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WHAT OUR HEALTH CARE SYSTEM FAILS TO RECOGNIZE ABOUT WOMEN’S PAIN
 
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Kayley Corley
September 16, 2025
The Progressive
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_ Preserving and expanding access to Medicaid—and improving
women’s access to health care—is a matter of life or death. _

, PeopleImages/Shutterstock

 

t was the spring of 2024, and on paper, I was a twenty-nine-year-old
with a glittering resume. I was a law student in Arkansas, with
clerkships, internships, and a previous career in public service. No
one who knew me back then would have described me as sick or
struggling with my health. In reality, I was desperately ill, and had
been for a long time. 

That spring, I had finally convinced a gynecological surgeon to
perform a routine laparoscopy to investigate the pelvic pain,
bloating, urinary urgency, and other symptoms I had been living with
for more than a decade. For years, doctors had waved it off with
non-urgent explanations: stress, cysts, hormones, diet. Nothing that
required more than ibuprofen and endurance. My surgeon expected to
find mild endometriosis, if anything.

But when the surgical team opened me up, they saw something they
weren’t expecting: a pelvis glued together by severe endometriosis,
and a tumor growing quietly on my ovary. I was quickly diagnosed with
an adult granulosa cell tumor, a rare form of ovarian cancer nobody
expected to find in a twenty-nine-year-old. There was no way to tell
how long it had been there, or where else it could have spread inside
my pelvic cavity.

That moment split my life into two parts: before cancer, and after it.
Before, I was a normal woman trying to keep up with what everyone
needed me to be. Afterwards, I was a young woman suddenly living with
cancer in a state where women’s health outcomes rank among the worst
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in the nation. In Arkansas and across the country, women are made to
rely more on luck for diagnosis and relief than they do on medicine.
If I hadn’t gotten lucky, I might be dead by now. 

My cancer was not the first time a woman in my family had been told to
wait, to cope, to accept suffering as normal. My mother spent her
twenties cycling through birth control pills and dismissive doctors
who told her heavy bleeding and late miscarriages were “just part of
being a woman.” My grandmother, too, was handed aspirin and silence
instead of answers. Three generations of us, carrying pain as if it
were an inheritance.

My grandmother never knew the reason behind her suffering. She
received a hysterectomy at the same time she gave birth to my mother
in 1969. My mother pleaded with her doctor to do something, anything,
for years. Finally, after a failed endometrial ablation
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procedure to stop her heavy menstrual bleeding, they discovered she
had a severe uterine septum. It was a birth defect that was present
her whole life, which separated her uterus into two parts. This
condition causes heavy bleeding, pain, and miscarriages. If she had
been diagnosed earlier, she would have had access to better treatments
and better care. When she had a hysterectomy, she was also diagnosed
with endometriosis. 

For women in Arkansas, medical neglect isn’t an anomaly. It’s the
standard of care. Arkansas also ranks among the worst states in the
country for maternal mortality, according to recent research published
by the Commonwealth Fund
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and the Centers for Disease Control and Prevention
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When it comes to ovarian cancer, more than 70 percent
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of women in Arkansas are diagnosed at a late stage, after treatment
options become limited and survival rates plummet. By the time most
women in my state know they have gynecological cancer, it’s already
too late for early intervention.

Unfortunately, the infrastructure needed to change these outcomes
barely exists. Half of Arkansas is considered to be a maternity care
desert
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without any birthing facilities or obstetric clinicians. While 35
percent of all U.S. counties are considered maternity care deserts,
nearly 51 percent
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of the counties in Arkansas do not have access to obstetrical care. 
To make matters worse, 66 percent
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of rural hospitals in Arkansas are at risk of closure due to pressing
financial constraints. These financial struggles are largely
attributed to inadequate reimbursement from patients’ private health
care plans, an issue that will be exacerbated by the passage of the
new One Big Beautiful Bill Act
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While these rural hospitals are currently held afloat by government
reimbursements for Medicaid patients, the legislation will cap
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these payments and force state Medicaid programs to reduce
reimbursement, further devastating rural hospitals’ finances. With
the closure of even more hospitals, more women in small towns will be
forced to drive hours for even basic screenings or prenatal visits.
Government-supported research projects have tracked
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these disparities for years
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kept up with need.

The pain that my doctors wrote off as stress or “just cysts” was
actually endometriosis
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disease in which uterine lining tissue begins growing outside of the
uterus. Endometriosis can spread to multiple organs, causing
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severe pelvic pain and fertility complications. By the time my
endometriosis was finally recognized, it had wrapped itself around my
bladder, colon, and ovaries, twisting and tethering them in ways that
made daily life unpredictable.

Endometriosis affects an estimated one in ten women
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reproductive age, yet diagnosis in the United States still takes an
average of
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seven years from the onset of symptoms. In that time, organs can
become permanently damaged
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I lived that reality. I was collecting degrees while collecting
diagnoses, trying to prove I was both brilliant and believable. 

