# Gender and disability

Gender and disability examines the intersection of gender and disability, exploring how social, cultural, and economic factors shape the experiences of individuals with disabilities based on their gender identity. Women and non-binary individuals with disabilities often face compounded discrimination, experiencing both ableism and gender-based inequalities in areas such as healthcare, employment, education, and social participation. The intersectional nature of gender and disability influences access to resources, legal protections, and opportunities, with marginalized groups frequently encountering higher rates of poverty, violence, and exclusion.
Historically, gender norms and stereotypes have shaped perceptions of disability, often reinforcing traditional roles and limiting autonomy. Feminist and disability rights movements have increasingly addressed these issues, advocating for more inclusive policies and practices that recognize the diverse needs of disabled individuals across different gender identities. Research in this field spans disciplines such as sociology, gender studies, disability studies, and public policy, aiming to challenge systemic barriers and promote equality.

## Medical misogyny
### Historical
#### Hysteria

"Hysteria is undoubtedly the first mental disorder attributable to women, accurately described in the second millennium BC, and until Freud, considered an exclusively female disease." Since Ancient Greek times, the idea that a woman can go mad in a way that effects exclusively women was not an uncommon one, and until Sigmund Freud it was believed that often the reason for this madness was an improper sex life, with Plato arguing that the cure for hysteria was to "join with the male and... give rise to a new birth." Hippocrates wrote that the cause of hysteria was the buildup of putrefied humors which caused various disorders within the body and could only be expunged through regular sexual behavior.
In the Middle Ages, Trota of Salerno approached the idea of hysteria from a different perspective, offering the explanation that "the suffering related to gynecological diseases was “intimate”: women often, out of shame, do not reveal their troubles to the doctor." Later, hysteria was a common reason for innocent women to be tried as witches and put to death.
Freud recontextualizes the theory of hysteria, arguing instead that it is related to a dysfunction within the brain and not contained within the uterus, but that it is still a woman's disease, only serving to bring the concept of the "possessed woman" into the modern age.

### Modern

Many disabilities, such as Fibromyalgia, are vastly disproportionally diagnosed in female patients compared to male patients even though there is no known medical cause for this gender disparity. However, disorders involving the female reproductive system are often unnoticed, under-diagnosed, or reported to have diagnostic processes involving dissatisfactory amounts of delay or labor on behalf of the patient. These include Endometriosis and Polycystic ovary syndrome.
Disabilities common to both females and males, especially developmental disabilities, often favor male patients in ease of diagnosis. Studies done on both autism and attention deficit hyperactivity disorder suggest that "masculine defaults" in healthcare influence diagnosticians by creating a mental platonic ideal diagnostic case, which often excludes women who present the same symptoms as men.

#### Interactions with racism

Stemming from Medical racism, there is a common phenomenon experienced by people of color who seek medical attention where their bodies are believed to be fundamentally different than those of white people by white people who work in medical fields. One such particularly pervasive belief is the idea that "blacks have thicker skin than do white people," which leads to the idea that Black patients have a higher innate pain tolerance than white patients.
Similarly to the seen-above idea of the male default, there exists a parallel white-as-default which influences medical practice. Medical devices such as the Pulse oximeter are calibrated to white skin, causing them to read improperly when used on Black patients. Diagnostic tests, such as kidney function screens, read Black patients as having higher risk when tested. Often, medical training itself is oriented around light skin as a standard. These and additional factors, when amplified across an entire anti-Black medical system, end up treating Blackness itself as a chronic condition.
Black patients have described the way their concerns about themselves and their family members are dismissed by the medical profession as Gaslighting. For example, ALS, on average, is diagnosed later in Black patients than equivalent white ones, if not missed entirely. Studies have found systematic barriers to breast cancer diagnosis in Black women. Ethnic minority patients diagnosed with fibromyalgia report higher levels of sleep and mood disturbances than white patients.
In following with the concept of misogynoir, Black female patients, explained by intersectional feminism, suffer both from racism and sexism within healthcare and often find that the combination of the two synthesizes into something separate from each on their own. College-educated Black mothers are nearly six times as likely to die from pregnancy-related complications, and as the rate of fatal complications decrease in white patients correlating with education level, it stays nearly the same among Black patients.
Significant parts of the profession of Gynaecology are reliant on information that was obtained by using the bodies of Black women as testing equipment, only to dispose of them after the information had been gleaned, often without medical treatment. J. Marion Sims, often referred to with the epithet "Father of Gynecology", was notorious for operating on enslaved women without anesthesia, a practice common among medical professionals at the time.

