Q: Is there more to poor bedside manner?
A: Without a doubt.
Q(s): Is your pain real? Is the suffering abnormal? Are your concerns valid?
A(s): Yes. Absolutely. Of course.
These inquiries shouldn’t even be up for discussion. Unfortunately, however, pelvic pain survivors who are denied the compassionate, comprehensive care that they deserve may dwell on the second set of posed questions.
Pelvic pain entails varying degrees of discomfort in the pelvis and lower abdomen region, which may impact the reproductive organs, fertility, as well as one’s overall functioning and quality of life. Related symptoms could also entail conditions such as endometriosis and uterine fibroids. Although the aforementioned questions appear benign, they are capable of unleashing a potentially lethal viral load of doubt that can multiply, spread like a contagion, and quickly contaminate one’s cognition. Ultimately, these reproductive health care experiences and outcomes connect to two major concepts that frequently devastate pelvic pain patients:
Medical trauma: A type of subjective, patient-related trauma experience that occurs during or following direct contact with medical setting aspects—including providers, procedures, and diagnostic evaluations—and evokes posttraumatic stress symptoms, such as persistent avoidance and hyperarousal (Hall & Hall, 2017).
Medical gaslighting: Emotionally manipulative, dismissive, or minimizing comments and/or gestures that medical providers direct at patients, which alters the patient’s perception of reality (pain and suffering), increases self-doubt, as well as influences posttraumatic stress symptom onset and/or retraumatization.
“This is very normal.”
“Every woman goes through this!”
“You just have a low tolerance for pain.”
Medical professionals should not have to see pain in order to believe it. No one should have to see you doubled-over or see the actual fibroid(s) and cyst(s) that sustain your suffering before taking your concerns seriously. Your words should be more than enough. Your words have weight.
Overall, reproductive health-related medical trauma has essentially terrorized and stunned women who already feel helpless as they put up a daily fight to simply function. Medical trauma frequently impacts racially and ethnically minoritized women—especially Black women—who continue to deal with the lingering effects of gruesome scientific racism and toxic medical myths, which come to life when providers approach such patients with bias, believe that they have a high tolerance for every type of pain, and, thus, convince themselves that the patients will be just fine. Turning a blind eye, however, fuels medical trauma, medical gaslighting, and muffled cries for relief. Despite being given the run around or overlooked altogether, there are actions that you can take to fade emotional scarring and feel empowered:
- Education: If you have access to resources, take a moment to become familiar with your anatomy and physiology, especially pertaining to your reproductive health. Feel free to read about the relevant condition(s), symptoms, onset factors and prevalence, as well as comprehensive—and effective—treatment options.
- Self-advocacy: Prior to consultations or annual specialist visits, track or record your symptoms and list questions in advance for the specialist in order to help determine best fit. Jot down and pose questions about procedure-related complication rates, care outcomes, and additional referral options—for second or third opinions. Consider inviting allies to your appointment— if that’s an option—or loved one who you can tap in to advocate on your behalf.
There’s also always an opportunity to collaborate with a person-centered mental health professional who resonates with your experience.
Hall, M., & Hall, S. (2017). What is medical trauma? In Managing the Psychological Impact of Medical Trauma: A Guide for Mental Health and Healthcare Professionals. New York, NY: Springer Publishing Company.