What Getting an IUD Taught Me About Medical Misogyny

There’s nothing quite like a doctor’s appointment. The vulnerability of showing your most intimate self to a stranger, the looming possibility of judgment, the fear of an unwelcome diagnosis. For women, this anxiety runs deeper, colored by experiences that go beyond just a big white box.

Hospitals have never seemed particularly daunting to me. While most people would disagree, the clean, white sterility always felt welcoming—reassuring, even. But as I’ve grown, I’ve realized that hospitals should offer more than just a façade of cleanliness. They should provide care that is informed, empathetic, and free of the biases that often undermine women’s experiences.

In Africa, birth control use has surged by 56.1%, with injectables emerging as the most popular option. Despite this increase, many women report significant gaps in their healthcare experiences, citing a lack of knowledge and empathy from their doctors.

When I first walked into the clinic to get an IUD, I was optimistic. I had done my research, prepared myself mentally, and felt confident in my decision. The clinic staff were unusually kind, a rarity in many Nigerian hospitals. Seeing only female doctors and nurses made me even happier; it seemed considerate and reassuring. But as it turned out, my confidence was premature. I soon realized that I had much more to worry about than just friendly nurses.

The actual insertion was far more painful than I had been led to believe. I couldn’t help but wonder why no form of pain relief or anesthetic was offered. Initially, I thought this might be a uniquely Nigerian issue. However, I soon discovered that women around the world share this experience. Doctors often overestimate women’s pain thresholds, dismissing their discomfort as something everyone should be able to bear, silently questioning what’s wrong with you.

The procedure itself is fairly straightforward. A speculum is inserted into the vagina, followed by a special device that places the IUD. It’s supposed to take no more than five minutes. But when you’re on that table, with half your body hanging off the edge and the torture device that is the speculum shoved into your deepest crevices, five minutes feels like an eternity. Many websites claim that “some women experience cramping,” but I’m inclined to believe that unless you’re one of those rare women who sneeze and give birth, you *will* experience cramping. The speculum alone is uncomfortable, and that’s just the beginning.

After the insertion, you’re advised to rest. Ideally, someone should drive you home, and you should avoid work or strenuous activity for a day or two, as bleeding and cramping are common in the days following the procedure. However, like me, you might find yourself heading straight to the market afterward, going to work the next day, and even attending classes the day after that—all because the “research” you thought you did, and the information you thought you had, failed to prepare you for the reality.

“Many women, according to surveys, even drive themselves home after the procedure, a testament to the lack of care and support they receive.”

Contrary to what some might think, sexism isn’t just about outdated notions like “women belong in the kitchen.” It’s a systemic issue, woven into the fabric of society, where situations are naturally tilted in favour of men. This is particularly evident in healthcare, where medical misogyny thrives.

Broadly speaking, medical misogyny refers to the gender biases that affect (or create barriers to) medical care for women—whether those biases are conscious or unconscious. Despite the fact that women represent over 70% of the healthcare workforce, they are largely concentrated in nursing and caregiving roles. In contrast, men dominate decision-making positions, such as Chief Medical Directors (CMDs), hospital presidents, board members, and department heads. This male-dominated hierarchy perpetuates a system where women’s needs and experiences are often overlooked or dismissed.

Medical misogyny shows up in so many places. Men prescribed opioids while women get Tylenol for the same problem. No pain management for IUD insertion. Over diagnosis of BPD in women. Delayed diagnosis and treatment for endometriosis. Requiring husband permission for tubals…

— RobinHoodlum (@RobinHoodlum) August 24, 2024

To fully grasp the depth of medical misogyny, it’s crucial to explore its historical roots. Consider the modern vaginal speculum, a tool routinely used in gynecology. It was developed by J. Marion Sims, a 19th-century doctor who conducted experiments on enslaved women without anesthesia. These unethical and inhumane experiments earned Sims the title of the “father of modern gynecology.”

Today, despite its troubling history, this tool remains the standard method for examining women regardless of the fact that most medical technology have continued to evolve. Laparascopic cameras and AI powered tools exist yet women are subjugated to an archaic tool. This has persisted that some women have taken it upon themselves to recreate and redesign the modern speculum which is a giant leap in the right direction. However, my question is why it took so long to realize that women deserve better.

Medical misogyny relegates female-predominant illnesses to the "functional"/hysteria sewer in a reciprocal, reinforcing process: the lack of respect ensures research isn't conducted to find biological causes, and the lack of empirical evidence serves to confirm the bias. pic.twitter.com/CQYwjwBemz

— Dreamy Run (@dreamy_run) September 16, 2024

From my research and experience, medical misogyny permeates various aspects of a woman’s experience in healthcare. Academically, there’s a glaring lack of data and research specifically focused on women. It wasn’t until the 1990s that women were consistently included in clinical trials. Before this, test subjects were predominantly male, creating a significant knowledge gap in understanding how women react to certain treatments.

This gap is compounded by the persistent dismissal of women’s pain due to pre-existing biases. Women are often stereotyped as the more emotional and dramatic sex, leading to their pain being downplayed or outright ignored by medical professionals. As a result, misdiagnosis is common, particularly with conditions like endometriosis and polycystic ovary syndrome (PCOS). Studies show it can take an average of seven years for a woman to be correctly diagnosed and start a proper treatment plan. Many women recount experiences of being prescribed painkillers or told to lose weight instead of receiving the care they need.

medical misogyny bro, why is your response to a woman’s pcos diagnosis is for her to get married????

— iced tea (@missandryea) September 14, 2024

These instances of medical misogyny are further fuelled by the lack of protection for women’s sexual and reproductive rights. The female body has been dissected and politicized to such an extent that laws regarding women’s health are often made for the perceived good of society, which frequently contrasts sharply with what is actually beneficial for women. Such biases have lingered in healthcare for centuries, and undoing them requires a fundamental re-education of medical professionals—starting from medical school curricula to ensure these outdated ideas are not only rejected but replaced with accurate and compassionate knowledge. Compassion and Empathy also needs to be reintroduced to the medical profession. Doctors need to be taught how to balance believing their patients and trusting their gut.

Women on the other hand need to advocate for themselves. It is not enough to fight the good fight intellectually but not personally. It’s your body, and you have the right to fully understand what is happening with it. Demand the care you need; refuse a treatment that is not right for you; ask for a second opinion. Ensure that you are doing all you can to make sure your voice is heard.