Menopause is finally having a moment and for good reason. The impacts of menopause on women, non-binary and gender diverse people is a long, overdue conversation. As is often the case when we don’t see an issue through an inclusive or diverse lens, migrant and refugee women in Australia are largely left out of this dialogue.
Conversations about menopause and race and ethnicity are heating up in the UK, thanks to the efforts of Dr Nighat Araf placing the menopausal experiences of black women in the limelight, exploring topics ranging from menopausal symptoms, such as hair thinning and melasma to gendered ageism at work.
We are pleased to see that in Australia, menopause is also being discussed and taken seriously, with the Federal Government’s calling of a Senate Inquiry into the physical, mental, economic and financial impacts of menopause and perimenopause on the lives of people who menstruate. MCWH intends to put forward a submission because as with all health-related issues, menopause is an intersectional issue.
We know that those seeking menopausal healthcare in Australia already face challenges finding General Practitioners who have the knowledge to confidently discuss management and treatment. But for migrant and refugee women and people who menstruate, there are the additional challenges of finding in-language information on menopause and accessing culturally responsive healthcare.
While Medicare is described as Australia’s universal healthcare system the reality is, it is far from universal. Especially for those on a temporary visa, the lack of access to Medicare is a systemic barrier that actively restricts some migrants from achieving optimal menopausal health. For example, people experiencing perimenopausal and menopausal transitions require longer appointments for comprehensive and individualised assessments, which are more costly. Even for those who do have access to Medicare, booking longer appointments is often difficult and expensive due to Medicare incentivising short GP appointments.
Additionally, although treatments for menopause are available on the Pharmaceutical Benefits Scheme (PBS), the cost of these treatments can be out of reach for patients, particularly those with limited incomes. It is important to note that the PBS is only available to residents who hold a Medicare card, meaning temporary migrants are not eligible to receive subsidised medications and treatment. As a result some migrant women simply cannot afford the optimal menopausal healthcare they need.
As we have argued, we need to remove residency restrictions to ensure all sexual and reproductive health prevention, early intervention, support and treatment services and interpreting services, are available to migrant women free of charge, regardless of migration status. Support services should be available to all migrant and refugee people on all visa categories in Australia to avoid a multi-tiered system in which certain groups of residents and citizens have access to more support than others.
When it comes to employment, we also know that migrant and refugee women are overrepresented in precarious modes of work. In a positive move, some workplaces in Australia have implemented menopause leave policies as a way to support the working lives of women. But for those employed in casual or informal work, this area of the labour market is less likely to see provisions and supports that proactively challenge inequality or discriminatory practices surrounding menopause.
While it’s great to see the spotlight shining on menopause, we need to go further by acknowledging that menopause is a health equity issue that goes beyond the experiences of white, middle-class professionals. When we do so, we are faced with the glaring reality of disparities in access to information, resources, and support that exist for migrants and refugees experiencing menopause in Australia. Addressing these disparities is the first step to ensuring that migrants and refugees have equitable opportunities to information, care, and treatment, and feel empowered to navigate menopause on their own terms.
This article was first published in edition #129 of The WRAP on February 2024.