It’s Probably Not Cool to Be Infertile
New York Magazine had an article about “prestigious” diseases, or the hierarchy of disease. The author explains,
Physicians were asked to rate 38 categories of diseases on a prestige scale from 1 to 9, based on how they felt health professionals viewed the disease-category in question. In all three surveys, there was stability at the top: Leukemia, brain tumors, and myocardial infarctions (heart attacks) were the top three in all three surveys, though the order switched around. At the bottom were fibromyalgia, depression, anxiety, and cirrhosis of the liver.
I’m not sure where infertility falls on the actual prestige list, but I’m going to guess that it falls close to the bottom. The article goes on to summarize what gives a disease high prestige (at least, in Norway):
- “Non-self-inflicted, acute and lethal diseases with clear diagnostic signs, located in the upper part of the body, preferably the brain or the heart.”
- Diseases “associated with active, risky and high technology treatment leading to a speedy and effective recovery.”
- Diseases “associated with young patients, patients who accept the physician’s understanding of the disease, and whose treatment results do not involve disfigurement, helplessness or other heavy burdens.”
Infertility is not lethal and it involves organs in the lower half of the body. It definitely can be treated with what I would consider high technology, though perhaps IVF is not as cool as robotic surgery. And while infertility involves young patients in the sense that it is not a geriatric disease, I get a sense — based on my own experience — that people find family building a burden, whether that’s covering for them at work so they can get treatments or accommodating time off for maternity leave on the other end.
We want people to have babies, we just don’t want their babies to impact us in any way. It goes hand-in-hand with the societal message of children are precious angels and disruptive brats at the very same time. Infertility follows that duality of everyone should want a baby but no one’s attempt to have a baby should impact anyone else around them.
The most interesting thought in the article is that this idea of disease prestige impacts how doctors practice medicine. How they may subconsciously make decisions on your treatment. It’s not just what area of medicine draws the most people but how much energy doctors expend on what they perceive to be a simple case vs. a difficult case or a known fertility issue vs. an unknown fertility issue.
What do you think? The article gave me a lot to chew on, especially the role the patient could (would? should?) play when suspecting this sort of prestige bias.