Tension-Type Headache, Interstitial Cystitis, Fibromyalgia, Irritable Bowel Syndrome, Vulvodynia, Temporo-mandibular Disorders, Chronic Low Back Pain and Endometriosis, and investigates how these debilitating conditions frequently overlap and are often misdiagnosed or even ignored. She discusses the lost opportunities, lost employment or school days, the failed relationships and general ill health suffered by women as a result of this failure to recognise and effectively treat women’s health. She argues that ‘for most of human history, the widespread idea that a woman is inherently irrational and brimming with uncontrollable emotions and bodily functions has justified her subordination’ and she laments the lack of knowledge around female body parts and their functions, even the incorrect language commonly used – often by women themselves! She reveals numerous examples of how women’s pain – throughout history – has been minimalised, trivialised, ignored or mistreated.
Covering everything from Aboriginal women’s health to the #MeToo movement, Jackson talks about how ‘racism, poverty, violence, trauma, abuse and stress all contribute to poor health, and women suffer disproportionately in many of these areas’, and discusses the links between anxiety and depression and poor physical health.
But it’s not all doom and gloom. Jackson summarises her investigation by exploring the advances made in women’s health, and highlights some of the promising research and funding opportunities. Perhaps most importantly, Pain and Prejudice opens a frank and open discourse about women and their bodies, and urges everyone – men, women and medical professionals – to have informed conversations with each other and to vigilantly pursue improved women’s health.
September 28, 2019
Ladies! When was the last time you were accused of being “hysterical”? If you’re anything like me, it was recent, and you’re still so angry about it that you’re grinding your teeth right now. That anger is felt, understood, and reflected in this jaw-dropping new book from Gabrielle Jackson, Pain & Prejudice. Braiding together memoir and science, she explores the ways in which social structures—particularly the medical system—have underserved and oppressed women, keeping them sick and in pain, for far too long. Allen & Unwin was kind enough to send me a copy for review.
Jackson is a journalist; in 2001, she was diagnosed with endometriosis, and then, in 2015, adenomyosis. She has spent years researching these conditions, and the broader medical system in which they are studied and treated. In this book, from Plato’s wandering womb to the present day, she unpicks the complex social history that has got us to this point. “Women are socialised to believe their pain is normal,” she says, and she’s writing this book to give voice to the silent suffering of centuries.
An extended review of Pain and Prejudice is available for subscribers at Keeping Up With The Penugins.
Jackson is a journalist; in 2001, she was diagnosed with endometriosis, and then, in 2015, adenomyosis. She has spent years researching these conditions, and the broader medical system in which they are studied and treated. In this book, from Plato’s wandering womb to the present day, she unpicks the complex social history that has got us to this point. “Women are socialised to believe their pain is normal,” she says, and she’s writing this book to give voice to the silent suffering of centuries.
An extended review of Pain and Prejudice is available for subscribers at Keeping Up With The Penugins.
March 1, 2020
I’m giving this book four stars because it sheds light on a really important topic which isn’t often discussed. Women tend to experience more pain than men in their lifetime, yet often can’t find adequate or compassionate treatment for their pain and associated conditions. This book was well researched and presented an interesting mix of the authors own experience, statistics, and insights from doctors she had interviewed.
However...
I had a lot of frustrations with how this book was written and the way in which it approached some issues.
Overall I found the structure really difficult to follow. Not only were the same statistics and key points repeated seemingly in each chapter, a handy explainer on the main conditions discussed in the book comes RIGHT AT THE END! It would have been super helpful to present this at the start of the book so that when the author repeatedly discussed say, painful bladder syndrome, I actually knew what that was.
At times the book felt dismissive of psychological illness somehow, which I understand was not the authors intention. Like, not all pain can be treated with medication and sometimes yes it might be “all in your head” or at be very least, psychological therapy can help you deal with chronic pain. A doctor is not a monster for suggesting that a woman with chronic pain that is unresponsive to traditional treatments should seek psychological help. On page 168, Jackson criticises a doctor for stating that “there is a lot of psychology, just as much as there is pathology [in gynaecology]”, yet just four pages later shares another quote from a doctor in a positive light, which states “we know there is a relationship between pain and mood, we know that when mood is worse pain will be worse... they’re interrelated issues-you can’t treat one without treating the other”. So on the one hand, Jackson is highly critical of doctors for seeing their patients through a psychological lens, but then lets slip a few pages later the importance of doing so, and indeed a few chapters later the book briefly discusses how pain can continue long after any physical damage resolves. We know that women suffer from anxiety at much higher rates than men and it would be interesting to see a sincere discussion on how this could manifest as pain.
