(Medical) Neglect of the Female: A Manifesto for New Intersectionalism

‘Notice how unnoticed we are!’ Madeleine Baber on gender norms, biology, and the neglect of the female

Madeleine Baber

I believe everybody can be grateful for Simone de Beauvoir’s ever-astute analysis that ‘one is not born, but rather becomes a woman.’ Revolutionary at the time, this view of gender has become more and more normalised, and rightfully so. We are indeed socialised into our ‘femininity’ and into our ‘masculinity’. Neither concept exists without the other and both are mostly, if not entirely, products of our collective imagination. Wear a skirt, be docile, giggle in a high-pitched discord gf voice – be feminine. Provide the family with steak, beat up other men for sport, own a vicious pitbull – be masculine. Obviously, I’m being facetious, but the point still stands (and, even if you disagree, it’s not the point I’m arguing); gender is a social relation. 

Yet, in recent years, intersectional feminists have fallen into a dangerous trap. 

Discussions of social identity have dominated discourse. This isn’t surprising as attempts to deconstruct the gender binary have sparked a widespread and hateful ‘trans panic’. Discussions of gender have become so heated that, in a mere decade, gender nonconforming people have gone from relative obscurity, to the main boogeyman of right-wing sentiment. It’s Piers Morgan on Good Morning Britain; it’s the radical feminist renaissance; it’s Rishi’s recent ban on gender neutral toilets. We might recognise the question (posed by both gender critical feminists and right-wing jargon-spewers alike), what is a woman? Is she a pair of X chromosomes? Is she anyone in a dress and high heels? With boobs? Without them? With childbearing hips and pussy lips in shade #FF94A4?  

We are, naturally, exhausted by these vacuous and unproductive discussions. We are especially tired of feminists such as the infamous she-who-shall-not-be-named, author of the ‘Harry Potter’ series, who have shamefully allowed this ‘trans-issue’ to not only dominate, but crush and dangerously divide mainstream feminist discourse.  Many of us, intersectional feminists, leftists, members and allies of the LGBTQ+ community, are now afraid of the dreaded biology discussion. In order to protect people and to fight against transphobic rhetoric, we have let anti-feminists take our biology and make it an issue of culture war, an issue of identity.

But we cannot let these hateful voices make us afraid of the biology discussion. We know that womanhood is an identity – a demonised, feminine one – but we also know that the female is nowhere near freed from the biological chains that hold it down. Whilst women are culturally constructed, we are still material and biological. De Beauvoir was right in that we become ‘woman’ – - but then what are we before then?

September 2022. After a year of struggle on hormonal contraception, an 18-year-old girl walks into Calderdale and Huddersfield Sexual Health Centre, on time for an appointment that had been set almost a month before. The nurses, smiling in an uncanny “I was trained to be nice to you” kind of way, guide her through the clinic and into a small room. She takes her underwear off behind a curtain and lays, spread-eagle style on the bed.  

‘Did you take an ibuprofen before this visit?’ The nurse asks.  

No, she hadn’t. No one had told her to do that. 

‘How are you getting home after this?’  

Both parents are working so she’s taking the bus. 

She’s assured she’ll be fine.  

What follows is not only the most intrusive and uncomfortable experience of her life, but also several days devoted to extreme, debilitating pain. 

I won’t keep insulting your intelligence by pretending that this story isn’t about me. Every official source I had read when I was looking into getting my IUD fitted told me the procedure could ‘cause some discomfort’, but local anaesthetic was available, and that pain would subside. In reality, I struggled for over a month with blinding abdominal pain unlike any other I’d felt before. When the procedure was done and the nurse had taken the metal torture devices out of my nether regions (vagina, if you’re not afraid of the word), the confusion and light-headedness I felt was borderline traumatic. I tried to get the bus home, but quickly found that I couldn’t move at all, so paralysing was my ‘“discomfort”’.  

