Kat THEOPHANOUS (Northcote): It is with a great sense of pride and gratitude for the women who came before me in this place that I rise to speak in support of this motion, which marks 100 years since women won the right to stand for election to Victorian Parliament. I wish women right across Victoria a very happy International Women’s Day today. Of course just over 100 years ago I would not have been welcome in Parliament House. As a young woman, a mum, a woman from a migrant background, standing to speak and be heard on issues of the day would have been unthinkable back then. Women had no political voice and few protections from harms or rights in the workplace, and for our First Nations women, they had no rights at all – a dark thing to remember. So I would like to begin by acknowledging the work of First Nations women across our state, their strong leadership, their advocacy, their work on the front lines of critical services, all instrumental in the charge towards equality, against gendered violence and for the self-determination of Aboriginal-led services.

We cannot address gender equality and health inequalities without addressing the compounding and disproportionate impact of discrimination that First Nations women continue to experience. It is only by acknowledging our collective history and past harms and listening deeply to the voices, stories and wisdom of First Nations women that we can move forward and achieve real change. I know that I stand on the shoulders of the strong, powerful women who came before me and who continue to surround me.

As others who have spoken on this motion have noted, decades of action, including affirmative action, have meant that 54 per cent of Labor members of Parliament are women. This extends to the cabinet, where 64 per cent of ministers are women. Labor women in this Parliament have led some of the bravest and boldest reforms in our state, things like workplace manslaughter legislation, voluntary assisted dying, the circular economy, free TAFE, wage theft legislation, medicinal cannabis, family violence reform and treaty. I cannot emphasise enough the tangible difference it makes to have women in government, in the caucus room, in the cabinet, in our departments, in councils, on our committees. Truly representative democracy inherently leads to better decisions. Over the last few years, with women in the room, we have seen some incredible progress: a Royal Commission into Family Violence, a nation-leading gender equality act, the introduction of gender-responsive budgeting, free kinder reforms, the inquiry into economic equity for Victorian women, affirmative consent models and Respectful Relationships programs, and gender parity on paid government boards.

But we know there is more work to do. The pandemic exposed persistent and pervasive structural inequalities and barriers that continue to impact women today. Women across the world were shaken by the Roe v. Wade decision in the US, and housing, economic security, wellbeing and physical safety continue to be real and deeply felt concerns for women across the country. But as I speak with women in my community and as I listen to the debate today, I am not discouraged by the road ahead; I am heartened to know that there are so many of us striving, fighting and working together to go further, push harder and achieve more.

As the Parliamentary Secretary for Women’s Health, I am focused on bringing equity to our health system. Women and girls make up more than half our population, yet even after centuries of truly world-changing research and medical advancements, women’s health continues to be impacted by gender bias, medical ignorance and an exclusion from medical research. A historical focus on males and research, taboos around sexual and reproductive health as well as pervasive gender bias have all contributed to a medical system that is not gender-inclusive, and it is hurting women. Too often women’s symptoms are ignored, health issues are minimised or disregarded entirely. All it takes is a quick scan of the hashtag #MedicalMisogyny on social media to see thousands of stories from women of sexism and ignorance impacting their care, and I would wager that every single Victorian woman would either have experienced or know someone personally with their own story of this.

This lived experience is supported in the research. We know that there are sex and gender differences in susceptibility to certain diseases, the way we respond to treatments and medications, as well as symptoms for general conditions, yet the male experience is still overwhelmingly cast as the default in everything from discovery research to treatment in emergency and the very diseases that we look at. As Dr Sarah White, the CEO of Jean Hailes, has noted:

We intuitively understand that small boys are not the same as men, but for some reason, we treat women as if they’re small men.

Women are a staggering 75 per cent more likely to experience adverse reactions to prescription drugs than men, we are twice as likely to suffer from chronic pain conditions and we are more susceptible to Alzheimer’s, autoimmune diseases and challenging conditions like rheumatoid arthritis and multiple sclerosis. Yet women’s pain and symptoms of disease are more likely to be diagnosed as psycho-symptomatic or mental illness, harkening back to diagnoses of hysteria. Women are very familiar with having to strategise ahead of a visit to the doctor to try to make sure we are taken seriously, for fear that we will be told that we are overreacting or that we are making it up. We know that these disparities in treatment and health outcomes are only compounded for women facing intersectional barriers, like our First Nations women, the LGBTIQ community, women with a disability, women living in regional and rural Victoria and women from multicultural backgrounds.

Endometriosis is characteristic of how gender gaps in health care can play out for women. For those unfamiliar with the condition, it occurs when tissue similar to the lining of the uterus grows outside the womb, usually in the pelvis but it can migrate to other parts of the body. The condition can lead to inflammation and scarring and cause organs to stick together, causing intense pain, heavy bleeding, bloating, fatigue, anxiety and depression. Around one in nine women and girls will suffer from endometriosis by the time they are 40, but it still takes seven years on average for a woman to be diagnosed. The symptoms are brushed aside or misdiagnosed as mental health conditions or IBS, or women are told that they are normal. Endometriosis costs Australians about $9.7 billion annually in lost productivity and direct health costs. At the individual level persistent pain is preventing women from fully participating in work, sport and daily life.

I remember the immediate and visceral reaction to the menopause speech in Fleabag, ‘Women are born with pain built in.’ So many felt that to be true. Periods, sex, Pap smears, IUD insertion, birth, breastfeeding, miscarriage, menopause – pain has been seen as part of the package. But just as we should not and do not accept the inevitability of the gender pay gap, we should not and must not accept the gender pain gap. To be clear, this is not about sexist doctors or uninterested researchers; rather, it is about a structural legacy that has created a system which is sex and gender blind, and it will take courage, leadership and critical structural change to address this. The status quo simply is not good enough.

It is why the Andrews Labor government is taking action to make sure that women’s health gets the funding and focus that it deserves, and I was very happy to join the Minister for Health this morning at Northern Hospital, where we spoke with midwives and researchers who have used a small grant to co-design abortion care for women from multicultural backgrounds. At the last election Labor put forward our ambitious plan for improving women’s health. Central to this plan is improving access to quality care, culturally appropriate care and close-to-home care. We will deliver 20 new women’s health clinics and expand our existing sexual and reproductive health hub network to 20 sites. These new clinics will be one-stop shops for women needing treatment and advice on issues ranging from contraception to pelvic pain, polycystic ovary syndrome, endometriosis and menopause. To ensure culturally appropriate care and equity of access are built in from the start, we will also create a dedicated Aboriginal-led women’s health clinic with our First Nations partners as well as a mobile clinic to reach rural and remote Victorians. We will also double the number of surgeries for endometriosis over the next four years and invest in more support for women living with chronic conditions. We are supporting our health workforce with new scholarships. We will also lead a fundamental shift in medical research with a new women’s health research institute.

We now have an opportunity to build a legacy in women’s health, and we will continue to strive to make our health system more equitable for women and girls who live in Victoria. We will also do that by establishing an inquiry into women’s pain management – an opportunity for women across Victoria to share their lived experience of this and to be heard. This is a truly exciting and humbling time, and I look forward to supporting it.