A trailblazing, conversation-starting history of women's health--from the earliest medical ideas about women's illnesses to hormones and autoimmune diseases--brought together in a fascinating sweeping narrative. Elinor Cleghorn became an unwell woman ten years ago. She was diagnosed with an autoimmune disease after a long period of being told her symptoms were anything from psychosomatic to a possible pregnancy. As Elinor learned to live with her unpredictable disease she turned to history for answers, and found an enraging legacy of suffering, mystification, and misdiagnosis.
In Unwell Women, Elinor Cleghorn traces the almost unbelievable history of how medicine has failed women by treating their bodies as alien and other, often to perilous effect. The result is an authoritative and groundbreaking exploration of the relationship between women and medical practice, from the wandering womb of Ancient Greece to the rise of witch trials across Europe, and from the dawn of hysteria as a catchall for difficult-to-diagnose disorders to the first forays into autoimmunity and the shifting understanding of hormones, menstruation, menopause, and conditions like endometriosis.
Packed with character studies and case histories of women who have suffered, challenged, and rewritten medical orthodoxy--and the men who controlled their fate--this is a revolutionary examination of the relationship between women, illness, and medicine. With these case histories, Elinor pays homage to the women who suffered so strides could be made, and shows how being unwell has become normalized in society and culture, where women have long been distrusted as reliable narrators of their own bodies and pain. But the time for real change is long overdue: answers reside in the body, in the testimonies of unwell women--and their lives depend on medicine learning to listen.
This is a really tricky one to rate. On the one hand, Elinor Cleghorn writes with convincing passion about how the long-standing patriarchal biases of the medical profession have resulted in the misunderstanding of women's illnesses and suffering, and have often compounded them. (Cleghorn looks at western Europe fairly broadly in the early part of the book, but the closer she gets to the present day the more she focuses on Anglophone bio-medicine in the UK and US.) I appreciated her awareness of how race and class affect how women are treated: wealthy white women might be patronised or infantilised about their illnesses, but Black women's pain is often dismissed by physicians as non-existent. Some of the events Cleghorn recounts are really horrific, like the early testing of the contraceptive pill on poor and mostly illiterate Puerto Rican women who were unable to give informed consent and who suffered horrific side effects.
On the other hand, Cleghorn isn't actually a trained historian of medicine (her Ph.D. is in "humanities and cultural studies", and her dissertation appears to have been on twentieth-century dance and film studies), and it shows. Her understanding of ancient and medieval history simply isn't strong, either in the general terms or in the specifics of medical history. There are factual errors (no, Gutenberg didn't invent the printing press in 1500; no, dissection was not illegal in the Middle Ages), simplistic presentations of medieval women like Jacoba Felicie and Trota (the yas queen framing of the latter in particular had me side-eyeing), and an overall reliance on cliché not grounded in any real knowledge of pre-modern history (the Middle Ages as a "time of superstition" while the eighteenth-century was one of enlightenment—both characterisations that don't quite work because they're founded on a Whiggish belief in history as an upward trajectory).
Cleghorn is writing with the goal of improving the lot of women in the present day, and that is an admirable goal! But at least in the earlier chapters of the book I could see a tendency on her part to highlight aspects of history that are more dramatic and emotive than necessarily illuminating for the topic at hand. Did the witchcraft trials (presented here as medieval but actually far more an early modern phenomenon) exert more of a force on how women were treated in medical situations than, say, the development of coverture laws? I don't think so. But the former topic is "sexier" and more dramatic than the latter, and I imagine far better known. Plus, the fact that there were medieval feme sole and that economic opportunities for women may well have constricted in the early modern period would be another point that would jar a bit with that Whiggish trajectory that is one of the book's unquestioned assumptions.
Take my three-star rating here as being a rough average of her overall argument (five stars) and Unwell Women as a work of history (two stars).
'When a woman tells you she is in pain, believe her the first time.' ~Maya Angelou
This is a statement that every single health professional should carry and keep with them, on every single shift at the doctor's surgery, or at the hospital. Health professionals should also be reminded to read the patients notes, as for some reason, communication within parts of the health service, is entirely non existent. We should not not have to constantly keep explaining ourselves to the same person, only to be sent away with yet more paracetamol. This book really, really made my blood boil, and although women's health experiences to do with pain have improved from many years ago, even as of now, it is still heavily stigmatized, and laden with the pathetic line 'Are you sure you're not imagining it?'.
My health has been complicated for about 7 years or so. As it is all coinciding with the menstrual cycle, I first tried pain relief, which didn't actually help. After a year or so, I started suffering from not only physical symptoms of pain, but then there were migraines, fatigue, hallucinations, palpitations, insomnia and debilitating brain fog for two weeks of every month. So, instead of waiting for nothing, I did my own research, and thought it could be PMDD. When suggesting this to a health professional, I was hoping to receive support, but instead, I was given yet more painkillers, and was told to rest more. Rest more! Still, even after seeing a female consultant, I still couldn't get my point across, and in fact, this particular person laughed at me, like I was stupid, and I didn't know what I was talking about.
I might be crazy, but when it comes to my body, I know exactly what I'm talking about.
To read of how women in the past suffered and fell prey to horrific ordeals, and as I'm a woman with mental health and gynecology issues, I think they definitely would have applied to be. It makes me shiver to even consider what might have been my fate. So really, I probably should feel lucky, which I do, but when one is told for seven years that you are imagining things, and you're just anxious, and it's your hormones, it doesn't make me feel so lucky. It makes me quite angry.
The way in which women have been abused, neglected and shoved to the side (quite literally) in medicine is both devastating and shocking for the individual, and more importantly, for us as women, it doesn't leave us with much faith in our doctors.
I thought this book was written well, and I liked how the chapters are clearly laid out in different sections. There isn't one that I didn't enjoy reading, and learning all about, because obviously, I don't know it all.
