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An Original
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From Story Studio Network
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The first wave of feminists fought for women to be able to vote and own property.
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Until these gains were made, women often needed main guardians to transact business on their behalf.
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The second wave of feminism was a social movement that focused on issues like workplace equality, reproductive rights, and domestic violence.
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Third wave feminism celebrates individuality in personal choice. It recognizes that women should be free to make their own decisions about their bodies, careers, relationships, and lifestyles without judgment or coercion.
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The fourth wave of feminism is a modern feminist movement that focuses on intersectionality, digital activism, and tackling systemic inequalities.
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I believe the fifth wave is equality. Women having equal rights to men in all areas, but it has to start with health care.
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It has to start with bodily autonomy. It has to start with being seen and included in everything, including research and education.
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Women need to be seen. We need to be included. We need to be equal. And when that happens, it will change the world.
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I'm Jennifer Gillivan, president and CEO of the IWK Foundation and a lifelong champion for women. Join us in this powerful global conversation and help us spark a movement.
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I'm Avis Favaro and welcome to the fifth wave, curing the health care bias against women.
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[Music]
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Mr. Mrs. Hormann, can you settle this for us? If so, when you love us kind of depressed, should you shower them with kindness or give them space?
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Well now that's a very good question.
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A question that got last in the prime time sitcom that 70s show.
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And it really takes a lot of living with someone to get it right.
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That's true.
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Or not. But you'll find the thing to do is shower them.
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Kitty and her husband, Red, heard the same thing, considered the same issue.
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But come on, Kitty, when men oppose makes you crazy, I could be with you all day and I wouldn't do any good. You need space.
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[Music]
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The comedic irony of the show makes the point that remains true today. Women are still typecast as neurotic, crazy, overly emotional and more.
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In fact, a recent survey found 29% of women say their doctor has dismissed their concerns.
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[Music]
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Jennifer Gillivan is the president and CEO of the IWK Foundation in Halifax.
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In 2025, the Foundation conducted a survey to find out more about the state of women's health and what women need.
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She says that while they hope to solicit 2,000 responses from women in Nova Scotia, PEI and New Brunswick, they actually received more than 27,000.
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Jennifer says there was an overarching theme, which they called the Maritime Women's Burden.
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The word "burden" is a huge one because women overwhelmingly are taking care of their parents, they're trying to do their job.
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They overwhelmingly feel stressed but they put themselves last. They self-regulate.
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They don't even go to the health care system because one, a lot of times they've only got 10 minutes and they can only talk about one thing.
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Well, women's bodies are interconnected and the emotional is just as much connected and the mental health is as the physical health.
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Jennifer Gillivan says that as women keep trying to do all the things and handle all the stress, the burden of also staying healthy and looking after themselves becomes more than a lot of women can do.
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It really came through loud and clear their burden, what also came through is that they're dismissed and they're not listened to.
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And so women are telling you sometimes the way we communicate is not the same as man, it just isn't.
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What did you say?
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I said what you said.
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And we communicate through emotions. We communicate, I feel something's wrong here.
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I don't know if this feels right, that is completely dismissed.
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Over and over we saw that.
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So what happens when women's concerns about their physical health are ignored?
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Jennifer Gillivan says that physical and mental health are intertwined and we need to acknowledge that.
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Yeah, they're mental health of what they're going through, just going through man-upause and not even knowing that there's 34 symptoms.
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And the pains in your knees, you don't have arthritis, you're going through something in your entire body.
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That also affects your mental health.
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So the whole ecosystem of a woman's health has to include the physical, the emotional, as well as the mental health.
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And if we don't do that, we're only looking at half the picture.
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Jennifer Gillivan isn't the only one who's seen this type of scenario play out over and over again.
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Dr. Naomi Gibersen is a licensed psychologist and also the co-founder and chief clinical officer of Nestwell Health,
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which is Canada's first virtual multidisciplinary perinatal care clinic.
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She has learned a lot from her patients and their stories as they go through health challenges.
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I'm hearing from patients who are telling me that they're told to ignore the very real symptoms in their bodies,
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because it's just something that's in their mind, or that they are being overly emotional,
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or that they're being almost histrionic, if you will.
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And there are some women who I've heard from, who they are told, "Oh, the fatigue you're experiencing,
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that's just because your new mom comes with a territory."
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And that lump in your breast, that's actually just from lactation.
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That's not something that you really need to pay attention to, but something that you can ignore.
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I've had women who, not necessarily intentionally, but they've been made to feel like they are shallow for wanting to keep their hair,
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because they don't want to distress or scare or confuse their young children.
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Women who've been made to feel like they are being difficult for asking for anesthetic for certain procedures,
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that if it was on the male body, I am willing to bet, probably would provide some anesthetic without question.
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Dr. Christine Korol is a registered psychologist, and is the owner of Still Mind Studio.
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She's also an adjunct professor in the Department of Psychology at the University of British Columbia.
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She says, dismissing women's concerns, their experiences and trauma goes back a long, long way.