The book seemed needlessly disparaging towards men at times. Jackson makes a remark that straight, while male doctors are unlikely to be discriminated against, bullied or harassed. While I 100% agree that women and non-white doctors are more likely to face these issues, and the research backs this up, the research also states that a sizeable minority (in one study of junior doctors I found it was 32%) of male doctors reported being harassed at work. That’s a lot more than few, and to brush off the toxic culture in medicine as something that only impacts women and minorities is to downplay the whole situation. In a similar vein, Jackson tells the story of a woman who died from sepsis after repeatedly being ignored by the medical system. It’s a sad story and Jackson implies it happened because the patient was Aboriginal and female, however I can think of two recent cases where the symptoms of teenage white boys were brushed off by the medical system and they ended up dying of preventable illness. To frame this as just a women’s issue overlooks the broader picture of the flawed system that doctors operate in (even if women may be more likely to suffer because of it) and how this could be addressed.
Okay one last point - there was no discussion of the current opioid crisis and how this might be playing into doctors reluctance to treat pain with medication or take reports of pain seriously. I know you can’t cover everything in one book, but I suspect it’s another one of those bigger factors contributing to women’s poorer outcomes, which again was not mentioned at all.
I want to reiterate that overall this book was enjoyable and informative and I recommend reading it. I just feel like it could have been a lot better if it were structured more clearly and there was a better appreciation for the bigger picture, rather than distilling the main message down to “women experience pain and it’s because of the patriarchy and misogyny”. I felt a similar way after reading Invisible Women so maybe I just have an issue with books that report on data...
However...
I had a lot of frustrations with how this book was written and the way in which it approached some issues.
Overall I found the structure really difficult to follow. Not only were the same statistics and key points repeated seemingly in each chapter, a handy explainer on the main conditions discussed in the book comes RIGHT AT THE END! It would have been super helpful to present this at the start of the book so that when the author repeatedly discussed say, painful bladder syndrome, I actually knew what that was.
At times the book felt dismissive of psychological illness somehow, which I understand was not the authors intention. Like, not all pain can be treated with medication and sometimes yes it might be “all in your head” or at be very least, psychological therapy can help you deal with chronic pain. A doctor is not a monster for suggesting that a woman with chronic pain that is unresponsive to traditional treatments should seek psychological help. On page 168, Jackson criticises a doctor for stating that “there is a lot of psychology, just as much as there is pathology [in gynaecology]”, yet just four pages later shares another quote from a doctor in a positive light, which states “we know there is a relationship between pain and mood, we know that when mood is worse pain will be worse... they’re interrelated issues-you can’t treat one without treating the other”. So on the one hand, Jackson is highly critical of doctors for seeing their patients through a psychological lens, but then lets slip a few pages later the importance of doing so, and indeed a few chapters later the book briefly discusses how pain can continue long after any physical damage resolves. We know that women suffer from anxiety at much higher rates than men and it would be interesting to see a sincere discussion on how this could manifest as pain.
The book seemed needlessly disparaging towards men at times. Jackson makes a remark that straight, while male doctors are unlikely to be discriminated against, bullied or harassed. While I 100% agree that women and non-white doctors are more likely to face these issues, and the research backs this up, the research also states that a sizeable minority (in one study of junior doctors I found it was 32%) of male doctors reported being harassed at work. That’s a lot more than few, and to brush off the toxic culture in medicine as something that only impacts women and minorities is to downplay the whole situation. In a similar vein, Jackson tells the story of a woman who died from sepsis after repeatedly being ignored by the medical system. It’s a sad story and Jackson implies it happened because the patient was Aboriginal and female, however I can think of two recent cases where the symptoms of teenage white boys were brushed off by the medical system and they ended up dying of preventable illness. To frame this as just a women’s issue overlooks the broader picture of the flawed system that doctors operate in (even if women may be more likely to suffer because of it) and how this could be addressed.
Okay one last point - there was no discussion of the current opioid crisis and how this might be playing into doctors reluctance to treat pain with medication or take reports of pain seriously. I know you can’t cover everything in one book, but I suspect it’s another one of those bigger factors contributing to women’s poorer outcomes, which again was not mentioned at all.