The author tells us a very personal account of her experience with the healthcare system and her chronic illness, which could have cost her her life. As I read this chapter, I could almost feel the eye rolls from the doctors, the sighs when they realise I don't use birth control because I'm a high risk stroke individual, or, just the general feeling that they wanted me out of their doctors office as fast as possible. I could really relate to Cleghorn, and her long, painful battle to be heard, and what makes it even more difficult to stomach, is it's not going to improve any time soon. But that's ok, because I have an extraordinary amount of fight left in me.
I found this an excellent book detailing the history of sexist and racist treatment of women through the centuries. Every woman should read it!
BUT: if you, like me, practiced ObGyn for many years, you may cringe at some of the inaccuracies and odd terminology the author uses. The rest of this review may be too technical to be of use to non-medical readers.
She consistently uses the term "ovariotomy" to refer to oophorectomy. Ovariotomy literally means an incision into the ovary, such as in ovarian cystectomies; it does NOT, in current and common medical usage, refer to REMOVAL of the ovary. British readers, help me here: is this term commonly used in UK to refer to oophorectomy?
On page 103, she describes a procedure in which a woman's "cervix" was dilated with a Sims speculum, followed by removing the ovaries though an incision in the vaginal cul de sac. It was the vagina that was dilated, NOT the cervix.
The author ascribes the "insistence on often completely unnecessary surgery" [hysterectomy] to the fact that US regulations require Gyn residents "to perform a minimum of 70 hysterectomies during their residencies." [This was not the case when I completed residency in 1983.] The current regulation requires residents to perform 70 "minimally invasive" hysterectomies, but even that would only account for an increase in unnecessary procedures DURING residency, not after completing training. IMHO the primary reason why many private practice US Gyns perform unnecessary hysterectomies is FINANCIAL: they are paid more to do surgery! Private practice insurance reimbursement is far lower for less invasive treatments and procedures, many of which require much more of the physician's time in clinic. Far easier and more lucrative to perform the definitive procedure. [And FYI, Gyns employed by HMO's like Kaiser Permanente receive fixed salaries and are NOT reimbursed more to perform surgery; they only schedule surgeries that they feel are truly medically indicated.]
On page 198, the book states that "removing the uterus places extra strain on the pelvis, causing chronic pain and mobility problems." Not true in the vast majority of hysterectomy patients! I discovered her source to the the website for a for-profit group of Pelvic Rehabilitation Medicine clinics, with 13 locations in NY, NJ FL, DC, MI, Il, TX and GA. They may do wonderful work, but... Their site states something a bit different than that implied by the book: "A hysterectomy may lead to secondary pelvic floor muscle spasms/hypertonia and the scar tissue secondary to the surgery may lead to restricted fascia and ultimately decrease mobility of the fascia as well as decrease blood to local nerves and muscles." So it can cause decrease in mobility of the fascia, NOT mobility problems in general.
She describes Fannie Lou Hamer's unnecessary hysterctomy as a "radical hysterectomy," which is an extensive procedure done to treat cervical cancer, involving removal of the upper vagina, entire uterus and cervix, and the supportive tissues lateral to the uterus all the way out to the pelvic sidewall. Hamer likely underwent a "total hysterectomy," or removal of the entire uterus. I could find no sites that mention whether or not her ovaries and tubes were removed, which, contrary to popular belief, is NOT implied in the term "total hysterectomy." The extent of her surgery surely was unnecessary, but it was very unlikely to have been a "radical hysterectomy."
This book contains some potentially dangerous statements regarding hormonal treatments. She discussed Depo-Provera, a contraceptive in common use currently, as "temporary sterilization" (pejorative imho) and mentions that "the truth about its dangerous side effects was deliberately withheld." Was this truly deliberate, or were its side effects even known in the 1970's? Nearly all of its side effects (uneven or no menstrual periods, headaches, depression, acne, weight gain, unwanted facial/body hair, hair loss, bloating, breakthrough bleeding, decreased libido, fatigue) are not "dangerous" and usually resolve with discontinuing the medication. Several studies, the first from 1991, have shown that bone density can decrease by a small amount in women using Depo-Provera. Most of the decrease happens during the first few years of treatment, then the bone density stabilizes. The decrease in bone density is probably greater in young women (in their teens and early twenties) than in older women. However, follow-up studies have shown that bone density improves again when women stop using Depo-Provera, and will come back to near the original levels after a few years. So even this side effect is not truly "dangerous."
Her description of the findings of the WHI study  about hormone replacement therapy (HRT) contains blatant misinformation. The study did NOT show "rising rates of ... colon and bowel cancers;" it showed a DECREASE in the rates of GI cancers!
Although I agree that most of the book's information on the sexism and racism inherent in the white male medical establishment's opinions of and treatment of women's symptoms rings true, beware her occasional use of pejorative and biased language, such as describing "surgical butchery" (page 201). This use detracts from the serious and informative nature of the history she details.
And for heaven's sake: usage of the US slang term "ahold of," [page 228] detracts from the seriousness of the subject matter discussed, in this case the ability of women of color to obtain contraceptives from an alternative source, one not involving white male medical providers. Better editing and proper grammatical usage needed!
This is a thorough journey through medicine and feminism. It shows how women's ails since the time of Hippocrates has been assigned to mental issues and hysteria. The assumptions made long before medicine existed as a discipline has continued to color diagnoses today. It's even worse if you're not white.
Common debilitating women's illnesses such as endometriosis takes several years to diagnose, even though one in ten women suffer and are incapacitated for a couple of days a month. I am one of them. I am still undiagnosed because the gynecologist thinks the bumps he feels on my uterus are scar tissue. I have scar tissue, but it's not actually on the outside of my uterus since that was never cut. Two days a month, for decades, I take several grams of common pain medication to be able to function. I thought this was normal, because no one tells you that periods aren't actually supposed to be that painful. Women's pain though, according to the medical profession, is something to grin and bear. There are much worse examples, with worse consequences.
The author takes us through history up to modern day. Along the way we meet the suffragettes and the women - and men - who stood up for women's rights. Many suffragettes were force fed in prison. Not to save them from starvation, but to torture and humiliate them. It's just a little over 100 years ago. The time that women could not rule over her own life is a blink of history ago, and the millennia of being chattel, still linger with us. The American abortion debacle was cast in another light with this book, although certainly not a more positive one, it's understandable. Women should - according to cis gender white men - have no right to their own bodies. For so long we have been nothing but wombs on legs.
