In his 16th-century tragedy, Romeo and Juliet, William Shakespeare delved into the question, "What's in a name?" exploring the concept that names merely function as conventions to distinguish objects or individuals, devoid of intrinsic value or meaning. However, this perception of arbitrary labels does not hold true in the field of medicine, where a significant portion of terminology originates from ancient Latin and Greek.
The root word of a medical term is meant to depict the anatomical structure of its reference. For example, as the root “card(i)—” means "heart," the adjective “cardiac” means “pertaining to the heart” and the noun “cardiology” means "the study of the heart." This simple formulation, appearing harmless and practical in its approach, has unfortunately led to the oppressive, misogynistic formation of the term “hysteria.”
Table 1. Formulaic deconstruction of the term "hysteria"
Stiles, Lewis, and Stephen Russell. The Anatomy of Medical Terminology: A Formulaic Introduction. Radix Antiqua, 2019.
Deconstructing "hysteria" into its fundamental components would lead one to anticipate its translation as “an abnormal condition pertaining to the uterus.” In its contemporary usage, however, the term has taken on a significantly different meaning—employed to describe something frenzied, frantic, or out of control. How did this new definition come to be?
Dating back to 500 BCE, the term “hysteria” was coined by the Greek physician, Hippocrates (2). He believed hysteria to be a physical ailment exclusive to women, caused solely by the migration of an “unsatisfied” uterus. When deprived of the benefits of intercourse or childbearing, the uterus was said to wander the female body, disturbing various organs and leaving an empty cavern in its wake. Consequently, “hysteria” became a catch-all diagnosis for females, allowing physicians to address any unexplained symptomology, including anxiety, melancholy, bursts of emotion, headaches, tremors, and convulsions (2).
The perception of hysteria underwent a significant transformation in the late 19th century, transitioning from a physical ailment to a more psychological condition. However, the sexist undertones persisted. According to Freud's theory, women suffered from hysteria due to the "feminine Oedipus attitude" (3). This theory posited that young girls struggle to come to terms with a perceived loss of male external genitalia, leading to feelings of inferiority, passivity, discomfort, and dissatisfaction. Consequently, these negative emotions were believed to be the cause of their behavioural issues.
Over time, advancements in modern psychological research led to the deconstruction of hysteria as this sex-specific, all-encompassing disease entity (4). Certain symptoms once attributed to hysteria were identified as components of physical diseases like fibromyalgia, while the remaining symptoms were explained by psychological disorders such as clinical anxiety and depression. Hysteria was officially removed from the Diagnostic and Statistical Manual of Mental Disorders in 1980 (2).
While no longer classified as a gender-specific disorder, the enduring impacts of "hysteria" persist in contemporary society. The perception of femininity remains intrinsically linked to hysteria, perpetuating the stereotype that women are excessively emotional and prone to drama. This bias proves especially detrimental in the context of medicine, with 38% of women reporting negative interactions with their healthcare providers (4). Women’s health concerns often face dismissal, underestimation, misdiagnosis, and victimization due to the prevailing belief that “pain is just a normal part of being a woman.” Conditions like endometriosis, polycystic ovary syndrome, or fibroids are frequently overlooked, not due to their rarity or diagnostic challenges, but rather a widespread lack of education about the female body (5).
The underrepresentation of women in research and drug trials further exacerbates the existing disparities in medical care (6). This phenomenon was influenced by the unfounded belief that studying women posed challenges due to hormonal fluctuations and pregnancy concerns. As a result, the broader application of numerous research findings is restricted, as biological sex characteristics can influence disease presentation, pathophysiology, adverse side effects, and responses to treatment (7).
Departing from historically glorified opinions of men regarding women's bodies and behaviour, it is with hope that modern medicine shifts toward more effective research and treatment for all. While substantial progress has been made in the medical and mental health sectors, gender bias continues to persist. More efforts must be taken to ensure equal opportunities and appropriate healthcare for all demographics. Acknowledging the oppressive, sexist, and etymological ramifications of hysteria is a singular stride toward dismantling the systemic biases that afflict our society.
References
1. Stiles L, Russell S. The Anatomy of Medical Terminology: A formulaic introduction. Hamilton, ON: Radix Antiqua; 2019.
2. Tasca C, Rapetti M, Carta MG, Fadda B. Women and hysteria in the history of Mental Health. Clinical Practice & Epidemiology in Mental Health. 2012;8(1):110–9. doi:10.2174/1745017901208010110
3. Gumiandari S, Nafi’a I. An analytical study on Sigmund Freud’s concept of psycho-sexual based on Islamic Psychology Perspective. 2018; doi:10.31234/osf.io/4usdv
4. Michelle Long BF, 2023 F. Women’s experiences with provider communication and interactions in health care settings: Findings from the 2022 KFF Women’s Health Survey [Internet]. 2023 [cited 2024 Jan 19]. Available from: https://www.kff.org/womens-health-policy/issue-brief/womens-experiences-with-provider-communication-interactions-health-care-settings-findings-from-2022-kff-womens-health-survey/
5. Is bias keeping female, minority patients from getting proper care for ... [Internet]. [cited 2024 Jan 12]. Available from: https://www.washingtonpost.com/health/is-bias-keeping-female-minority-patients-from-getting-proper-care-for-their-pain/2019/07/26/9d1b3a78-a810-11e9-9214-246e594de5d5_story.html
6. Fultinavičiūtė U. Sex and science: Underrepresentation of women in early-stage clinical trials [Internet]. 2022 [cited 2024 Jan 11]. Available from: https://www.clinicaltrialsarena.com/features/underrepresentation-women-early-stage-clinical-trials/?cf-view
7. Islam N, Jdanov DA. Age and sex adjustments are critical when comparing death rates. BMJ. 2023; doi:10.1136/bmj.p845
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