Female Hysteria and Healthcare: How Does the History of Female Hysteria Affect Women’s Healthcare Today?
By Tulsa Johnson
When I was in high school, I read a short story by Charlotte Perkins Stetson called “The Yellow Wallpaper”. In reading this story I felt comraderie with the main character’s experiences. Published in 1892, “The Yellow Wallpaper” expresses a woman’s descent into madness resulting from the patriarchal views of her husband. The main character of the story, likely suffering from postpartum depression is treated for hysteria by her physician husband who does not believe she is sick. He treats her by locking her in a room with yellow wallpaper. In her confinement, she begins to see a woman in the wallpaper and is consumed by the urge to free her from her confines. This leads to the eventual deterioration of her mental state, believing she was the woman in the yellow wallpaper who is now freed. When I read this, I got overwhelmingly angry. I struggled for five years to obtain a diagnosis for my arthritis and fibromyalgia, a disorder that causes pain, tenderness throughout the body, fatigue, and trouble sleeping. Doctors do not know what causes fibromyalgia however it is more common in females than it is in males. I was a kid when I was struggling to get a diagnosis and, unfortunately, my age did not aid my credibility. I was often told my pain was due to stress or “it was all in my head”. I had such a visceral reaction to the book because I felt the fear the main character felt. I felt the disappointment and abandonment that drove her to madness. To aid myself after my diagnosis I started to investigate the experiences I had in the doctor’s office and found that sadly, not only is this a big problem, but a very old one. That got me thinking, how does the history of female hysteria affect women’s healthcare today? To examine this question, I need to examine the history of female hysteria, the discrimination females face in the doctor’s office today, and whether the system of healthcare is set up to help women. In this paper I will be using women and females interchangeably however it is prudent to note that these experiences are not exclusive to people who identify as women but also with assigned female at birth (AFAB) people and female-presenting people.
To begin one must look at the history of female hysteria to understand how society has viewed women’s pain in the past. The ancient Egyptians in 1900 BC identified the cause of hysterical disorders as spontaneous uterus movement within the female body. The Argonaut Melampus believed that women’s madness was caused by their uterus being poisoned from a lack of orgasms and uterine melancholy. In Greece, the idea of female madness was related to the lack of a normal sexual life. Plato argued that the uterus is sad when it does not join with a male and becomes pregnant. He believed that to fix this, women must engage in wine and orgies. Hippocrates was the first person to use the term hysteria and he also believed that the cause of this disease lies in the movement of the uterus. In Rome around the 1st century BC, Aulus Cornelius Celsus said epileptic-like symptoms arise in women from a sick uterus. Claudius Galen says of hysteria that ancient physicians and philosophers have called this disease hysteria from the name of the uterus (Tasca et. al.). This all goes to show the main idea throughout early human history, women’s uteruses will become sick unless they have children. This blatantly dismisses all other problems women have and makes it so the solution to any problem is to engage with a man, often for the pleasure of the man in the situation. A more “scientific” view of hysteria and treatments emerged in late-medieval Europe. A subsection of the scientific community began to view female hysteria as having some relation to the nervous system and the brain. For example, this idea advocated the use of lemon balm as a natural nerve comforter. Psychotherapy was also practiced as a treatment for female hysteria around this time. However, the world did not move on from its prior beliefs, and at the time women were often not described as patients but rather as the cause of the disease as a result of unfulfilled sexual desire. Generally, women were viewed as physically and theologically inferior beings, an idea that has its roots in the Aristotelian concept of male superiority. St. Thomas Aquinas believed that women were failed men and considered women a consequence of sin. In the thirteenth century, the Inquisition saw manifestations of mental illness as bonds between women and the Devil. Exorcisms were used to treat women with hysteria and were considered a cure; however, during the late Middle Ages, exorcisms became a punishment as hysteria was confused with sorcery (Tasca et. al.). Women become viewed as morally corrupt and the cause of their disorders. Due to oppressive forces, they were eventually punished for their supposed disorder. In the late nineteenth and early twentieth century, hysteria was treated with vibrators, hypnosis, or an insane asylum. Men were historically considered more reliable as witnesses to the functioning of their own bodies than women (Chainey). Women’s bodies have always been viewed to be solely sexual. Problems that they had were a result of this unfulfilled purpose and inevitably morally corrupt due to that fact.
All this history leads into the present-day ideas of women’s health which is defined as the branch of medicine consisting of the treatment and diagnosis of diseases and conditions that affect women's physical and emotional well-being (Tecco and Cheek). Clinicians often act as though women’s physical symptoms are exaggerated or made up. Often, they believe an emotional or mental disturbance causes the symptoms of which they complain. People who have unexplained neurological issues many times are diagnosed with conversion or somatoform disorders, which are considered to be modern-day forms of female hysteria. Women are up to ten times more likely to receive one of these diagnoses than men. Women who have lupus, fibromyalgia, chronic fatigue syndrome, and Parkinson’s disease deal with years of misdiagnosis and incorrect treatment before they receive due care (Lines). One would also think with all the years of uterine obsession it would be quite easy to get an endometriosis diagnosis; however, a diagnosis of endometriosis takes an average of 7.5 years, as complaints are consistently attributed to normal menstrual function (Chainey). Women feel this discrepancy in the doctor’s office. More than a quarter of women polled said a healthcare provider ignored or dismissed symptoms they reported, and thirty-one percent felt they needed to prove their symptoms to their doctor. Twenty-five percent of women polled said a healthcare provider did not take their pain seriously (“Feel Discriminated against at the Doctor’s Office? You’re Not Alone”). Forty-five percent of women said they have been labeled as chronic complainers (Tecco and Cheek). Young women felt especially dismissed by their healthcare providers and of women eighteen to thirty-four with a chronic health condition, forty-nine percent felt they needed to prove their symptoms, and thirty-eight percent said their symptoms were ignored or dismissed by a healthcare provider. Nearly half of women with chronic conditions under thirty-four said their doctor did not diagnose their condition properly and nearly one in every three women polled under fifty-four said the same. This is compared to eighteen percent of women over age fifty- four saying that their doctor did not diagnose their condition properly. Women struggle more with healthcare than men do even just at the surface-level. Due to these experiences, women engage less in healthcare for fear of being discredited and ignored. Not only is this disheartening and unhelpful but the added monetary loss makes the idea of a woman going to the doctor deplorable. Therefore, for a woman to go to the doctor she must be in extreme pain or fear for what is going on with her body. Sadly, even if doctors were to listen to her, they are not adequately trained to help women, and the system is not set up to keep women safe.