This book is well-written, interesting, horrifying and a must read for anyone who believes in equal rights. And also equal rights to being respected and being taken seriously in the doctor's office.
This is a compelling historical survey of the way that medicine has failed and exploited women since the Classical period and beyond. Cleghorn includes her own perspective as an unwell woman but it is primarily an objective account of the rhetoric that was and is used to control women's bodies, perpetuate myths about child-bearing being the raison d'être of every woman's life, and discredit women's accounts of illness while legitimizing men's accounts. I recommend this book to anyone who is interested in an overview of the ways in which the medical and pharmaceutical fields are driven by outdated ideas about women's bodies.
I received an ARC of this novel through NetGalley in exchange for an honest review.
Olisin halunnut pitää tästä enemmän. Onhan tämä kaikkinensa hieno ja tärkeä teos, mutta muutama juttu jäi kaihertamaan.
"Muutamat jutut" ovat siis esim. se, että ilmeisesti (ainakin, jos uskon arvosteluihin) kirja ei ole aivan totuudenmukainen, vaan se yksinkertaistaa ja jopa vääristelee asioita. Kirja alkaa myös hienosti historiallisen laajalla länsimaisella perspektiivillä, mutta loppua kohden sen näköala kaventuu ja kaventuu. Näköalan kaventuessa ja sivumäärän vähetessä kirja muuttuu enemmän tietokirjasta feministiseksi manifestiksi. Sinänsä feminismissä tai feministisessä manifestissa ei tietenkään ole mitään vikaa, päin vastoin, mutta kapea katsantokanta ja asioiden raju yksinkertaistaminen ja vääristely(?) syövät pohjaa uskottavuudelta. Kirja nostaa esille tärkeitä, usein unohdettuja seikkoja, kuten etnisyyden kysymykset, mutta ei mainitse sanallakaan esim. ylipainoa ja sen vaikutuksia naisten saamaan huomioon ja hoitoon.
Kaiken kaikkiaan kyllä pidin kirjasta, sen rakenne on selkeä ja asia tärkeää. Kyllä tämä lukea kannattaa, mutta kannattaa myös ehkä vähän suodattaa.
Die Kulturhistorikerin Elinor Cleghorn ist von ihrem Thema selbst betroffen. Sie erkrankte noch jung an systemischem Lupus Erythematodes (SLE). Die Krankheit wurde nach jahrelangen Fehldiagnosen eher zufällig entdeckt und hätte die Autorin vor der Diagnose bereits das Leben kosten können. Da auch andere Autoimmun-Krankheiten schwer zu diagnostizieren sind und verstärkt bei Frauen auftreten, liegt die - verkürzte - Frage nahe, ob die späte Diagnose auf das Frauenbild von Medizinern zurückzuführen sein könnte. Cleghorn geht in ihrer Betrachtung zurück bis in die Antike zu Hippokrates, als Frauenkörper bereits als fehlerhaft und unvollkommen definiert wurden und männliche Ärzte nahezu alle Erkrankungen von Frauen auf deren Gebärmutter zurückführten. Wer glaubt, dass mit verbesserter Diagnostik Mythen über den weiblichen Körper durch Fakten ersetzt würden, sieht sich jedoch getäuscht.
Obwohl die Medizin im 19. Jahrhundert – teils gegen den erbitterten Widerstand der Kirchen – gewaltige Fortschritte machte, wurden Mythen nicht im Tempo des Wissenszuwachses durch Fakten abgelöst. Bis in die Neuzeit ignorierte eine androzentrische Medizin schmerzhafte Erkrankungen der weiblichen Unterleibsorgane nicht selten und forderte Frauen – offen misogyn – auf, ihr Leiden durch Ehe und Schwangerschaft zu kurieren. Bis ins 20. Jahrhundert konnte sich die verzerrte Wahrnehmung halten, dass „Frauenkrankheiten“ eingebildet wären und durch Ablehnung der bürgerlichen Frauenrolle als Ehefrau und Mutter verursacht würden. Wenn zugleich Frauen nicht zum Medizinstudium zugelassen sind und klinische Forschung hauptsächlich an jungen, gesunden, männlichen Probanden stattfindet, können Wissenslücken nur schwer gefüllt werden. Da Cleghorn sich auf die Entwicklung in den USA und Großbritannien konzentriert, stößt sie neben einer Frauen diskriminierenden Medizin auch auf die rassistische Einstellung, Schwarze hätten kein Schmerzempfinden; ihre Krankheiten wären anders als bei Weißen zudem selbst verschuldet und auf ihren Lebenswandel zurückzuführen.
Der wandernde Uterus als Auslöser weiblichen Leidens wurde bereits im 11. Jahrhundert von Trota von Salerno widerlegt, die das dreibändige Lehrbuch Trotula verfasste. Cleghorns Blick in die Medizingeschichte legt nahe, dass Respekt, Empathie und Fürsorge erst im 20. Jahrhundert Einzug in die Gynäkologie hielten, als sich die Frauengesundheitsbewegung (ab 1970) und weibliche Ärzte für Frauen engagierten. Ihre Quellenstudien zeigen jedoch auch, dass (in den USA und GB) Frauengesundheit erst in den Focus rückte, als Frauen im Zweiten Weltkrieg als Arbeitskräfte gebraucht wurden und eine eklatante Müttersterblichkeit um die Zukunft dieser Nationen fürchten ließ.
Cleghorn liefert zu den – bei Interessierten größtenteils bekannten - Irrwegen in der Diagnose gynäkologischer Erkrankungen ausführliche Zitate und aktuelle Quellen, und sie hinterfragt die Motive zumeist männlicher Mediziner, wider besseres Wissen an Mythen über den weiblichen Körper festzuhalten. Ärztliche Fehleinschätzungen werden u. a. verstärkt, wenn Ärzte nur wohlhabende Patienten zu sehen bekommen, da nur sie einen Arztbesuch finanzieren können. Dass ein rückständiges Frauenbild und die Ablehnung von Ärztinnen als Kolleginnen u. a. Ärzten lange Zeit üppige Einkünfte von Privatpatient*innen sicherte, das ist in Cleghorns besonnenem Buch nicht zu übersehen.
