Richard Trembath on the historical antecedents of dismissing endometriosis
Sir, – For man the physiological psychology of woman is full of difficulties. He is not a little mystified when he encounters in her periodically recurring phases of hypersensitiveness, unreasonableness, and loss of the sense of proportion. He is frankly perplexed when confronted with a complete alteration of character in a woman who is child-bearing . . . And it leaves on his mind an eerie feeling when he sees serious and long-continued mental disorders developing in connection with the approaching extinction of a woman’s reproductive faculty . . . these upsettings of her mental equilibrium are the things that a woman has most cause to fear; and no doctor can ever lose sight of the fact that the mind of woman is always threatened with danger from the reverberations of her physiological emergencies.
It is with such thoughts that the doctor lets his eyes rest upon the militant suffragist.
The above extract is taken from a letter to The Times from distinguished doctor, Almroth Edward Wright, which was published in March 1912 at the height of the suffragette campaign in the United Kingdom.[i] (They were more generous with letter length in those days.) I cannot claim to be a trendsetter in citing this as it has been a source of quotable quotes for many years, a reliable source of misogynistic looniness. It serves here as a handy introduction to how female illnesses, whether fake such as ‘hysteria’, or genuine such as endometriosis, can be used to demean and politicise a woman’s suffering. In this article I shall examine some contemporary sources and events to illustrate how endometriosis, in particular, may be manipulated to prop up gender inequality. I start with the now ex-radio broadcaster, Marty Sheargold, then go back a few years to the publication of an important work by Australian journalist, Gabrielle Jackson, and the self-help manual how to endo by Bridget Hustwaite.
In February 2025, Marty Sheargold, then working for Triple M radio, had quite a week. On the Monday he made crass remarks about recent poor performances by the women’s national soccer team, the Matildas, in which he mentioned driving a nail through his penis rather than watch any more women’s sport. (You can’t make this stuff up.) His employers, Southern Cross Austereo, dismissed him on the Wednesday. In between, Sheargold committed another peccadillo. As he was suffering back pain, he borrowed a heat pack from a producer who used it to alleviate her difficult periods. God only knows what connections then met and married in his brain, for the following has to be one of radio’s more obviously pre-planned ‘shock’ comments.
‘God, don’t ladies carry on, Jesus Christ, there is no end of it. Honestly, endometriosis, and this is controversial’, he said, before a fellow host attempted to cut him off. ‘No, I’m going to say it, it’s controversial. It’s made up.’
The reaction of experts to Sheargold’s nitwit remarks makes pleasant reading.[ii]
Endometriosis occurs when tissue, which is like that of the endometrium (the inside layer of the uterus) develops outside that organ. Locations may be the ovaries, the vagina, fallopian tubes or the intestine. The symptoms of endometriosis include, but are not restricted to, the following – severe pain associated with menstrual cramps, bowel movements or sexual intercourse, and back pain during menstruation. Over time psychological problems and fatigue are often present. Pregnancy may be difficult or impossible. The subsequent effects on personal relationships and daily life can be extreme.[iii]
In 2021, Bridget Hustwaite wrote that approximately 800, 000 Australian women, plus a few men, suffered endometriosis. The world figure was said to be around 176 million. Those figures were provided in several sources at that time. [iv] But in 2024, an article published in the Australian Journal of General Practice stated that the illness ‘is a common yet frequently under-recognised condition affecting one in nine Australian women.’[v] Let us do some basic arithmetic here. As I write, the estimated Australian population is approximately 27 million. Ignoring the fact that there are more women than men in the country, half of 27 million is 13, 500, 000. One-ninth of the latter figure is 1, 500, 000 which is the purported number of endometriosis sufferers in Australia. It is unlikely that ‘endo’ has almost doubled in just three years, so we are looking at both greater awareness of the condition amongst health practitioners and sufferers and refined diagnostic techniques.