Society is not organized to keep women safe and when they get hurt, it is not built to keep them alive. Women are forty-seven percent more likely than men to get severely injured in car crashes even when using seat belts as car safety testing is done with male test dummies. Women are underrepresented in clinical trials and therefore have a greater risk for adverse side effects from medications (Tecco and Cheek). In fact, until 1993 there was no precedent for diversity in clinical research. The Revitalization Act of 1993 Public Law 103-43 made for clinical trials to include women and minorities as a part of their human test group (National Institutes of Health). Thirteen-point-three percent of women and twelve-point-six percent of men whom male doctors treated, died from complications of heart attacks when coming into the emergency room. Female doctors provided treatment that resulted in twelve percent of the women dying and eleven-point- eight percent of the men dying. Though the survival rate of female patients increased as men practiced on more women patients it came at the expense of the earlier female patients (Greenwood et. al.). This lends credence to the idea that the male-centric model medical professionals are taught is harmful as they do not learn how to treat women in the field, often at the cost of the patient’s life. Women’s inclusion in studies and research is a rather recent development and its effects are not yet felt in the medical field. Hopefully, with time these effects will start to impact patient care.
There are ways to mitigate this or work towards a better future. Things such as training clinicians in implicit biases and listening skills, programs that help patients navigate the healthcare industry, and finding research that conducts analyses on sex- and gender-related differences based on the particular disease or condition (Lines). There are gendered differences that need to be examined. Many diseases present differently in men and women, such as autism (Schuck et. al.) and heart attacks (“Women vs. Men Heart Attack Symptoms”). Doctors also need to take the time to examine the institutional biases they operate under and examine their behavior. As a person who has experience with this, I am convinced that it is a large issue that has made my quality of life worse; and it is something we as a society should try to prevent other women from experiencing. Women are entitled to health and fair treatment in a doctor’s office, not the gaslighting they currently experience.
References
Chainey, Naomi. “How Sexism Is Hindering Medical Research.” The Sydney Morning Herald, The Sydney Morning Herald, 11 Feb. 2018, https://www.smh.com.au/lifestyle/health-and-wellness/how-sexism-is-hindering-medical-research-20180206-h0uy60.html
“Feel Discriminated against at the Doctor’s Office? You’re Not Alone.” TODAY.Com, TODAY, 13 May 2019, https://www.today.com/health/today-survey-finds-gender-discrimination-doctor-s-office-serious-issue-t153641
Greenwood, Brad N., et al. “Patient–physician gender concordance and increased mortality among female heart attack patients.” Proceedings of the National Academy of Sciences, vol. 115, no. 34, 6 Aug. 2018, pp. 8569–8574, https://www.pnas.org/doi/10.1073/pnas.1800097115
Lines, Lisa M. “The Myth of Female Hysteria and Health Disparities Among Women.” RTI International, RTI International, 9 May 2018, https://www.rti.org/insights/myth-female-hysteria-and-health-disparities-among-women
“NIH Policy and Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research.” National Institutes of Health, U.S. Department of Health and Human Services, https://grants.nih.gov/policy-and-compliance/policy-topics/inclusion/women-and-minorities/guideline, Accessed 24 Feb. 2024.
Schuck, Rachel K et al. “Brief Report: Sex/Gender Differences in Symptomology and Camouflaging in Adults with Autism Spectrum Disorder.” Journal of autism and developmental disorders vol. 49,6 (2019): 2597-2604. doi:10.1007/s10803-019-03998-y
Tecco, Halle, and Julia Cheek. “WOMEN’S HEALTH IS MORE THAN FEMALE ANATOMY AND OUR REPRODUCTIVE SYSTEM—IT’S ABOUT UNRAVELING CENTURIES OF INEQUITIES DUE TO LIVING IN A PATRIARCHAL HEALTHCARE SYSTEM.”
Women’s Health Is More than Female Anatomy and Our Reproductive System-It’s about Unraveling Centuries of Inequities Due to Living in a Patriarchal Healthcare System. - Blog: Health Supplement, 18 Jan. 2022, https://www.hbs.edu/healthcare/blog/post/defining-womens-health-womens-health-is-more-than-female-anatomy-and-our-reproductive-systemits-about-unraveling-centuries-of-inequities-due-to-living-in-a-patriarchal-healthcare-system
Tasca, Cecilia et al. “Women and hysteria in the history of mental health.” Clinical practice and epidemiology in mental health : CP & EMH vol. 8 (2012): 110-9. doi: 10.2174/1745017901208010110
“Women vs. Men Heart Attack Symptoms.” Www.heart.org, https://www.heart.org/en/health-topics/house-calls/women-vs-men-heart-attack-symptoms
“The Yellow Wallpaper.” Sparknotes, SparkNotes, https://www.sparknotes.com/lit/yellowwallpaper/section1/ Accessed 26 Feb. 2024.