For far too long, women’s pain has not received the proper attention that it deserves, with research showing that there is a clear gender gap when it comes to treating women’s pain compared to men. That’s why the Victorian Government’s Inquiry into Women’s Pain is a welcomed initiative.
However, in asking women and girls to share their experiences of pain, it is crucial that we don’t ignore the voices of those who are more likely to experience barriers to access and disparities in patient care, such as migrant and refugee women and gender diverse people, women with disability and Aboriginal and Torres Strait Islander women.
We must not make the mistake of only talking about pain through a gender lens and understand how gendered experiences of pain and pain management are shaped by race, ethnicity, ability and socio-economic status. Migrant and refugee women often experience both gender and racial bias, and their capacity to access quality care can be further impeded by their visa or migration status. Without an understanding of the broader structural issues impacting migrant and refugee women and gender diverse people, strategies to improve access will not always be effective or meaningful.
Take for instance, the National Action Plan for Endometriosis.
Under this plan, the Federal Government has committed $87.2 million for a suite of initiatives aimed at supporting people living with endometriosis and pelvic pain. 22 specialised endometriosis and pelvic pain clinics have been established across the country as part of the plan. The 2024/25 Federal Budget also had a focus on women’s pain, with an investment of $49.1 million for the creation of two new items that will be added to the Medicare Benefits Schedule (MBS), which will enable extended consultation times with GPs and higher rebates for gynaecological care.
Despite significant investment, these initiatives are only likely to benefit Medicare holders. People on temporary visas, who do not have access to Medicare, are excluded from timely and affordable care for pain relating to their sexual and reproductive health, thereby bringing into question the equitability and accessibility of these new initiatives.
Additionally, the state government has committed $153.9 million to the Women’s Health and Wellbeing Program. As part of this package, 20 new women’s health clinics across the state and a mobile clinic that will service regional and remote areas will be unveiled over the coming years. By offering free and comprehensive care, these proposed clinics have significant potential to improve women’s access to sexual and reproductive healthcare. As we take the necessary steps to equalise health outcomes, it is essential that these proposed clinics are equipped to deliver equitable, culturally and linguistically responsive and safe care for migrant and refugee women and gender diverse people. This can only happen through meaningful collaboration with expert migrant and refugee women’s organisations and communities themselves.
As part of the Women’s Health and Wellbeing Program, the Victorian government has also announced an additional nine sexual and reproductive health hubs, bringing the total number of hubs across the state to 20. Almost all of the current sexual and reproductive health hubs are bulk billed. And although this is great for Medicare card holders, those on temporary visas will have to continue to pay out-of-pocket costs, for essential and timely care for their sexual and reproductive health. The location of the current hubs are also not meeting the demand for sexual and reproductive services in growing metropolitan regions, such as Wyndham, Hume, Melton and Whittlesea – areas which have high migrant and refugee populations which may result in service gaps and further disparities in sexual and reproductive health.
As we witness the unfolding of women’s health and wellbeing initiatives across the country, it is important to recognise that improving access and models of care for migrant and refugee women and gender diverse people, requires a gender-responsive, intersectional response. It means addressing systemic barriers, as well as funding expert organisations to lead the conversation about how intersectional policy can be imbedded in service delivery.
While it’s great to see the spotlight shining on women’s pain, if there is one key takeaway message, it’s that women’s pain is not only a health issue. It is a human rights issue, and a matter of access and equity. Addressing systemic barriers is a fundamental first step to ensuring that migrant and refugee women and gender diverse people can access care and support for their pain.
This article was first published in edition #135 of The WRAP on July 2024. This article was released ahead of MCWH’s submission to the Women’s Pain Inquiry which you can read here.