Im Fall von Margaret Sanger (1879-1966), der gefeierten Aktivisten für Empfängnisverhütung zeigt die Autorin auf, dass Pionier*innen der Frauenheilkunde auch handfeste rassistische und eugenische Ziele verfolgten.
Wenn Autoimmunerkrankungen (Lupus, MS, Firbromyalgie, Morbus Crohn, Schilddrüsenerkrankungen), sowie Endometriose schwer zu diagnostizieren sind und in der Mehrzahl der Fälle bei Frauen auftreten, fragt sich noch immer, ob der jahrelange Weg zur Diagnose auch mit dem „Gender Bias“ zu tun haben kann, der die Beschwerden von Frauen bagatellisiert.
Elinor Cleghorn schließt mit ihrer eigenen Krankengeschichte den Kreis ihres – auch für Laien gut lesbaren – medizinhistorischen Werks. Die Beschränkung auf die USA und Großbritannien finde ich etwas unbefriedigend, weil ich beide Gesundheits- und Gesellschafts-Systeme für sehr speziell halte.
This incredibly scholarly and historical treatment of how women have been treated in western medicine is an absolute must read. Cleghorn does an amazing job catagoing mind-blowing injustices wreaked upon women's bodies since the inception of modern medicine.
Throughout modern medicine and up to today, being a woman itself is considered a pathological state. The female body has been “shrouded in mystery” and cloaked in deliberately weaved mysticism. The uterus has been a source of mythical malintent as well as a precious resource that patriarchy seeks to control, including to this very day. The genesis of the word “hysteria” will cause you to completely excise this word from your vocabulary. Medical experients done on female POC and American slaves were crimes against humanity and are rarely discussed.
From contraception to abortion, this book covers so much. Women are simply not heard. Their pain is ignored. They are chronically underdiagnosed with things like Lupus, MS, thyroiditis, Sjogrens and other autoimmune diseases. I couldn’t help thinking about these female dominated diseases and wonder why they are the majority women. It’s speculation but I can’t help but conclude that their expulsion from medical research and ignoring woman’s health has lead to the disparate outcome and not just a sex proclivity.
I expected to give this book a 5-star read. This is an issue very near and dear to my heart, and I have written about some of my own painful experiences of sexism and objectification in the medical system. The topic is crucial and timely.
Overall, Cleghorn is a thorough researcher and engaging writer. And although some sections of this book have been written about elsewhere, she offers an interesting treatment of some of the issues, and makes some compelling new connections. For example, her discussion of the impact of medical misogyny on the suffrage movement was eye-opening for me. Fascinating for sure.
The part of this book that disturbs me is the complete absence of attention to fatophobia in treating women. In her introduction, for example, she details many intersections of oppression that women face, focusing on racial issues, which are certainly crucial. However, she neglects to even mention in a passing comment that women's body size is arguably the number one issue that keeps women today from getting the help that they need from the medical system. And this oversight continues through the entire book.
The issue was constantly on my mind as I read this book, because the author focuses a lot on how the medical system reflects social constructs of correct femininity, especially on sexuality and reproduction. In this context, it strikes me that medical fatophobic misogyny is a modernized reflection of some of these issues. A woman who does not LOOK the way she is supposed to look is assumed to have incorrect sexuality. And also, is assumed to have all the qualities that go along with incorrect womanhood -- too much passion, too many opinions, not enough servitude. And this got me thinking a lot about what it means to be a woman who eats. How the medical establishment tells women to eat less. To feel less, to want less, to desire less. All these things are direct reflections of the kinds of messages women got from the medical system for centuries. The entire eat-less-as-healthy mantra of the medical establishment is little more than the latest iteration of doctors telling women to live a little less.
The failure to include this whole issue in the book was frustrating for me. And it makes me wonder what the author actually THINKS about it.
Because there are many people out there in the world, even otherwise feminist advocates, who still think that if women are "overweight" according to how western medicine defines overweight, then they SHOULD be put on a diet and they SHOULD be blamed for anything that goes wrong in their bodies and if they DON'T diet, then they have nobody to blame for themselves and don't be surprised or upset or angry if the doctor says something you don't like. It's your own fault for being fat.... as if medical fatophobia isn't an issue of discrimination of socially controlled femininity, like all the other topics raised in this book...
I can't help but wonder why this author, who is powerful in her advocacy for women versus the medical establishment in some crucial areas, stopped short of advocating for women who face this kind of abuse on the basis of body size and appearance.
There’s too much in this book. Too much history to cover, too many names, and too many issues as a whole. The book often felt like a parade through women’s medical history rather than a focused piece of non-fiction, and I frequently got lost in all the names.
I found the sections of the book in which the author talks about her own struggles with lupus very compelling and enlightening. I learned a lot about the symptoms of lupus and associated pregnancy complications from these pages. Unfortunately, I had to wade through 300+ pages to get there.
In my opinion, Cleghorn’s book would be much stronger if she squarely discussed the medical community ignoring and misdiagnosing autoimmune diseases. I would gladly read that book or, frankly, even an ailment-centered autobiography from her in the future just not this one again.
I thought it would take me longer to get through this book. It's dense, complex and extremely well-researched. I figured that I'd get an early start on it and dip in and out of it throughout the month, but it had me hooked. I was horrified by it, I was enraged by it and I was emotionally invested in it from the very beginning. I know way more about post-childbirth vaginal fistulas than I ever thought I would, owing to the fact that I don't plan on ever going through childbirth. (Incidentally, the other book I was reading at the same time as this one, Paladin's Hope, also had a section on the mistreatment of vaginal fistulas, which was a crossover I was not expecting.)