## In transgender people

Transgender patients seeking medical care, especially those on Hormone replacement therapy, are often subject to what is known as Trans broken arm syndrome, a phenomenon in which "a provider incorrectly assumes that a medical condition results from a patient's gender identity or medical transition."
Transgender people are nearly twice as likely to be disabled when compared to cisgender people. In studies of trans youth, it has been reported that trans people are more likely to have Ehlers–Danlos syndrome and Psychosis, among other disabilities.

## Citations

* 1 2 3 Tasca, Cecilia; Rapetti, Mariangela; Carta, Mauro Giovanni; Fadda, Bianca (2012-10-19). "Women And Hysteria In The History Of Mental Health". Clinical Practice & Epidemiology in Mental Health. 8 (1): 110–119. doi:10.2174/1745017901208010110. ISSN 1745-0179. PMC 3480686. PMID 23115576.
* ↑ Yunus, Muhammad B. (2001-03-01). "The role of gender in fibromyalgia syndrome". Current Rheumatology Reports. 3 (2): 128–134. doi:10.1007/s11926-001-0008-3. ISSN 1534-6307. PMID 11286669.
* ↑ Davenport, Sophie; Smith, Diane; Green, Dan J. (2023-07-13). "Barriers to a Timely Diagnosis of Endometriosis: A Qualitative Systematic Review". Obstetrics & Gynecology. 142 (3): 571–583. doi:10.1097/AOG.0000000000005255. ISSN 0029-7844. PMID 37441792.
* ↑ Ballard, Karen; Lowton, Karen; Wright, Jeremy (November 2006). "What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis". Fertility and Sterility. 86 (5): 1296–1301. doi:10.1016/j.fertnstert.2006.04.054. ISSN 0015-0282. PMID 17070183.
* ↑ Gibson-Helm, Melanie; Teede, Helena; Dunaif, Andrea; Dokras, Anuja (December 2016). "Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome". The Journal of Clinical Endocrinology & Metabolism. 102 (2): jc.2016–2963. doi:10.1210/jc.2016-2963. ISSN 0021-972X. PMC 6283441. PMID 27906550.
* ↑ Cruz, Sara; Zubizarreta, Sabela Conde-Pumpido; Costa, Ana Daniela; Araújo, Rita; Martinho, Júlia; Tubío-Fungueiriño, María; Sampaio, Adriana; Cruz, Raquel; Carracedo, Angel; Fernández-Prieto, Montse (2024-01-29). "Is There a Bias Towards Males in the Diagnosis of Autism? A Systematic Review and Meta-Analysis". Neuropsychology Review. doi:10.1007/s11065-023-09630-2. ISSN 1573-6660. PMID 38285291.
* ↑ Hull, Laura; Petrides, K. V.; Mandy, William (2020-12-01). "The Female Autism Phenotype and Camouflaging: a Narrative Review". Review Journal of Autism and Developmental Disorders. 7 (4): 306–317. doi:10.1007/s40489-020-00197-9. ISSN 2195-7185.
* ↑ Lockwood Estrin, Georgia; Milner, Victoria; Spain, Debbie; Happé, Francesca; Colvert, Emma (2021-12-01). "Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review". Review Journal of Autism and Developmental Disorders. 8 (4): 454–470. doi:10.1007/s40489-020-00225-8. ISSN 2195-7185. PMC 8604819. PMID 34868805.
* ↑ Mowlem, Florence; Agnew-Blais, Jessica; Taylor, Eric; Asherson, Philip (2019-02-01). "Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Sex differences among children with high ADHD symptoms". Psychiatry Research. 272: 765–773. doi:10.1016/j.psychres.2018.12.128. ISSN 0165-1781. PMC 6401208. PMID 30832197.
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* ↑ Cheryan, Sapna; Markus, Hazel Rose (November 2020). "Masculine defaults: Identifying and mitigating hidden cultural biases". Psychological Review. 127 (6): 1022–1052. doi:10.1037/rev0000209. ISSN 1939-1471. PMID 32804526.
* 1 2 Hogarth, Rana Asali (October 2019). "The Myth of Innate Racial Differences Between White and Black People's Bodies: Lessons From the 1793 Yellow Fever Epidemic in Philadelphia, Pennsylvania". American Journal of Public Health. 109 (10): 1339–1341. doi:10.2105/AJPH.2019.305245. ISSN 0090-0036. PMC 6727282. PMID 31415198.