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It's the outcome of decades, centuries of bias, you know, when we looked at the very first psychosarphus Freud,
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interviewed women and found that they were reporting incest and sexual abuse.
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And when he presented that, got so much backlash that he invented penis-endee and edible complexes.
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And so it starts way back from the beginning.
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And even terms like hysteria, that was a diagnosis given to women in the 1800s and women received his directories for different mental health concerns.
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But even in the 50s, we had housewife syndrome that was diagnosed, a woman were given tranquilizers to get through the isolation and limited roles that they had at that time.
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This echoes a lot of what we've learned throughout this series, that the gender bias goes back to ancient times.
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And yet, here we are today, still living with the consequences of the ideas and the words of men who have been dead for hundreds or seven years.
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Where has that left us?
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Mostly women have been called emotional, that our problems are exaggerated, we're told to be stoic, and accept our fakes a lot of times.
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And it has, you know, things have changed, but not as much as we would have liked.
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We're working on centuries of bias and thinking women are emotional when we react to things that maybe aren't that fun for us.
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You know, that are quite difficult for us.
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The Canadian Mental Health Association issued a state of mental health in Canada report in 2024.
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It includes a fact sheet called gender in the spotlight.
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Some of its findings, women report higher rates of poor mental health, including mood and anxiety disorders than men.
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Women are hospitalized twice as often as men for self-harm.
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At 9.7% of Canadian women who needed care reported that their needs were not met compared to 5.7% of men.
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Dr. Coral says the burden on women is a lot, and it's a lot heavier for some women.
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I think just how much women put on themselves to hold it together.
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Women historically are the ones who are more likely to live in poverty.
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Or if you're a woman of color, you're going to face extra challenges.
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And most victims of violence or domestic violence are women.
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There's a lot of vulnerability and just the level of systemic trauma that women face is quite high.
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I think that is definitely under researched right now, you know, from economic dependence to gender-based violence,
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to just even misogyny in the office place, you know, and not being heard.
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Is an incredible frustration that women have to tolerate every day.
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Dr. Lisa Galea is the Tra Living Family Chair in Women's Mental Health at the Center for Addiction and Mental Health in Toronto.
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She's also a professor of psychiatry at the University of Toronto.
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She says almost everything about women's health is under-recognized, including, you guessed it, mental health.
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So there was a really lovely study that was done in Denmark looking at over 1300 different disorders.
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And they found on average when you average them all up, women were diagnosed two years later than men were for all the same kinds of disorders.
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And I looked at depression. That's one of the things I study is depression and it was two years.
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I looked at anxiety. It was also two years. All signs of diseases. Another one that I said it was also two years.
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Some were much more of course because it was an average and some they were diagnosed earlier.
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Dr. Galea points out something we have heard time and time again during the course of the fifth wave,
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which is that so much of this goes back to the outdated idea that women's bodies are just a smaller, penis-less version of men's bodies.
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And so we could study men and it wouldn't matter. It's going to be the same thing.
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But so much so that most of our research, like 97% of our research is focused on males worse with sex or gender as agnostic,
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so they're not actually looking at it. So much so that even the way we diagnose people is based on symptoms and experiences in men and not women.
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This is true for a wide variety of disorders, including mental health disorders. And you'll even see the label of atypical in women.
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You see this atypical label with ADHD. You see it with depression. You see it with bipolar disorder. You see it in stroke.
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And I mean it doesn't matter. The list goes on. And what's so interesting about that is that is true. It shows up in disorders where there are many more men that are diagnosed than women.
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Really? Dr. Galea says that we see it. For example, with ADHD and autism, where there is about a three or four to one ratio of men being diagnosed than women.
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But you also see in depression where you see twice more females being diagnosed with depression than males or women than men.
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And so obviously that's a weird thing to say that say two thirds of the population are being labeled as atypical when they're the more third more likely to get two more to the third of the population of that particular disorder more likely to get it.
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And they're also able to take a so why are women diagnosed later with depression? For example, Dr. Galea says that is a great question.
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I mean again, I think that's a million dollar question. If I had the answer to that, I'd have a lot of money. I think it's a lot of different factors that are coming into that from both a sort of biology side and the psychosocial side of things.
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We know that women are more typically dismissed at doctor's offices. Despite this idea that women are more likely to go to the doctors, I think we have many reasons to go to the doctors.
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Right, we have these, I mean they're going away now with self-collection, but pap smears, yearly pap smears. If you're a person of a certain age, you're going to get your mammograms every year.
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So we do have more opportunities perhaps that were, you know, accepted opportunities to go to the medical doctor's offices. But we're still dismissed for our symptoms.
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And Jennifer Gillivan says that the survey, the IWK Foundation, put out the one where they got 25,000 more responses than they were expecting, bears that out.
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Well, you're seeing that in cardiovascular disease where we're presenting totally different, you know, symptoms. You're seeing it in, you know, cancer starts in the South and women are like, something's off. And I'm seeing that in the survey. They're all telling me I knew something was wrong and nobody would listen to me.
