Medicine Was Built for Men & Women Are Paying the Price

Photographed by Jordan Tiberio.

Most women know the frustration of leaving a doctor’s office feeling unheard — being told their pain is nothing serious and to take a Panadol and get on with it. The familiar experience, experts say, are symptoms of a much larger issue within Australia’s healthcare system itself: medical misogyny. For decades, modern medicine has treated the male body as the default, shaping everything from laboratory experiments and clinical trials to surgical implants and diagnostic guidelines, leaving a faulty system that misunderstands female health.

“We see it throughout the entire pathway… women are forgotten, ignored, or just treated as smaller men,” Zoe Wainer, Director General of the Australian Centre for Disease Control, said at the Sydney Opera House’s All About Women event. “The consequence is that we have poorer outcomes, or our pain is dismissed.” The gap, she argued, begins long before a patient walks into a clinic. Historically, medical studies relied almost entirely on male animals during laboratory research. Female animals were often excluded because their reproductive cycles were considered “too complex” for researchers to study, or to “fix” those issues, their ovaries were removed ahead of the trials. With the assumption that women are essentially smaller men, findings from those studies then moved into human clinical trials, which also, inevitably, included far fewer women. But biologically, that assumption is inherently flawed — which Australia’s healthcare system seems to only be waking up to now.

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One of the clearest examples is heart disease, according to Wainer. Heart attacks remain one of the leading causes of death among women, yet the symptoms doctors were historically trained to recognise were based on male patients. While men often experience crushing chest pain, women may present with symptoms such as nausea, fatigue, jaw pain, or shortness of breath. Because these symptoms didn’t match the traditional definition, they were often labelled “atypical”, and the consequences can be serious. “If you’re a woman and you present to an emergency department and you’re having a heart attack, your heart is likely to be diagnosed as a man, and you’re twice as likely to be dead in six months,” Wainer said. “That data,” referring to a Medical Journal of Australia article from 2018, “is now new, yet we have not seen any shift in the health system to address that.”

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If you’re a woman and you present to an emergency department and you’re having a heart attack, your heart is likely to be diagnosed as a man, and you’re twice as likely to be dead in six months.

Zoe Wainer, Director General of the Australian Centre for Disease Control

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Another example, she shared, is medicaldevices like hip and knee implants. Again, they were historically designedusing male anatomy, despite well-known differences in pelvic structure betweenmen and women. “Women are twice as likely to have complications because thesedevices are not designed for us,” she said. The issue becomes even more complex whengender bias intersects with racism, according to Summer May Finlay, AssociateProfessor of Indigenous Health and Director of the Ngarruwan Ngadju ResearchCentre at the University of Wollongong.

Aboriginal and Torres Strait Islander peoples are even less likely to be involved and understood, she said. Even when Indigenous participants are included in studies, their experiences are often treated simply as numbers within a dataset rather than examined within their social and cultural contexts. “We know that our experiences are not included in research generally unless it is specifically focused on Aboriginal and Torres Strait Islander people,” she pointed out. “And then when we are included in research, we are actually often just part of the number. Our unique experiences, histories, aren't always actually explored or understood particularly well.”

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That lack of context can have serious consequences for how healthcare systems respond to Indigenous patients, she stressed. When research fails to capture the social, cultural, and historical realities shaping people’s lives, policies and medical guidelines risk being built on an incomplete understanding. Especially when Aboriginal and Torres Strait Islander Australians experience higher rates of chronic illness and lower life expectancy than non-Indigenous Australians. Trust also plays a significant role, Finlay said. Racism and culturally unsafe care — a reality for many Indigenous peoples — can make patients hesitant to seek medical help, particularly if previous interactions with the healthcare system have been dismissive or discriminatory. For some, those experiences create a reluctance to return to healthcare settings at all, delaying treatment until conditions become more serious.

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Our unique experiences, histories, aren't always actually explored or understood particularly well.

Summer May Finlay, Associate Professor of Indigenous Health and Director of the Ngarruwan Ngadju Research Centre

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Addressing these gaps, Finlay argued, requiresmore than simply collecting more data. It means ensuring Indigenous voices areincluded in the research shaping healthcare systems in the first place. Thesame principle applies more broadly across medicine. Wainer said one of themost effective ways to challenge medical misogyny is by increasing diversityamong the researchers, doctors, and policymakers designing the system itself.“You can see the absence,” she said.

However, there is some hope. Wainer acknowledged that there are some women’s health programs across the country doing good, raising awareness, and providing education — but “there’s a long way to go”.

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