Unwell Women

Unwell Women Plot Summary

Introduction

Imagine being told that your womb is wandering freely through your body, causing madness when it reaches your brain, or that reading too many books will cause your ovaries to shrivel. For centuries, women have endured medical theories and treatments that seem not just misguided but actively harmful when viewed through a modern lens. Yet these weren't fringe ideas—they represented mainstream medical thinking that shaped how women were diagnosed, treated, and controlled across generations. The story of medicine's relationship with women's bodies reveals a disturbing pattern: scientific "facts" have often been constructed to reinforce existing social hierarchies rather than to understand female health. From ancient Greece to modern emergency rooms, women's pain has been dismissed, their symptoms attributed to emotional causes, and their normal bodily functions pathologized. This historical journey helps explain why even today, women wait an average of seven years longer for accurate diagnoses of certain conditions, receive less pain medication than men with identical symptoms, and face skepticism when reporting their experiences. By understanding these deeply rooted myths and misconceptions, we gain insight into why gender bias persists in healthcare and how women have continuously fought to reclaim authority over their own bodies and experiences.

Chapter 1: Ancient Myths: The Wandering Womb Theory (400 BCE-1500)

In ancient Greece, a young woman experiencing symptoms like difficulty breathing, seizures, or mental distress might receive a troubling diagnosis: her womb had broken free from its moorings and was wandering through her body, pressing against other organs and causing havoc wherever it traveled. This wasn't a fringe belief but mainstream medical thinking established by Hippocrates, the revered "father of medicine," and his followers in the 4th and 5th centuries BCE. The Hippocratic Corpus, a collection of medical texts from this period, described in detail how the womb—believed to be an independent, animal-like entity—could move upward toward the liver, heart, or even the brain, causing symptoms ranging from suffocation to madness. The prescribed treatments revealed much about ancient Greek attitudes toward women's bodies and social roles. To lure the wandering womb back to its proper place, physicians recommended marriage and frequent pregnancy as the most effective cures. Sweet-smelling substances might be placed near the vagina to attract the womb downward, while foul odors were applied near the nose to repel it from the upper body. These recommendations weren't merely medical—they reinforced women's primary purpose as reproductive vessels. As one Hippocratic text bluntly stated: "The cure for a woman's disease is for her to become pregnant." This understanding of female anatomy persisted well into the medieval period, reinforced by influential physicians like Galen of Pergamon, whose medical theories dominated for over a millennium. Galen described female genitalia as essentially inverted male organs—the vagina was an internal penis, the ovaries were internal testicles—establishing an anatomical hierarchy that positioned women as imperfect versions of men. This wasn't just an anatomical curiosity but a framework that justified women's subordinate social position. If women were biologically inferior to men, their exclusion from education, politics, and public life seemed natural rather than constructed. Christianity further complicated medical understanding of female bodies. As the religion spread throughout Europe, religious texts portrayed menstruation as evidence of women's inherent impurity, a punishment for Eve's original sin. The 13th-century text "Secrets of Women" described menstrual blood as so toxic it could kill plants, tarnish mirrors, and drive dogs mad if they tasted it. These beliefs weren't confined to religious authorities—they influenced medical practice, with physicians warning against sexual intercourse during menstruation lest it produce leprous or deformed children. Despite these misunderstandings, women maintained their own networks of healthcare knowledge. Midwives and female healers developed considerable expertise in childbirth, gynecological issues, and herbal medicine, passing this knowledge through apprenticeship rather than formal education. The Trotula, a collection of texts from the medical school at Salerno, Italy, became one of the most important gynecological works of the Middle Ages, acknowledging that "women are so different from men... and because they are ashamed to reveal their distress to men, they need their own kind of medicine." The wandering womb theory and its associated beliefs established patterns that would persist for centuries: the mystification of female anatomy, the pathologizing of normal female processes, the exclusion of women from medical knowledge, and the use of medicine as a tool to control women's bodies and behavior. These weren't merely historical curiosities—they formed the bedrock upon which modern gynecology and women's healthcare would be built, with consequences that continue to reverberate through medical practice today.