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Nobody would take me seriously. You know, I read a book about the word hysteria comes from hysteria, comes from its Greek, you know, but it was all around the notion that it was just made up, that women were hysterical, where in fact women have an inbuilt physiology that actually can handle stress more than men.
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But somehow we're the weaker sex and we're the hysterical ones. And so this idea that all your start like relax, calm down, put up with it. You know, you'll be fine.
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Words like emotional and hysterical are usually pinned onto women and often unfairly. And since we're still quoting words that have been said by men for a millennia,
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we know that they creep in and language plays a big role. Sometimes we need to shine a light on what those words actually mean, it says Dr. Coral.
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She says highlighting and describing the behavior instead of calling out a word can help.
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I kind of use a trick if somebody is saying something about somebody like, oh, you know, Jill was hysterical in the meeting. And I said, oh, should we talk to her about that? Did you tell Jill your concern? She's hysterical.
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I usually touch it down.
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As our modern life continues to get busier, faster, bigger women are often the ones carrying the mental load as well as the physical one, both at home and at work. And that takes a toll after a while.
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Is there a superwoman complex for women where they're expected to do it all and we expect ourselves to do it all without admitting we may actually be struggling?
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Dr. Coral says it's not something a lot of people talk about.
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Nobody talks about it or it's rare to have someone talk about, you know, how hard it is to just be a new mother. After you have a baby, it kind of hits people like a ton of bricks and they don't realize, you know, the sleep deprivation and how the baby doesn't cooperate.
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Never mind everything else. And we're told that we can have it all as well that, you know, we should be able to get child care and keep working.
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So a lot of women say that they try and work like they're single, but parent like they're a stay at home mom and they feel this pressure from both sides to keep it all together.
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And wonder why they are having a hard time when it seems like, in the keyword, there is seems seems like everybody else is holding it together as well.
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For women who are mothers and caregivers, the constant divide between work and raising children is one that ends up creating a loop of no-win situations that leave women feeling stuck and always behind says Dr. Coral.
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It is a bit of a phenomenon, so not to feel guilty about it, but realize like we're stretched too far. I mean, how are supposed to raise children is probably like in a small village with about 150 people.
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Everybody cooks together. Everybody, you know, raises the babies together. Maybe you even got someone to nurse your baby for you so you can have a nap.
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And we're not supposed to do it alone. And the workload on families is completely un-enternable. It's very difficult. So, you know, what happens is a lot of people start throwing money at conveniences and beating themselves up thinking that it's their fault that they should be able to handle it.
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And really, we're not built for this level of workload.
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What kind of support is out there? For those women who are mothers, Dr. Coral says that most of the research and help has been focused on post-partum depression, not necessarily care.
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She says there's hardly any research or resources on post-partum anxiety. Post-partum is just one part of some women's lives. But is there a way to do more to promote better care?
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It depends on the community that you're in here in Vancouver. We have DC Women's Hospital. They have a wonderful reproductive psychiatry department.
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I've told women to go over there. They've been in Likitty Split. They've just opened up a new menopause clinic, which I'm kind of excited about. I think it's the first, it might be the first in the pantry to help women with some of the mental health issues and physical symptoms that they have during menopause, which are astoundingly high.
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But yeah, I think across all areas from post-partum to menopause to being a senior widow, it's really difficult. There's a lot of research guiding what we do because of the nature of research funding.
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A lot of projects haven't looked at, say, menstrual cycles, post-partum, how hormones affect different disorders.
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Dr. Galea really wanted to establish an animal model of post-partum depression. Part of the reasoning is researchers wanted to see a fluctuating hormone levels would be something they would see and measure in an animal model as well.
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Because, of course, in a human's life, we have so many social pressures that occur. We have so many things that are happening, caregiver. I'm sure many of us are very well aware of this.
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Or pressures at home, you're taking care of your kids, you're taking care of your elderly parents. All of those pressures can really add up.
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And so part of the dismissal, even in the doctor's office, could be, hey, you're dealing with a lot of things, you're dealing with a lot of pressures at work. Maybe that's what's going on rather than, there's something biological.
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So, is it a human thing? Dr. Galea says the results have been interesting.
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Anyway, what we saw is a recapitulation of what we thought was happening in humans. We saw it in animal models, which gives us a lot of confidence to say, hey, it's not just a social issue because we can keep so many things.
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The beauty of an animal model is we can keep so many things tight, we can give them all the same diet, the same exposures, the same temperature, the same kind of ways that they grow up. We can keep all the potential compounds away.
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So, anything that we think might be interfering with the data, whereas you can't do that, obviously in human research.
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But the gender bias continues to crop up in research, even in research about postpartum depression. Dr. Galea has had her own experiences with this.
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I started realizing as people didn't realize how hard it was to get grants in the area. And I was being told things like, just write about a grant, or I'm really interested in how sex-specific experiences can influence brain aging, for example.
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So, one of them being pregnancy was something I was interested in. And the first time I wrote this grant to look at, okay, we've been looking at the short term, so postpartum depression models, but what about what happens long term does that influence the brain?
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And we were told just to add males. And I was like, well, males don't get pregnant, so I can't actually do that, particularly, at least a male rat. It's not physically possible.
