When my mom had a minor heart attack this summer while we were at the beach, I sat in the waiting room with sand between my toes, praying that she would be okay.
She laid a few yards away, praying that she would be believed.
Invisible: How Young Women with Serious Health Issues Navigate Work, Relationships, and the Pressure to Seem Just Fine, by Michele Lent Hirsch, uses the author’s experience as well as extensive interviews with young women across the spectrums of geography, race, gender identity and sexuality to explore how serious health issues have unique consequences for people at the intersection of youth and womanhood. She chronicles how often people—including doctors—assume young women to be fine when they are not, and how that assumption leads women to downplay (and undertreat) their pain in order to keep their jobs, relationships, and lives afloat.
At the heart of many women’s stories, like the story of my mom, is a fear that they will not be believed by the very people with the power to heal them. Stereotypes about women’s lack of credibility and inherent emotionality make doctors more likely to ignore or undertreat women’s pain—not just anecdotally, but systematically. Women’s pain is consistently taken less seriously, with women waiting longer to receive treatment for the same level of pain, and far more often receiving sedatives for the same pain that, for men, is treated with painkillers. (For example, my mom waited seven hours before receiving pain medicine in the E.R. She was too afraid to ask for pain medicine earlier for fear of being accused of fabricating her symptoms in search of painkillers.) Studies of chronic pain conditions are overwhelmingly conducted on male subjects, even though 70% of chronic illness sufferers are women.
This medicalized sexism has especially disastrous effects for women of color. A landmark 2016 study showed that half of the medical students and residents interviewed still believe that black people experience less pain than white people do. Not half of all white people—half of medical students, the people who will one day be physicians to black people in pain. When medical racism interacts with medical sexism, the results are deadly: black women die in childbirth three to four times more often than white women do. Serena Williams’s harrowing ordeal with the birth of her child in 2017 brought the issue to national attention—and very nearly cost her her life.
Women, especially women of color, develop varied strategies to combat the assumptions people make about women’s lack of credibility in reporting the experiences of their own bodies. Comedian Wanda Sykes recently appeared on John Oliver’s Last Week Tonight to discuss her strategy for combating medical racism and sexism: bring a white man to the doctor to repeat everything you say. Hirsch also references a study aptly titled “I am not the kind of woman who complains of everything,” saying “some women...practice a version of self-policing in which they try to avoid becoming the ‘stereotypical female.’”
When trying to get a doctor to understand how much pain they’re in, women have to make careful calculations concerning how they present themselves. Too emotional, and a woman risks being seen as irrational, hysterical, or dramatic, and written off entirely. Too composed, and the doctor may assume the pain is not as bad as the patient says it is.
I learned these strategies young. Talking about my back brace would invariably make me cry, but when I was in the doctor’s office, I would hold my feelings in until my throat ached, not letting the tears fall until I had made it to my mom’s minivan with my lollipop in my hand. I knew, even at ten years old, that I had to be seen as “reasonable” to be believed. But I also almost always left appointments feeling like the doctor and his team didn’t understand how much I hurt.
Anxiety about seeing a doctor for my pain kept me from finding a pain specialist when I got to Durham. I was at a place, medically and geographically, where my orthopedist from home could no longer help me. But the possibility of not being believed or understood terrified me, even as I knew that my whiteness, my status as a Duke student, and my insurance coverage mean that I’m more likely to be believed than the majority of women.
I was able to live with pain without seeing a doctor for a year and a half before I slipped on some ice and spent the next two weeks with pain so severe that it hurt to breathe. Desperate for relief and worried that something major was wrong, I walked into Student Health.
I soon found myself doing exactly what I feared doing: sobbing uncontrollably, unable to perform the role of Reasonable and Believable Girl In Pain that I had rehearsed for half of my life.
But the doctor said something that still makes me tear up every time I think about it.
Get The Chronicle straight to your inbox
Signup for our editorially curated, weekly newsletter. Cancel at any time.
“I believe you.”
Her belief led me to see a pain specialist: a doctor who did not take my pain as seriously as I had hoped. But a year later, it led me back to that same clinic, with the hope that I could find another person who believed me. It gave me enough courage to tell the scheduler on the phone that I needed to see a female doctor. It led me to a doctor whom I am growing to trust, and who has been more honest and empathetic than I could have imagined a doctor to be.
When I told my best friend about how it felt to read Invisible, to see my own anxiety, fear, and shame reflected in the experiences of so many other young women, she said, “I’m so glad that somebody else wrote this book so that you didn’t have to.”
I am, too. It is validating to know that not only is my pain itself real and valid, but that the pain I have experienced in the medical system is also real and valid.
But I also want more for women—all women, certainly, but for women at the intersection of anti-blackness, homophobia, transphobia, classism and xenophobia in particular. I want my future daughters, nieces, goddaughters and granddaughters never to hurt, but beyond that, I want them to be believed when they do hurt—no matter their race, gender identity, class, sexual orientation, or how they present their pain to their doctors. I want that for my mother and the other women in my life now. And I want that for me.
Liddy Grantland is a Trinity senior who is currently rage-snacking. Her column, feel your feelings, runs on alternate Mondays.