Because Pain is Reason Enough. Why Femade May Cause a Tipping Point

Why now? They all ask me. The Federal Election is at arm’s reach and none of the platforms appear to include or appreciate chronic pain, women’s health or the gender inequality we face globally. So why open a pain centre for women when politically nobody seems to give a damn about the patient?

Malcolm Gladwell described the tipping point as the “that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire.” In 2017 Jennifer Weiss-Wolf released a book titled “Periods Gone Public” which was a game changing voice for women and their ability to utter the words ‘period’, ‘menstruation’ and ‘tampon. She taught us about women advocates who, globally, have helped women be women in their most honest capacities. In March of 2018, another book - the first memoire of its kind - was released by author Abby Norman titled ‘Ask Me About My Uterus: A Quest To Make Doctors Believe In Women’s Health”. Following the launch of Norman’s book many women with Endometriosis, a disease that affects 1 in 10 women worldwide, began sharing their stories on social media. Not only were women sharing their journey’s for the first time, or perhaps in louder voices, we started to see public figureheads come out with their truest stories as well. Lena Dunham, who has dedicated her social media ranting to provide awareness to endometriosis, was accompanied by the likes of Halsey, Padma Lakshmi, Susan Sarandon and Whoopi Goldberg. It seemed we were building awareness and creating a community of women suffering in silence, together. In parallel, other Hollywood moguls were going public with their battles with chronic pain. Lady Gaga talked heavily about her battle with Fibromyalgia in her Netflix documentary. Female pop singer Selena Gomez revealed her diagnosis with Lupus. Selma Blair appeared on an interview demonstrating some of the more tragic symptoms of Multiple Sclerosis. And the list continues.

Somewhere looming in the background, between 2017 and 2018, ‘The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain’ resurfaced from its 2001 publication date and started circulating on gender equality websites, patient advocate blogs and slowly made its way on to nighttime television. Earlier this month, late night show host John Oliver dedicated a 20min segment dedicated to research showing strong indication of women being treated differently than men when presenting with pain. These are huge strides for the community of women - both cis and trans - battling with invisible illness and/or chronic pain.

But we have not tipped yet, as per Gladwell’s definition. And certainly looking at the archaic demonstration of women’s rights in this year’s Federal Election, we don’t appear to be tipping anytime soon. When we step back and look at pain alone - setting aside the gender bias and the lack of understanding of these invisible illnesses - pain is being siloed between general practitioners, and the pain physicians who run the clinics. This referral process is creating a bottleneck from when patients are given the referral and the time it takes to be seen by the pain physician. Within these pain clinics are a mix of allopathic medicines and alternative therapies which is the integrated system we need to see across Canada. Some of the people right here in Canada who are pushing the needle are Pain BC - who’s mission and data are exemplary, WHRI and their #ItsNotInYourHead movement is the beginning of a revolution, and Julie Drury - Canada’s Patient Advocate Extraordinaire. The Minister of Health has put forth several new initiative in the name of patient centric care. The first is the Patient and Family Advisory Council. The Second is the Canadian Pain Task Force, whose June Report has diligently and transparently laid out the current status of Pain in Canada today. As per a recent study included in this report, the economic burden of chronic pain in Canada estimated the weighted annual direct cost to manage chronic pain across Canada is $7.2 billion (Hogan et al., 2016).

Evidence points to the need for increased availability of pain care, from wellness-oriented, community-based care for people with mild functional impairment due to pain, to specialized, multidisciplinary and interdisciplinary care for those experiencing moderate to severe pain and functional impairment.

However, provincial funding and private healthcare under the umbrella of alternative therapies is very limited. Until we can get medical practitioners to begin using the right terminology with their patients to iterate an integrative approach, the use cases for these therapies will predominantly be focused on elderly populations and post-injury. Thus, government and insurance companies will not allocate coverage to chronic illness and chronic pain until the case has been made that the alternative therapies have been proven to reduce pain, increase quality of life, and could have a potential on reducing work-disability payments.

So why now? They continue to ask me. Because today, in October 2019 women need a space where they can come to be treated for pain and be completely understood. Today, Femade needs to be that space, for cis and trans women to feel like they are not being pigeon-holed, not being judged, not being consumed by societal norms. Today, we need to desperately shine a light on the gap between allopathic treatment and ‘alternative therapies’ which they are so poorly coined. Today, medical practitioners need to be aware and vocal of their shortcomings in the areas of pain and need to be willing to refer a patient to a pain clinic of their choice; not just the ones runs by other pain doctors. Today, a patient needs to be able to make their own choices about adhering to their pain medications; as sometimes they don’t work and sometimes it’s the only thing to get you through a day. Today, there needs to be a place for women to talk about their pain meds without being suspected of being a drug addict. Today, pain needs to be talked about just as much as any other symptom and it needs to be accepted that pain can be pain on its own, without any other indicator. Because sometimes, pain is all we have to go by. We will build as a community as we continue to push policy makers, medical practitioners and patients alike in the way we think about pain management and the various forms of pain that exist today. We may be early, but we are right.