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So, what is the mental load? Mental load is this invisible cognitive and emotional work of managing daily life and anticipating the needs of others.
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It includes things like planning, organizing, scheduling, such as meal planning, managing appointments, and remembering those details for school at work.
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This invisible work is constant, can be boundaryless, and often falls disproportionately on one person, commonly, women.
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Dr. Coral says the mental load is heavy for women everywhere, and in every profession, including academia. And that has repercussions down the line for all women.
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Often women in academia have to put up with a lot. They get less funding. They're put on every committee to be a representative for women.
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On these committees, but they haven't hired enough women in most departments to have gender parity. So a lot of women academics that I work with are burning out because they're asked to do so much.
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And then trying to do research on top of that, so it's really challenging. Or even having a baby can slow down your research prospects and make it harder to get tenure.
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So, if we're not supporting women academics who might be doing that research, then it's getting harder to get it sorted out.
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We've often heard that there is a focus in medical training on men. Studies and researcher done primarily with men, male mice, etc.
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It's a fact that not only are women's bodies different than men's, so too are our brains.
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Psychology profession different? Do they talk about mental health in general? Or do they talk about men's mental health and women's mental health as separate things?
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Dr. Coral says her experience is that it's mainly about mental health in general.
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I think there just wasn't the research to guide it. I would say even though psychology now is pretty much a female dominated profession when I was in school, most of my professors were men.
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Even into grad school, I would say most, but it was getting better, were men. And I think other than a child treatment course that I took where I know the professor was talking to us about the difference of ADHD and girls and boys back then.
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There wasn't too much talk to it.
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But Dr. Coral says she was able to see and learn more when she was in an obstetrics rotation in her residency at the Ottawa Hospital.
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I was working on the maternity ward, so I mostly, and my research was in the Neomatal Intensive Care Unit.
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So a lot of my early work was in helping women with post-pum psychosis, depression, anxiety.
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So I was able to get that before I graduated when I was a resident, and that's where I learned most of it, but there was hardly anything there, right?
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There was a few psychodynamic papers I remember beating for guidance on how to help women with paranetal loss and all the different things.
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There was nothing on anxiety. There's still really not much on anxiety, just a handful of articles.
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So it's really not out there. There's not much to teach to be fair.
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While women are often described as hormonal when they're upset or angry, Dr. Gallia says it's good to remember that women are not the only ones with hormones.
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Actually, human males have what we call a diurnal or daily rhythm in their testosterone level.
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So they're very high in the morning and very low at night, they decline by about 50%.
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So given that males have this daily rhythm, and females have a monthly rhythm, if you will, through the menstrual cycle, my standard response is like, who's more hormonal?
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Like, we have a daily rhythm.
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So again, there's these biases we have in everybody's has them, every single person has them, and including in the medical literature, including in medical professionals.
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Dr. Gallia says it's important to recognize that these biases can affect the way we are working and what we're researching and how we are interpreting that research.
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She says sometimes it's good to stand back and take a look at your biases and views to ensure that we aren't excluding people just by virtue of the way we think.
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Dr. Coral says in daily life, it's not just biases we need to check and be aware of, and she has some thoughts on how to improve things.
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Instead of therapies, how are people going to therapy? It would be nice if we just fix some of the underlying problems, right?
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People get sent to therapy and therapies often thrown out there. I know I'm not the only therapist who feels this, but therapy gets thrown out there well.
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We have a mental health epidemic, go to therapy, we need to make therapy more accessible, and I'm like, how about we make housing more accessible?
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How about we have more programs that get women out of difficult domestic violence situations?
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How about we work on wage parity?
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There's so many things that if they were fixed, you wouldn't need as many therapists as we do.
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There's a lot of what therapists are doing these days is just helping people name some of the oppressive systems that they're living under, and that it's not their fault.
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And then how to stay at peace even though the world is really messed up.
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Pushing for change is Jennifer Gillivan's mission as the president and CEO of the IWK Foundation.
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And while she's hopeful that the fight for equity in healthcare and everywhere for women is well underway, and that progress on that front is happening, she knows there is still a lot of work to be done.
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I also heard a comment because when you do anything, when you push for any kind of change, you're always going to spark debate, which is good, that's the way it should be.
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But I've heard one of the comments back was, I was from a man, I'm so tired of excessive female privilege.
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Well, you know what? I want to know where that lives because I'm getting that passport and I move in there, and I think me and everyone else, it's called female, it's going there, doesn't exist.
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The views, thoughts and opinions expressed by the host, guests and participants of the fifth wave belong solely to the individuals involved and do not necessarily reflect the official policy or position of the IWK Foundation.
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The information discussed in this podcast is for informational purposes only and should not be taken as medical, legal, or professional advice from the IWK Foundation.
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While we strive for accuracy, the IWK Foundation makes no representations as to the accuracy, completeness, suitability or validity of any information on this podcast and will not be liable for any errors, omissions, or any losses, injuries or damages arising from its use.
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Listener discretion is advised.
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This is SSN.