Chapter 2: From Witches to Hysterics: Pathologizing Female Experience (1500-1800)

By the 16th century, medical and religious authorities had developed a sinister new framework for understanding women's mysterious ailments. No longer merely victims of wandering wombs, women exhibiting unusual symptoms or behaviors risked being labeled as witches in league with the devil. This shift occurred against the backdrop of the devastating Black Death, which had killed an estimated 20 million Europeans in the 14th century. In the aftermath of such catastrophic population loss, controlling women's bodies and reproductive capacities became an urgent social priority. The infamous "Malleus Maleficarum" (The Hammer of Witches), published in 1486 by Dominican friar Heinrich Kramer, provided a detailed manual for identifying, trying, and executing suspected witches. The text explicitly linked women's biology to their supposed susceptibility to demonic influence. "Women are more carnal than men," Kramer wrote, claiming their "slippery tongues," "feeble minds," and "insatiable" sexual appetites made them easy targets for Satan's corruption. Midwives received particular attention, accused of offering newborns to Satan and causing miscarriages and infant deaths. "No one does more harm to the Catholic faith than midwives," Kramer declared, effectively criminalizing women's traditional healing knowledge. The witch hunts that swept across Europe in the 16th and 17th centuries resulted in the execution of approximately 45,000 people, 80% of whom were women. Those most vulnerable to accusation were older women, particularly those past childbearing age, unmarried women, and those involved in healing or midwifery. In essence, any woman who existed outside the control of marriage and motherhood represented a threat to social order. The persecution of these women wasn't separate from medical history but integral to it—it represented the violent suppression of female healing traditions as male physicians consolidated their authority. As the witch trials raged, some physicians began offering alternative explanations for women's mysterious symptoms. In 1603, English physician Edward Jorden published "A Briefe Discourse of a Disease Called the Suffocation of the Mother," arguing that conditions previously attributed to demonic possession were actually natural diseases of the uterus. "Mother" was an early modern term for the uterus, and Jorden claimed it could cause extreme symptoms that "simple and unlearned people" might mistake for possession. While this represented a step away from supernatural explanations, it still placed the blame squarely on women's reproductive organs. The 17th century witnessed significant advances in understanding human reproduction, though progress was uneven. William Harvey's work on blood circulation led him to challenge Aristotle's theory that women were merely passive vessels in reproduction. In 1651, he proposed that all animals, including humans, develop from eggs. However, these scientific advances occurred against a backdrop of continued persecution of female healers and the systematic exclusion of women from universities and medical education. When Jacoba Felicie was prosecuted in Paris for practicing medicine without credentials, despite testimonies from her patients about her successful treatments, the court ruled that her gender, not her skills, disqualified her: "It is not fitting that a woman should be master over a man." By the late 18th century, the concept of "hysteria" had emerged as a medical diagnosis that would dominate women's healthcare for the next century. The term derived from the Greek word for uterus (hystera) and encompassed a vast array of symptoms from convulsions and paralysis to excessive laughing or crying. Physicians like Thomas Willis began to locate the cause of hysteria not in the wandering womb but in disorders of the nerves and spirits. Nevertheless, hysteria remained a distinctly female malady, with women's supposedly delicate nerves and excessive emotions making them particularly vulnerable. The transition from demonizing women as witches to pathologizing them as hysterics represented not a liberation but a shift in the method of control.

Chapter 3: Victorian Control: Surgery, Rest Cures and Medical Authority (1800-1900)