The overall purpose of this book can be summarised by the title of the final chapter conclusion, which is: Believe Us. If you have a chronic illness, know someone with a chronic illness or you are a woman who has ever had to deal with a medical professional's disinterest then this book is for you. It took my mum over 7 years to be diagnosed correctly and even now she continues to face doubt and flippancy when seeking medical treatment. It didn't take me quite as long to get diagnosed with chronic pain but I have definitely bought into the culture of minimising the pain and even sometimes being embarrassed about seeking treatment through fear of not being believed. About half of the women I know have similar experiences and those are just the ones I've spoken to about it. I'm almost tempted to buy bulk copies of this book and drop them in my doctor's waiting room like a nerdy vigilante.
I really commend Elinor Cleghorn for the work that went into creating this book. Especially the fact-based approach to the historical cases they covered and intersectionality that was addressed in regards to race, sexuality and trans identities. I really felt like they covered absolutely everything you could want from a modern feminist take on the medicalisation of women's bodies throughout the 19th and 20th Centuries. It's a resource that should be taught in medical school.
*via Overdrive app from the library * Narrator: 5 stars 🌟 Content: 5 stars 🌟 ---
Highly recommend this to read with "Everything below the waist: Why Health Care needs a Feminist Revolution" by Jennifer Block as well. Both are important books 📚 I think everyone needs to read.
I knew some of what this book talked about but it blew my mind how much I didn't know and some of these theories of how women's worked. I could see in some cases when they didn't know much but others.. I was constantly giving the book "looks"/side-eye and flipping off the societal attitudes in many cases.
One particular story made me nauseous... I have no words still for it.
The thought crossed my mind from time to time, what would I have been told as someone with migraines/scoliosis/anxiety. I can imagine some of it.
We still have some work left to do to fix medicine and I hope we can do it where its fair to everyone and no one is discouraged/dismissed.
Words are failing me somewhat but I hope y0u check this book out and pass it on
„Die weibliche Biologie bestimmte und beschränkte das Frausein, und das Frausein verschmolz mit dem weiblichen Geschlecht und wurde darauf reduziert.“
Ziemlich oft hören FLINTA , dass sie zu hysterisch sind und sich nicht so anstellen sollen, wenn sie Schmerzen haben. Dass die Medizin seit Jahrhunderten sexistisch und rassistisch ist, ist kein Geheimnis mehr. Krankheiten, die ausschließlich Menschen mit Uterus betreffen, sind immer noch nicht ausreichend erforscht worden. Deshalb erhalten Menschen mit Uterus häufiger als Menschen ohne Uterus „Beruhigungsmittel und Antidepressiva statt Schmerzmittel.“ Bei ihrer Recherche wird der Autorin Elinor Cleghorn nochmal bewusst, wie unsichtbar Menschen mit Uterus gemacht bzw. der männliche Körper die Norm der Medizin wurde. Die Recherchen gehen tiefer, als man denken würde.
Nach der Lektüre ging mir ständig die Frage durch den Kopf, on ich die passenden Worte für dieses Buch habe. Was soll ich eigentlich dazu sagen, außer, dass man es gelesen haben muss. Zumindest die ersten 50 Seiten, um verstehen zu können, dass die Medizin ein sexistisches, rassistisches und von patriarchalen Mythen geprägtes System ist.
Die Autorin unterteilt dieses Buch in drei Hauptartikel und blickt zunächst von der griechischen Antike bis ins 19. Jahrhundert zurück. „Frauenkrankheiten“ wurden in der griechischen Antike als „Männerkrankheiten“ behandelt und Hippokrates merkte, dass viele Frauen leiden und sterben mussten. Er „erkannte somit zwar an, dass „Frauenkrankheiten“ besondere und spezifische Heilmethoden erforderten, doch das Recht von Frauen auf körperliche Autonomie und aufgeklärte medizinische Entscheidungen war ihm eher fremd.“ Leider, bestimmte man in der griechischen Antike „die Gebärmutter will, was die Gebärmutter will“ und so meinten die Herrschaften, dass die Gebärmutter „einen Hunger nach Geschlechtsverkehr und Schwangerschaft“ habe.
„Weil Frauen als körperlich und geistig schwach gälten, habe man sie unterworfen und aus Politik und Gesellschaft ausgeschlossen.“ Im zweiten Kapitel „Ende des 19. Jhdt. bis in die 1940-er Jahre“ zeigt Cleghorn, wie die Frauenbewegung „nicht nur für Wahlrecht und politische Beteiligung“ kämpfte, „sondern auch gegen die Bedingungen und Umstände, unter denen Leben und Freiheit von Frauen beschnitten worden.“ Zu dieser Zeit war die Medizin aus der Sicht der cis Männern viel weiter, aber für Frauen hieß es noch unter Schmerzen zu leiden. „Selbst wenn sich eine Frau die Betreuung durch ihren Hausarzt oder einen Geburtshilfearzt leisten konnte, erhält sie eine Anästhesie nur, wenn er fähig und bereit war, sie einzusetzen.“ Auch hier glaubten viele Ärzte, dass die Anästhesie gefährlich für die Frau ist, weil „die meisten Mediziner vertraten zu dem die Ansicht, sie selbst könnten die Schmerzen der Geburt am besten beurteilen.“
Im letzten Hauptkapitel vertiefte die Autorin ihre Recherche von 1945 bis in die Gegenwart und „erst durch den zweiten Weltkrieg rückte die enorme Bedeutung von Traumata für die Gesundheit in den Vordergrund.“ Sie untersucht die psychischen Krankheiten und Methoden, die aus Verzweiflung, Mythen und wenig Forschung auf grausamste Art durchgeführt worden sind. „Für Ärzte, die sich mit „erregten“, „verängstigten“ oder „obsessiven“ Frauen konfrontiert sahen, stellte die Lobotomie eine kurzfristige Lösung da, um >die Patienten wieder auf die Erde und zu den irdischen Freuden zurückzuholen<“. Das Patriarchat dominierte die Medizin und tut es weiterhin. Auch hier ergaben Elinors Recherchen, dass „Frauen, die taten, was man ihnen sagte, galten als informiert, aufgeklärt und kerngesund.“
Ein umfassendes Buch mit sehr vielen Quellenangaben und durchforsteter Recherche in der Medizin zeigt Elinor ganz deutlich, dass wir noch längst nicht dort angekommen sind, wie wir es oft denken zu sein. Trotz der vielen Beschwerden von Menschen mit Uterus, wird erst, wenn es zu spät ist, geglaubt. Zunächst sind es „stell dich doch nicht so an“-Aussagen und schließlich Fehldiagnosen mit denen FLINTA-Menschen zu kämpfen haben. Dieses Buch ermutigt zum Einen allen Menschen die eigenen Schmerzen nicht absprechen zu lassen und zum Anderen erschreckt es doch, wie wenig geforscht wurde und wird. Nicht nur für die Medizin ist dieses Buch eine Bereicherung, sondern für die ganze Menschheit. Es werden Nischen aufgedeckt, die durch den Sexismus und das Patriarchat lange Zeit nicht sichtbar waren.