I want to reiterate that overall this book was enjoyable and informative and I recommend reading it. I just feel like it could have been a lot better if it were structured more clearly and there was a better appreciation for the bigger picture, rather than distilling the main message down to “women experience pain and it’s because of the patriarchy and misogyny”. I felt a similar way after reading Invisible Women so maybe I just have an issue with books that report on data...
August 24, 2020
As a woman suffering from auto-immune disease Hashimoto that took years to diagnose, I feel profoundly understood by this book. Hopping from doctor to doctor, hoping for someone to shed light on my symptoms or just something as simple as listen to me, just to be brushed off or hear over and over again that I'm "just stressed", took quite a toll on my mental health.
I felt alone and misunderstood – until this book opened my eyes to how much of a problem this is for so many women out there, most of them being labeled as "hysterical", not getting enough attention or treatment for their pain or suffering, nor science stepping away from its approach to reductionist medicine and investing properly into understanding chronic pain conditions.
I feel less alone now; but it's also time that things change.
(Minus one star for structure and some repetition.)
I felt alone and misunderstood – until this book opened my eyes to how much of a problem this is for so many women out there, most of them being labeled as "hysterical", not getting enough attention or treatment for their pain or suffering, nor science stepping away from its approach to reductionist medicine and investing properly into understanding chronic pain conditions.
I feel less alone now; but it's also time that things change.
(Minus one star for structure and some repetition.)
September 11, 2019
A very valuable read, and one that was highly engaging. By a hundred pages in I had already sworn, cackled and rolled my eyes inadvertently at various times. This isn’t just a book for women either. Everyone should read it. You will learn so much. And probably even laugh a little.
(Also a note on “women” - the author addresses gendered language in her introduction).
A few warnings particularly if you’re reading as a disabled person. While I enjoyed the book on the whole, the author is clearly not au fait with disability activism (nor does she purport to be).
A number of points in the book (e.g. p 313, 321) note that “pain doesn’t kill”, despite the book not drawing in any research regarding links between chronic pain and suicidal ideation. Failing to accurately identify the cause of suicide makes it impossible to accurately measure the impact of health conditions (historically this was an issue for deaths caused by cancer which were nevertheless recorded as acute issues like septicaemia). Complying with this flawed system perpetuates the dismissal of chronic pain by the medical system and limits our advocacy.
Additionally, a warning that autism and ADHD are implicitly classed as “psychiatric and academic problems” made more prevalent by “sperm...corrupted by DNA damage” in older fathers (p154).
As I said, nevertheless a very valuable book and highly engaging to read.
[Cover description: The title is “Pain and Prejudice” in large red text with nails sticking into it. Its surtitle is “a call to arms for women and their bodies”. The author is Gabrielle Jackson. The cover also features a floral representation of a female reproductive system. The endorsement featured in the bottom right corner on the cover is “This book is a brilliant, blood-drenched page turner. Every girl, woman and man—and most particularly every doctor—should read it.” Emily Wilson, Editor at New Scientist].
(Also a note on “women” - the author addresses gendered language in her introduction).
A few warnings particularly if you’re reading as a disabled person. While I enjoyed the book on the whole, the author is clearly not au fait with disability activism (nor does she purport to be).
A number of points in the book (e.g. p 313, 321) note that “pain doesn’t kill”, despite the book not drawing in any research regarding links between chronic pain and suicidal ideation. Failing to accurately identify the cause of suicide makes it impossible to accurately measure the impact of health conditions (historically this was an issue for deaths caused by cancer which were nevertheless recorded as acute issues like septicaemia). Complying with this flawed system perpetuates the dismissal of chronic pain by the medical system and limits our advocacy.
Additionally, a warning that autism and ADHD are implicitly classed as “psychiatric and academic problems” made more prevalent by “sperm...corrupted by DNA damage” in older fathers (p154).
As I said, nevertheless a very valuable book and highly engaging to read.
[Cover description: The title is “Pain and Prejudice” in large red text with nails sticking into it. Its surtitle is “a call to arms for women and their bodies”. The author is Gabrielle Jackson. The cover also features a floral representation of a female reproductive system. The endorsement featured in the bottom right corner on the cover is “This book is a brilliant, blood-drenched page turner. Every girl, woman and man—and most particularly every doctor—should read it.” Emily Wilson, Editor at New Scientist].
