“This Is Not Your Fault”: The Truth About Women and Medicine

Some conversations do more than inform. They reshape understanding. That is what happened after a conversation with Dr. Elizabeth Comen, a breast oncologist, historian of medicine, and author of the book, All in Her Head, on the unPAUSED podcast. What began as an interview about women’s health became a deeper reckoning with the medical system itself and how it has historically failed women.

Dr. Comen has spent her career caring for women at their most vulnerable while also studying how modern medicine developed. What she makes clear is that the way women are treated in healthcare today is not accidental or isolated. It is rooted in history, embedded in structure, and still actively harming women.

The conversation offered language and context for experiences many women have but struggle to name. It reframed how medicine was built, how women are perceived within it, and why so many women leave medical encounters feeling dismissed or blamed.

Modern Medicine Was Built on Male Bodies and Women Continue to Pay the Price

For many years, gaps in women’s healthcare were often explained as individual failures. A rushed appointment. A distracted clinician. A missed symptom. Over time, that explanation no longer held up.

The deeper the conversation went, the clearer it became that these gaps are systemic. Modern medicine was built with the male body as the standard reference point, while the female body was treated as a variation or complication.

Dr. Comen traces this pattern through medical history. Early cardiology texts described women’s chest pain as emotional or neurotic. Physicians claimed women did not die from heart disease. Clinical research overwhelmingly studied men and then generalized those findings to women, even when women were excluded from the data.

Once this history is understood, it becomes impossible to ignore. The medical system was never designed around women’s physiology, and the consequences continue to appear in diagnosis, treatment, and outcomes today.

How Medicine Taught Women to Carry Shame Into the Exam Room

One of the most striking moments in the conversation involved a dying patient who apologized to Dr. Comen for sweating during her final hours.

That apology reflected something deeply ingrained. Women routinely apologize for their bodies in medical settings. They apologize for leg hair, for odor, for weight, for tears, for taking up time or space. They apologize moments before invasive exams to the clinicians tasked with examining them.

This shame is not innate. Women are not born believing their bodies are offensive or inconvenient. It is taught through culture and reinforced by medical encounters that frame the female body as difficult, unpredictable, or problematic.

The impact of this learned shame is profound. It silences women, delays care, and causes symptoms to be minimized or dismissed. A woman’s body is not something to apologize for, and her presence in the exam room is not a burden.

Women’s Medical Harm Is Not Confined to the Past

The historical examples discussed in the conversation were unsettling, not because they are ancient, but because their logic persists.

When anesthesia became available, plastic surgery expanded rapidly. Surgeons used it to reconstruct faces damaged by war, but they also used it to alter women’s bodies and faces to make them more socially acceptable or marriageable. Physicians warned that riding bicycles would cause permanent facial damage, infertility, or moral decline. These debates appeared in respected medical journals.

Women were institutionalized for reading novels, for desiring more sex than their husbands, or for experiencing normal emotional changes. While the terminology has evolved, the pattern remains familiar. When medicine does not understand a woman’s symptoms, it has historically blamed the woman rather than questioning the science.

Today, women experiencing autoimmune disease, cardiac events, neurological symptoms, or endometriosis are still told they are anxious or overreacting. Medical harm to women is not a closed chapter. It is ongoing and documented.

Women Are Central to Patient Care but Largely Absent From Medical Education

Women make up a significant portion of patients across many medical specialties, yet they remain largely invisible in how medicine is taught. Medical education still centers male anatomy as the default model. The female body typically appears only in reproductive contexts.

This omission has serious consequences. Heart disease remains the leading cause of death for women. Alzheimer’s disease affects women at twice the rate of men. Autoimmune diseases disproportionately impact women. Endometriosis takes years to diagnose. Treatment induced menopause is often minimized or ignored.

Despite these realities, women’s health is still narrowly defined. The rest of the female body is assumed to function like a male body with minor adjustments. As Dr. Comen stated during the conversation, women are not defined solely by reproduction.

Women Are Rewriting the Future of Healthcare

Despite the weight of this history, this conversation did not end in despair. It pointed toward change already underway.

Hope exists in physicians like Dr. Comen who challenge entrenched systems from within. It exists in patients who refuse to accept dismissal or oversimplification. It exists in data showing improved outcomes for patients treated by women physicians. It exists in medical students who are questioning outdated norms before they become ingrained.

It also exists in women who are sharing their stories publicly and recognizing that their experiences are not isolated failures but part of a larger pattern. These voices are reshaping how women’s health is understood and practiced.

Why This Conversation Matters

Listening to this episode offers more than information. It provides validation. It gives context to experiences many women have internalized as personal shortcomings. It pulls back the curtain on what is broken in the medical system and what can be rebuilt.

For anyone who has been told their symptoms are stress, anxiety, or imagination, this conversation offers clarity and relief. It reframes women’s place in medicine and underscores the urgency of change.

This is not just a podcast episode. It is an invitation to see the medical system differently and to demand a future in which women’s bodies are finally understood on their own terms.

Listen or watch the full conversation of unPAUSED.
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