In Unwell Women Elinor Cleghorn unpacks the roots of the perpetual misunderstanding, mystification and misdiagnosis of women's bodies, and traces the journey from the 'wandering womb' of ancient Greece, the rise of witch trials in Medieval Europe, through the dawn of Hysteria, to modern day understandings of autoimmune diseases, the menopause and conditions like endometriosis. Packed with character studies of women who have suffered, challenged and rewritten medical orthodoxy - and drawing on her own experience of un-diagnosed Lupus disease - this is a ground-breaking and timely exposé of the medical world and woman's place within it.
This book will resonate with any woman who has gone to the doctor with a medical complaint only to be sent away with a course of antidepressants because what they are experiencing is likely all in their head, Bias within medicine might not be as bad as it was, but it is still a long way from being eradicated.
Unwell Women is a comprehensive and clearly communicated history of the way medicine and doctors have treated women throughout history. Starting in the ancient Greek times where any ailments women suffered were blamed on her "wandering uterus", to all women's ailments being blamed on hysteria and the weak female mind, forced hysterectomies and unneeded lobotomy. Whilst a good deal of this book made me feel angry, I can't lie I couldn't help but stifle some giggles during the Ancient Greek parts at the image of a wandering, mischievous uterus roaming around causing havoc!
Unwell Women also examines the treatment of women today, with particular emphasis on chronic illness and how difficult it is for women to be believed and receive a diagnosis- their pain and symptoms being dismissed constantly and Dr Cleghorn pulls on her own experience of having Lupus. I would have like this section of the book to be longer and more of a focus than the past but overall it is a small part of the book.
However, the book’s overriding message is one that that needs to be heard loud and clear by the medical profession today; believe women!!
I came to this as an unwell woman I have a number of chronic illnesses. It took years for me to receive my major diagnosis and along the way I was most definitely the victim of medical gaslighting and it needs to stop. Hopefully books like this will help bring the horrendous treatment of many many women to the forefront.
“Medicine has historically pathologised what it means to be a woman, and what is to live in a female body, to such a degree that being unwell has been normalised in society and culture, while a women’s rights over her own body remain contested even today.”
Having read Gabrielle Jackson’s Pain & Prejudice earlier this year, I was elated to learn of the publication of another book demystifying medical sexism. Unwell Women is a work that seeks to educate the reader on long-held biases against women in medicine by detailing how historical, political and social attitudes have informed the discipline over time.
Split into three sections, Cleghorn sets the stage in Ancient Greece, recounting historic theories about woman’s bodies—specifically their uteri—that had been postulated by many a philosopher. The uterus, for centuries, was an entity to be reckoned with, perceived as the formidable force behind a woman’s bodily ailments.
The chronological account of the treatment of women from Ancient Greece to date made the book well-structured and easy to follow, though at times the volume of names, dates, medical jargon and commentary did become a bit tedious and dry to trudge through. That being said, Cleghorn does make an active effort, when relaying the lives of certain unwell women, to write a story-like account, which I found thoroughly engaging.
Acknowledging the efforts of various feminists and sociopolitical movements in championing woman’s rights and advocating for woman’s voices to be heard by medicine, Cleghorn doesn’t shy away from calling out the not-so-covert racism, classism and ableism of many traditional feminist thinkers. I appreciated this critique as women of colour, particularly Black women, face more challenges than middle class western white women.
Cleghorn doesn’t really delve into cultural/religious practices bar a number of references to Christianity and the Book of Genesis in justifying cruel treatment towards “deviant” women. It would have been great to have had more analysis on the extent to which cultural and religious influences shape women’s attitudes towards medicine in the modern day.
Though this a pretty solid read, it is a lot of information to take in and can at times get very dry. I prefer Jackson’s writing to Cleghorn’s and if I was to choose between the two I’d recommend Pain and Prejudice.
As a woman in her early 30s that has suffered from Endometriosis for over half her life, I was so excited to see this book and even more so to read it. I knew a decent amount of history on the medical failings of women and even more on the current failings, seeing as I have lived through many. I was hoping for a book that would engage readers and clearly show the failings in medicine for women. Sadly what I read was a very wordy and overloaded book which made me bored at times and definitely didn't show enough about current medical failings. It is definitely well researched and some chapters I found really interesting but I did have to skim read others as I felt there was too much dry information and even a decent amount of repetition.
I am pretty gutted as this was a book that could have educated the masses but I doubt many people that don't have strong reason to read this book would ever wade through all of it.
I went into this book hoping to learn more about the legitimate disparity in medical professionals' treatment towards women and men and statements such as this gave me hope: "Women are more likely to be offered minor tranquillisers and antidepressants than analgesic pain medication. Women are less likely to be referred for further diagnostic investigations than men. And women’s pain is much more likely to be seen as having an emotional or psychological cause, rather than a bodily or biological one." I wanted to explore that with real research. Not with a quote of a quote. Not with flimsy inflammatory conclusions. And certainly not with a feminazi bias. Such a disappointment.
