Monique Ryan (Kooyong, Independent) Share this | Hansard source

I thank my colleague the member for Mayo for raising this very important issue. Two out of three Australian women report health care related bias and discrimination, including delays in diagnosis and delays in treatment. It's worse for women who don't speak English as a first language and for Indigenous Australians. It's not as simple as pure misogyny. Much of the entrenched systemic conscious and unconscious bias in our medical system reflects either a lack of understanding of physiological differences or a lack of respect for the significance of that variation.

Women spend more on their out-of-pocket medical expenses than men. Women's pain is more likely to be seen as emotional or psychological rather than biological. Women in pain are more likely to be offered minor tranquilisers or antidepressants than analgesia. Women are less likely to be referred for diagnostic investigations when they see a GP.

Medical research focuses more on male patients, this despite the fact that our body composition is demonstrably different. Our organs and our skeletons are different. Our chemistry is different. Our experience of pain is different. Many women spend months or years of their lives incubating humans. This is a time in which we are specifically excluded from clinical trials. Why provide anything other than basic obstetric care to a pregnant woman? In many cases it's not recognised that our cholesterol, our lipids and our other metabolic markers vary as much with our menstrual cycles as with our diet or our genetics.

When women have a heart attack our symptoms are different from those of men. Our outcomes are often worse. Our cardiovascular disease is diagnosed, on average, seven to 10 years later than men's. Women with serious heart attacks are half as likely as men to get proper treatment and twice as likely to die within six months. Those figures are twice as bad again for Indigenous women.

Although it affects almost one million Australians, it takes an average of seven years for women to be diagnosed with endometriosis. More than 10 per cent of women giving birth in this country experience what they describe as obstetric violence. While much of this relates to a loss of choice and control, which is systemic, some does relate to actual physical injury.

We have a system which fails to ensure that women in rural and regional centres have sufficient access to reproductive advice and treatment. In many cases women can only access faith-based services, which will not provide contraception or termination services, even after rape or with non-viable pregnancies. They won't provide IVF or family-planning advice. And a woman undergoing a caesarean section can't have a tubal ligation at the same time. Men would not put up with this restriction of care.

There is further intersectionality in the experiences of trans and gender-diverse people. They speak of concerns regarding their bodily autonomy, sexual harassment, refusal of access to health care, poor treatment and a common lack of medical understanding of their specific healthcare needs. Complex and chronic medical conditions, especially those dealing with gender and with gynaecological issues, need sensitive treatment. They can't generally be addressed well in a 15-minute consult. But our medical system pays more for shorter consultation for minor ailments. It rewards speed, not need. It pays $253 for a 15-minute vasectomy, but only $88 for a 45-minute IUD insertion. It doesn't yet cover the cost of gender-affirming surgeries like chest surgery or genital reconfiguration.

The government has taken steps to address these issues. It has established the National Women's Health Advisory Council to address medical misogyny and to assist in implementation of the National Women's Health Strategy. I want to acknowledge the real and ongoing efforts of both the assistant minister for health and the minister for health in this space. But there is much more to do, and it needs to be done effectively, equitably and with urgency. This is not just a women's problem.

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