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Story Studio Network
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[BLANK_AUDIO]
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An Original
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From Story Studio Network
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The first wave of feminists fought for women to be able to vote and own property.
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Until these gains were made, women often needed main guardians to transact business on their behalf.
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The second wave of feminism was a social movement that focused on issues like workplace equality, reproductive rights, and domestic violence.
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Third wave feminism celebrates individuality in personal choice. It recognizes that women should be free to make their own decisions about their bodies, careers, relationships, and lifestyles without judgment or coercion.
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The fourth wave of feminism is a modern feminist movement that focuses on intersectionality, digital activism, and tackling systemic inequalities.
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I believe the fifth wave is equality. Women having equal rights to men in all areas, but it has to start with health care.
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It has to start with bodily autonomy. It has to start with being seen and included in everything, including research and education.
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Women need to be seen. We need to be included. We need to be equal. And when that happens, it will change the world.
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I'm Jennifer Gillivan, president and CEO of the IWK Foundation and a lifelong champion for women. Join us in this powerful global conversation and help us spark a movement.
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I'm Avis Favaro and welcome to the fifth wave, curing the health care bias against women.
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[Music]
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Mr. Mrs. Hormann, can you settle this for us? If so, when you love us kind of depressed, should you shower them with kindness or give them space?
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Well now that's a very good question.
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A question that got last in the prime time sitcom that 70s show.
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And it really takes a lot of living with someone to get it right.
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That's true.
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Or not. But you'll find the thing to do is shower them.
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Kitty and her husband, Red, heard the same thing, considered the same issue.
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But come on, Kitty, when men oppose makes you crazy, I could be with you all day and I wouldn't do any good. You need space.
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[Music]
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The comedic irony of the show makes the point that remains true today. Women are still typecast as neurotic, crazy, overly emotional and more.
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In fact, a recent survey found 29% of women say their doctor has dismissed their concerns.
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[Music]
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Jennifer Gillivan is the president and CEO of the IWK Foundation in Halifax.
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In 2025, the Foundation conducted a survey to find out more about the state of women's health and what women need.
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She says that while they hope to solicit 2,000 responses from women in Nova Scotia, PEI and New Brunswick, they actually received more than 27,000.
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Jennifer says there was an overarching theme, which they called the Maritime Women's Burden.
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The word "burden" is a huge one because women overwhelmingly are taking care of their parents, they're trying to do their job.
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They overwhelmingly feel stressed but they put themselves last. They self-regulate.
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They don't even go to the health care system because one, a lot of times they've only got 10 minutes and they can only talk about one thing.
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Well, women's bodies are interconnected and the emotional is just as much connected and the mental health is as the physical health.
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Jennifer Gillivan says that as women keep trying to do all the things and handle all the stress, the burden of also staying healthy and looking after themselves becomes more than a lot of women can do.
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It really came through loud and clear their burden, what also came through is that they're dismissed and they're not listened to.
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And so women are telling you sometimes the way we communicate is not the same as man, it just isn't.
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What did you say?
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I said what you said.
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And we communicate through emotions. We communicate, I feel something's wrong here.
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I don't know if this feels right, that is completely dismissed.
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Over and over we saw that.
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So what happens when women's concerns about their physical health are ignored?
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Jennifer Gillivan says that physical and mental health are intertwined and we need to acknowledge that.
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Yeah, they're mental health of what they're going through, just going through man-upause and not even knowing that there's 34 symptoms.
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And the pains in your knees, you don't have arthritis, you're going through something in your entire body.
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That also affects your mental health.
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So the whole ecosystem of a woman's health has to include the physical, the emotional, as well as the mental health.
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And if we don't do that, we're only looking at half the picture.
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Jennifer Gillivan isn't the only one who's seen this type of scenario play out over and over again.
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Dr. Naomi Gibersen is a licensed psychologist and also the co-founder and chief clinical officer of Nestwell Health,
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which is Canada's first virtual multidisciplinary perinatal care clinic.
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She has learned a lot from her patients and their stories as they go through health challenges.
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I'm hearing from patients who are telling me that they're told to ignore the very real symptoms in their bodies,
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because it's just something that's in their mind, or that they are being overly emotional,
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or that they're being almost histrionic, if you will.
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And there are some women who I've heard from, who they are told, "Oh, the fatigue you're experiencing,
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that's just because your new mom comes with a territory."
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And that lump in your breast, that's actually just from lactation.
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That's not something that you really need to pay attention to, but something that you can ignore.
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I've had women who, not necessarily intentionally, but they've been made to feel like they are shallow for wanting to keep their hair,
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because they don't want to distress or scare or confuse their young children.
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Women who've been made to feel like they are being difficult for asking for anesthetic for certain procedures,
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that if it was on the male body, I am willing to bet, probably would provide some anesthetic without question.
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Dr. Christine Korol is a registered psychologist, and is the owner of Still Mind Studio.
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She's also an adjunct professor in the Department of Psychology at the University of British Columbia.
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She says, dismissing women's concerns, their experiences and trauma goes back a long, long way.
