A Century of Being Unseen: The Women Medicine Left Behind

Content note: this piece touches on medical dismissal, misdiagnosis, and the historical treatment of women and girls.

There is a particular kind of exhaustion that comes from not being believed. The kind that sits alongside an anxiety you can't quite name, because no one has ever given you the right framework to understand it. Not just once, but across a lifetime. In doctors' rooms, in classrooms, in the quiet moments where you wondered if maybe they were right and you were too much, too sensitive, too difficult to understand. Many of us know that feeling. What most of us are only now starting to understand is how far back it goes, and how deliberately it was built.

Women have been told their pain is normal. That their emotional response to that pain gets labelled before the pain itself is investigated. That the reaction to being unwell, unseen, and unheard becomes the diagnosis, while the actual cause goes unfound. But the fuller truth is this: women's health has not been prioritised. Some studies were done and suppressed. Others were never conducted at all. Both were true at the same time, and sitting with that is uncomfortable, because it means the gap in our understanding was not always accidental. When knowledge is missing or buried, something else fills the space. And for women, that something has almost always been the same. It's all in her head. Pain and discomfort are just a normal part of our lives that we have to find a way to live with, and do it with a smile on our face. Because if we don't, we get labelled.

This is not a new story. It is a very old one. And if you follow the thread back far enough, you will find it woven into the history of medicine itself. You will find it in the word hysteria, taken from the Greek word for uterus, as though the very organ that defines female biology was also the source of female instability. You will find it in the way women who we now understand as neurologically different were called hysterical, dramatic, difficult, unstable. The medical dismissal, the misdiagnosis, the historical treatment of women and girls as though their inner experience was always the problem and never the signal.

Her name was Grunya Efimovna Sukhareva. She was a Soviet Jewish psychiatrist and neurologist who worked in Moscow in the 1920s, at a time when women in clinical research were deliberately overlooked, let alone celebrated. In 1925, she documented autistic traits in boys. In 1926, she presented her work on girls, published in 1927, going further than anyone had before. She noted that the presentation looked different, that the emotional experience was more complex, and that the diagnostic picture required a different kind of attention. She was thorough, she was accurate, and she was ahead of her time in ways we are only now beginning to fully appreciate. Being Jewish in that era, in that political climate, added another layer to what she was navigating. The systems that were designed to protect certain voices and erase others were very much in operation. And they worked. Her name was buried. Another man's name was elevated in its place, nearly two decades later, and even then, only for a specific presentation of autism in males. The work she did on girls was not built upon, not referenced, not carried forward. It was left behind. Just like the girls themselves. This is not an isolated oversight. It is a pattern. Medical advancement has moved forward for centuries, and women have consistently been left out of the picture. Maybe it was being unseen herself that allowed her to look deeper into the behaviours others were punishing. And you can feel that in the case studies. In the details she chose to notice. The girl who cried at night when no one could see her. The girl who wrote the same careful message in every classmate's autograph book. The girl who tested every new teacher to see if they would stay calm. These were not problems to be solved. They were people to be understood. Sukhareva saw that. The world never even considered it.

Her work on girls was written in German and Russian. It was not translated into English until 2020, and nearly a century passed before the English-speaking world had access to what she had documented. And in that century, generations of autistic girls went undiagnosed, misdiagnosed, or diagnosed so late that the damage of not knowing had already shaped their entire lives. They were called difficult, dramatic, oversensitive, and hysterical. They were medicated for anxiety and depression. Told their exhaustion was just part of life. Nobody looked underneath. The framework that should have existed to see them was never built. And the girls went unseen for many more decades.

I found out about Grunya Sukhareva from a comment on one of my social media ads about my book, When My Brain Is Messy. Not a research paper, not a conference, not a colleague. A comment. In October 2025, someone left a few words that I didn't fully understand at first. They wrote, in both English and Russian, "a century after Grunya Sukhareva published a description of autistic traits, Tania Wieclaw made it understandable for the rest of us, and the children too." I had never heard her name before. I later found that many people knew of her 1925 research on boys, but very few knew about her 1927 work on autistic girls. It had been hidden behind a paywall for nearly a hundred years and was only translated into English in 2020. Once I got access to her work, I realised what that comment actually meant. Someone had referenced me alongside a woman who deserved so much more credit than she was ever given. A woman who saw girls clearly, documented them carefully, and was quietly erased from the story anyway. I still think about that. That someone connected us. And that it came from a comment on my book ad, on a day like any other.

What struck me most when I read her work was not just the accuracy of it. It was the humanity. Sukhareva was working within the language and frameworks of her era, and yes, some of that language is clinical in ways that sit uncomfortably now. But underneath it, you can feel someone who was genuinely trying to understand these girls rather than contain them. She noticed the details that mattered. The ones that told you something real about what it felt like to be them. She recognised that environment played a significant role in how these girls presented, that difficult circumstances shaped behaviour in ways that needed to be understood in context, not pathologised in isolation. And she made an argument that I think about a lot, that hysteria should be removed as a symptom, because it was getting in the way of actually seeing what was there. She was not describing dramatic, unstable girls. She was describing girls whose nervous systems were working differently, who were responding in completely understandable ways to a world that was not built for them, and who kept being misread because the framework being used to assess them was never designed to find what she was finding. That feels uncomfortably familiar. Not just historically, but right now.

