In Conversation with Royal Women's Hospital CEO Sue Matthews

One day, an hour after the final call for visitors to leave, Professor Sue Matthews — now CEO of Royal Women’s Hospital — found a man by his wife’s bedside in the gynaecology ward she was working at. After asking the man politely to leave, Matthews noticed he had tears in his eyes.

“My wife and I have just spent seven years and $35,000 trying to obtain the dream we just lost. You want me to leave her to grieve alone?” he said. It was in reference to the dilation and curettage procedure his wife had just endured following a miscarriage.

The moment struck an emotional chord with Matthews, who vowed from then onward to rethink the way women’s health is managed — both under her watch and in a broader, societal context.

“I will never forget it. What seemed like a simple procedure from a medical perspective was life-altering for the woman and her husband. I realised then that we had been doing things wrong for years, by asking the women’s partners to leave,” she said.

Since then — and following an extensive career in forensic sexual assault — Matthews has advocated passionately for the better treatment of women in the healthcare system.

She now sits on several committees, including the National Women’s Health Advisory Council and Victoria’s Women’s Health Advisory Committee, where she also chairs the Women’s Pain Inquiry.

In each role, she takes a stand against inequities in women’s health care. Medically, these include the 20–30% higher rates of misdiagnosis among women and the four additional years it takes for women to get diagnosed, relative to men.

Experientially, they include issues like medical gaslighting and pain minimisation.

Stigma, politicisation and research bias

When asked where these inequities stem from, Matthews points to historically biased practices within governments and medical research.

“We have seen recently, in the USA, how women’s health — in particular their sexual and reproductive health — is often politicised, in a way that men’s never is,” she said.

“We have also seen in our lifetime terms like ‘hysteria’ — which stems from the Greek word ‘uterus’ — being used as formal medical diagnoses.

“What’s less visible is the ongoing exclusion of women in medical trials. This is often justified on the basis of women’s hormonal volatility — but, in my view, this is the very reason women should be the focus of medical trials.”

Lessons hard-earned

Indeed, although 70% of the people who experience chronic pain are women, 80% of pain studies are conducted on men or male mice.

This has already seen catastrophic health outcomes for women.

In 2016, researchers noticed that a sleeping pill, widely prescribed in the USA, was causing a spike in road accidents the morning after women had taken it.

The drug was being metabolised differently by women, but this side effect had been missed in the trial regime, given the exclusion of women participants.

Major health issues, like heart attacks, are also rarely considered through a woman’s lens.

“When we hear the term heart attack, we tend to conjure up an image of a person clutching their chest when, in reality, women can experience cardiac arrest very differently. For women, it often presents as indigestion, shoulder, neck or tooth pain,” Matthews said.

A consequence of this is that women’s pain is often not taken as seriously, she added.

“Women presenting with pain can be perceived as hysterical and are more likely than men to be given antidepressants or antianxiety medication, instead of the treatment they actually require.”

Driving change

While Matthews is excited to see women’s health issues being taken more seriously over time, she says there is a way to go before they are given equal weight to men’s. To help drive this change, she is advocating for the inclusion of women participants in all future medical research.

“This is one of the most impactful ways we can improve health equity for women,” she said.

“At the very least, the public should be made aware if a drug has been approved on the basis of male-only trials.”

However, her efforts do not stop at the broader, policy level.

Just this month, Matthews sent an email to key government leaders reporting that a national shortage in migraine medication would disproportionately affect women. She also works tirelessly to ensure that daily care at the Royal Women’s Hospital is delivered without bias or judgment.

“The reason we have a standalone women’s hospital is not just to provide four walls of care. It is to make sure we are adequately supporting the most vulnerable patients and advocating for health equity,” she said.

A mother to two girls and a grandmother to one, Matthews said her drive to improve health equity will never wane.

And, on days where she feels disheartened by the slow pace of change, she thinks back to that night on the gynaecology ward and remembers her ‘why’.

Image source: Royal Women's Hospital.