The Victorian era witnessed an unprecedented medicalization of women's bodies, with new technologies enabling invasive scrutiny and control. The invention of the speculum in the early 19th century revolutionized gynecological examination but sparked fierce debate. In 1850, British physician Marshall Hall condemned the instrument as "a new and lamentable form of hysteria," arguing it threatened female modesty and could stimulate improper desires. This controversy revealed how medical innovations were filtered through Victorian anxieties about female sexuality and propriety. Surgical interventions became increasingly common as physicians sought to "cure" women of various physical and behavioral issues. Isaac Baker Brown, a prominent London surgeon, performed clitoridectomies (surgical removal of the clitoris) on women exhibiting "unnatural" behaviors including masturbation, hysteria, and even the desire for divorce. Though Brown was eventually expelled from the Obstetrical Society in 1867, similar procedures continued. American surgeon Robert Battey pioneered "normal ovariotomy"—the removal of healthy ovaries to treat conditions ranging from menstrual pain to "nymphomania" and "insanity." By 1906, an estimated 150,000 women had undergone this procedure, which physicians justified as necessary to control women's "unruly" bodies and behaviors. The "rest cure," developed by neurologist S. Weir Mitchell, exemplified Victorian medical control over women's bodies. This treatment for "neurasthenia" or "nervous exhaustion" prescribed complete bed rest, isolation, force-feeding, and prohibition of all intellectual activity. Charlotte Perkins Gilman, subjected to this treatment in 1887, later chronicled its devastating psychological effects in her semi-autobiographical story "The Yellow Wallpaper" (1892). The protagonist, confined to a bedroom and forbidden to write, gradually descends into psychosis, revealing how medical "treatment" could function as a form of patriarchal control. As Gilman later wrote of her experience: "It was not a choice between going and staying, but between going, sane, and staying, insane." Education became another front in controlling women's bodies. When women began seeking higher education in the 1870s, Harvard professor Edward Clarke published "Sex in Education," arguing that intellectual activity would divert blood from women's reproductive organs to their brains, causing infertility and nervous disorders. Clarke claimed that education during puberty could lead to "monstrous brains and puny bodies... flowing thought and constipated bowels." Mary Putnam Jacobi, one of America's first female physicians, methodically dismantled these claims in her award-winning research "The Question of Rest for Women During Menstruation" (1876), using statistical data and physiological measurements to prove menstruation did not impair women's physical or mental capabilities. As the century progressed, women increasingly challenged medical authority. The first generation of female physicians, including Elizabeth Blackwell in America and Elizabeth Garrett Anderson in Britain, fought for medical education despite fierce resistance. The "Edinburgh Seven," led by Sophia Jex-Blake, sued for the right to attend medical lectures in 1869. Though they ultimately lost their legal battle, their campaign led to legislation allowing women to qualify as doctors. These pioneering women recognized that medical knowledge was a crucial form of power, and that women's health would never be properly addressed until women themselves had a voice in medical institutions. The Victorian era established patterns of medical control that would persist well into the twentieth century. By pathologizing normal female processes, dismissing women's pain, and using invasive treatments to enforce social norms, Victorian medicine created a framework where women's bodies were simultaneously mystified and controlled. Yet this period also witnessed the beginnings of resistance, as women physicians, patients, and activists began challenging medical authority and reclaiming knowledge about their own bodies—a struggle that would intensify in the coming decades.

Chapter 4: The Birth Control Revolution: Fighting for Reproductive Freedom (1900-1960)

The early twentieth century marked a pivotal shift in women's relationship with medicine as they began demanding control over their reproductive lives. This era was defined by the pioneering work of Margaret Sanger, who in 1916 opened America's first birth control clinic in Brooklyn, New York. Within ten days, police raided the clinic and arrested Sanger for distributing "obscene" materials—information about contraception. Her subsequent thirty-day jail sentence only fueled her determination to fight the Comstock Laws, which since 1873 had criminalized the distribution of contraceptive information and devices as "obscene materials." Sanger's activism emerged from her experiences as a nurse in New York's Lower East Side, where she witnessed women dying from self-induced abortions and the physical toll of constant childbearing. Her publication "Family Limitation" provided practical contraceptive advice, while her newspaper "The Woman Rebel" boldly proclaimed "No Gods, No Masters" and connected reproductive freedom to women's economic independence. Sanger framed birth control as a fundamental right: "No woman can call herself free who does not own and control her body." Her advocacy was complicated by her support of eugenics—a common position among early birth control advocates—yet her work fundamentally challenged the medical establishment's control over women's bodies. Across the Atlantic, British author and activist Marie Stopes published "Married Love" in 1918, breaking taboos by discussing female sexual pleasure and contraception. Despite medical and religious opposition, the book sold 2,000 copies in its first two weeks. Stopes opened Britain's first birth control clinic in 1921, staffed entirely by women and offering free advice to married women. On opening day, hundreds of women queued around the street, demonstrating the enormous unmet need for contraceptive information. Like Sanger, Stopes believed that controlling fertility would improve women's health and lives, though her advocacy was similarly tainted by eugenic beliefs about "racial improvement." The medicalization of childbirth accelerated during this period, transforming what had traditionally been a female-centered experience managed by midwives into a clinical procedure controlled by male physicians. In 1914, "twilight sleep"—a combination of morphine and scopolamine that induced amnesia during labor—was introduced in America after journalist Mary Boyd underwent the procedure in Germany and promoted it as a revolution in pain-free childbirth. The National Twilight Sleep Association, led by women activists, organized rallies and demonstrations, declaring: "If you women want it you will have to fight for it; for the mass of doctors are opposed to it." While twilight sleep had serious risks and ultimately reinforced medical control over childbirth, the movement represented women's determination to have their pain taken seriously and to make decisions about their own bodies. As Tracy and her colleague Mary Boyd wrote: "It was the first time a doctor had ever admitted that I had a bad pain when I had one... I felt at last that I had found a place where people realized that pain was pain." The twilight sleep movement collapsed after reports of increased maternal and infant mortality, revealing the complex relationship between women's autonomy and medical risk. The development of the hormonal birth control pill in the 1950s, approved by the FDA in 1960, represented the culmination of decades of struggle for reproductive autonomy. Yet the pill's development revealed continuing patterns of medical exploitation—its clinical trials in Puerto Rico subjected women to high hormone doses without informed consent about potential risks or side effects. Three women died during the trials, but their deaths were never properly investigated. The pill promised liberation, but its history demonstrated how women's bodies continued to be sites of medical experimentation and control, even as they gained unprecedented reproductive freedom.