* ↑ Hoffman, Kelly M.; Trawalter, Sophie; Axt, Jordan R.; Oliver, M. Norman (2016-04-19). "Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites". Proceedings of the National Academy of Sciences. 113 (16): 4296–4301. Bibcode:2016PNAS..113.4296H. doi:10.1073/pnas.1516047113. ISSN 0027-8424. PMC 4843483. PMID 27044069.
* ↑ Petsko, Christopher D.; Rosette, Ashleigh Shelby (February 2023). "Are leaders still presumed white by default? Racial bias in leader categorization revisited". Journal of Applied Psychology. 108 (2): 330–340. doi:10.1037/apl0001020. ISSN 1939-1854. PMID 35467925.
* ↑ Moran-Thomas, Amy (August 5, 2020). "How a Popular Medical Device Encodes Racial Bias". Boston Review.
* 1 2 3 Sederstrom, Nneka; Lasege, Tamika (March 2022). "Anti-Black Racism as a Chronic Condition". Hastings Center Report. 52 (S1): S24 – S29. doi:10.1002/hast.1364. ISSN 0093-0334. PMID 35470878.
* 1 2 Carter, Chelsey R. (November 2022). "Gaslighting: ALS, anti-Blackness, and medicine". Feminist Anthropology. 3 (2): 235–245. doi:10.1002/fea2.12107. ISSN 2643-7961.
* ↑ Brand, David; Polak, Meraida; Glass, Jonathan D.; Fournier, Christina N. (2021-02-09). "Comparison of Phenotypic Characteristics and Prognosis Between Black and White Patients in a Tertiary ALS Clinic". Neurology. 96 (6): e840 – e844. doi:10.1212/WNL.0000000000011396. ISSN 0028-3878. PMID 33372030.
* ↑ Jones, Claire EL; Maben, Jill; Jack, Ruth H.; Davies, Elizabeth A.; Forbes, Lindsay JL; Lucas, Grace; Ream, Emma (2014-02-01). "A systematic review of barriers to early presentation and diagnosis with breast cancer among black women". BMJ Open. 4 (2): e004076. doi:10.1136/bmjopen-2013-004076. ISSN 2044-6055. PMC 3927711. PMID 24523424.
* ↑ Marr, Nicole C.; Liew, Charles Van; Carovich, Tessa F.; Cecchini, Gianna A.; McKinley, Lauren E.; Cronan, Terry A. (2020-04-16). "The Effects of Racial/Ethnic Minority Status on Sleep, Mood Disturbance, and Depression in People with Fibromyalgia". Psychology Research and Behavior Management. 13: 343–353. doi:10.2147/PRBM.S242699. PMC 7174195. PMID 32368163.
* ↑ Declercq, Eugene; Zephyrin, Laurie (2020-12-16). "Maternal Mortality in the United States: A Primer". www.commonwealthfund.org. doi:10.26099/ta1q-mw24. Retrieved 2024-10-17.
* 1 2 Owens, Deirdre Cooper (2017-11-15). Medical Bondage: Race, Gender, and the Origins of American Gynecology. University of Georgia Press. doi:10.2307/j.ctt1pwt69x. ISBN 978-0-8203-5303-6. JSTOR j.ctt1pwt69x.
* ↑ Wall, Catherine S. J.; Patev, Alison J.; Benotsch, Eric G. (2023-03-01). "Trans broken arm syndrome: A mixed-methods exploration of gender-related medical misattribution and invasive questioning". Social Science & Medicine. 320: 115748. doi:10.1016/j.socscimed.2023.115748. ISSN 0277-9536. PMID 36736052.
* ↑ Smith-Johnson, Madeline (2022-10-01). "Transgender Adults Have Higher Rates Of Disability Than Their Cisgender Counterparts: Study examines rates of disability among transgender adults and cisgender adults". Health Affairs. 41 (10): 1470–1476. doi:10.1377/hlthaff.2022.00500. ISSN 0278-2715. PMID 36190882.
* ↑ Jones, Jordan T.; Black, William R.; Moser, Christine N.; Rush, Eric T.; Malloy Walton, Lindsey (January 2022). "Gender dysphoria in adolescents with Ehlers–Danlos syndrome". SAGE Open Medicine. 10. doi:10.1177/20503121221146074. ISSN 2050-3121. PMC 9806399. PMID 36600979.
* ↑ Barr, Sebastian M.; Roberts, Dominic; Thakkar, Katharine N. (2021-12-01). "Psychosis in transgender and gender non-conforming individuals: A review of the literature and a call for more research". Psychiatry Research. 306: 114272. doi:10.1016/j.psychres.2021.114272. ISSN 0165-1781. PMID 34808496.