I am a 42-year-old autistic woman. I was diagnosed at 37 as AuDHD, with a PDA profile. I was not diagnosed as a child. I was not diagnosed as a teenager. I moved through the world collecting labels that were never quite right, experiencing a body and a mind that no one seemed to have the framework to understand, including me. And in October 2025, the same month I discovered Sukhareva's work, I had a hysterectomy. A surgery that was necessary because of adenomyosis and endometriosis, two conditions I wasn't diagnosed with until I was 41. It actually took longer for my physical pain to be taken seriously than it did for how I present as an autistic female to be recognised. Autistic females are already significantly underidentified and identified late. And yet it took extreme burnout, and my capacity dropping so low that I was almost catatonic, before either was investigated seriously. All of this while being the primary carer of two neurodivergent children, whose needs the system was also not adequately meeting. I had been told the bleeding was my new normal. I had been told the pain would improve after having children. Nothing was investigated. It took switching to a female doctor, who had been through menopause herself, to actually take me seriously. She referred me to a women's clinic with specialised imaging. And even then, what the imaging found was only part of what was actually there. It was only in surgery that the true extent became clear. My uterus had completely fused to my bladder. The surgery took over three hours. And I had been walking around, raising two kids, running a business, writing books, trying to show up, on a body that was quietly being depleted every single month. Nobody looked. Until someone finally did.

And this is where Sukhareva's observations about women ageing become painfully relevant. She noted that certain presentations became more visible in women as they got older. We now understand some of why that happens. Oestrogen does a lot of quiet, neurological heavy lifting. It supports the coping strategies and masking that many autistic women have been running, often without even knowing it, for decades. When oestrogen production slows down in perimenopause and menopause, that scaffolding comes down with it. And suddenly, things that were once manageable are not. Sensory sensitivities intensify. Executive function and capacity levels drop. Emotional regulation becomes harder. Women end up in consulting rooms being told it is anxiety, depression, carer's fatigue, or the stress of parenthood. What was actually happening was that a lifelong neurological profile was becoming visible for the first time. This is why so many women are only finding out they are autistic in their 40s and 50s. It was always there. The hormones were just quietly holding it together.

I am telling you all of this because it is not separate from Sukhareva's findings. It is the same pattern. A century apart, but the same story. Women's pain going uninvestigated. Women's neurology being misread. Women's inner experience being explained away rather than explored. The girls in Sukhareva's case studies were described as difficult, dramatic, and "negativistic". I was told my bleeding was normal and my burnout was circumstantial. Others are told to lose weight, come back in six months, or that stress is probably the cause. The language has changed. The mechanism has not. And this is not just my story. It is the story of countless women who are sitting in doctors' rooms right now, being handed explanations that don't fit, being told to manage, to cope, to come back if it gets worse. Women who are exhausted in ways that have never been properly investigated. Women who have been autistic their whole lives and are only finding out now, in their 30s, 40s, 50s, because the framework that should have existed to see them was buried a century ago and never properly recovered.

And that is where the anger lives for me. A quiet, heavy one. Because this information was always there. Sukhareva's findings existed. The research existed. What separated me, and so many women like me, from understanding our own neurology was not a lack of science. It was a lack of consideration. Our chromosomes determined what got prioritised, what got translated, what got carried forward and built upon. We had a right to this knowledge. We had a right to understand ourselves, our bodies, our minds, our children, without having to wait a century for someone to think we were worth the effort. And beyond that, we had a right to an understanding of neurodivergence that was never shaped around deficit, never built on the idea that something needed to be fixed. Sukhareva was not writing about broken children. She was writing about different ones. That distinction got lost somewhere along the way, buried under decades of pathologising frameworks that told us what was wrong, rather than helping us understand what was real.

Grunya Efimovna Sukhareva deserved better. So did every girl she documented. So do the women reading this right now who are only just starting to understand why their lives have felt the way they have. Her work was there. It was always there. And now that you know her name, I hope you say it out loud. I hope you go looking. I hope this is the beginning of something for you, the way that comment on my book ad was the beginning of something for me, on a day like any other.

Had you heard of Grunya Sukhareva before today? And how many of you have your own story of being dismissed, misdiagnosed, or told your pain was just part of being a woman? I'd really love to know. Join the conversation on my Facebook page.

References

Sukhareva, G. E. (1925). Die schizoiden Psychopathien im Kindesalter. Monatsschrift für Psychiatrie und Neurologie, 60, 235–261. Translated by Sula Wolff (1996). European Child and Adolescent Psychiatry, 5, 119–132.

Sukhareva, G. E. (1927). Die Besonderheiten der schizoiden Psychopathien bei den Mädchen. Monatsschrift für Psychiatrie und Neurologie, 62, 171–200. Translated by Charlotte Simmonds (2020). European Child and Adolescent Psychiatry, 29, 549–564.