When Abby Norman found herself reeling in pain on the floor of her dormitory bathroom during her freshman year at college, she knew something was not right in her body. This pain would eventually force her to leave Sarah Lawrence, to give up dance, to stop having sex; it would rob her of many of the things that belong to a young woman experiencing the world. This pain would also send her on a several year long search to find a diagnosis for this ailment that had seized her body so completely and to find a doctor who would even believe it was real.

In her debut book Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain, to be released on March 6 from Nation Books, Norman details her journey to find a diagnosis for her pain. And along the way she finds that she is not the first to undertake this search to make the outside world believe in women’s pain, that the pages of medical history are punctuated by women’s suffering so often unheard and disbelieved. This negation of women’s pain has deep roots in history, and by weaving together her personal memoir with historical accounts of women’s experiences with pain, she shows how the hetero-patriarchal foundations of the medical system continue to work against women today.

Norman recounts doctor visit after doctor visit, which form a maddening pattern of dismissal and misdiagnosis. From the time she disclosed the abuse and neglect she received at home to her pediatrician who did nothing to the time an ER doctor insisted her pain was caused by a bladder infection without even performing proper diagnostics, Norman learned the myriad of ways that the medical system could let her down. For many of the doctors that Norman saw, her fertility seemed to be more important than her her pain or quality of life. When Norman was no longer able to have sex because of the pain it caused her, people assumed she was covering for the fact that she just didn’t like it. Only when her partner attested to the fact that her pain had disrupted their sexual relationship did doctors pay attention. Norman reminds us that women often pay the price for male pleasure, which is unquestioningly accepted as a necessity and right

“When I began to realize that they wouldn’t or couldn’t help me, I started trying to find a way to save myself,” she writes. Driven by natural curiosity and her desire to discover what was causing her pain, she educated herself while working at a hospital and reading its onsite medical library. While combing through medical texts, she found what doctors couldn’t give her: a diagnosis of endometriosis, the thing that had been causing her so much pain since that morning on the dormitory bathroom floor. She also suspected that she suffered from chronic subacute appendicitis, and when her doctor performed surgery at her urging, he discovered just that. When patients bring their own research and theories into the exam room, physicians often discourage them from seeking help from the internet or elsewhere. But despite some doctors’ thinking that patients are usurping their power and knowledge, these patients are only trying to take an active role in their medical care because all they really want is to be well.

Norman’s narrative is further animated by her exploration of the historical and present day relationship between women’s mental health and physical pain. In her personal journey, Norman faced doctors who theorized that her physical pain was not medical, rather a result of her childhood trauma or of anxiety—one even wildly postulated that she had been sexually abused. In her historical research, she stitched together a similar narrative where doctors disregarded women’s physical pain as a manifestation of their own uncontrollable emotions. In the hysteric cases of Karen Armstrong and Sybil Dorsett, both women were found to have underlying medical ailments, epilepsy in the former and endometriosis in the latter.

From past to present, Norman finds that “[a]n emerging thread seems to be that if a woman is both sick and anxious, she’s sick because she’s anxious—not anxious about being sick.” Psychological pain and physical pain, indeed, bleed into each other, not because one directly causes the other but, in part, because women are told that the pain in their bodies is not real, that it is in their heads, to the point that their psychological pain also becomes unbearable—and unbelievable.  

This book can provide validation for people whose pain has been dismissed and disbelieved by a medical system that pathologizes bodies that do not conform to that of the cis white male. But it is not just for those who would find kinship in its pages; it is also for physicians and healthcare providers to help them question, confront, and tear down their own biases and prejudices that they bring into the exam room.

Early in the book, Norman writes, “If only someone on the outside knew the language we speak inside ourselves to keep our pain a secret, to silence our suffering, to find one hundred reasons why we’re fine and not one reason why we’re sick.” Ask Me About My Uterus is an attempt to make this internal language heard by those on the outside. Norman does not claim that her struggles with the medical system are representative of anyone else’s. As a straight, cis, white woman hers is a voice of privilege, and that while her particular medical journey has centered her uterus, she recognizes that not everyone’s does. Each person’s individual identities across race and gender and ability engages differently with the medical system, and they too are trying to make their internal language heard. As more voices join this chorus, it will, with any hope, become impossible for medicine to ignore them.