“It will be $400,” says the gynecologist’s receptionist coldly.
My card hits the machine with a thud.
Oh.
After that, rent and bills, I'll have about $100 left to play until my next paycheck.
Since I began bleeding heavily in my early teens, I have racked up tens of thousands of “multidisciplinary care” bills while trying to suppress the debilitating pain.
Like many people with adenomyosis and endometriosis, I was used to confusing directions and cold prodding from strangers.
But exorbitant personal expenses still sting.
When I moved to Sydney from Queensland earlier this year, I found myself navigating a different public health system too.
Queensland has a clear referral criteria for its state system, while New South Wales has criteria in general gynecology “in 2026”.
A month before spending $400 at the gynecologist, I visited a new GP in Sydney for abnormal bleeding and pain.
A battery of tests came back normal, with the exception of the polycystic ovary syndrome (PCOS) indicators, but the doctor insisted that my symptoms required a specialist ultrasound and a referral to a gynecologist.
She took one look at my address and said I would have to refer me privately because my local health district doesn't have a public option.
I asked her what people in my zip code should do if they need a gynecologist but can't afford one, and she acknowledged that one hospital in the area can sometimes squeeze in public gynecology patients.
While I was waiting for an answer about my referral to the government gynecologist, I went for the ultrasound recommended by my GP which cost $540.95 with a Medicare rebate of $95.95. This left me $445 out of pocket.
It wasn't a big shock; I've had expensive ultrasounds before. My previous one cost $350, of which Medicare only covered $90.50.
In 2020, my first gynecologist in Brisbane told me that treatment options for chronic pelvic pain were like an “iceberg”, with no quick fix.
She handed me a detailed list of multidisciplinary care referrals that I was to attend to before my next appointment.
A month later, my life under the iceberg of pain relief looked something like this:
-
Cost of long-term consultation with a general practitioner: US$198; $84.90 Medicare rebate.
-
Gynecologist: US$350; $78.05 Medicare rebate.
-
Ultrasound: US$350; $90.50 Medicare rebate.
-
Psychiatrist: $340 for half-hour appointment; Benefit of $130.85.
-
Dietitian: $222.95; and they insisted that I buy two supplements for $100.
-
Pelvic floor physical therapist (two visits): $95 for half-hour session ($190) and pelvic floor exercise product for $68.
-
CBD oil: $155 out of pocket, not covered by the Pharmaceutical Benefits Scheme (PBS).
Excluding these measly discounts, my total bill this month was $1,589.65.
This does not include the cost of other pain relievers, medications, or foods and supplements offered to relieve inflammation.
I was a 19-year-old university student working two part-time jobs. When I left my parents' private health insurance plan, the cost of supplemental insurance became untenable—and it didn't cover most specific women's health services anyway.
Back in modern-day Sydney, $445 out of pocket for a pelvic ultrasound, I waited another month to see if I could get on the government gynecologist's waiting list.
Concerned about my symptoms and not hearing from the public system, I gritted my teeth and returned to my GP ($88.90; $43.90 discount) for a temporary referral to a private gynecologist.
In context, abnormal bleeding and pain can be a sign of problems that threaten life and fertility – which is why GPs tend to refer to specialists when a patient develops these symptoms, even though they are common in patients with adenomyosis, endometriosis and PCOS.
I borrowed $400 and went to a private gynecologist, who prescribed me new medications and asked me to schedule a follow-up consultation.
After seeing a primary care physician for abnormal bleeding before seeing a gynecologist, my costs were already $868.75 after the Medicare rebate for six weeks:
-
Two GP visits: $238.80; Medicare rebate: $128.90.
-
Ultrasound: $540.95; Medicare rebate: $95.95.
-
Gynecologist: 400 US dollars; Medicare rebate: $86.15.
Then my faith in the government system was officially destroyed.
Two weeks after the private appointment, I received an automated refusal message from the hospital: “We confirm that we have received your referral from [GP name]. Unfortunately, our service cannot meet your current needs.”
It said that “additional information” had been sent to my GP and I would need to contact him for “more details and to explore other options.”
When I contacted my GP's office they said my private appointment had “solved the problem” so a public referral was unnecessary. I continued, justifying this by saying that my chronic incurable diseases require constant, expensive treatment.
I never heard from my GP about why the first referral was declined; I just received a message from New South Wales Health a second referral was received. I'm still waiting to see if I can get on the public waitlist.
This incredibly isolates bleeding funds from healthcare costs while literally bleeding.
While I'm pursuing my dream career, I'd like to save my salary to travel the world instead of spending it on medical services meant for people outside my demographic just to avoid being struck by lightning bolts of pain.
Despite National action plans To cope with diseases like endometriosis, which affects at least one in nine girls, women and people with AFAB, and even with the advantage of education and an urban zip code, I still don't have thousands of dollars in my pocket.
I'm not alone. Data is limited, but 2019 national online survey found that the average cost of treating chronic pelvic pain in Australia could be between $16,970 and $20,898 per woman per year.
To manage our symptoms, we must take the right supplements, follow the ideal diet, exercise, see our specialists—and pay for every step.
Then, when women do make it through the doors of the government system, we often still have to navigate it. medical misogyny.
March 2024 #EndGenderBias Survey Summary Report found that treating conditions in women is disproportionately expensive, with much of the treatment not funded by the public system. As well as paying more, two thirds of Australian women experience gender bias or discrimination when accessing health care.
For those with fewer resources to navigate bureaucratic outreach and advocacy, including BIPOC, rural residents, and non-native English speakers, the divide is even starker.
We assume that healthcare is free in Australia, but the system is harsh on people with chronic gynecological conditions, as if access to basic well-being is a luxury item.
Health reporter Natasha May's series investigating specialist fees confirmed my experience of being caught in the Medicare “safety net” and exposed the excessive burden on my shoulders. personal expenses was a widespread national problem.
Why is it our responsibility to be perfect patients and expert bureaucratic navigators while screaming in pain?