Endometriosis is strongly indicated by a range of symptoms and the elimination of other possible chronic inflammatory abdominal problems, of which there are plenty. Definitive diagnosis comes via a laparoscopy which is the insertion into the abdomen of an instrument with a small camera. The laparoscope can also treat existing conditions or excise material for laboratory testing, that is, a biopsy. According to the Australian Journal of General Practice:
Diagnostic laparoscopy with histological confirmation has traditionally been considered the gold standard for the diagnosis of endometriosis.[vi]
But unless there has been a massive increase in laparoscopy within Australian clinics, many diagnoses are still being made on the basis of the symptoms listed above, which means that there is often an interminable delay in determining what a patient is suffering from. It is not surprising therefore that British writer, Nicky Hudson, wrote an article in 2021 entitled “The missed disease? Endometriosis as an example of ‘undone’ science”. Once you have waded through a sargasso sea of terminology and circumlocution you get to this:
Somewhat counter-intuitively, whilst cases of endometriosis have risen, persistent complexities in the classification and identification of the disease mean that the average time to diagnosis is still 7.5 years in the UK . . . Studies show how women experience delegitimization of their symptoms before, during and following diagnosis, reporting that they are disbelieved by professionals or that their concerns are fobbed off. [vii]
That figure of 7.5 years till diagnosis is similar to figures in Australia and the United States.[viii]
Six years before, in September 2015, Australian journalist, Gabrielle Jackson, had published an influential article in Guardian Australia whose heading stated:
I’m not a hypochondriac. I have a disease. All these things that are wrong with me are real, they are endometriosis. I feel sad that this is the hardest story I’ve ever written and that I’m embarrassed that people will read it and know the intimate details of my life. But I’m also hopeful that a conversation has begun.
There are several significant issues in this piece. Firstly, there is the cold shoulder many endometriosis sufferers have hitherto received from the medical establishment. Jackson recalls listening to Geoffrey Reid, a gynecologist and infertility specialist, whose ‘discussion of fertility and endometriosis broke my heart’ as he ‘spoke about his endo patients as humans’.
If you think that’s a strange statement, then you haven’t presented to a doctor with symptoms of endometriosis. Support groups world-wide are linked by a common theme: too many women being dismissed by their doctors for years as anxious ‘type A’ personalities, hypochondriacs or merely difficult. It is the 21st century’s ‘hysterical’.
A second issue is the claim that there is an apparent link between suffering endometriosis and being more likely ‘than the general female population’ to have other chronic conditions, including chronic fatigue syndrome (CFS), fibromyalgia, sinus or perennial allergic rhinitis. These conditions and others such as irritable bowel primarily syndrome affect women. I note here that several of what I call the ‘linked complaints’, such as CFS and fibromyalgia, are themselves mysterious as to cause and have no firm diagnostic markers.[ix]
In 2019, Jackson published another article in Guardian Australia entitled, ‘Why don’t doctors trust women? Because they don’t know much about us.’[x] This coincided with the publication of her book, Pain and Prejudice. This is a full-length discussion of her ‘endo’, deficiencies in treatment, and the historical roots of male and medical dismissal of the condition, except when it reinforced notions of women as tied to their troublesome – and deviant – biology. [xi]
A century of diagnosis and medical science still has no idea what causes endometriosis or how it works, and we are no closer to a cure. How could this possibly be? And while there are many doctors working in the field who are making a huge difference to the lives of people with endometriosis, there are many more who remain ignorant of the disease, who still push tired old myths about its curescauses?, and who treat people with the disease as hysterical.
Jackson is puzzled as to why we have no clue as to the cause or progress of endometriosis, nor any as to a solution. The answer to that is complex, possibly more complex than she thinks. First, if we accept that there has been widespread indifference amongst the medicos in Australia and elsewhere, this will have also resulted in a lack of the heavy-duty research that is essential for improving treatment. Secondly, any amount of medical research, conducted over long periods of time, with massive public awareness, and infused with more money than Elon Musk could imagine, may still fall short of a talismanic cure. It can be a long road to a cause and an even longer one to a cure. Ask anybody with motor neuron disease.
