The Pathologised Woman: Hysteria and Medical Bias
- Nuriza Tukiran
- 6 hours ago
- 5 min read
As a woman and a mental health researcher, I’ve had my fair share of frustrating doctor visits. Nothing tops the time when my skin suddenly began to itch and erupt in bumps. I feared I was experiencing an allergic reaction. After calling 111 for medical advice, they sent paramedics to my home and, unsure yet concerned about my condition, they insisted on taking me to A&E.
After the never-ending hours in the waiting room, the doctor dismissed me. “Are you sure it’s not just hormonal acne? I can see you have acne scars, so surely it’s just that? Are you on your period?” he questioned. I assured him I would not have waited all those hours if it were just hormonal acne. After three days of agony, I sought further medical advice from my GP, only to discover that I had adult chickenpox.
Although the condition itself was not life-threatening, I was left invalidated and embarrassed. We women know this feeling too well, having our pain questioned, our bodies scrutinised, and our concerns reduced to something ‘hormonal’ or imagined.
Throughout history, the term ‘hysteria’ was used to pathologise a woman’s emotional experiences. Symptoms included emotional outbursts, hallucinations, attention-seeking behaviours, increased suggestibility and loss of sensation. Rooted in misconceptions about its origin, hysteria reflected societal beliefs towards femininity, religion, sexuality, medicine and mental health.
From its original conception and Freud's use in the last century, the perceptions of hysteria have drastically shifted. Despite no longer holding relevance in medical diagnosis, the historical context demonstrates the ongoing understanding of mental health and medical conditions affecting women.
Origins of the Wandering Womb
In Ancient Greece, it was believed that a woman’s uterus could wander through her body, evoking a series of emotional and physical symptoms. This concept, called The Wandering Womb Theory, led to the term hystera, the Greek word for uterus, which later became the root word of hysteria. This umbrella term classifies all kinds of conditions in women, from irregular menstruation to anxiety. Hippocrates documented these ideas in his medical texts. By attributing psychiatric symptoms to the reproductive biology of women, he helped solidify the link between femininity and fragility in medical thought.
Plato reinstated the beliefs of his time, famously stating that a uterus becomes ‘sad’ or ‘restless’ when deprived of male companionship. His proposed cure? Marriage, sex and childbirth, all solutions which entrap women into their expected societal roles. Ancient beliefs trickled down for centuries, contributing to the misunderstanding of women’s health.
From Spiritual Origins to Medicalisation
With the rise of Christianity in the Western World during the Middle Ages, hysteria was interpreted as spiritual failure. Women experiencing psychotic symptoms, abnormal behaviours, symptoms of erotic fantasies, or epileptic seizures were believed to be witches or under demonic possession. The cures were brutal and extreme, going as far as exorcisms, witch trials, and institutionalisation. By the 18th to 19th century, spiritual reasoning for hysteria began to lose traction and was replaced by a medicalised view. Despite this, sexist ideologies persisted.
In the Victorian Era, physicians conjured up invasive and problematic treatments to cure hysteria. With the belief that hysteria originated from sexual dissatisfaction, doctors would induce a ‘hysterical paroxysm’ via genital stimulation in their hysterical patients. Around the same time, neurologist Jean-Martin Charcot was working to redefine hysteria as a neurological disorder. Interested in the aetiology of hysteria, Charcot believed that the condition was of hereditary or psychological origin and challenged long-standing gender assumptions by attributing its symptoms to both men and women.
Although Charcot broke away from the outdated idea that hysteria was linked to the uterus, his approach came with its own set of issues. He became known for his dramatic public hypnosis demonstrations, where he attempted to unveil his patients’ traumas, emotions and subconscious thoughts. These shows often featured the same patients, most notably Marie ‘Blanche’ Wittman, who earned the nickname ‘Queen of Hysterics.’ As hypnosis had limited scientific backing at the time, the line between medicine and theatrical spectacle became quickly blurred.
It’s important to emphasise that this piece is not challenging the fact that people can express psychological suffering through physical symptoms, especially in cultural and historical contexts when medical explanations are more acceptable than psychological ones. What we are challenging, however, is the notion that such a concept has been used in the past predominantly for women and beyond the cases that would now fulfil the criteria of "somatoform disorder”.
Beyond the 20th century, knowledge and understanding of psychiatric conditions were propelled. Diagnoses of hysteria declined, coinciding with anxiety and depression becoming well-recognised disorders, and by 1980, hysteria was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Modern Perception and Medical Biases
Today, female hysteria is widely discredited and recognised as a product of control in patriarchal systems. Nevertheless, its legacy is a reminder of how medical and cultural narratives throughout history are used to silence and marginalise women. Despite the term ‘hysteria’ itself no longer in use in modern medicine, its history seeps into the persistent medical bias women face today. Conditions of the reproductive system, autoimmune disorders, and chronic pain take years to be properly diagnosed, and when finally addressed, they are often under-diagnosed or misdiagnosed.
Research shows that the perception of a woman’s symptoms by healthcare professionals (HCPs) is influenced by gender stereotypes. The underestimation of a woman’s pain originates from the belief that women are oversensitive to pain and exaggerate their pain to others. This research coincides with the Nurofen Gender Pain Gap Index Report 2024, wherein 81% of women aged 18-24 in the UK believed that their pain had been neglected by HCPs, with an additional 25% of women feeling unable to access pain treatment due to their gender. Through systemic minimisation of medical issues attributed to women, the pain experienced is ascribed to emotional distress or anxiety. Such systems may amount to medical negligence, by which biases from HCPs result in delayed diagnoses, inadequate treatment, or outright neglect.
As awareness surrounding medical biases in women’s health grows, it is imperative to recognise and critique the legacy of hysteria. Once used as a catch-all diagnosis to disproportionately silence women, hysteria pathologised emotional expression and reinforced patriarchal norms under the guise of medicine.
In today’s technologically advancing world, gender biases in research and medicine persist. Artificial Intelligence (AI) is being developed for healthcare tools, many of which are programs used to diagnose and predict a patient’s disease risk.
AI-powered risk prediction models are operated by identifying patterns from past patient data; therefore, it is imperative to steer away from creating male-centric models. Since cardiovascular disease is often mistakenly viewed as a ‘man’s disease,’ it is frequently under-diagnosed in women. Researchers from Imperial College London identified this gender gap in diagnosis, treatment and clinical research, and have developed an AI model to read electrocardiograms (ECGs) to identify women at risk of cardiovascular disease.
By eradicating biases from seeping into healthcare AI, we can help break the cycle of perpetuating medical inequalities and move toward equitable care for all. This is especially important when we consider how historical biases have shaped women’s health.
The history of hysteria reminds us that discussions around mental health and women’s health are shaped by cultural expectations, institutional power, and long-standing inequalities that continue to influence the decision on whose pain is considered and whose is dismissed.