Fighting the “Bog Standard”: Intersectional experiences of gender and disability discrimination within healthcare among women in Scotland

Accumulating evidence highlights that gendered health inequalities are shaped by structural and interpersonal discrimination. Existing research also suggests that disabled people suffer worse healthcare experiences and outcomes than the remainder of the population. Despite women being more likely to have a chronic illness or disability than men, and women more frequently experiencing dismissal and disbelief about their health conditions and pain, there is a scarcity of evidence surrounding the healthcare experiences of disabled and chronically ill women. Through four focus groups (n=14) and 28 semi-structured interviews, we explored the links between discrimination and health among women in Scotland. We used intersectionality as a theoretical and applied framework to zoom in on the experiences of women with a chronic illness or disability, integrating other axes of inequality where relevant. We argue that these women occupy a particular position of amplified discrimination within healthcare, which is borne out of sexist and ableist framings of what constitutes a ‘healthy’ body. Weight blame is one neoliberal logic used in healthcare contexts that restricts disabled women’s access to referrals, diagnosis, treatment, support and respect. To navigate these discriminatory healthcare systems, women advocate for themselves, alter their behaviour and balance sometimes conflicting presentations of self. We articulate how these experiences are likely drivers of entrenched gender and disability inequalities. • Women with a chronic illness or disability experience healthcare discrimination • Sexist and ableist framings conceptualise the ideal ‘healthy’ body • Weight blame is a core logic through which these women experience discrimination • These experiences create distinct barriers to timely treatment and dignity • Challenging systemic intersectional discrimination could improve women’s health