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It's the outcome of decades, centuries of bias, you know, when we looked at the very first psychosarphus Freud,
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interviewed women and found that they were reporting incest and sexual abuse.
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And when he presented that, got so much backlash that he invented penis-endee and edible complexes.
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And so it starts way back from the beginning.
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And even terms like hysteria, that was a diagnosis given to women in the 1800s and women received his directories for different mental health concerns.
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But even in the 50s, we had housewife syndrome that was diagnosed, a woman were given tranquilizers to get through the isolation and limited roles that they had at that time.
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This echoes a lot of what we've learned throughout this series, that the gender bias goes back to ancient times.
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And yet, here we are today, still living with the consequences of the ideas and the words of men who have been dead for hundreds or seven years.
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Where has that left us?
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Mostly women have been called emotional, that our problems are exaggerated, we're told to be stoic, and accept our fakes a lot of times.
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And it has, you know, things have changed, but not as much as we would have liked.
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We're working on centuries of bias and thinking women are emotional when we react to things that maybe aren't that fun for us.
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You know, that are quite difficult for us.
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The Canadian Mental Health Association issued a state of mental health in Canada report in 2024.
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It includes a fact sheet called gender in the spotlight.
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Some of its findings, women report higher rates of poor mental health, including mood and anxiety disorders than men.
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Women are hospitalized twice as often as men for self-harm.
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At 9.7% of Canadian women who needed care reported that their needs were not met compared to 5.7% of men.
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Dr. Coral says the burden on women is a lot, and it's a lot heavier for some women.
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I think just how much women put on themselves to hold it together.
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Women historically are the ones who are more likely to live in poverty.
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Or if you're a woman of color, you're going to face extra challenges.
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And most victims of violence or domestic violence are women.
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There's a lot of vulnerability and just the level of systemic trauma that women face is quite high.
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I think that is definitely under researched right now, you know, from economic dependence to gender-based violence,
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to just even misogyny in the office place, you know, and not being heard.
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Is an incredible frustration that women have to tolerate every day.
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Dr. Lisa Galea is the Tra Living Family Chair in Women's Mental Health at the Center for Addiction and Mental Health in Toronto.
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She's also a professor of psychiatry at the University of Toronto.
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She says almost everything about women's health is under-recognized, including, you guessed it, mental health.
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So there was a really lovely study that was done in Denmark looking at over 1300 different disorders.
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And they found on average when you average them all up, women were diagnosed two years later than men were for all the same kinds of disorders.
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And I looked at depression. That's one of the things I study is depression and it was two years.
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I looked at anxiety. It was also two years. All signs of diseases. Another one that I said it was also two years.
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Some were much more of course because it was an average and some they were diagnosed earlier.
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Dr. Galea points out something we have heard time and time again during the course of the fifth wave,
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which is that so much of this goes back to the outdated idea that women's bodies are just a smaller, penis-less version of men's bodies.
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And so we could study men and it wouldn't matter. It's going to be the same thing.
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But so much so that most of our research, like 97% of our research is focused on males worse with sex or gender as agnostic,
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so they're not actually looking at it. So much so that even the way we diagnose people is based on symptoms and experiences in men and not women.
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This is true for a wide variety of disorders, including mental health disorders. And you'll even see the label of atypical in women.
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You see this atypical label with ADHD. You see it with depression. You see it with bipolar disorder. You see it in stroke.
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And I mean it doesn't matter. The list goes on. And what's so interesting about that is that is true. It shows up in disorders where there are many more men that are diagnosed than women.
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Really? Dr. Galea says that we see it. For example, with ADHD and autism, where there is about a three or four to one ratio of men being diagnosed than women.
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But you also see in depression where you see twice more females being diagnosed with depression than males or women than men.
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And so obviously that's a weird thing to say that say two thirds of the population are being labeled as atypical when they're the more third more likely to get two more to the third of the population of that particular disorder more likely to get it.
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And they're also able to take a so why are women diagnosed later with depression? For example, Dr. Galea says that is a great question.
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I mean again, I think that's a million dollar question. If I had the answer to that, I'd have a lot of money. I think it's a lot of different factors that are coming into that from both a sort of biology side and the psychosocial side of things.
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We know that women are more typically dismissed at doctor's offices. Despite this idea that women are more likely to go to the doctors, I think we have many reasons to go to the doctors.
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Right, we have these, I mean they're going away now with self-collection, but pap smears, yearly pap smears. If you're a person of a certain age, you're going to get your mammograms every year.
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So we do have more opportunities perhaps that were, you know, accepted opportunities to go to the medical doctor's offices. But we're still dismissed for our symptoms.
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And Jennifer Gillivan says that the survey, the IWK Foundation, put out the one where they got 25,000 more responses than they were expecting, bears that out.
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Well, you're seeing that in cardiovascular disease where we're presenting totally different, you know, symptoms. You're seeing it in, you know, cancer starts in the South and women are like, something's off. And I'm seeing that in the survey. They're all telling me I knew something was wrong and nobody would listen to me.