May 23, 2021
I found the chapter on COVID-19 and potential (positive) impacts of this pretty inspiring and there were a few interesting tidbits but mostly I think I’ve had my head stuck into chronic illness research for a decade due to well..... being chronically ill for a decade so a lot of this is repetition for me personally. I hope doctors and maybe friends of chronically ill people who want a glimpse in will read this (mainly doctors tho)
March 12, 2020
Read this book! A powerful read.
Its spotlight on Endometriosis week - Endo - read this book!
Its spotlight on Endometriosis week - Endo - read this book!
May 18, 2021
You know what, this book took me a LONG fucking time to get through because of uni and work and the general 2020 climate, but it really did not leave my mind the entire time. In fact, I was recommending it to people even when I had barely scratched the surface of it. Pain and Prejudice is powerful, insightful and passionately written, and it unpacks ever facet of sexism, both historically and currently, embedded in health care’s perception of female health and chronic pain. As someone going into the health field, it was transformative in some ways to read this and know I can apply the knowledge to my future. It makes me want to become more knowledgeable in pelvic floor physio/women’s health physio and contribute to a change in the burden of disease and illness in our population. I screenshotted so many great quotes from Jackson’s writing, and I know they will stick with me for a long time. Not to mention, she does a pretty great job at acknowledging the range of genders and sexes who experience issues with female biological health, and the role of intersectionality in these issues. I wish this was a mandatory read for anyone working in health. It really is that good.
January 12, 2020
This book is easy to read, captivating, and important. It’s a book that everyone with a woman in their life should read! I found it incredibly validating and full of the words and explanations I never knew I so deeply needed to hear. Five stars!
January 16, 2023
Journalist Gabrielle Jackson has endometriosis and it is this, and other experiences within the medical system that has led her on this worthy campaign to highlight the way women are marginalized within the health system and to motivate us to learn more about our bodies and stand up for ourselves using that knowledge.
Jackson explores the interaction and inadequacies of medicine from multiple perspectives including women as doctors, patients and as the subject of research. She considers the history of this prejudice by focusing largely on the treatment of pain in various countries. What she claims, most of which is very well supported by solid evidence, is shocking, scary, appalling and all such adjectives. Although, having been a nurse for over 20 years and a female patient for over 60 I knew and had experienced a good deal of what was being said, I was still fascinated and educated by this book. Despite being a little repetitive, and perhaps that is not a bad thing when trying to get a message across, this is a book that needs to be read - not just by women.
Jackson explores the interaction and inadequacies of medicine from multiple perspectives including women as doctors, patients and as the subject of research. She considers the history of this prejudice by focusing largely on the treatment of pain in various countries. What she claims, most of which is very well supported by solid evidence, is shocking, scary, appalling and all such adjectives. Although, having been a nurse for over 20 years and a female patient for over 60 I knew and had experienced a good deal of what was being said, I was still fascinated and educated by this book. Despite being a little repetitive, and perhaps that is not a bad thing when trying to get a message across, this is a book that needs to be read - not just by women.
February 14, 2022
A valuable and fascinating read into the way Western medicine has historically excluded/shunned women from their research and practice. This book is mostly a memoir mixed with cited research. I'm a novice to this particular field so I can't offer much in the way of having a background to this topic. However, her writing was quite open and balanced and she took in many considerations when it comes to the different aspects of female exclusion from healthcare.
I really appreciated her underlying premise which is that as young girls and women, there is an unspoken accepted stance that pain is normal for us. To be in pain, pre or during period, puberty, even consensual sex, childbirth, post partum you name it, that *type of pain* is normal and well, we just have to get on with it. It's an interesting paradigm to consider - is there a biological element that female bodies are built with a specific type of endurance? That are our bodies are strong, but within that strength there is severe pain? Or, has that idea been exacerbated due to a male dominated structure?
Moving on, the author acknowledges her position as a white woman and stresses that her research is based on analysing the Western approach ie. Australian, UK and American.
She does dedicate a chapter to the treatment of Aboriginal women and children and how systematically racist and sexist the healthcare system is in Australia, with correlating issues such as low socio-economic mobility that all coalesce into a terribly underfunded situation. She also discussed the terrible maternity related issues Black women face, in both the US & UK, when going into hospitals - Black women are 3 to 4 times more likely to die than their white counterparts an Black infants are more than twice as likely to die as white infants.
