Anti-Intellectualism Hurts Women's Healthcare While Claiming to Protect It

How hormone coaches and wellness influencers profit off of women's pain and historical mistreatment in healthcare to create a future where women never get as good of healthcare as men

I work as a psychiatrist in eating disorders and perinatal psychiatry. This means for the past four years of my residency and now as I start my child psychiatry fellowship have meant many clinical hours of witnessing women struggling with their psychiatric health concerns, but often with their more “classically medical” health concerns at the same time. Modern psychiatry has been aiming at reducing dualism in healthcare for years, and no where is this approach as important as in treating patients with eating disorders or who are actively going through complex whole body changes during and after pregnancy.

I love this work. It is complex, quickly evolving, and often a population of people who have pushed themselves and expect so much perfection that many of our conversations end up being about compassion and liberation from the terror they have of existentially not being good. The biology of both clinical populations is also fascinating as it expands our understanding of who we are, how we feel, and how every neuron and signal cascade in the body can impact our sense of ourselves and one another.

proof that you can make studying concepts of well-being cute without abandoning research methods

This means I hear many stories from women about themselves and their lives. This means I read notes from other clinicians, and hear from patients when I ask them about what has worked and what has not gone well. It means I spend my time looking for and wondering why research on certain issues that affect people with a uterus aren’t further along compared to something like, I don’t know, erectile dysfunction. Being a clinician in Boston means I spend a lot of time with the people—often women themselves—doing the research that is making having answers and treatments for under-studied, under-represented, and under-treated conditions in women possible.

Is psychiatry perfect? No. Is healthcare perfect? No. Are women, particularly women of color, still treated with bias both intentionally and, at other very frequent times, unintentionally? Yes. We have a flawed system that is not free of its history. We have a system that has not fully reckoned with its past, or, very frankly, some of its present. If you have followed my writing and my work on my psychiatry podcast, here, you know I have a lot of complaints from within the academic field about how it needs to change, now.

Conspiracy will not fix this problem, and conspiracy on TikTok and in talking points being legitimized by the current FDA (looking at the SSRI “panel” recently held) certainly are not doing women any favors. The scientific method is still sound, and as someone who works with women who are suffering, what I want most is rigorous, systemic, and standard of the field research and implementation that will help find evidence-based approaches for them. One large aspect of mistreatment of women in healthcare is the history of not studying women’s issues because it can be an expensive trial to run when studying subjects who have naturally fluctuating month long cycles, vs girls or post-reproductive women who are no longer having those fluctuations. We need time, money, and changing academic institutions that value the people who want to research and think about this work.

What those who focus on “balancing hormones” or lauding coaches over licensed clinicians do is a failure of ethical triage. It is hard to recognize this if you are not one of the “intellectuals” in the field, and very frankly, academics are taught to be scared of social media and the public sphere. Many of us are in a lot of debt and have had many lectures on “professionalism” over the years. Even more—most of these people have dedicated over a decade of their lives to one specific topic, and these years did not include teaching skills on how to sell a story (even a true one) in the public eye.

In a world of worsening misinformation from both humans and AI, triaging information and orienting people to the importance and context of that information is crucial.

Imagine you go to the emergency room, and you’ve recently been in a car accident: multiple bones are broken, you are bleeding heavily, and you need urgent treatment. If your clinician looked at you and said, “Okay, but first let’s talk about how your blood pressure last month was 135/80 instead of 120/80.” If you survived this horrible care, you would sue. It is completely inappropriate in urgent situations to focus time and resources on something that may be of 5% of the importance of the thing that might kill you 100% now. In the focus of MAHA and online “crunchy” spaces (on the right and to a smaller but still present extent at times on the left), it takes time and resources away from dealing with issues that are harming people now. Sure, we should study or reduce red dye 40 or “toxic chemicals” that may impact human well-being and health. But when we spend equal time on a small and non-urgent, unproven problem as on a known crisis such as the maternal mental health crisis, we are not doing something ethically neutral.

What those who focus on “balancing hormones” or lauding coaches over licensed clinicians do is a failure of ethical triage. It is hard to recognize this if you are not one of the “intellectuals” in the field, and very frankly, academics are taught to be scared of social media and the public sphere. Many of us are in a lot of student loan debt and have had many lectures on “professionalism” over the years. Even more—most of these people have dedicated over a decade of their lives to one specific topic, and these years did not include teaching skills on how to sell a story (even a true one) in the public eye.

I could say so much more on this, but I have to get back to my patient-care work. If I could give one piece of advice for those who want to be citizens of an internet world that values accurate information and improving care for women, it would be to start asking more of those you get your health information from online. Go to their website or bio, and actually look at their credentials. When there is a surprising piece of information, ask for a study or a clinical guidelines from one of the academic bodies in healthcare to validate their claim. I am myself not innocent of falling for false health information on the internet in fields I’m not in, and I literally graduated medical school.

Whether the information makes you feel good or bad, we need to have higher standards. It is not rude or not being a girl’s girl to ask that discussions on women’s health is based on high quality and validated information. Just because a hypothesis is kind or affirming to the experience of being a woman does not make it true.

Women have lived with the lies of what our biology “means” for hundreds of years. If we participate in a knowledge ecosystem that no longer values evidence, expertise, and rigorous study for claims to be accepted as truth, we are paving a way for old lies about “femininity” to be uncontested and accepted once again.

Later this week, I’ll be putting up a resource document for different folks—academics, influencers, and creators—who put out health information that doesn’t discredit the systemic approach of science.

Take care, and take your time,

Margaret of Bad Art Every Day