November 15, 2023 - 7:00am

When Endometriosis South Coast announced the appointment of a trans woman as its CEO, the message to women was clear: “object to this, bigots! Go on, we dare you!”

It felt like trolling, because that’s what it is. For several years trans activists have told us that our female bodies have nothing to do with whether or not we are women. Hence we are bleeders, gestators, cervix owners and the like. We have objected to this dehumanisation, and now here’s the response: “Oh, so you wanted a woman in charge of a women’s health issue? Here you go! What’s that? It’s the wrong sort of woman? Honestly, no pleasing some people.”

The appointment is cruel, and those behind it will be perfectly aware of the hurt it will have caused. Nevertheless, those who are offended will be expected to suffer in silence. It’s particularly poignant, given the history of endometriosis, and the way in which it has been coloured by a lack of interest in female experiences and the devaluation of female pain. 

I am aware, of course, of the way in which the appointment of Steph Richards is being defended. One does not need to suffer personally from a disease in order to treat it. One does not have to have given birth to be a midwife, or to have a vagina to be a gynaecologist. But being the head of an endometriosis charity is not the same sort of thing. Women’s healthcare campaigning is political, and it’s political because women’s bodies have been so badly neglected by science and medicine. 

And why have our bodies been neglected? Because men have insisted that their idea of what women are trumps our own embodied realities. Because gender is a construct, they tell us, and they will construct us as they see fit: as helpmeets, as gestational vessels, as privileged cis ladies. Never as human beings with internal experiences which have nothing to do with them.  

Right now, we know far less about endometriosis than we might if it were something that happened to men. As Elinor Cleghorn points out in Unwell Women, it remains “one of the most frequently misdiagnosed, misunderstood and medically stigmatised chronic diseases”:

Sufferers today wait an average of seven and a half years from first reporting their symptoms to receive a correct diagnosis. There is still no cure.
- Elinor Cleghorn, Unwell Women

Cleghorn notes that prejudice regarding femaleness and femininity has led to sufferers being mistreated and bullied by the medical profession. “One ignorant misbelief,” she writes, “has held fast: endometriosis is a punishment for women who dare to deviate from the biological imperatives and social duties marked ‘female’.” It’s yet another story of women being told that what they believe their bodies are going through doesn’t matter. Femininity must define them, or else. 

In such a context, forgive me — and many other women — for being less than impressed when a charity for endo sufferers considers it appropriate to put a trans activist at its helm. The pain of sufferers is intimately connected to the prioritisation of male perceptions of womanhood at the expense of women’s own. A movement in which male people compare their penises to miscarried foetuses or describe “the asshole” as “a kind of universal vagina through which femaleness can always be accessed” prioritises these perceptions more than most. 

What’s especially grotesque about the Endometriosis South Coast appointment is that the women who complain are being portrayed as bullies. Don’t women know how unfeminine it is to voice their pain? As in women’s healthcare, so in the politics of women’s healthcare. Suck it up, uterus-owners.

Victoria Smith is a writer and creator of the Glosswitch newsletter.