It was an eye-opener. I liked her historical narrative on how the term 'hysteria' has been applied to women struggling to explain their health problems. Of course, I agree with her view that making reproduction and fertility the *only serious* issues women face as absurd and limiting, with dire consequences e.g. heart disease in women being under-studied and misdiagnosed. Her focus was also on talking about endo and chronic widespread pain. She presented a number of statistics showing how government grants or research facilities by the big pharma companies has only recently started to give more money to these specifically female-issues.
Side note - how has the company Johnson & Johnson not been shut down yet!? Amid a whole host of other issues and lawsuits it has faced (persistent cough), there's a section in this book which talks about vaginal mesh implants and how Johnson & Johnson's devices held no proper controlled trials back in 2018. This resulted in more than 100,000 lawsuits and of course, the mostly irreversible physical effects on female bodies.
There were some interesting remarks on the topic of how sexuality in the West has changed - i.e. the so-called Sexual Revolution of the 60s and 70s and the encouragement of masturbation as a way of 'freeing the female-self' from the West's patriarchal society. As a woman of faith, where my religion shapes my worldview, those arguments, which are powerful strands of the general female empowerment movement, are a point of friction for me. Interestingly, the author does acknowledge how pornography and the rise of sexual content in media, in daily life etc, has led to an unprecedented case load of harassment, assault, and more importantly, the objectification of women. The following quotation is good at summarising this:
"the truth of the sexual revolution: it freed men to feel comfortable with their fantasies of sexual dominance without uprooting the culture that shames women and people of all genders and lower social classes both for enjoying sex and for speaking out about sexual violence.”
Having said this, I think Western feminism, particularly the white strain, has a reckoning to face on how far their self professed empowerment has truly liberated them, and how we truly measure that.
Finally, the author cited a number of statistics showing how even though more women are entering medicine, the structures are still heavily male dominated and correlate to a staggering hike in sexual harassment, assault, promotion-hindering and a toxic medical research culture. I also liked the following comment:
"Medicine has become so equated with science that we've forgotten about the art part of it, or the beside manner part of it."
It's a criticism of our super-scientific world, in which the body has been reduced to a lab specimen, and progress is measured in numbers and statistics. This has left a gap in healthcare, where the human/person behind the problem is minimised, and holistic approach which considers the body and mind is laughed at or ridiculed. Like many things in life and history, it's all circular - I wonder at what point is the healthcare system going to move away from a Western approach to a new one?
I really appreciated her underlying premise which is that as young girls and women, there is an unspoken accepted stance that pain is normal for us. To be in pain, pre or during period, puberty, even consensual sex, childbirth, post partum you name it, that *type of pain* is normal and well, we just have to get on with it. It's an interesting paradigm to consider - is there a biological element that female bodies are built with a specific type of endurance? That are our bodies are strong, but within that strength there is severe pain? Or, has that idea been exacerbated due to a male dominated structure?
Moving on, the author acknowledges her position as a white woman and stresses that her research is based on analysing the Western approach ie. Australian, UK and American.
She does dedicate a chapter to the treatment of Aboriginal women and children and how systematically racist and sexist the healthcare system is in Australia, with correlating issues such as low socio-economic mobility that all coalesce into a terribly underfunded situation. She also discussed the terrible maternity related issues Black women face, in both the US & UK, when going into hospitals - Black women are 3 to 4 times more likely to die than their white counterparts an Black infants are more than twice as likely to die as white infants.
It was an eye-opener. I liked her historical narrative on how the term 'hysteria' has been applied to women struggling to explain their health problems. Of course, I agree with her view that making reproduction and fertility the *only serious* issues women face as absurd and limiting, with dire consequences e.g. heart disease in women being under-studied and misdiagnosed. Her focus was also on talking about endo and chronic widespread pain. She presented a number of statistics showing how government grants or research facilities by the big pharma companies has only recently started to give more money to these specifically female-issues.
Side note - how has the company Johnson & Johnson not been shut down yet!? Amid a whole host of other issues and lawsuits it has faced (persistent cough), there's a section in this book which talks about vaginal mesh implants and how Johnson & Johnson's devices held no proper controlled trials back in 2018. This resulted in more than 100,000 lawsuits and of course, the mostly irreversible physical effects on female bodies.
