‘Policies Are Being Written About Us, Without Us’: Why We Need An Intersectional Lens On Women’s Hea

In what was dubbed the “women’s budget,” the Federal Government dished up $354 million last month to support the health and wellbeing of Australia’s women over four years.

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Given the significant and enduring gaps in women’s health, such funding is welcome; as is the suggestion that it will contribute to furthering our research, diagnosis and treatment of common conditions such as cervical and breast cancer, endometriosis and reproductive health.

But while we’re pleased to see some action in this area, it became clear last week as an attendee of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG’s) Health Summit at Parliament House, that more work needs to be done to ensure that adequate funding is allocated to all underserved areas of women’s health and an intersectional lens applied.

For example Nicky Bath, the Chief Executive Officer of LGBTIQ+ Health Australia says that the challenges faced by women in her community are complex and thus commonly misunderstood.

“Practitioners often don’t know whether their patients are part of the LGBTQI community”, says Bath which causes problems from the outset. “They’re not asking the questions” even when they’re specialising in sexual health.

The impacts of this were revealed in a study conducted by the Australian Research Centre in Sex, Health and Society at La Trobe University in the second half of 2019. Compared to work, family and educational settings, healthcare is where lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) Australians felt least accepted (43.4%).

That’s a huge problem when we consider that over 4 percent of Australians recognise themselves as LGBTQI and could be missing out on essential healthcare through fear of discrimination.

Another part of the equation is the complete lack of Federal Government funding. “Unlike other health sectors, we don’t get any health funding”, says Bath. “Unless we’re funded appropriately for people to hear our needs and act on those needs then we’ll continue to struggle”, she told the audience.

Tricia Malowney, the president of Women with Disabilities Australia, echoed a similar sentiment. “People make assumptions about us, and our lives and what our lives are,” she says. Health practitioners and policy makers are failing to co-design solutions with women with disabilities.

“Give us the same level of service you give to all women. That means all women, not just the easy ones,” says Malowney, adding that Australia “needs data around women with disabilities”.

“Many women with intellectual disabilities for instance, aren’t on the electoral roll so they’re not considered for things like breast screening”, she said. It’s not good enough. “Every woman with a disability is an expert in her own body, yet policies are being written about us without us.”

Adjunct Professor Ruth Stewart, National Rural Health Commissioner at the Department of Health agrees that co-designing solutions with minority groups of women is critical.

“We need to be asking women, ‘what do you feel safe with’?” she says.

Elaborating on the challenges faced by women in rural and regional areas of the country, she highlighted the importance of having quality care and practitioners easily accessible.

“What do women want? They want continuity of care and carers, they want to make their choices in a collaborative manner with their care provider and they want to be as close to home as possible”, she says.

Bringing in the perspectives, expertise and preferences of First Nations women is also a key component. “We need to stop colonisation now,” says Stewart. “We need to recognise the cultural authority of Torres strait Islander and Aboriginal women in designing healthcare solutions that meet their needs.”

“Cultural responsiveness of the health system at the health practitioner level” is vital.

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