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31st March 2022

UK healthcare is structurally sexist – how do we fix it?

What better way to celebrate Women’s History Month than by discovering the severe structural sexism of the UK healthcare system?
UK healthcare is structurally sexist – how do we fix it?
Photo: Alex Priomos @ Flickr

To say it’s been a tumultuous time for the UK healthcare system is an understatement. If it’s not year-long waiting lists for mental health services, it’s inadequate healthcare for trans people or steadily increasing waiting times for cancer treatment.

The UK healthcare system has always had problems lingering below the surface. The blow caused by Covid-19 only worsened them and devastated a structure that was already under strain.

And now, we’ve uncovered another issue; the UK healthcare system is structurally sexist. The news was surprising when I first heard it, but once the initial shock wears off, it suddenly makes sense.

Welcome to the UK, where inequality is inescapable.

The news actually emerged last December, when Omicron was arriving just in time for Christmas, cranking the Covid anxiety up to 11. The worries about the new strain meant that the findings got swept under the rug at the time.

There is some irony to news about the gender gap within the system drowned out by the very virus that has crippled it. Great – even Omicron is sexist. But we’re here now, and the findings are in our hands. And they’re as bad as you think.

The government put out the call in March 2021, asking for evidence to inform England’s first Women’s Health Strategy. The response proves the necessity of the Strategy;  there were 110,123 responses to the public survey and 400 written responses. These numbers demonstrate that these issues have always existed and that women and people assigned female at birth have been waiting for this opportunity.

It’s hard to know where to start with these findings. Perhaps the unsettling statistic that 8 in 10 women feel they are not listened to by healthcare professionals.

Also alarming is the finding that two-thirds of respondents with health conditions or disabilities said they do not feel supported by services made available to them.

Making patients feel supported and heard should be the main priority of any service, but especially one that exists to keep us healthy. This gender gap goes beyond meetings in GP offices and inadequate services, leaking into almost every aspect of healthcare.

From older women receiving less care for dementia than men, to women being half as likely as men to receive painkillers after surgery. Medical professionals tell women across the age spectrum that their debilitating symptoms are no cause for alarm, delaying severe and much-needed diagnosis.

Data from the Office of National Statistics found that women and AFAB people are more likely to have to go back to the doctor a second or third time for a reproductive issue. Women’s issues are not a priority for the healthcare system; the result of a lack of specific education and stigma surrounding women’s issues (particularly reproductive issues). The result is a lesser quality of medical care.

The issue even extends to vaccine trials, with women (particularly pregnant women) frequently being left out of the research. This leads to a lack of data on how new treatments could affect women and people who menstruate, also meaning a lack of trust on their part.

U.S. Secretary of Defence @Flickr

Like any issue affecting women, intersectionality should be critical to our analysis. While it is true that this ineffectiveness leaves all women vulnerable, the results are worse for women of colour.

The medical community has long known that women of colour face an increased risk of dying in childbirth (with Black and Asian women facing the highest risk). But a 2021 study found an increased risk of miscarriage for Black and Brown women. The racial gap holds for all aspects of pregnancy and childbirth; women of colour in the UK have an increased risk of premature birth, stillbirth and babies with low birth weight.

Data also shows that women of colour face more obstacles concerning cancer diagnosis and treatment. There are higher mortality rates for Black women with breast cancer, as well as lower rates of cancer screenings when compared with white women. In addition, it’s been found that Black women do not receive sufficient emotional support, referral services or understanding about their cultural needs.

With this influx of data and statistics, you might be looking at it all thinking, ‘okay… what now?’. Unfortunately, it’s a serious challenge and not something we can change overnight. The new Women’s Health Strategy is a good start, but it’s just that: a start.

The solution might appear simple on paper; if the issue is a lack of understanding of women’s health, simply hire more female doctors. While better representation for women is positive for any field, increasing the number of female doctors would be just one solution.

This is a structural issue and needs structural changes for us to see any real improvements. Yes, better representation is essential, especially when you factor in the issues facing BAME women. But what needs to change is training, teaching and how healthcare is run.

Medical training should include problems that specifically affect women. Professionals should ensure that women’s voices are listened to at all levels. And by that, we mean all women – not just white cis straight women. The industry must acknowledge these inequalities at the base level of education, ensuring that the male body is not the default in medical research.

Above all, we need a serious reflection on why and how these inequalities came to be. Where did they come from, and how are they still being propagated today?

It will take a long time, and whatever the solution is will likely be far more nuanced and complex than what I’ve highlighted here. But now that we know that the problem exists, there is no excuse for this to continue. Women constitute 50% of the UK population; it’s past time that the healthcare system took our issues seriously.

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