If you were assigned female at birth (AFAB) in the United States, you’ve probably gotten used to being treated like a second class citizen by this county’s health system. Maybe after years of suffering from intense menstrual cramps you finally went to your doctor only to be dismissed as overly sensitive. Maybe you suffered a stroke and no one around you knew what was happening because you’d only ever been educated on the male symptoms. Maybe you were even needlessly forced to experience crushing pain for hours on end like Rachel, the wife of Huffington Post writer Joe Fassler. Maybe you’ve experienced discrimination in a form as simple as not being able to find out more about your body because of how little research and funding is focused on the health of AFAB bodies. Even if you did find some information, it’s even possible that the research that providing that information was tainted by sexism. AFAB health in America is a joke, and it’s not funny.
Women and people assigned female at birth are getting screwed out of the healthy lives they deserve. This could even be true in some of the most well meaning of institutions, such as the Institute for Health Metrics and Evaluation. Despite this institution’s reputation for being founded on the importance of seeking out the truth, I would question the nature of their methods for finding it. Epic Measures, a book on this institution and its quirky (quirky being a word I chose ironically) founder Christopher Murray, never adequately justifies their methods for determining the severity of a disease or disability. After completing “a wholesale reassessment of the impact of different nonfatal health problems” at the Harvard School of Public Health, Murray’s former employee Josh Salomon became convinced that “‘There’s so much of a common understanding of what health is that transcends cultures… I was surprised by just how consistent that is'” (Smith, 168). The book then goes on to say that this similarity was proof that health may be a “universal construct” and thus the opinions of large pools of people can be used to judge a condition’s severity. There is nothing supporting the idea that these similarities in and of themselves should mean that the collective understanding of health should define the extent of how humans suffer. The simple fact is that a lot of humans can all be wrong about the same thing. That is where biases come in. There are a lot of people out there with misconceptions about women, and these misconceptions color their opinions, whether or not they are conscious of it. Thus, the system used by IHME for understanding the extent of suffering from disabilities and diseases is at the mercy of biases.
The vulnerability IHME’s system has to biases means that they are unreliable in documenting the suffering of AFAB individuals. AFAB people are often seen by society as being wimps in regards to pain. This misconception likely stems from the fact that AFAB people rank pain from stimuli at a slightly higher rate then assigned male at birth people, but is definitely rooted in sexism. The truth of the matter is that AFAB people actually feel pain more sharply and more often than AMAB people. Despite this, AFAB people only rank their pain as slightly worse than that experienced by AMAB people because they’ve been socialized to suck it up. As such, neither AFAB people or AMAB people would properly rank the suffering of AFAB people, making the data gathered by IHME biased. As Epic Measures discounts every other institution gathering data on the world’s suffering, I am left with the conclusion that there is no reliable documentation for the suffering of AFAB people. That there is so little focus on researching purely AFAB health issues also means that more often than not, very little is known about the AFAB body. How could we possibly expect AFAB people to seek diagnoses of health problems at any kind of consistent rate if we barely understand these issues in the first place. At this point in time there is no way to know the extent of the suffering of assigned female at birth people.
Polycystic Ovarian Syndrome is the perfect example of a specifically AFAB condition that has been left under the radar for years. I’ve known that I have Polycystic Ovarian Syndrome for six years now, and despite my best efforts, what I know about PCOS is limited. I know that I am more at risk for diabetes and high blood pressure, that I need to eat right, and that when I’m not having periods it is somehow connected to a raised probability of cervical cancer. I know that I don’t actually know what’s happening in my body, or how likely I am to experience consequences because of my PCOS. I know that not a lot of people, if any, actually do know enough about their PCOS to make informed health decisions. PCOS is an example of the world’s lack of care for the health of assigned female at birth people in that we have no idea how bad the actual consequences of it is. Despite being so overlooked by the media, PCOS is prevalent in 5-10% of the reproductive-aged female population. For how many people this syndrome affects, IHME’s numbers for expressing the suffering of the AFAB population on this issue seems low, but I’m not just arguing that these numbers are likely inaccurate. I’m arguing that these numbers don’t reflect the human suffering they are supposed to based on the nature of their collection.
The answer to all of this is painfully simple. We as a society need to start understanding that just because something is widely agreed upon doesn’t mean it’s correct. In other words, we need to stop thinking of humans as perfect so long as they’re en mass, realizing that unreasonable biases can be shared as far as across the world. Rearranging IHME’s methods to account for biases would be an amazing first step, as we could use a tool like GBD Compare to prove the importance of AFAB health problems. The work of IHME has proven that with funding, major issues like Malaria and Child Death rates can be taken on and cut to size. The first step to having funding is having advocates, but advocacy for AFAB people’s issues can only be truly effective if we know the extent of AFAB suffering. As of right now, the world is stuck in a loop, but if the IHME would just rearrange how they collect their data we could begin the process of making life better for assigned female at birth people.