Pain and Prejudice by Gabrielle Jackson – Rather Missing The Point Here


There are indeed historical reasons why we know more about the male body than the female. We could even describe the reasons why as being the result of prejudice.

But none of these cures were proven, and most of the causes were entirely theoretical – because women have rarely been studied in detail by medical science. You just need to look at a textbook to see that the default human is a slender white man, and any difference has always been considered a deficit: uninteresting and not worthy of scientific pursuit.

Well, no, not really. Rather, most of the vivisection which led to grasping how the body bits worked together was done on the corpses of condemned criminals. Most of which were men because that’s just the way the prejudice worked. More men than women were hanged over the centuries. Appalling sexism by our forbears of course but there we go.

Women weren’t included in clinical trials until the 1990s. While we make up 70% of chronic pain patients, 80% of pain medication has been tested only on men. Even in preclinical trials with cell lines and rodents, males have been favoured over females. Researchers have justified this bias by claiming that oestrous cycles in female rodents – and menstrual cycles in human women – would potentially corrupt results. If that were so, wouldn’t it be quite important to find out before selling the drug to women?

Yes, it’s true, that hormonal cycle has led to men being favoured as the experimental subjects. There’s also the point that we test stuff on volunteers, more men than women – among the usual poverty stricken student population that is the usual source – volunteer to be tested upon.

But it’s not just this. Up until recently – the pill was only in the 1960s recall – an adult women might spend half of her fertile years – you know, those healthy adult ones – either pregnant or lactating. Not times that we really want to be trying out experimental drugs on them. True, we might actually have wanted to do rather more of this but then we can read the thalidomide problem either way, do or don’t test on the pregnant.

We can, obviously, call this prejudice and or sexism. Or even being sensible.

The 1990s sounds about right as when this might change too. What’s the fertility rate at this point? What portion of adult life is spent pregnant or lactating?

Then there’s this:

When I was diagnosed with endometriosis at age 23, I didn’t know enough to ask the right questions. I assumed my gynaecologist had all the answers, and listened carefully to his thoughtful explanations. I thought I knew it all. Or at least that he knew it all. But I was wrong. It was only after more than a decade of feeling weak, second-rate, wimpy and writing myself off as a hypochondriac that I started to formulate the questions that needed to be asked. This time the questions weren’t about what was happening to my body. They were about how there could possibly be such a lack of knowledge about a disease that has been in the medical textbooks for more than a century.

A century of diagnosis and medical science still has no idea what causes endometriosis or how it works, and we are no closer to a cure.

Well, no, not really. The cause – proximate, not ultimate – is tissue akin to the lining of the womb turning up not as lining of the womb. That hormonal cycle then leads to something very akin to menstruation where it ain’t supposed to be happening. We also know how to cure it. Remove the tissue that runs the hormonal cycle – radical hysterectomy? Ovectomy? – and we’re done.

Or, obviously enough, go permanently on the pill in order not to have the hormonal cycle.

True, this isn’t a cure. But then there are a lot of medical problems that we can’t cure, can only manage.

Can’t help thinking that the lady doth protest too much, hasn’t quite grasped the subject she’s just written a whole book about. But then perhaps this is just mansplainin’