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Nobody would take me seriously. You know, I read a book about the word hysteria comes from hysteria, comes from its Greek, you know, but it was all around the notion that it was just made up, that women were hysterical, where in fact women have an inbuilt physiology that actually can handle stress more than men.
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But somehow we're the weaker sex and we're the hysterical ones. And so this idea that all your start like relax, calm down, put up with it. You know, you'll be fine.
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Words like emotional and hysterical are usually pinned onto women and often unfairly. And since we're still quoting words that have been said by men for a millennia,
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we know that they creep in and language plays a big role. Sometimes we need to shine a light on what those words actually mean, it says Dr. Coral.
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She says highlighting and describing the behavior instead of calling out a word can help.
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I kind of use a trick if somebody is saying something about somebody like, oh, you know, Jill was hysterical in the meeting. And I said, oh, should we talk to her about that? Did you tell Jill your concern? She's hysterical.
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I usually touch it down.
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As our modern life continues to get busier, faster, bigger women are often the ones carrying the mental load as well as the physical one, both at home and at work. And that takes a toll after a while.
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Is there a superwoman complex for women where they're expected to do it all and we expect ourselves to do it all without admitting we may actually be struggling?
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Dr. Coral says it's not something a lot of people talk about.
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Nobody talks about it or it's rare to have someone talk about, you know, how hard it is to just be a new mother. After you have a baby, it kind of hits people like a ton of bricks and they don't realize, you know, the sleep deprivation and how the baby doesn't cooperate.
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Never mind everything else. And we're told that we can have it all as well that, you know, we should be able to get child care and keep working.
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So a lot of women say that they try and work like they're single, but parent like they're a stay at home mom and they feel this pressure from both sides to keep it all together.
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And wonder why they are having a hard time when it seems like, in the keyword, there is seems seems like everybody else is holding it together as well.
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For women who are mothers and caregivers, the constant divide between work and raising children is one that ends up creating a loop of no-win situations that leave women feeling stuck and always behind says Dr. Coral.
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It is a bit of a phenomenon, so not to feel guilty about it, but realize like we're stretched too far. I mean, how are supposed to raise children is probably like in a small village with about 150 people.
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Everybody cooks together. Everybody, you know, raises the babies together. Maybe you even got someone to nurse your baby for you so you can have a nap.
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And we're not supposed to do it alone. And the workload on families is completely un-enternable. It's very difficult. So, you know, what happens is a lot of people start throwing money at conveniences and beating themselves up thinking that it's their fault that they should be able to handle it.
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And really, we're not built for this level of workload.
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What kind of support is out there? For those women who are mothers, Dr. Coral says that most of the research and help has been focused on post-partum depression, not necessarily care.
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She says there's hardly any research or resources on post-partum anxiety. Post-partum is just one part of some women's lives. But is there a way to do more to promote better care?
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It depends on the community that you're in here in Vancouver. We have DC Women's Hospital. They have a wonderful reproductive psychiatry department.
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I've told women to go over there. They've been in Likitty Split. They've just opened up a new menopause clinic, which I'm kind of excited about. I think it's the first, it might be the first in the pantry to help women with some of the mental health issues and physical symptoms that they have during menopause, which are astoundingly high.
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But yeah, I think across all areas from post-partum to menopause to being a senior widow, it's really difficult. There's a lot of research guiding what we do because of the nature of research funding.
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A lot of projects haven't looked at, say, menstrual cycles, post-partum, how hormones affect different disorders.
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Dr. Galea really wanted to establish an animal model of post-partum depression. Part of the reasoning is researchers wanted to see a fluctuating hormone levels would be something they would see and measure in an animal model as well.
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Because, of course, in a human's life, we have so many social pressures that occur. We have so many things that are happening, caregiver. I'm sure many of us are very well aware of this.
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Or pressures at home, you're taking care of your kids, you're taking care of your elderly parents. All of those pressures can really add up.
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And so part of the dismissal, even in the doctor's office, could be, hey, you're dealing with a lot of things, you're dealing with a lot of pressures at work. Maybe that's what's going on rather than, there's something biological.
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So, is it a human thing? Dr. Galea says the results have been interesting.
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Anyway, what we saw is a recapitulation of what we thought was happening in humans. We saw it in animal models, which gives us a lot of confidence to say, hey, it's not just a social issue because we can keep so many things.
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The beauty of an animal model is we can keep so many things tight, we can give them all the same diet, the same exposures, the same temperature, the same kind of ways that they grow up. We can keep all the potential compounds away.
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So, anything that we think might be interfering with the data, whereas you can't do that, obviously in human research.
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But the gender bias continues to crop up in research, even in research about postpartum depression. Dr. Galea has had her own experiences with this.
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I started realizing as people didn't realize how hard it was to get grants in the area. And I was being told things like, just write about a grant, or I'm really interested in how sex-specific experiences can influence brain aging, for example.
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So, one of them being pregnancy was something I was interested in. And the first time I wrote this grant to look at, okay, we've been looking at the short term, so postpartum depression models, but what about what happens long term does that influence the brain?
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And we were told just to add males. And I was like, well, males don't get pregnant, so I can't actually do that, particularly, at least a male rat. It's not physically possible.
