All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today

Today, the practice of cosmetic medicine is one that walks the line between empowering women to control their bodies and trapping them in a gilded cage of punishing beauty standards.

Thousands of year ago, a Viking warrior was laid to rest in a grave adorned with a sword, an axe, a spear, armor piercing arrows, a battle knife, two shields, and two horses, all suggestive of a professional, high-ranking commander. When the grave was discovered in the late nineteenth century, experts agreed this must be the burial site of an esteemed MALE warrior. It wasn't until the 1970s that some scientists looked more closely at the remains and asked: Could these small, gracile bones be the remains of a woman? The greater scientific community balked; the very idea of a female warrior was too ridiculous to entertain. And yet, fifty years later, a DNA analysis of the Viking skeleton by Stockholm Unversity osteologist Anna Kjellstrom conclusively proved it accurate. It only took so long, and required so much, because the bones told a different story than the medical institions and experts of the 1800s did. The skeleton was clearly female - but the men saw what they wished to see, what they'd been taught to see.

The mistake doctors made, and continue to make, is imagining that a disease that’s in the patient’s head must therefore, in some sense, be a fabrication over which the patient has control.

Women remain underrepresented and overlooked in medical research, even though many treatments interact differently in a female body than in a male one.

Yet evidence shows that women also spend more time with patients, embrace more empathic roles, and connect with their patients better (resulting in better outcomes).

In France in the 1860s, the proximity of the female heart to the female bosom made a physician named René Laennec so uncomfortable that he invented an early prototype for the stethoscope, just so he could avoid putting his ear to his female patients’ chests.

A lot of our colleagues are almost afraid of taking care of pregnant women,” Bose says. “But when fear stops us from asking questions, it stops us from solving treatable problems.

A man with high testosterone, it was understood, was virile, a warrior, a stud. A woman with too much estrogen, on the other hand, was just crazy.

A delicate euphemistic vocabulary has sprung up alongside these new procedures: lifting, plumping, smoothing, filling. It all sounds so gentle, less like medicine, more like self-care. And yet we are still no closer to disentangling what women want for their faces and bodies from what doctors, or husbands, or social pressures might tell them they’re supposed to want.

Beauty, as always, was in the eye of the beholder - but now, the beholder was holding a scalpel.

Western medical storytelling has largely eschewed the discussion of women’s bodies, let alone elevated them as powerful, capable, or of equal worth to men’s. In the medical history that defines women’s “normal” bodily functions—as well as their pain, pleasure, strength, and intellectual capacity—the voices of women themselves are notably absent. This

But here, there were obstacles: religious, cultural, and legal. In the United States, disseminating contraceptives—or even just information about how to use them—was banned by the government well into the 1960s. The National Institutes of Health refused to fund basic research in the reproductive sciences and was outright forbidden from funding birth control research until 1959.

The role of women was proscribed in medicine as in society, bolstered by the stereotype of the female nurturer: Doctors cured. Nurses cared.

but the greater difference comes in the form of active pushback, from within and often by female physicians, against the twin forces of objectification and paternalism that have dominated for too long in orthopedic medicine.

By refusing to let it take her beauty, Amrita wasn’t just giving herself the gift of a more youthful appearance; she was reclaiming a sense of control over her life.

Rather, it is to ask for a medical world that is more human, more holistic, more capable of seeing the patient as a whole person and not just a series of broken parts.

What such research reveals is not the inherent superiority of female physicians, but the way that gendered cultural norms may allow women to meet the needs of their patients more effectively than their male counterparts. Why is it that male physicians are more likely to interrupt their patients sooner than female physicians? Is it that women are expected to be better listeners, to interrupt less, to demonstrate emotion and empathy? What would happen if we built those expectations into every medical education, for every doctor, from the very beginning? What would medicine look like if all the female energy that was squeezed out and sidelined from it over the course of two millennia was allowed back in?

Female physicians are more likely to take on volunteer “peace-making” roles in academic institutions, and be pushed toward caretaking as opposed to leadership. Yet evidence shows that women also spend more time with patients, embrace more empathic roles, and connect with their patients better (resulting in better outcomes).

In all my years of both training and practice in internal medicine and oncology, I cannot recall a male patient ever expressing this sort of shame. As a physician aiming to partner with women in their return to good health, I find this difference baffling.

The list of things for which patients have apologized to me over the years is both endless and obscene: these women are sorry not just for sweating, but for being sick, for having to seek treatment at all. They blame themselves for missed mammogram appointments, for failing to see their own symptoms, for not accurately diagnosing themselves with cancer amid the mad rush of full-time work, motherhood, caring for elderly parents, running a household. They are even ashamed of the side effects of the treatments and surgeries that allow them to survive.

And the female body, so many of whose workings remain medically mysterious even in an otherwise enlightened age, and so revered for its ability to grow, nurture, protect, and eventually give forth new life, also remains a vessel into which we can place all manner of things: blame, ignorance, incuriosity, fear.

The immense ignorance surrounding heart disease in women is one of the better-known scandals to come out of medical history, an egregious example of entrenched bias within not just circulatory medicine but science altogether, one whose influence is plainly visible today.

Medical history is full of moments in which a woman suffering from a functional illness—that is, an illness with no apparent cause—was told that her condition was psychosomatic, all in her head.

beginning in the 1930s in Puerto Rico

She is Martin Luther’s syphilitic whore. She is the immigrant cook

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We need to stop apologizing for our medical needs

they are closer to children and savages than to an adult