Chapter 5: Our Bodies, Ourselves: The Feminist Health Movement (1960-1990)

The 1960s witnessed a seismic shift as women began collectively challenging medical authority and reclaiming knowledge about their bodies. This transformation was crystallized in the publication of "Our Bodies, Ourselves" in 1970, originally a 193-page booklet created by the Boston Women's Health Book Collective. What began as a workshop where women shared their frustrating experiences with doctors evolved into a revolutionary text that demystified female anatomy, sexuality, and health care. The book's radical premise—that women could and should understand their own bodies—directly confronted centuries of medical gatekeeping. "We are not simply passive victims of our bodies," the authors declared, "but active participants in our own health care." Feminist health activism took many forms during this period. In Chicago, the Jane Collective provided underground abortion services from 1969 until Roe v. Wade in 1973, eventually training members to perform abortions themselves when they could no longer find willing physicians. Carol Downer and Lorraine Rothman traveled the country teaching women to perform vaginal self-examinations using plastic speculums and mirrors, empowering them to observe their own cervixes rather than relying on male gynecologists' interpretations. In 1971, Downer shocked an audience at a women's liberation conference by using a speculum to display her own cervix, demonstrating that women could literally take their healthcare into their own hands. These self-help groups created spaces where women could share knowledge and experiences previously shrouded in shame and secrecy. The movement for reproductive rights reached a pivotal moment with the Supreme Court's Roe v. Wade decision in 1973, which established abortion as a constitutional right. However, this legal victory came after decades of women suffering from dangerous illegal abortions—an estimated 200,000 to 1.2 million per year in the 1950s and 1960s, resulting in thousands of deaths and injuries. The fight for safe, legal abortion revealed how laws controlling women's bodies were enforced through medical institutions, with doctors serving as gatekeepers even after abortion was legalized. Women of color led crucial efforts to address the specific ways medical oppression affected their communities. The National Black Women's Health Project, founded by Byllye Avery in 1981, created self-help groups addressing the health disparities affecting Black women, who suffered higher rates of maternal mortality, hypertension, diabetes, and certain cancers. At their first national conference in 1983, over 2,000 women gathered at Spelman College to break the silence around conditions disproportionately affecting Black women. The conference adopted as its rallying cry the words of civil rights leader Fannie Lou Hamer, who had been sterilized without her consent in 1961: "I'm Sick and Tired of Being Sick and Tired." The women's health movement directly confronted the pharmaceutical industry's exploitation of female bodies. In 1970, Barbara Seaman's book "The Doctor's Case Against the Pill" exposed the dangerous side effects of early high-dose oral contraceptives that pharmaceutical companies had downplayed. This led to Senate hearings where women activists from DC Women's Liberation disrupted proceedings, demanding to know why women weren't testifying about a drug that affected only women. Their activism resulted in the first patient package insert explaining medication risks and the eventual reformulation of the pill with lower hormone doses. By the 1990s, women had transformed from passive patients into informed health consumers and medical researchers. The Women's Health Initiative, launched in 1991, represented the largest clinical research study ever conducted on women's health, addressing the historical exclusion of women from medical research. The 1993 NIH Revitalization Act finally mandated the inclusion of women and minorities in clinical trials, acknowledging that drugs affect different populations differently—a fact previously ignored as researchers used male bodies as the universal standard. Though barriers and biases remained, women had successfully challenged centuries of medical mystification and begun the long process of reclaiming authority over their bodies and health.

