Development of women’s health centres in NSW, the establishment of women’s health movement, the need for gender specific services and the Blacktown Women’s and Girls’ Health Centre Inc………

The resurgence of the Women’s Movement in the late 60s and 70s brought a new awareness amongst women of the effects of their social conditioning and disadvantaged position in society.

Issues relating to women’s health and existing health care services also became a major focus at the time. Women expressed dissatisfaction with the nature, provision and direction of existing services. In particular they complained of paternalism in a predominately male medical profession, of having their complaints trivialized or denied, of receiving little or no information regarding medical procedures and prescribed treatment and of the increasing medicalisation of normal events such as pregnancy, birth and child rearing.

It is acknowledged that there are aspects of health which are gender neutral (eg a broken leg), however, other areas of medicine are strongly influenced by the gender of both the patient and practitioner.

Historically the gender of doctors has been almost exclusively male. Certainly the people who administer funds, decide curricula, choose research projects and determine priorities in medicine have been male. This has profound consequences for women’s health.

Instinctively, people ground their knowledge and interests in what they know and experience in their own lives. Men know about maleness and it has been assumed that this maleness is the normal human condition, however there are fundamental ways in which women and men differ in their embodiment. One of these is that men’s experience of their biology is monophasic. Apart from puberty, men have a straight line relationship with their bodies.

In contrast, women’s bodies are cyclical. Women have menarche and menopause and monthly menstrual cycles for the intervening years. Unconsciously women constantly monitor their bodies to their cycles. This habit of body surveillance means that women pick up the signs of illness quickly, and may be one reason to explain why women frequent medical services more often than men. 

Women have a number of specific health needs:

BODILY: We have periods, pregnancy and childbirth, go through menopause and are in most cases responsible for contraception. Women’s entire reproductive systems have a significant impact on both their physical and emotional well-being.

LIFESTYLE: Women are the main caregivers to children and usually fulfill the role of linchpin within a family.

ISSUES:  Such as domestic violence, incest and sexual assault mainly effect women and require a sensitive approach. 

The reality is that men do not have a direct experience of the effects of women’s gynecological and reproductive systems, and this makes it difficult for them to provide appropriate and empathic treatment for women. This has been compounded by the lack of training provided to medical practitioners in this area.

The different relationship that men and women have to their bodies has consequences for the way our health system is structured. For instance, men are more focused on dramatic or crisis intervention and in a medical system which reflects male values a lot of resources are devoted to coronary and intensive care units. In a medical system which reflected women’s concerns, more resources would be put into primary care and prevention. This system would explore the relationship of the illness to the whole person and the way people interact with their environment.

Funding structures and research are two primary ways in which the dominant male understanding is reinforced. The Medicare system is an elaborate schedule of fees which has been negotiated between doctors and the health department. These fees reflect what these two groups consider is valuable and worth rewarding. What is most important is the high technology quick fix. Surgery and high tech toys such as cat scans and pathology tests are well rewarded. In contrast listening, diagnosis and education is not well rewarded. 

The notion of male normalness also pervades the area of research. In trials of new medicines or therapies researchers often use only male subjects. For example in the Physician Health study, an extremely expensive study which involved 22,071 people, all the people were male. One of the conclusions of the study was that a small dose of aspirin could be prophylactic against heart disease. The findings were passed onto doctors world wide and doctors began advising their male and female patients that a small dose of aspirin was a good idea, although there is no evidence that this is so for women. This is no accident – women are deliberately excluded from medical research because they are biologically too complex and get in the way of ‘efficient’ research. The complex rhythms women experience make them too hard to study. 

Our health includes how we feel emotionally and how we see ourselves as well as what’s happening in our bodies……