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

我的博士研究发现，歇斯底里的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)和患者对经前综合征(PMS)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，与歇斯底里有关的持久的性别神话正在影响参与者的描述。特别是，人们普遍认为健康的女性身体(先是子宫，现在是女性性激素)会导致严重的心理健康问题，这一不真实但令人惊讶的普遍看法在描述经前综合症的方式中得到了强烈的反映。不幸的是，这一假设错误地将“所有女性”定位为在生理上倾向于非理性的信念和行为(包括对症状和其他痛苦经历的夸大、发明或想象)(King，2020)。这种性别神话似乎导致了对典型的轻微经前情绪变化的不科学分离和优先排序，以及对更常见和更严重的(周期性)疼痛经历的忽视和排挤。黑人和其他种族患者对自己症状的怀疑程度似乎比白人顺性女性更高，这表明性别和种族神话结合在一起可能会加剧歧视观念和做法。另一项主要发现是，教育资源(从高中生物学到妇科专业教科书)将月经周期减少到只是“荷尔蒙变化”。由于遗漏了有关女性生殖系统的关键信息，一个更有可能导致周期性症状(炎症)的原因在过去100年里一直被忽视。这种教育上的差距无意中重现了荷尔蒙/歇斯底里女性的神话，并导致了“糟糕的科学”--研究人员错误地认为，症状的出现时间意味着它们一定是由荷尔蒙变化引起的(而不是与排卵、子宫内膜增厚和月经有关的炎症)。许多经前综合征临床研究试图证明女性性激素与周期性症状之间存在因果关系，但未能证明。很有说服力的是，这些持续的负面研究结果被医学上的经前综合症专家定位为女性生殖体神秘本质的证据，而不是暗示着替代的科学解释。事实上，医学(以及更广泛的社会)中“女性”和“荷尔蒙”的配对似乎严重限制了研究人员和临床医生用任何其他术语来解释女性流行的症状和情况的能力。我的博士论文最后建议将有问题的周期性症状重新定义为PMI(长期感染)，以帮助引导社会和医学话语从顽固的性别/种族神话和隐喻转向更准确的解释。希望这将有助于说明和照顾个别患者的需要，而不会意外地污蔑整个性别和/或种族主义人口。我已经和布里斯托尔大学出版社签订了一份合同，要写一本面向学术和公众受众的科普书籍。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作品，以获得更大的专业可信度。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(以及女性流行的症状)的知识，改善治疗选择和患者结果，并提出社会神话阻止这些信息被传授的方式。

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.