In response to growing concern, the Commonwealth Government published the National Action Plan for Endometriosis in 2018.[xii] Groups such as Endometriosis Australia now exist to raise awareness of the condition, and to advocate for further research. A growing number of well-known women, including, amongst many candidates, the current premier of Victoria, Jacinta Allan, and American tennis star, Danielle Collins, have talked openly of their problems with this condition.[xiii]
Broadcaster Bridget Hustwaite is one of these. In how to endo: a guide to surviving and thriving with endometriosis Bridget Hustwaite commences with her personal and scarifying experiences of the disease. This is uncomfortable reading and so it should be. Not just because of her pain and prolonged distress. In 2017, Hustwaite ‘decided to see a local female GP who was recommended to me based on her specialisation in women’s health’. But:
I was beyond excited at the thought of seeing someone who would finally understand my pain, but it turned out to be my most disappointing encounter with a medical professional. Ever. From the moment I entered the room, this GP didn’t want a bar of me. I’m not sure if she was having a bad day but the whole time, she was beyond disinterested.[sic][xiv]
So, it is scarcely surprising when Hustwaite later comments:
I’m definitely not saying all health professionals are bad but, frankly, too many have failed us. I mean, we are talking about a system that historically has been rooted in sexist notions of women’s hysteria. To take just one famous example, English doctor Isaac Baker Brown surgically removed the clitorises of thousands of women as a cure for insanity, epilepsy and hysteria.[xv]
It might have been useful if Hustwaite had placed that sentence about Brown in its historical context or even dated it. (He practiced in London in the mid 19th century.) It would also have been useful to note that Brown’s medical career came to a thumping conclusion when it was discovered that he had carried out clitoridectomies without consent. And it’s a long bow to draw a comparison between past medical theories and modern practice without explanation. That is my instinct as an historian, but it would also be misunderstanding the purpose of her book which is to direct women to resources, help and a community.
Hustwaite is another who refers to long-held pseudo-science about hysteria, which in more recent language might be described as neurosis (itself an outdated term) or personality type. This indeed has a distinguished history, all the way back to Plato in fact. I might strain editorial patience if I spend too long on the wandering womb thesis proposed in Plato’s truly bizarre, but highly influential, dialogue, Timaeus. However, there is a point to the following:
Wherefore also in men the organ of generation becoming rebellious and masterful, like an animal disobedient to reason, and maddened with the sting of lust, seeks to gain absolute sway, and the same is the case with the so-called womb or matrix of women. The animal within them is desirous of procreating children, and when remaining unfruitful long beyond its proper time, gets discontented and angry, and wandering in every direction through the body, closes up the passages of the breath, and, by obstructing respiration, drives them to extremity, causing all varieties of disease.[xvi]
The floating womb ranks high on the list of ludicrous health theories but before we have a good laugh at the expense of the ancient Greeks, we might want to recall the more deranged treatments proposed for COVID-19. Long after the concept of the nomadic uterus was abandoned, hysteria was still often seen as the ultimate cause of many women’s ‘problems’ or supposed social weaknesses, as can be seen by the epigraph for this article. If we look at a popular family medical dictionary from 1968, the predecessor of today’s Dr Google, but with less misinformation, we can gauge some changing opinions, and the residue of vintage attitudes. Black’s Medical Dictionary was first published in 1906, just as science-based medicine, public health reforms, and both domestic and hospital nursing were coming to the fore. Black’s ran through many updated editions and in 1968 the entry on ‘masturbation’ was sensible and non-judgemental, and the entry on ‘ovaries’ flatly stated that it was no longer correct to attribute so many female illnesses to disease of the reproductive organs. But when it gets to ‘hysteria’, medical prejudice is hard to dismiss:
The condition is far more common in women than in men . . . Faulty upbringing in children predisposes to hysteria, which in young women of unequally developed mind and pampered habits, may be produced by sudden fright, family worry, grief, or a love affair. . . No hysterical young woman should remain unoccupied, but should be provided with, and forced to do, some congenial work.[xvii]
Alright, 1968 seems like the ancient world to most of the world’s current inhabitants. But zombie myths in history do what zombies do best: stick around. And even if ‘hysteria’ is dated as a term these days, ascribing something as serious as endometriosis to psychological characteristics of women is as dangerous as it is delusional.