This woman appears to be the embodiment of the reason why people are afraid to call themselves feminist. Every man is a sexist pig - never mind their help to women or their uncharacteristic feminist tendencies given the norm of the age they lived in. She goes out of her way to ensure that every male mentioned has his "true colours" revealed just in case you were confused by this act of altruism mentioned. Women, on the other hand, are downright saints.
Every argument she made up to the point where I DNF'd was inflammatory, poorly researched or the takeaway was often not only far-fetched, but seriously missing the point.
And since I have just used rather inflammatory language myself, let me demonstrate what I mean:
- "When clinical research exempts women from studies and trials on the grounds that female hormones fluctuate too much and upset the consistency of results, medical culture is reinforcing the centuries-old myth that women are too biologically erratic to be useful or valuable". Let's break this down: we have a legitimate issue presented of women not being used in medical research; we have a reason given i.e. hormone fluctuation leading to inconsistent results; and then we have Elinor Cleghorn's takeaway which I believe entirely misses the point. 50% of the population not being used in research is a real issue. Another issue is that the expected hormone fluctuation affect on medicine is not actually explored and mitigated in any way. *That* is the problem here - lazy research. Not necessarily sexism. We can't just go around attributing to misogyny everything that can be explained by incompetence. If the problem was phrased in a way suggesting that nobody peer-reviewing such research noticed this oversight implying a subconscious bias against women, then I'd be happy. Alternatively, if the problem was phrased in this exact same way, but had the very important backing of a reference containing proof, I'd also be satisfied. But we got neither. - using "Women's Bodies in Classical Greek Science" rather than the original works it cites means that you are quoting a quote and potentially missing increased scopes of context each time. There is a reason you aren't allowed to quote Wikipedia in school papers. This was a glaring issue in my opinion and a strong reason to make me question the value of anything being said here. - blaming the Christian church for specifically holding back the study of women in medicine is another odd conclusion for two reasons. Firstly, all science suffered. People were burned at the stake and we were plunged into the dark ages. Is she genuinely implying that only women were affected? Secondly, get your ass out of your eurocentric Christian views! Even if we disregard the fact that other religions and cultures still discriminate against women (a disregard driven by the different scope of discussion, not due to merit), are you suggesting that the only medical research of any merit or use was done by Christian men?! - in a book condemning men for not caring about women in medicine, this author has the gall to describe the excitement of male doctors when they finally have a female cadaver to study - an example demonstrating both the clear desire to study female anatomy to better understand us *and* the actual sexism against men who were clearly disproportionally affected by law. But we still make it about "men bad, women good".
There are other examples, of course, but unlike Elinor Cleghorn, I don't intend to drone on forever making the same point over and over.
Works like this are ironically contributing to the same problem they are trying to solve. If our best argument to medical bias against women is that men are evil and have never done anything good for us, whereas women are downright saints who can do no wrong, then we can never win the battle for the minds of the undecided. If a disgrace to the scientific method such as this book is held in high regard, then I am starting to wonder if we have gone so far up our own asses as a society that peace and collaboration among genders is a distant dream.
I don’t speak often enough on this account about life as a chronically ill person. partly due to how much I chew the ear off people about it irl and on my other account, but mainly because it can be difficult to introduce that side of my life to people who aren’t aware of it. this reluctance rears its head for a lot of reasons; shame, difficulty coming to terms with how much my life has changed, exhaustion at having to explain myself over and over and this fear of being disbelieved or patronised. I have chronic sciatica, a condition that affects the nerves in my hips, upper legs and spine. many people will experience some form of this in their lifetime, however I experience it in the extremities. I suffered a fall as a teenager that left me temporarily and partially paralysed and incapacitated.
Recovery was slow and thankfully, flare ups were rare and uncommon. however, as time goes on and the body changes, my flare ups have become more frequent and the pain has only become more crippling and debilitating. oftentimes, you can find me in bed looking more like the second picture than the first. it took me almost half a decade after my injury to receive a diagnosis. I wasn’t listened to on account of my age, not only by medical professionals but by some closest to me and was passed from specialist to specialist to be simply told there isn’t much to be done. in severe cases, degeneration can reach the point where wheelchair use is necessary and surgery is complicated. thankfully, I’ve managed to come to terms with my illness and manage my own needs and symptoms accordingly. I have a wonderful group of friends, family and work colleagues who listen to my needs and go above and beyond to meet and surpass them.
however, I know my fortune is an exception and it does not cancel out how I and countless other women have been treated at the hands of medical professionals for centuries. in this brilliantly detailed account of medical history, cleghorn diligently documents the evolution of medical science from the ancient Greeks to today, with a personal recantation of her own experience with lupus. it should come as no surprise to any of us that medicine still has many significant strides to make to ensure that it’s an inclusive space not only for white women, but women of colour, trans women and disabled women, many of whom have faced the most gruelling hardships and cruelties in the name of medical science.
I gained much more from this book than I expected; from knowledge on the historical abuse of women through unnecessary surgeries, confinement to hospitals for non-medical reasons, to exclusions from drug trials and experiments on women in the name of those drug trials. this book is equal parts horrifying, traumatising, astonishing and frightening as it is necessary. cleghorn’s writing, though at times too clinical in style for my tastes, is direct and matter of fact. she doesn’t shy away from presenting the horrific facts with the figures to back them up. it took me a while to digest this book in all its glory on account of the heavy subject matter and language, but I’m grateful to have had the opportunity to read and learn from it. the appalling way in which unwell women have been treated and continue to be treated today has left me in no doubt that we still have a long way to go in how women are treated by medicine. huge trigger warnings for surgical scenes, graphic descriptions of illness, historical ableism, sexism and racism, discussions of fertility, abortion and miscarriage.