Chapter 6: Invisible Suffering: Autoimmune Diseases and Gender Bias (1990-Present)

The 1990s marked a turning point in recognizing gender bias in medical research and treatment, yet paradoxically saw the emergence of new "mystery" illnesses predominantly affecting women. In 1991, cardiologist Bernadine Healy, the first female director of the National Institutes of Health, coined the term "Yentl Syndrome" to describe how women received adequate medical attention only when their symptoms mimicked men's. Her landmark article in The New England Journal of Medicine revealed that women with heart disease were less likely to receive diagnostic tests or treatments than men with identical symptoms, contributing to heart disease being the leading cause of death among American women. This period saw increasing recognition of autoimmune diseases—conditions where the immune system attacks the body's own tissues—which affect women at dramatically higher rates than men. Lupus, rheumatoid arthritis, multiple sclerosis, and Hashimoto's thyroiditis all strike women at rates three to nine times higher than men. Despite affecting an estimated 50 million Americans, these conditions remained under-researched and poorly understood. Women often endured years of being dismissed as "anxious" or "depressed" before receiving proper diagnoses. A 1994 study found that women with autoimmune symptoms visited an average of five doctors over four years before being correctly diagnosed, with many being told their symptoms were psychosomatic. The 1990s also witnessed the emergence of contested illnesses like chronic fatigue syndrome (ME/CFS) and fibromyalgia, which disproportionately affect women. When an outbreak of ME/CFS occurred in Incline Village, Nevada, in the mid-1980s, the media dubbed it "yuppie flu," implying it was a psychosomatic condition of privileged, stressed women. Despite patients reporting debilitating fatigue, pain, and cognitive dysfunction, the medical establishment was slow to recognize these conditions as legitimate biological illnesses. A 1999 study found that physicians were more likely to prescribe antidepressants than order diagnostic tests when women presented with these symptoms. Research funding disparities perpetuated these knowledge gaps. A 2001 analysis found that conditions primarily affecting women received significantly less research funding relative to their disease burden than those affecting men equally or predominantly. Multiple sclerosis, lupus, and fibromyalgia all received less than half the expected funding based on their prevalence and impact. Meanwhile, the pharmaceutical industry continued developing drugs primarily tested on male subjects, leading to medications that worked differently—and sometimes dangerously—in women's bodies. The digital age transformed how women with chronic, contested illnesses built communities and advocated for themselves. Online forums and social media platforms enabled patients to share experiences, compare symptoms, and compile research in ways previously impossible. Patient advocacy organizations like the Lupus Foundation of America and the National Fibromyalgia Association grew in influence, pushing for increased research funding and physician education. These grassroots efforts gradually shifted medical perception of these conditions from psychological to biological, though progress remained frustratingly slow. By the early 2000s, emerging research began uncovering biological mechanisms behind gender disparities in autoimmune disease. Scientists identified how sex hormones modulate immune function, with estrogen generally enhancing immune responses while testosterone suppresses them. Genetic factors also play a role, as the X chromosome contains more immune-related genes than the Y chromosome. These discoveries validated what women patients had long reported: their symptoms often fluctuated with hormonal cycles, worsening during pregnancy, postpartum, or menopause. Yet translating this knowledge into effective treatments remained an ongoing challenge, with many women still struggling to have their complex symptoms taken seriously by a medical system that continued to privilege objective test results over subjective experiences of illness.

Summary

Throughout history, medical understanding of women's bodies has been shaped more by social control than scientific inquiry. From ancient Greece's wandering womb theory to Victorian diagnoses of hysteria, medical myths have consistently portrayed female biology as inherently defective and in need of management. This pattern reveals a fundamental truth: medicine has never been a neutral observer of female experience but rather an active participant in defining what it means to be a woman. The persistent pathologizing of normal female processes—menstruation, pregnancy, menopause—served to justify limiting women's education, employment, and political participation by framing their bodies as fundamentally unsuited to life outside the domestic sphere. The story of women's medical treatment offers crucial lessons for addressing healthcare inequities today. First, we must recognize that medical knowledge is never separate from the social context in which it develops—biases about gender, race, and class inevitably shape what questions are asked and which answers are accepted. Second, meaningful change requires listening to women's voices and experiences rather than dismissing them as unreliable narrators of their own bodies. When women like Mary Putnam Jacobi conducted research based on women's actual experiences of menstruation, or when Charlotte Perkins Gilman wrote about the torment of the rest cure, they challenged medical orthodoxy in ways that purely scientific arguments could not. Finally, the historical struggle for women's bodily autonomy reminds us that healthcare justice is inseparable from broader social and political equality—the right to vote, to work, to control one's reproduction, and to be believed when speaking about one's own pain are all facets of the same fundamental human right to dignity and self-determination.

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Elinor Cleghorn

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