We’re near the end so let’s return to Sheargold. How should we evaluate him? Was there anything in his mind besides a brief rise in ratings? What electorate was he addressing? His defenders, such as they are, run the line that he is a comedian, that what he said was a joke, people should accept it as such – in other words, get over it. Outside this group, it does not appear that Sheargold’s comments resonated with many people. Initially, I felt flat about his schtick but now I feel quietly hopeful. Nobody within the mass of silly groups and conspiracy theorists in Australia seem anxious to pick up the baton Sheargold threw them. And that surely is a good thing.
Richard Trembath
Ballarat
richard_trembath@hotmail.com
As per usual, if anybody wants additional material on this subject feel free to contact me. Or go to the original sources like the organisations, documents and advocates named in this article.
[i] Dr A. E. Wright, letter to The Times, 28 March 1912. Wright later expanded his arguments at considerable length in the book, The Unexpurgated Case Against Woman Suffrage, published in 1913. Wright’s work on female militancy is unhinged but his contribution to medicine was significant including an early warning about the possibility of antibiotic resistance.
[ii] Georgie Hewson, ‘Experts slam “disappointing” comments about endometriosis from Marty Sheargold’, ABC News, 28 February 2025, https://www.abc.net.au/2025-02-28/endometriosis-sheargold-comments-disappointing/104993576
[iii] Brian Mastroianni, ‘People Living with Endometriosis Often Aren’t Believed: What to Do’, Healthline.com, 16 December 2021, https://www.healthline.com/health-news/people-living-with-endometriosis-often-aren’t-believed.
[iv] Bridget Hustwaite, How to Endo: A Guide to Thriving and Surviving, Allen & Unwin, Sydney, 2021, p. 25.
[v] ‘Endometriosis: A review of recent evidence and guidelines’, Australian Journal of General Practice, Vol. 53, Issue1-2, Jan-Feb 2024, https://www1.racgp.org.au/ajgp/2024/january-february/endometriosis
[vi] Endometriosis: A review of recent evidence and guidelines’.
[vii] Nicky Hudson, ‘The missed disease? Endometriosis as an example of “undone science”, Reproductive Biomedicine & Society Online, 2021 Aug 13;14:20-27, https://pmc.ncbi.nlm..nih.gov/articles/PMC8517707/
[viii] endometriosis.org, ‘myths and misconceptions in endometriosis’, endometriosis.org/resources/articles/myths/, 20 November 2016.
[ix] Gabrielle Jackson, ‘I’m not a hypochondriac. I have a disease. All these things that are wrong with me are real, they are endometriosis’, Guardian Australia, 28 September 2015, https://www.theguardian.com/society/2015/sep/28/im-not-a-hypochondriac-i-have-a-disease-all-these-things-that-are-wrong-with-me-are-real-they-are-endometriosis
[x] Gabrielle Jackson, ‘Why don’t doctors trust women? Because they don’t know much about us.’, Guardian Australia, Monday 2 September 2019, https://www.theguardian.com/books/2019/sep/02/why-dont-doctors-trust-women-because-they-don’t-know-much-about-us
[xi] Gabrielle Jackson, Pain and Prejudice: A Call to Arms for Women and Their Bodies, Allen & Unwin, Sydney, 2019. The book has been rechristened as Pain and Prejudice: How the Medical Profession Ignores Women and What We Can Do About It.
[xii] Australian Government Department of Health. National Action Plan for Endometriosis, Canberra, 2018. www.health.gov.au/sites/default/files/national-action-plan-for-endometriosis.pdf
[xiii] Age, 1 June 2025; BBC Online, 28 May 2025, https://www.bbc.com/sport/tennis/articles/cg66kd6wlveo
[xiv] Hustwaite, p. 6.
[xv] Hustwaite, p. 36.
[xvi] Plato, Timaeus, 91c.
[xvii] William A. R. Thomson, Black’s Medical Dictionary, 28th edition, Adam and Charles Black, London, 1968.