Very insightful! I was already aware of a number of prejudices and stereotypes within the medical system, but I'd never learned the history behind them. This gave a fairly in-depth yet comprehensive study of women and medicine, which don't get me wrong - depressing, anger-inducing, the lot, but something I think is important to understand especially when it isn't exactly at the forefront of people's minds when they think of gender inequality (especially in intersectional terms). However, I will say that pretty much the entire book was based on experiences in the UK and US, and while the book did acknowledge how women from ethnic minority, less economically advantaged backgrounds experience medicine even more differently, I think the addition of a more global perspective including the treatment of women in various cultures and communities from around the world (and not just the UK/US) would have added a lot to this book. So if anyone has any recommendations related to that, let me know!
This was excellent and thorough and very heavy. First, massive kudos to the narrator, whose amazing, light and clear voice helped me get through what was at times very triggering material.
Birth control in the vanguard of eugenics campaigns. The mysteries and incurability of endometriosis. Menopause or other hormonal fluctuations used as the thinnest excuse to perform LOBOTOMIES. Women have been wronged by the largely white, cishet male medical establishment for ages, and Cleghorn lays it bare.
And the author is "qualified" to attack these flaws in medical history, having borne eyerolls and disbelief from NHS doctors while lupus made her life and pregnancies battlegrounds.
I don't have much else to say - an important, well-done book.
Everyone should read this book. Did it take me 2 months to read? Yes. Did I have to re-check it out several times? Yes. But only because it was so depressing that I could only read a few pages at a time. This book is a history of medicine focusing in on women’s health. The connections between women’s place in society and attention given to medical issues is horrific. It genuinely makes me sick to my stomach to have read about all of the mistreatment in the past and what physicians believed. The ancient Greeks were idiots with what they thought about women and who got to control their bodies. Two interesting tidbits- 1) the word uterus comes from the Greek work “hysteria” 2) the women who founded the group that later became planned parenthood were also big into eugenics
Covers the history of western medical misogyny and, less extensively, racism, starting with Hippocrates and the ancient greeks, through the beginnings of the corona pandemic. For anyone already familiar with medical misogyny, there isn't much surprising in here, but this is a great primer or introduction to the subject for men, or people who haven't experienced, studied, or learned much about it. She's very careful to position her privilege throughout, and makes sure to include women of the global majority in her research with intention and care. The final chapter is about her own struggle with lupus, and her (mis)diagnosis, and experiences of medical misogyny despite all the admitted access and privilege she has as a (presumably middle class, though she doesn't say explicitly) white woman living in the UK.
Listened to this as an audiobook, and found it engaging, distressing, and educational in equal parts. I'm waiting to get an ebook copy so I can see if there is a bibliography, because I'm interested in her sources.
todella tärkeä kirja, josta kirjailijan intohimo aiheeseen näkyy - mutta joka ei tietokirjastatuksestaan huolimatta pysy neutraalina. mun mielestä aiheesta joka ei ole neutraali tai puolueeton, ei pidäkään kirjoittaa neutraalisti. sairas ja viallinen kuitenkin on ei-neutraali esim adjektiivien käytössä (kuvaillen lääkäreiden toimintaa naurettavaksi jne) ja siinä että ihan kaikki kirjassa ei taida olla täysin totta vaan mutkia on hiukan oiottu. tavallaan hyvä kansantajuisessa tietokirjassa, mutta aiheen ollessa näin merkittävä, ei hyvä juttu. kirjasta huomaa ettei kirjoittaja ole, laajasta taustatutkimuksestaan huolimatta, lääketieteen ammattilainen. se toisaalta aiheen huomioiden on myös hyvä.
annan silti neljä tähteä sillä joitakin faktantsekkausjuttuja lukuunottamatta tällainen kirja tarvitaan ja jokaisen tulisi se lukea - varsinkin jos ei itse kärsi kroonisesta sairaudesta tai ei ole tullut oireidensa takia vähätellyksi tms. totta kai olen tiennyt lääketieteen historiallisesti käyttäneen valkoisen miehen kehoa stereotyyppinä (koko maailmanhistoria on), mutta silti järkytti esim. miten myöhään moni asia on oikeasti edennyt edes lähelle siedettävää tasoa. ja taistelun tulee jatkua, siedettävä ei riitä.
I really really wanted to like this book, because the issue is so important and even today still relevant. Unfortunately I found the writing style not engaging enough to keep me interested for long. There is nothing I particularly disliked about the book, but I guess for me it just would have to be shorter.
Unwell Women: A Journey through Medicine and Myth in a Man Made World by Elinor Cleghorn is a concise account of how myth, misinformation and misdiagnosis of women's health issues has persisted to the current day where the understanding and treatment of unwell women still leaves much to be desired in far too many instances. Moving from ancient Greece and Rome through the Middle Ages, the Victorian Era and right up to the current day the author examines how the same ideas , often without any scientific basis, held sway for centuries until they could finally be proven to be wrong. The author does an exceptional job of clearly explaining the history and the science so that the book flows well and the reader never feels bogged down in dates or details. The case studies she utilises are sometimes heart breaking, and often frustrating as we see women being mistreated, used as human guinea pigs for surgical experimentation , or dismissed and discredited when they are struggling with complex auto immune conditions. As someone who works in healthcare, I cannot say that I was shocked by what I read , but I am hopeful that things are changing, albeit slowly. I read and reviewed an ARC courtesy of NetGalley and the Publisher, all opinions are my own.
Although it seems obvious, I never truly realised how the potential success of women and marginalised people is so reliant upon their access to high-quality health care. The stories of women told in this book horrify me, and my heart breaks for the women that have come before me. To think what my fate would have been as a woman with endometriosis and mental health issues had I been born in a different time. But it’s hard to feel lucky when research into women’s health is still a complete state, and we are constantly suffering from how behind it is compared to men’s. I have learned so much from this book: the eugenicism of the suffragettes, the way enslaved black women were used in surgical experiments (without anaesthetic!) for doctors to perfect their techniques ready for anaesthetised white women, and even the fact that the word “hysteria” comes from the Ancient Greek for “of the womb”. Everything makes perfect sense to me now: why most gynaecologists are men, why there is such a lack of research into endometriosis, why women get told it’s all in their heads. We have an insanely long way to come for women across the word, and we’re being failed on a daily basis. I’d seriously recommend this book to anyone.