There were some interesting remarks on the topic of how sexuality in the West has changed - i.e. the so-called Sexual Revolution of the 60s and 70s and the encouragement of masturbation as a way of 'freeing the female-self' from the West's patriarchal society. As a woman of faith, where my religion shapes my worldview, those arguments, which are powerful strands of the general female empowerment movement, are a point of friction for me. Interestingly, the author does acknowledge how pornography and the rise of sexual content in media, in daily life etc, has led to an unprecedented case load of harassment, assault, and more importantly, the objectification of women. The following quotation is good at summarising this:
"the truth of the sexual revolution: it freed men to feel comfortable with their fantasies of sexual dominance without uprooting the culture that shames women and people of all genders and lower social classes both for enjoying sex and for speaking out about sexual violence.”
Having said this, I think Western feminism, particularly the white strain, has a reckoning to face on how far their self professed empowerment has truly liberated them, and how we truly measure that.
Finally, the author cited a number of statistics showing how even though more women are entering medicine, the structures are still heavily male dominated and correlate to a staggering hike in sexual harassment, assault, promotion-hindering and a toxic medical research culture. I also liked the following comment:
"Medicine has become so equated with science that we've forgotten about the art part of it, or the beside manner part of it."
It's a criticism of our super-scientific world, in which the body has been reduced to a lab specimen, and progress is measured in numbers and statistics. This has left a gap in healthcare, where the human/person behind the problem is minimised, and holistic approach which considers the body and mind is laughed at or ridiculed. Like many things in life and history, it's all circular - I wonder at what point is the healthcare system going to move away from a Western approach to a new one?
October 17, 2021
Very important topic, so brave to write about it and I really loved the first half (demonstrated lack of female knowledge of our own bodies, and was informative and educational to change that lack right away, plus more anecdotal story telling of women and their experiences and some amazing women and men who are trying to change things), but the second half was I think too full of research statistics. It was hard to plow through and keep reading and the statistics seemed difficult at times to convert into meaning and very repetitive. I admire so much this author and what she has created, I feel her and can relate to this topic so strongly, I just thought the first half was more effective and enjoyable than the last. Also I leave the book feeling a bit angry and depressed. Maybe too much heaviness in my life at moment. Have to take these kinds of books when you're feeling strong.
July 19, 2020
This is a very important topic and a good book, and there are many people I would recommend it to. I was particularly fascinated by the statistics and studies it discusses (as anyone who’s spoken to me about any tangentially related topic in the last few weeks has found out), and its discussion of how medical education can and should change.
I always have trouble objectively rating medical books written for non-medical audiences - there are inevitably frustrations with the way some concepts are communicated, and I often feel a bit like I’m reading a textbook. This book had some of these features, and conversely there were some structural and written elements that I felt may be prohibitive to those with low health literacy.
I always have trouble objectively rating medical books written for non-medical audiences - there are inevitably frustrations with the way some concepts are communicated, and I often feel a bit like I’m reading a textbook. This book had some of these features, and conversely there were some structural and written elements that I felt may be prohibitive to those with low health literacy.
May 18, 2021
This was a great read and explained so much about the systemic gender bias in healthcare. I appreciated so much seeing endo described as the debilitating disease it is. I also learned a lot about why the medical profession has the attitudes it does toward people (namely, women, non-binary and trans people) with chronic pain. I felt both seen and incensed at the same time. I wish every doctor had to read this book. I recommend this book to anyone interested in the way the healthcare system treats anyone who isn’t a white, cis-male and the history behind the implicit bias in healthcare.
December 27, 2021
I never read health books but this is an absolute must.
January 1, 2022
A must read.
May 4, 2022
Very interesting and enlightening, but also slightly depressing, so I had to read this in short sessions.
May 26, 2023
Pain and Prejudice: A Call to Arms for Women and Their Bodies by Gabrielle Jackson is an excellent addition to my health feminism and bias in medicine shelves.
She does an excellent job of laying out why there are no incentives for treating or researching chronic pain, and how the healthcare system must adjust; she also makes a good case for why this change should come from the government and their funding. She breaks down well how the system is not set up for something like chronic pain, and highlights the issues of 'heartsink' patients, the pressure on doctors to cure and have all the answers rather than mitigate or investigate, and how a higher life expectancy does not necessarily mean a better life quality.