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So, what is the mental load? Mental load is this invisible cognitive and emotional work of managing daily life and anticipating the needs of others.
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It includes things like planning, organizing, scheduling, such as meal planning, managing appointments, and remembering those details for school at work.
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This invisible work is constant, can be boundaryless, and often falls disproportionately on one person, commonly, women.
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Dr. Coral says the mental load is heavy for women everywhere, and in every profession, including academia. And that has repercussions down the line for all women.
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Often women in academia have to put up with a lot. They get less funding. They're put on every committee to be a representative for women.
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On these committees, but they haven't hired enough women in most departments to have gender parity. So a lot of women academics that I work with are burning out because they're asked to do so much.
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And then trying to do research on top of that, so it's really challenging. Or even having a baby can slow down your research prospects and make it harder to get tenure.
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So, if we're not supporting women academics who might be doing that research, then it's getting harder to get it sorted out.
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We've often heard that there is a focus in medical training on men. Studies and researcher done primarily with men, male mice, etc.
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It's a fact that not only are women's bodies different than men's, so too are our brains.
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Psychology profession different? Do they talk about mental health in general? Or do they talk about men's mental health and women's mental health as separate things?
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Dr. Coral says her experience is that it's mainly about mental health in general.
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I think there just wasn't the research to guide it. I would say even though psychology now is pretty much a female dominated profession when I was in school, most of my professors were men.
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Even into grad school, I would say most, but it was getting better, were men. And I think other than a child treatment course that I took where I know the professor was talking to us about the difference of ADHD and girls and boys back then.
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There wasn't too much talk to it.
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But Dr. Coral says she was able to see and learn more when she was in an obstetrics rotation in her residency at the Ottawa Hospital.
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I was working on the maternity ward, so I mostly, and my research was in the Neomatal Intensive Care Unit.
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So a lot of my early work was in helping women with post-pum psychosis, depression, anxiety.
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So I was able to get that before I graduated when I was a resident, and that's where I learned most of it, but there was hardly anything there, right?
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There was a few psychodynamic papers I remember beating for guidance on how to help women with paranetal loss and all the different things.
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There was nothing on anxiety. There's still really not much on anxiety, just a handful of articles.
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So it's really not out there. There's not much to teach to be fair.
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While women are often described as hormonal when they're upset or angry, Dr. Gallia says it's good to remember that women are not the only ones with hormones.
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Actually, human males have what we call a diurnal or daily rhythm in their testosterone level.
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So they're very high in the morning and very low at night, they decline by about 50%.
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So given that males have this daily rhythm, and females have a monthly rhythm, if you will, through the menstrual cycle, my standard response is like, who's more hormonal?
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Like, we have a daily rhythm.
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So again, there's these biases we have in everybody's has them, every single person has them, and including in the medical literature, including in medical professionals.
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Dr. Gallia says it's important to recognize that these biases can affect the way we are working and what we're researching and how we are interpreting that research.
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She says sometimes it's good to stand back and take a look at your biases and views to ensure that we aren't excluding people just by virtue of the way we think.
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Dr. Coral says in daily life, it's not just biases we need to check and be aware of, and she has some thoughts on how to improve things.
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Instead of therapies, how are people going to therapy? It would be nice if we just fix some of the underlying problems, right?
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People get sent to therapy and therapies often thrown out there. I know I'm not the only therapist who feels this, but therapy gets thrown out there well.
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We have a mental health epidemic, go to therapy, we need to make therapy more accessible, and I'm like, how about we make housing more accessible?
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How about we have more programs that get women out of difficult domestic violence situations?
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How about we work on wage parity?
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There's so many things that if they were fixed, you wouldn't need as many therapists as we do.
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There's a lot of what therapists are doing these days is just helping people name some of the oppressive systems that they're living under, and that it's not their fault.
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And then how to stay at peace even though the world is really messed up.
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Pushing for change is Jennifer Gillivan's mission as the president and CEO of the IWK Foundation.
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And while she's hopeful that the fight for equity in healthcare and everywhere for women is well underway, and that progress on that front is happening, she knows there is still a lot of work to be done.
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I also heard a comment because when you do anything, when you push for any kind of change, you're always going to spark debate, which is good, that's the way it should be.
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But I've heard one of the comments back was, I was from a man, I'm so tired of excessive female privilege.
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Well, you know what? I want to know where that lives because I'm getting that passport and I move in there, and I think me and everyone else, it's called female, it's going there, doesn't exist.
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The views, thoughts and opinions expressed by the host, guests and participants of the fifth wave belong solely to the individuals involved and do not necessarily reflect the official policy or position of the IWK Foundation.
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The information discussed in this podcast is for informational purposes only and should not be taken as medical, legal, or professional advice from the IWK Foundation.
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While we strive for accuracy, the IWK Foundation makes no representations as to the accuracy, completeness, suitability or validity of any information on this podcast and will not be liable for any errors, omissions, or any losses, injuries or damages arising from its use.
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Listener discretion is advised.
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This is SSN.
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Story Studio Network
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