Disentangling gender and racial myths from clinical descriptions of female prevalent symptoms

从女性普遍症状的临床描述中解开性别和种族神话

• 批准号: ES/Y007816/1
• 负责人: Sally King
• 金额: $ 16.17万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FY007816%2F1
• 关键词: Disentangling; gender; racial; myths; clinical

My PhD research found that the myth of the hysterical female unintentionally influences the way in whichdoctors, researchers, and the public discuss, categorise, and treat female-prevalent symptoms.I compared expert (medical and academic) and patient accounts of PMS (Premenstrual Syndrome) with theavailable scientific data regarding cyclical symptoms. The main finding was that persistent gender mythsassociated with 'hysteria' were affecting participant descriptions. In particular, the untrue but surprisinglycommon belief that the healthy female body (first the womb, now the female sex hormones) causes seriousmental health issues was strongly reflected in the way in which PMS was described. Unfortunately, thisassumption wrongly positions 'all women' as biologically prone to irrational beliefs and behaviours (includingthe exaggeration, invention, or imagination of symptoms and other distressing experiences) (King, 2020).This gender myth appears to have contributed to the unscientific separation and prioritisation of typically mildpremenstrual mood changes, and the dismissal and de-prioritisation of far more common and severeexperiences of (cyclical) pain. Black and other racialised ethnicity patient participants appeared to be subject toeven higher levels of disbelief in their symptoms than White cisgender women, demonstrating how gender andrace myths may combine to worsen discriminatory beliefs and practices.Another major finding was that educational resources (from high school biology to specialist gynaecologytextbooks) reduce the menstrual cycle to just 'hormonal changes'. By omitting key information about thefemale reproductive system, a more likely cause of cyclical symptoms (inflammation) has been overlooked forthe past 100 years. This gap in education unintentionally reproduces the myth of the hormonal/ hystericalfemale and has led to 'bad science'- in that researchers have mistakenly assumed that the timing of symptomsmeans that they must be caused by hormonal changes (rather than the inflammation associated withovulation, thickening of the womb lining, and menstruation).Many clinical PMS studies have tried but failed to prove a causal relationship between the female sexhormones and cyclical symptoms. Tellingly, these consistently negative study findings were positioned by themedical PMS experts as evidence of the 'mysterious' nature of the female reproductive body rather thansuggestive of alternative scientific explanations. In fact, it appears that the pairing of 'women' and 'hormones'in medicine (and wider society) has severely limited the ability of researchers and clinicians to account forfemale-prevalent symptoms and conditions in any other terms.My PhD thesis concluded with a proposal for redefining problematic cyclical symptoms as PMI (PerimenstrualInflammation) to help steer societal and medical discourses away from persistent gender/ race myths andmetaphors towards more accurate explanations. It is hoped that this will help to account for, and attend to, theneeds of individual patients without accidentally stigmatising an entire gender and/ or racialised ethnicpopulation. I already have a contract with Bristol University Press to write a popular science book for academic and publicaudiences. I now need to publish my work in some influential medical and academic journals to gain greaterprofessional credibility. This will be needed if I am to secure further research funding and persuade thepublishers of school and medical textbooks to integrate more comprehensive information about the purposeand function of the healthy menstrual cycle. Ultimately, I hope to help boost patient and medical knowledge ofmenstrual health (and female-prevalent symptoms), improve treatment options and patient outcomes, andexpose the way in which societal myths have prevented this information from being taught before.

我的博士研究发现，歇斯底里女性的神话无意中影响了医生、研究人员和公众讨论、分类和治疗女性流行症状的方式。我将专家（医学和学术）和患者对PMS（经前综合征）的描述与有关周期性症状的现有科学数据进行了比较。主要的发现是，与“歇斯底里”相关的持续的性别神话影响了参与者的描述。特别是，健康的女性身体（首先是子宫，现在是女性性激素）会导致严重的精神健康问题，这种不真实但却非常普遍的信念强烈地反映在经前综合征的描述中。不幸的是，这种假设错误地将“所有女性”定位为在生理上倾向于非理性的信念和行为（包括夸大、虚构或想象症状和其他痛苦经历）（King，2020）。这种性别神话似乎导致了对典型的轻度经前情绪变化的不科学的分离和优先顺序，以及对更常见和更严重的（周期性）疼痛经历的忽视和去优先化。与白色顺性别女性相比，黑人和其他种族化的患者参与者似乎更不相信自己的症状，这表明性别和种族神话如何联合收割机可能会加剧歧视性信念和做法。另一个主要发现是教育资源（从高中生物到专业妇科教科书）将月经周期缩短为“荷尔蒙变化”。由于忽略了女性生殖系统的关键信息，在过去的100年里，一个更可能导致周期性症状（炎症）的原因被忽视了。这种教育上的差距无意中再现了荷尔蒙/歇斯底里女性的神话，并导致了“坏科学”-研究人员错误地认为，更年期的时间意味着它们必须由荷尔蒙变化引起（而不是与排卵相关的炎症，子宫内膜增厚，许多临床PMS研究试图证明女性性激素和周期性症状之间的因果关系，但未能成功。很能说明问题的是，这些一贯负面的研究结果被医学PMS专家定位为女性生殖体“神秘”本质的证据，而不是其他科学解释的暗示。事实上，看来医学上的“女性”和“荷尔蒙”的配对（以及更广泛的社会）严重限制了研究人员和临床医生用任何其他术语解释女性流行症状和状况的能力。我的博士论文以一项将有问题的周期性症状重新定义为PMI的提议结束。（围月经期炎症），以帮助引导社会和医学话语远离持久的性别/种族神话和隐喻，走向更准确的解释。希望这将有助于说明和照顾个别患者的需求，而不会意外地侮辱整个性别和/或种族化的种族人口。我已经和布里斯托大学出版社签了合同，要为学术界和公众写一本科普书。我现在需要在一些有影响力的医学和学术期刊上发表我的工作，以获得专业的可信度。如果我想获得进一步的研究资金，并说服学校和医学教科书的出版商整合关于健康月经周期的目的和功能的更全面的信息，这将是必要的。最终，我希望帮助提高患者和医学对月经健康（和女性流行症状）的认识，改善治疗选择和患者结果，并解释社会神话阻止这些信息被教授的方式。