‘Women’s Pain Is Less Important’: Documentary ‘Below the Belt’ Shows Why Endometriosis Is a Feminist Issue

“The doctor said the only thing I could do was accept it was part of being a woman and suck it up.”

A new documentary Below the Belt, executive produced by Hillary Clinton and directed by Shannon Cohn, demonstrates why endometriosis—and women’s health—is an urgent social justice issue for feminists.

The film follows the lives of four women living with endometriosis—a disease that can cause debilitating pain, infertility and menstrual issues. Endometriosis occurs when tissue similar to the uterine lining grows outside of the uterus, most commonly on the ovaries, uterus and fallopian tubes. However, it has been found in every organ in the body. The tissue causes inflammation and can lead to organ failure if it not treated properly.

For Jenneh Rishe, BSN, RSN, endometriosis is an aspect of systemic injustice toward women rather than an individual health issue for many people with ovaries. Rishe, who is a nurse and is followed throughout the film, highlights the misogyny and racism that she experienced at the hands of her medical professionals. For instance, she would often take her partner, a cisgender white man, to all her medical appointments and visits throughout the film in order for doctors to believe her.

Other women in the film have an equally difficult time getting doctors to believe their pain. For Emily Hatch Manwaring, an events coordinator and the granddaughter of the later Senator Orrin Hatch, the treatments for her endometriosis caused osteoporosis. Hatch Manwaring was only a teenager during filming, and the film highlights the struggles she had in attending school and participating in life events.

Over 200 million women worldwide have endometriosis, which equates to about one in nine people with ovaries. However, 82 percent of gynecologists cannot identify the disease, leaving most endometriosis patients to suffer for years. The film demonstrates just how little doctors know about this disease, leading to stigmatization and a refusal to recognize women’s pain.

Women’s health conditions have not been given the attention they deserve … so we don’t have the answers that we need.

Shannon Cohn, producer of Below the Belt

The average length of diagnosis is 10 years in the U.S. During those years, women are falsely told that pregnancy is a cure for their pain, a hysterectomy will cure their disease or that they’re being hysterical. Endometriosis research receives significantly less funding than other diseases that affect just as many individuals, which is a systemic failure of the U.S. government to recognize women’s health and menstrual diseases. Because of both the lack of funding and research into treatments, as well as doctors’ misinformation regarding the disease, very little has changed to help women and girls who live with this debilitating illness.

Cohn was motivated to create this film after her own experience with endometriosis. “I have two young daughters that I’m very fortunate to have despite having endometriosis. Those two daughters, [it’s] frankly quite terrifying because they are at a seven times increased risk of having this disease. And it was when I learned this, the genetic link, after my second daughter was born. That’s what galvanized me to action.”

Below the Belt brings endometriosis to the forefront of reproductive justice and feminist activism. The film shows how much our medical and political system marginalizes issues that directly affect women who need proper care. It’s up to feminist activists to pressure doctors and policymakers to change how endometriosis—and all women’s health issues—are treated here in the U.S.

“Endometriosis is a disease rooted in taboo and stigma and bias,” Cohn said. “Traditionally, women’s health conditions have not been given the attention they deserve. They’ve been historically underfunded and under-researched, so we don’t have the answers that we need.”

“What can activists do?” she continued. “They can speak up, use their voice, draw attention to it. If they have endometriosis or other health conditions that are considered taboo to talk about it, confront the taboo head-on and say, No, this is something that we need to be talking about. And because no one has been talking about it, millions of people have been suffering for far too long.”

Feminist activists can start creating change for the endometriosis community by educating others about the reality of the disease. Thirty-three percent of women and 74 percent of men do not know what endometriosis is, nor can they identify any symptoms. For a disease that affects more than 10 percent of women, the societal knowledge about endometriosis is staggeringly low. By sharing knowledge with others and using this film as an informational toolkit, feminist activists can start creating change for people living with the disease.

Endometriosis, and other diseases that affect menstruation, must be at the forefront of creating change in women’s healthcare. The four women shown in this film, who demonstrated that endometriosis is truly a life-altering disease, bravely show their frustration with the current status quo. Below the Belt can be the catalyst for creating the change that so many girls and women desperately need.

Watch the first episode of Below the Belt on PBS or below:

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Maria Rovito is a Ph.D. candidate in American studies at Penn State University. She is writing her dissertation on the medical and social history of endometriosis through a feminist lens.