Critics point to the medicalization of healthcare and health related issues as an example of institutionalized sexism. Medicalization refers to the process by which previously normal aspects of life are redefined as deviant and needing medical attention to remedy. Intersex people may have emotional and physical impacts throughout their lives due to medically necessary corrective surgery and sometimes random assignment of gender at birth. Many aspects of women’s lives have been medicalized, including menstruation, premenstrual syndrome, pregnancy, childbirth, and menopause. Men also face medicalization throughout their lives such as medication for attention deficit hyperactivity disorder (ADHD) as children and later in life for sexual performance issues such as erectile dysfunction.

9.4.1 Medicalization of Women’s Bodies

An example of this is in period product advertising. Blue liquid is used instead of more realistic blood-red liquid. Direct presentation of blood is widely accepted in masculine-based media, such as battles in films or television, but far less accepted in female-focused media, such as period product advertisements. A 2017 Australian television advertisement for period products showed blood-stained clothes and blood streaming down a person’s leg. The advertisers received numerous objections to the commercial. “Complaints ranged from bad taste to inappropriate to vilification and humiliation of women by publicizing a private matter, to concern for children being too young to see blood running down a woman’s leg in the shower.” (Meade 2017). Reaction to the commercials shows societal discomfort at seeing realistic images of everyday realities for females. Lack of use of realistic red-blood colored liquid in commercials lends support to perpetuating periods as deviant, thus medicalizing women’s bodies through a lack of menstruation acceptance.

The medicalization of pregnancy and childbirth has been particularly contentious in recent decades, with some women opting against the medical process and instead choosing natural childbirth. Fox and Worts (1999) found that all women experience pain and anxiety during the birth process but that social support relieves both as effectively as medical support. In other words, medical interventions are no more effective than social ones at helping with the difficulties of pain and childbirth. Fox and Worts further found that women with supportive partners needed less medical intervention and had fewer cases of postpartum depression. Of course, access to quality birth care outside the standard medical models may not be readily available to women of all social classes.

Menopause is the when the body stops menstruation through natural or other causes. This change in a person’s body can be viewed societally as a movement away from the traditional feminine role of sex for reproduction. “Men’s effective development was not in need of medical intervention, whereas women were expected to be in health crises at various transitions in life” (van de Wiel 2014: 75). Continual life changes in female bodies are seen as in need of medical intrusion rather than viewed as a naturally occurring change.

9.4.2 Health Insurance Coverage

As of 2017, 1 in 10 people in the United States do not have health insurance. People without insurance are less likely to have a primary care provider and may be unable to afford the health care services and medications they need. The workplace often provides health insurance in the United States. This is not true globally, as some countries offer health insurance through their governments. In 2013, the Affordable Care Act was signed into law which helped provide access to health insurance for groups of people who previously struggled to get insurance, including those in poverty and those with preexisting health conditions. A gap still exists for those in poverty who cannot afford healthcare but do not qualify for their state’s eligibility for Medicaid. Single mothers and people of color are more likely to be in poverty, so they are more likely to lack health insurance.

Women are more likely than men to be employed part-time and work in service industries, so they are less likely to have health insurance. Even for workers with health insurance, the premiums of coverage and associated expenses of chronic illness can cause financial distress. “Over the last decade, family premiums for employer-sponsored coverage have jumped 47%, according to a report from the Kaiser Family Foundation. That rate outpaces both wage growth (31%) and inflation (23%) over the same time period” (O’Brien 2021). Figure 9.12 shows that around 50% of people have health insurance through their employer, while the bottom line shows the percentage of the United States without health insurance.

Figure 9.12. The number of people without insurance has decreased in the last ten years due to the onset of federal healthcare requirements.

Transgender people face unique barriers to healthcare access. Insurance companies may not be willing to change names on accounts for transitioning people. Transgender people report being “denied coverage for services often considered to be gender-specific, including routine sexual or reproductive health screenings” (James et al. 2016: 6). With transgender people having a higher than average rate of unemployment, a lack of work-provided insurance can compound problems with accessing and affording healthcare.

Studies show that lack of health insurance negatively impacts people’s health and life outcomes. “When they are hospitalized, uninsured people receive fewer diagnostic and therapeutic services and also have higher mortality rates than those with insurance” (Tolbert and Orgera 2020). Patients without insurance coverage may delay needed care when medical interventions could prevent poor outcomes. Patients may also experience delayed care when they go to doctors and emergency rooms, increasing their chance of death (Usher et al. 2018).