I've reviewed many of these books and so I want to highlight specifics that Jackson brings to the table that I did not find in other books. These include a breakdown of Chronic Overlapping Pain Conditions (COPCs), descriptions of each of the primary ones and how they intersect, and a focus on chronic pain conditions overall throughout the book. She has a especially excellent breakdown of how the lack of knowledge of female biology overall results in hysteria narratives, an enforced need for women to go to the doctor more often for basic prescriptions due to an inherent distrust or policing, and how overall misogyny and sexism ties in with our inability to believe women about their pain. I appreciated how Jackson paired her discussion of a lack of education in female biology and chronic pain with an in-depth education about those things for women who might need it.
I also appreciated her quoting and acknowledging Maya Dusenbery. I've found that many books recently quietly use her research or issues she brought to the forefront but bypass her specifically, and so I really appreciated how much she was highlighted for her analysis of this issue.
Overall, Jackson's book is a tremendous success and call-to-action about the bias in medicine against women, the failures of the health-care system to treat or consider chronic pain conditions, and what can be changed. Her own endometriosis story influences much of her writing, and it adds a particular indignation throughout that is tremendously satisfying and convincing.
Content warnings for sexual assault, compulsory sexuality, misogyny, medical trauma.
She does an excellent job of laying out why there are no incentives for treating or researching chronic pain, and how the healthcare system must adjust; she also makes a good case for why this change should come from the government and their funding. She breaks down well how the system is not set up for something like chronic pain, and highlights the issues of 'heartsink' patients, the pressure on doctors to cure and have all the answers rather than mitigate or investigate, and how a higher life expectancy does not necessarily mean a better life quality.
I've reviewed many of these books and so I want to highlight specifics that Jackson brings to the table that I did not find in other books. These include a breakdown of Chronic Overlapping Pain Conditions (COPCs), descriptions of each of the primary ones and how they intersect, and a focus on chronic pain conditions overall throughout the book. She has a especially excellent breakdown of how the lack of knowledge of female biology overall results in hysteria narratives, an enforced need for women to go to the doctor more often for basic prescriptions due to an inherent distrust or policing, and how overall misogyny and sexism ties in with our inability to believe women about their pain. I appreciated how Jackson paired her discussion of a lack of education in female biology and chronic pain with an in-depth education about those things for women who might need it.
I also appreciated her quoting and acknowledging Maya Dusenbery. I've found that many books recently quietly use her research or issues she brought to the forefront but bypass her specifically, and so I really appreciated how much she was highlighted for her analysis of this issue.
Overall, Jackson's book is a tremendous success and call-to-action about the bias in medicine against women, the failures of the health-care system to treat or consider chronic pain conditions, and what can be changed. Her own endometriosis story influences much of her writing, and it adds a particular indignation throughout that is tremendously satisfying and convincing.
Content warnings for sexual assault, compulsory sexuality, misogyny, medical trauma.
December 2, 2021
This is an accessible and well informed book, highlighting the systematic problem of discrimination against women by the medical industry and bringing awareness to an issue that needs to be spoken about more. Too many women have been gaslit, dismissed or received the wrong (or no) diagnosis. So many diagnoses are focused on symptoms that men experience and there is a historic lack of research into how conditions manifest in women.
“In medicine, man is the default human being. Any deviation is atypical, abnormal, deficient.”
This book has a lot of research, interviews and personal experiences included to back up the statements Jackson makes. The sheer volume of harmful medical experiences of women and young girls is both eye-opening and alarming. Equally, hearing about other women’s experiences provides the validation for our own personal experiences – ones that we may have written off or blamed ourselves for.
There is also a focus on the normalisation of harmful sexual experiences and the fact that many women who experience pain during sex dismiss it as normal or something to be expected rather than seeking medical advice.
“Research in 2014 that looked at the sex lives of young women found an uncomfortable social setting where women’s pleasure and desires are neglected, where painful sex for women is seen as normal and where there appears to be a real risk of coercion.”
I also liked that Jackson included a call to action for males. This is not just a woman’s issue, this is everyone’s issue and we need to ensure that women are receiving the medical care they deserve. Men have the power to help influence change and they should be part of the conversation.
“In medicine, man is the default human being. Any deviation is atypical, abnormal, deficient.”
This book has a lot of research, interviews and personal experiences included to back up the statements Jackson makes. The sheer volume of harmful medical experiences of women and young girls is both eye-opening and alarming. Equally, hearing about other women’s experiences provides the validation for our own personal experiences – ones that we may have written off or blamed ourselves for.
