Author Abby Norman on women's pain
Abby Norman was a thriving college student at Sarah Lawrence College when on one otherwise unremarkable day, she experience an onslaught of excruciating pain while taking a shower. That day was the first in what would turn out to be a seemingly endless crusade to get doctors to take her pain seriously.
Even after she was eventually diagnosed with endometriosis, Norman’s pain persisted. For years, doctors not only failed to get to the bottom of her pain, but continued to suggest that it was “all in her head.” So Norman took it upon herself to research not only her own pain and illness, but the nefarious historical and long-standing dismissal of women’s bodies in western medicine.
Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain is Norman’s exploration of this experience. Recently, Norman talked to the FBomb about the book.
Why has women’s pain historically been ignored by both medical research and health care providers?
A lot of medical education is still very largely dominated by patriarchal institutions. Most of our contemporary history of medicine has been written and framed by men, because men have been in positions of power and influence.
But [this is] not necessarily [due to] an individual physician’s bias because male physicians aren’t always the ones who dismiss women’s pain or women’s symptoms. It could just as well be a female doctor; female physicians are just as much beholden to or under the influence of patriarchal structures as male physicians are. I’ve had the experience with both. Especially around problems with reproductive health or problems with my period, sometimes the women were even less empathetic because men, at least to some extent, do sometimes have the ability to articulate at least intellectually that they have not menstruated, so if there’s a gap in experience or knowledge there they may be more willing to accept that. But often I find that the female physicians, because they’ve menstruated themselves, may actually lack a particular empathy if they haven’t experienced periods that match what [women are] telling them about their experience.
There are a lot of complex layers, but a lot of it is actually very simple, and that is that medicine and health care both at the social and educational and practical level has been for a very long time and is still very much dominated by these sorts of patriarchal structures.
Why do you think there’s a difference between the way women and men may handle pain?
It wasn’t until my early 20s, when I was in a really intimate relationship, that I really paid attention to the experience of what being a man was like. I really didn’t realize up until that point how the differences in our cultural perspective on illness and pain is really entrenched in what seem to me like needless gender differences. I feel like suffering is suffering and we should have the ability to empathize regardless, but really there was this profound and pervasive bias around people’s knee-jerk reactions when he was sick versus when I was sick.
For example, I was also dealing with endometriosis; my pain was debilitating to me in a day-in, day-out, chronic, progressive way. Yet I felt like I always had to grin and bear it. I also felt this kind of intense pressure to make a really concerted effort to try to get better — and make sure people knew that, because I didn’t want them to think I wasn’t trying hard enough not to be sick. But also in those moments when I was really sick, I either felt guilty because I felt like people were really sick of hearing about it and I had to protect them from those feelings or I felt that they questioned it and thought I had some kind of motive: that I wanted attention or that I was depressed and wasn’t doing enough work on myself and now there were all these physical manifestations.
My boyfriend got migraines. I started to understand his experience of pain through that, but it seemed so much simpler for him. There was not this layer of questioning. People were not telling him to get off his ass.
Men don’t feel like they can admit how bad they feel. Their dedication to stoicism not only doesn’t help them, but it also doesn’t help women because it makes it harder for us to have our pain taken seriously. When the men in our lives are working really, really hard to not be honest about their own pain, it just raises that bar to this place of being so high [for women] that we can’t overcome it. We have to commit to that stoicism as well.
Women get set up for [tolerating pain] at a very young age. I was always told from the beginning that my period was going to hurt, that sex was going to hurt, and I would just have to put up with it. Even before I even had any of those painful experiences, they were set up to be painful. I’ve heard from many other women that that was very much the message they got, too. One of the things that disheartens me so much about that is that these were not messages that I was not necessarily getting them from men in my life or larger society. There was a feeling that women should tell other women these things to try to warn them or protect them or help them prepare. But why don’t we take these opportunities to challenge that and say, This is how it’s always been but I need you to mess that up”?’ We need to change the paradigm and not continue to teach girls to expect pain.
You write about many different experiences of pain related to your uterus in the book, but especially note that sex was painful. How did that affect your relationship and your life more generally?
I spent the first year of my first sexual relationship totally accepting that I was in pain because I was always taught it was going to hurt. I was so frustrated because I loved this guy. As I got to know myself as a sexual person, there were so many other parts of sex, in terms of intimacy and other experimental parts, that I liked. I was so frustrated, sexually and otherwise, that this component of heterosexual interoucrse was so excruiciatingly painful. The pain was residual. It wasn’t just while we were having intercourse, but also everything after that made me sick. I would bleed, I would have nausea. Sometimes it was a couple of days. It was this very deep, really almost nauseating ache.
I think a big part of [why I endured painful sex] was that I did not want to screw up his experience. I didn’t want to be a bad partner. I didn’t want him to break up with me. I didn’t want him to think I didn’t love him or wasn’t attracted to him because it was so not about that. I really didn’t want my pain to take precedence in that sexual encounter because I was afraid it would mean it would all be over. That’s, I don’t think, necessarily a unique feeling for women in this situation. It was so easy for me to not make my sexual pleasure my priority. But it was also so the impulse of everyone else not to make it a priority either. Until I wrote this book and started having these conversations I didn’t realize just how intense and common, unfortunately, this is.
It was very clear [at the end of the relationship] that when we were having penetrative intercourse, I was only doing it for his benefit and I was suffering. I think that fucked with him quite a bit, this idea that he knew on some level that I was just enduring this pain so that he could have pleasure. That I felt willing to do that, that I justified doing that for as long as I did, is really screwed up to me.
He also didn’t necessarily challenge it because there are a lot of messages socially that imply that that’s acceptable practice — that his pleasure certainly should have been the priority.
It was a really complex experience of growth and ultimately when we did break up there was this feeling for me, and there still is, that I always just wanted him to go have a good life and find someone to be with who could actually give him all of the things and not just a couple of the things. I internalized a lot of feelings of failure that I’ve had to work through. I mostly felt frustrated not so much by feeling that I had failed specific to femininity or my role as a woman, but failed in some great and really unfair way as a sexual being regardless of how I identified or even what my physical presentation might be. There was this core and crucial component to what it means to be a human being that I had not only not gotten to fully experience because it had been cut short for me from the beginning of my sexual awakening, but that there was really, it seemed, no hope of it ever really getting better.
I think it’s completely valid and worthy of our attention to have conversations about people who choose to have lives that don’t have a physical sexual component or that people can have an identity that doesn’t have a sexual component to it. But, for me, it wasn’t that I didn’t want or desire a sexual life or was making a choice about having one. That choice was taken from me because of a physical issue that has still gone woefully unresolved.
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