Experts in obstetrics and gynecology have been trying to raise
awareness and funding for these issues for years. A 2004 report in
_The Lancet_ concluded
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“There will probably be a new repertoire of approaches for treatment
and perhaps cure of this enigmatic disorder in the near future.” In
reality, there has been very little change in how endometriosis is
treated in the twenty years since that article was published. The
National Institutes of Health has documented systemic disparities
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care since. 

The inequity is especially stark when comparing endometriosis to
conditions that primarily impact men. Studies show men are more likely
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in the emergency room, while women are more likely to be told their
symptoms are psychological [[link removed]].
Appendicitis and related symptoms in men are treated as an emergency
in ER departments. With that condition, patients are often given
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medication, antiemetics, and booked for surgery. Crohn’s disease is
monitored aggressively
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with scans, scopes, and surgery by specialists and primary care
providers. But when women describe the same intensity of pain tied to
gynecological concerns, they are told
[[link removed](21)00035-3/fulltext] to
endure it with little to no medical management. In emergency rooms,
studies show that women wait longer
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for treatment, and their pain is more likely
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to be attributed to anxiety. Nationally, women are underrepresented
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trials, meaning the drugs and devices prescribed to us are scarcely
tested
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on bodies like ours.

In Arkansas, a near-total abortion ban
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leaves virtually no exceptions for women’s health emergencies. This
is even true in cases where a pregnancy threatens a woman’s health,
but is not clearly life-threatening
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This legal and cultural climate shapes the care women receive,
narrowing their options for reproductive care long before a crisis
arises. 

The very first gynecological oncologist I saw spoke like I wasn’t in
the room, recommended that I try for babies as soon as possible, and
prescribed birth control of all things. The next surgeon told me that
my pelvis was a wreck, and emphasized that there was no point in
trying to have a child based on my health status and the risk a
pregnancy would pose to me. He recommended a total hysterectomy. In
Arkansas, my diagnosis wasn’t about me as a person. It was about my
ability to have children. That was an odd thing for me to grapple
with, considering that fertility-preserving treatments are often out
of reach for women who don’t fit the traditional mold, and I was one
of them. 

When I expressed interest in receiving onco-fertility care, I found
that insurance in Arkansas does not require coverage of fertility
services
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for single adults, even if they have cancer. If I had been married
with a proven track record of wanting children but unable to have
them, insurance would have been forced to pay. Because I was single,
my fertility status didn’t matter. This happens to many cancer
survivors. This led me to push the state legislature to pass
legislation similar to a bill Texas recently passed
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These kinds of insurance gaps make matters worse for all women, not
just the ones needing fertility care. Arkansas has one of the highest
rates of Medicaid-covered births, with more than
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40 percent of births covered by Medicaid in 2023. Despite this,
Arkansas is the only state in the nation without
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twelve-month postpartum Medicaid coverage. Many women fall through the
cracks
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between what is covered and what is actually needed.

None of these patterns of women’s medical neglect is new, and none
of them is isolated to the backwaters of Arkansas. These trends are
systemic and national, costing lives that could be saved.

When my father was diagnosed with laryngeal cancer, his care was
immediate and coordinated. Surgeons, oncologists, and speech
specialists lined up to help him. No one doubted his pain. No one
questioned whether his body deserved intervention.

My experience of care was the opposite. By the time I heard the word
“cancer,” it felt less like a diagnosis and more like confirmation
of what I already knew: The system was never built to save me. Women
like me aren’t statistical outliers. We’re the evidence.

The state of women’s health care in Arkansas is simply an extreme
version of what women across the country endure on a daily basis.
Still, we see headlines questioning the decline
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U.S. birth rates. Women can’t have babies if we’re dead, and the
current public policy in Arkansas seems to be maximizing that
likelihood.

Survival should not depend on luck. But for women in Arkansas, and for
women all over the country, it still does.

_Kayley Corley is a native Arkansan. She is deeply committed to
advancing reproductive justice and reducing preventable maternal and
infant deaths. Check out her Substack: ‘She Didn’t Die.’_

_Since 1909, The Progressive has aimed to amplify voices of dissent
and those under-represented in the mainstream, with a goal of
championing grassroots progressive politics. Our bedrock values are
nonviolence and freedom of speech._

_Based in Madison, Wisconsin, we publish on national politics,
culture, and events including U.S. foreign policy; we also focus on
issues of particular importance to the heartland. Two flagship
projects of The Progressive include Public School Shakedown
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to resist the privatization of public education, and The Progressive
Media Project [[link removed]], aiming to diversify our
nation’s op-ed pages. We are a 501(c)(3) nonprofit organization. _

* women's health
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* Medicaid
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* Arkansas
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