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How to treat women in healthcare? Or how not to treat women.

Things I thought of recently when I was in hospital with an anxiety attack as a survivor of multiple violences and rape.

every woman is different and so are their experiences, the triggers are not always sexually related, they can be related to a million things, and particularly to do with power and control.

a male nurse closes the door and says to me (a woman):

-I need you to take your top off, are you wearing a bra?-"No" I reply

I am already obeying because I tend to do.

-Do you want me to get someone else.

Despite that most people will not understand, at this point I say "no" . Because despite my survivor story or maybe because of it, I struggle to have confidence when I am scared and vulnerable, me not having the courage to express when I am alone in a room with a man, feeling vulnerable, that I will prefer a female, is not me complying and being ok about it.

I feel the question should have been asked the minute I arrived in triage, I know it is difficult, I know you are over stretched...But we need to stop seeing this as a capricious choice, this is care and mental health.

I know that many professionals work already with protocols to detect domestic violence, I was asked by my midwives during pregnancy in different ways when my husband wasn't there if "things were ok at home" but reflecting on my experiences on Sunday it was alarming that not one professional asked me anything remotely about it when I turned up with a major anxiety attack, sobbing non stop, and talking about being suffocating, feeling I couldn't leave the house, not wanting to go back to my home, struggling to see an exit and so on. My situation is not related to domestic violence and it is to do with a complex family situation we are living at the moment and I am better now, but it really shocked me that they asked no questions whatsoever.

When one of the nurses took some interest in my circumstances and I explained some serious issues, she told me she didn't have a magic wand and to try to get some "me" time and go for walks, at which point I said, in order to relieve us both of further responsibilities that I will speak to a mental health professional. So there are at least two things that I feel we should be able to do better by now, one is a better understanding of common mental health issues and two women as survivors of male violence. And yes I am grateful to the NHS, and yes I know they are overworked and underpaid when I say this things.

But I can't now replicate victim behaviour with the institution and assume that my abuse or my lack of care is needed to favour other's comfort, my care matters it is the care of half of the human population, it is the care of those who birth the other half. And it is precisely because I believe in the work of the NHS and the high standards we require and the need to protect them fiercely that I say all this, I said it to a father who despaired in emergencies telling me about his teenage daughter not being properly diagnose and having kidney failure, he told me that they were looking for private care, I suggested that he complained, because I believe in demanding better joining the bodies that will put pressure on the governments, not abandoning a model of free care as a lost cause.

And it is because I believe we deserve better and the reality that globally 1 in 3 women are survivors of some kind of violence. That I need the world and the healthcare systems everywhere to know that this needs to be acknowledge and that as a 48 year old woman and a survivor and I am still waiting for a note in the leaflets that remind me to have a smear

test saying that they understand the suffering of women, that the test will be conducted b female practitioners and that I can discuss in confidence my survivor story and speak to a counsellor if I require assistance during the procedure. (Or something like that) Instead the latest modification to those leaflets in Scotland is around the fact that I am no longer a woman but one of those people with a cervix.

Well, in the reality where I am still a woman, one of those 1 in 3 who gets assaulted, abused or raped, 1 in 3 women who are still going through hell, not only because we are survivors but because we remain, and now are further, invisible, and because it is expected of us once again to put up with suffering, to be quiet, to ignore your trauma, to don't talk to much or just whisper that men are the violent majority and women the survivors of that violence. Pretend without any further questions or demands that not even you, the one with the experience, sees the scandal of 1 in 3 women suffering abuse.

Any time I have been asked how to improve this: In healthcare and many other situations with women, just treat every woman as if she could be a survivor. Everywhere else, stop silencing women.

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