I want to piece together a couple of items I read this week. The first is the following quotation, found via Shakesville, by Alasdair Thompson, the head of New Zealand’s Employers and Manufacturers Association.
“Look at who takes the most sick leave,” said Mr. Thompson. “Because you know, once a month they have sick problem.”– Alasdair Thompson, on why women are paid less than men.
Let’s ignore the erroneous assumption that all women menstruate monthly and that every person who menstruates presents as a woman. Let’s also ignore the fact that Mr. Thompson apparently provides no evidence regarding sick time or productivity to back up his assertion. They’re true and valid points, but they’re not quite what I want to talk about right now.
Because what I also read — and in fact requested to have written in some form — is a post at Beneath the Tinfoil Hat about endometriosis. Though it’s difficult to get exact stats because of difficulty with diagnosis, it’s estimated that endo affects 5-10% of people born with uteri and ovaries.
Whether you know it or not — whether they know it or not — you probably know somebody who has endometriosis. Everybody probably knows somebody — or somebodies — with endo.
Now, there is certainly not a one-to-one correlation here. That is, not everyone who has endo experiences menstrual pain, just like not everyone who has period pain has endometriosis. But as severe dysmenorrhea is the hallmark symptom of endo, there is considerable overlap.
And I take issue with Mr. Thompson’s dismissal of a potentially chronic, severe, and debilitating condition as “a sick problem” some women have once a month. Yes, it is a problem, but not because it’s costing corporations or countries money and productivity every month. It is a problem because it’s a condition that’s under-researched, under-diagnosed, under-treated, and under-accommodated — and it’s affecting people’s lives.
As I commented here (so you can find sources), on average there’s a 6 to 7 year delay between the onset of symptoms and reaching a diagnosis. That delay is even longer — 12 years on average — for people who present with symptoms prior to age 20. My personal diagnostic delay was 14 years — and that’s as someone who’s been fortunate enough to have health insurance and provider access nearly the entire time.
Why the delay?
There are a lot of reasons, certainly, but the normalization of bad menstrual pain is one of them. The idea that menstruation is a “sick problem” for most people who menstruate, that it’s “the curse of Eve” or “just part of being a woman” can lead people to internalize the idea that dysmenorrhea — no matter the level — is normal and to be expected. (And yes, I’d wager that some levels of pain are normal but that debilitating levels of pain are generally not.)
For people who experience pain personally, they may feel pressure to “suck it up and deal” or to blame themselves as just not being strong enough when they seem to be having more trouble than most. I was pretty physically active growing up, and a lot of my coaches, instructors, and trainers subscribed to the “no pain, no gain” philosophy. Nobody ever let me out of gym class or practice because of pain, at least not without a cutting remark. “You know, some of us just take Midol and move on with our lives.”
For those who respond to people in pain — particularly for health care providers — this internalization can sometimes mean dismissing or minimizing a patient’s self-reported pain. And when providers don’t respond sufficiently and sympathetically to patient symptoms, diagnoses get delayed, sometimes for years. But the patient’s life has to continue within that.
Sometimes — not always — that leads to people with endo (or suspected endo or other chronic pain) taking sick time off of work. That’s something that should be examined much more than it is now, yes. But it shouldn’t come from a place of, That’s why you don’t get paid as much (why your work isn’t worth as much), sorry. Instead, it should come from a place of providing accessible and understanding health care — not to mention more advancements in endo treatment and management — to help people not be in so much pain.