There is also a focus on the normalisation of harmful sexual experiences and the fact that many women who experience pain during sex dismiss it as normal or something to be expected rather than seeking medical advice.
“Research in 2014 that looked at the sex lives of young women found an uncomfortable social setting where women’s pleasure and desires are neglected, where painful sex for women is seen as normal and where there appears to be a real risk of coercion.”
I also liked that Jackson included a call to action for males. This is not just a woman’s issue, this is everyone’s issue and we need to ensure that women are receiving the medical care they deserve. Men have the power to help influence change and they should be part of the conversation.
This entire review has been hidden because of spoilers.
September 4, 2023
Just as a note on my review: I began reading this in 2020, shortly after it was published and I only picked it up again last week (this is nothing to do with the quality of the book and all to do with my personal life). In that period of time, a lot in medicine has changed, but a lot has not.
I think everyone should read this, not because it is the best thing since sliced bread when it comes to women’s medicine, but because it’s a very well rounded look at the way that history, society, and stereotypes have led to women being overlooked when it comes to healthcare.
I was shocked by some things and not surprised by others. Overall it is definitely worth a read and it’s also a good place to start if you want to know more and I would get ready to highlight/note/write in the margins as soon as you turn the first page.
However, I would highly recommend some follow up research on what has changed since the book was first published.
‘Pain doesn’t actually kill people- it keeps women in the home and out of work, which has no effect on the power structures of society’
I think everyone should read this, not because it is the best thing since sliced bread when it comes to women’s medicine, but because it’s a very well rounded look at the way that history, society, and stereotypes have led to women being overlooked when it comes to healthcare.
I was shocked by some things and not surprised by others. Overall it is definitely worth a read and it’s also a good place to start if you want to know more and I would get ready to highlight/note/write in the margins as soon as you turn the first page.
However, I would highly recommend some follow up research on what has changed since the book was first published.
‘Pain doesn’t actually kill people- it keeps women in the home and out of work, which has no effect on the power structures of society’
January 3, 2023
Quite surprised this book only achieved 4.18 stars. I’d call this a must read for everyone. The cover says ‘every girl, woman and man - and most particularly every doctor - should read it.’ I’d add to that every teenage boy. A lot is very important for them to also understand.
I also note that all the reviews here (I only scrolled through the first 50 or so) are by women. I wonder if the title of the book is off. ‘Pain and Prejudice’ js great. But ‘A call to arms for women and their bodies’ I think is likely deterring men and boys from thinking there is anything relevant here for them.
I also note that all the reviews here (I only scrolled through the first 50 or so) are by women. I wonder if the title of the book is off. ‘Pain and Prejudice’ js great. But ‘A call to arms for women and their bodies’ I think is likely deterring men and boys from thinking there is anything relevant here for them.
November 9, 2022
Every person should read this book. “Woman are born with pain built in.”
Educational, heartbreaking, funny.
Educational, heartbreaking, funny.
December 8, 2025
‘pain isn’t killing us, but it is denying us of our full humanity’
reading this was very interesting and informative, but it also made me feel less alone in my pain
reading this was very interesting and informative, but it also made me feel less alone in my pain
October 8, 2021
This book was really good. It took me a really long time to read because it made me really, really sad. I am a female medical student with a chronic pelvic pain diagnosis so this book described the failings of my future career in an area of medicine that directly impacts my health.
A really important read, would recommend for anyone with or without a uterus.
A really important read, would recommend for anyone with or without a uterus.
August 3, 2021
Deeply grateful to Gabrielle!
This brilliant book detailing the gender gap in medicine helped me recognise the systemic issues that led to my repeatedly unsuccessful attempts to get help.
Having suffered for 24 years with endometriosis and only just getting a diagnosis 2 months ago this book armed me with the research and historical context to comprehend the enormity of injustice that not only affected myself but so many women and people with reproductive organs!
Despite the harrowing statistics and shocking information within, it is an inspiring book that drives a desire in me to speak out and work towards transforming this mad reality!
This brilliant book detailing the gender gap in medicine helped me recognise the systemic issues that led to my repeatedly unsuccessful attempts to get help.
Having suffered for 24 years with endometriosis and only just getting a diagnosis 2 months ago this book armed me with the research and historical context to comprehend the enormity of injustice that not only affected myself but so many women and people with reproductive organs!
Despite the harrowing statistics and shocking information within, it is an inspiring book that drives a desire in me to speak out and work towards transforming this mad reality!
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