Diagnosing difficult women and pathologising femininity : gender bias in psychiatric nosology

As the outspoken, difficult woman of the 16th century was castigated as a witch, and the same woman in the 19th century a hysteric, in the late 20th and 21st century, she is described as 'borderline' or as having PMDD. All are potentially stigmatising labels. All are irrevocably tied to what it means to be 'woman' at a particular point in history. And whilst the 19th-century hysteric was deemed labile and irresponsible, as a justification for subjecting her to the bed rest cure or incarceration in an asylum (Ussher, 2011), women diagnosed as borderline today are often considered to be mentally disabled, subjected to involuntary institutionalisation or medication, as well as being stripped of child custody or parental rights (Becker, 2000: 429), and women diagnosed with PMDD are medicated with SSRIs (Steiner and Born, 2000). At the same time, a diagnosis of borderline can be used as a justification for denying women access to mental health care, because of supposed 'resistance' to treatment (Morrow, 2008). However, if we examine the negative consequences of contemporary bio-psychiatric 'treatment' for many women (Currie, 2005; Ussher, 2011), this may not be such a bad thing.