This story isn’t intended to frighten girls, although I realise it may (note: I appreciate my IUD now that my body is used to it). I’m simply oversharing about my vagina because this experience, and others like it, have revealed to me the staggering level of neglect that people assigned female at birth face.  

I realised on my journey with contraception (of which this IUD fitting was merely the closing chapter) how shockingly misunderstood and ignored female suffering is. For most of us with vaginas this is familiar. Traumatic pain is ‘some discomfort’. Metal objects pierced through the cervix are ‘a slight prick’. Depression or anxiety induced by hormonal imbalance is delusion. Unlike males, we have pain built in. We are made to endure. The menstrual cycle, period cramps, labour, the menopause, even sometimes sex itself can all be excruciating experiences. But really, are they ever unequivocally treated as such? I remember feeling embarrassed about the pain my IUD gave me. It was like a very extreme period cramp, and really, are those to be complained about? Just pop an ibuprofen or three and get on with it.  

This ignorance of the female sex has left women’s medical problems criminally under-researched, and their symptoms often ignored. Erectile dysfunction, which affects 19% of men, is researched 5 times more often than premenstrual syndrome, which affects 90% of women. Until 2023, there was no such thing as a female crash-test dummy, leaving females over 70% more likely to be harmed in head-on vehicle collisions. Many people don’t know that heart attack symptoms appear differently in females, meaning that a genuinely life-threatening condition can be totally and easily overlooked. (BTW, if you didn’t know – chest pain, shortness of breath, nausea and back or jaw pain). 

Furthermore, for centuries medical textbooks have erased the vulva and denied female sexuality. The clitoris, in particular, remains a mystery. Rarely ever looked at closely, an emblem of demonic, useless female pleasure. According to a review conducted by urologist Helen O’Connell, a pitiful 11 articles on the anatomical dissection of the clit were published between 1947 and 2020. That’s 11 articles in 73 years. 

Last month, tens of thousands of Icelandic women, including the country’s own president, went on strike against the gender pay-gap. As much as I marvel at this fantastic display of feminist solidarity and power, I take it ultimately as a frustrating reflection of how much this issue has gone unnoticed in western feminist discourse. Of course, we must challenge the societal norms that see women consistently underpaid and undervalued in the workforce, but there is a whole side to life as a female that is, even in our own circles, going unnoticed. The pay-gap really, is not our biggest enemy – the health-gap is. Our health and our bodies are not in our hands. 47% of UK doctors are now female, yet we are still woefully underrepresented in senior clinical positions. The truth remains: male is understood as the default and female as a mystical, unimportant other.

This is neglect on a mass scale: in research, in hospitals, in offices, in classrooms, in courts, in bed. And it is a symptom, or indeed one of the causes, of a wider systemic disease. A lack of understanding of differences between the sexes has left AFAB (assigned female at birth) people vulnerable to a society that does not understand our experience and does not know how to meet our needs. Women can never truly be socially liberated if the female body remains shrouded and untouched. 

How can we expect the iron maiden of the ‘ideal’ body to be unlocked if it is not common cultural knowledge that a healthy female body should have a 20-30% body fat percentage? How can we expect to close the pay-gap and promote female productivity if we do not understand the female hormone cycle, our monthly ebbs and flows, our need for more sleep? How can we ever win this war if we do not recognise that our bodies are the battleground?

Educate us! Demystify the female. Demystify the menopause! Demystify labour! Demystify that gnarly case of thrush you had last week! Give us those days of rest that our hormone cycle demands! Give us years, not pitiful months, to bond with our young children, to breastfeed them and hold them close. 

To tackle misogyny, to free us from gendered norms and to save masculinity from the toxic garbage-fire it is becoming – we must combat the demonisation of the feminine and deconstruct our ideas of gender binary. 

But to truly better the standing of women we must take back our biology and stop shying away from it. We must reclaim it in our own terms and force research, force understanding. Being female hurts and it is powerful and it is mystical and it is dirty and it is violent and it is being ignored.  

Notice how unnoticed we are.

In conversation with the author: