Could Women Be Facing "Election Uterus" as a Stress Response to Trump's Policies? | Vanity Fair

On June 27, 2024, Katie had a familiar, terrible feeling after watching President Joe Biden debate Republican opponent Donald Trump.

It wasn’t just the sinking dread that many felt after that debate, where Biden’s poor performance became a catalyst for Biden stepping aside in the presidential race and instead endorsing his vice president, Kamala Harris. Katie (whose last name has been omitted, like other patients I spoke to for this article, to protect her medical privacy), a 32-year-old with what she describes as a “boring” medical history, was hit with extreme pain in her stomach, so bad that she got dizzy, felt like she was going to pass out. She had felt like that once before, on September 26, 2016, another night that she watched Trump in a debate, that time against then-candidate Hillary Clinton.

She had an ovarian cyst, and it was bursting.

“We had been watching the debate, and then I got kind of overwhelmed, and we turned it off,” she told Vanity Fair of that night in 2016. First, she thought she had food poisoning. Then the pain got so bad that she worried that it was something much worse. Emergency room doctors suspected, then ruled out, appendicitis. It was only on a later follow-up with her primary care physician, comparing scans, that they pinpointed a ruptured ovarian cyst as the cause of her pain.

So when nearly eight years later she woke up in the night after Biden’s deflating debate performance, she recognized what was happening.

Katie believes both occurrences may be her body responding to the ongoing stress of the election, and perhaps to the specific threats against bodily autonomy. For the sake of this piece, which is based on anecdotes from various sources, conversations with medical experts, and research about stress’s impacts on the body, but not on any existing named medical condition that you’d find in a peer-reviewed journal, let’s call it Election Uterus. (Or, by the shorthand I gave it, to my editors’ terrified delight: Election Ute.)

Of course, it’s not funny. In the past two elections, reproductive freedom has been a core issue, and the 2024 decision may largely be a referendum on the repeal of Roe and the continued rollback of women’s rights under a Trump administration.

When I floated my theory to various social circles, I heard from a friend of a friend who had a six-week-long period following Trump’s 2016 win; another woman I ran into while shopping gasped “oh!” and then told me she’d been having some new symptoms.

I spoke to medical providers, researchers who study menstruation, group chats, and even former Planned Parenthood president Cecile Richards, and they all agreed: policies on the ballot may be taking a physical toll, especially on people with uteruses.

Dr. Theresa Rohr-Kirchgraber, an internist who has been practicing since 1991 and is a professor of medicine and a past president of the American Medical Women’s Association, pointed out the myriad and cascading effects that long-term stress can have on a body’s systems, including not only reproductive functions but digestive, cardiac, nervous processes and more. Existing in a state of fight-or-flight forces your body to reshuffle its basic bodily functions to prioritize whatever it decides is most critical to your own individual survival. And when that fight-or-flight response goes on for months or years? Things get weird, and potentially dangerous.

“With that level of fear and anxiety, the issue is that what happens to the whole rest of the body, including the uterus, is that level of stress really increases your heart rate,” she told VF as an example. “And if your heart has to work a little bit harder and pump a little bit stronger, it can wear out over time. If you have this low level of stress consistently, every time you turn on the TV, or every time you see his orange face in front of you, [and] it makes your heart go faster, and then that leads to things like arrhythmias or irregular heartbeat. It can lead to heart failure over a long period of time.”

Dr. Lara Hart, a board-certified OB-GYN who has practiced in Georgia for 13 years, and is in a leadership position in her hospital’s medical fellowship program, told VF that, when it comes to patient care, “these elections are the worst I’ve ever seen.”

“It’s not even just the funny periods, it's more women than I remember in a long time coming in with ‘I skipped my period last month,’ or ‘I had breakthrough bleeding,’ or ‘my period was longer, my period was heavier,’” she said. “It’s all these things, but then it's also the fact that I have more women than I feel like I ever have that are anovulatory, not able to get pregnant because they're just not ovulating. They're skipping so many periods. You do blood work and stuff, and it's like, you know, they don't have PCOS. Everything looks fine, there's nothing really to explain it. They're just not ovulating.”

She spoke of patients with unexplained weight gain, heightened anxiety, low libido, and more.

“I've got patients with IUDs in, they call up because they're like, ‘I haven't bled for, you know, three years, and all of a sudden I'm having a period every month,’” she said. “More often than not now, I tell patients, stress does crazy things to your body.”

M, a 35-year-old woman in Louisiana who asked to be identified by her first initial for privacy, told VF that though she has a Mirena, a hormonal IUD that can prevent pregnancy for up to eight years and typically makes menstrual cycles something of an afterthought in regards to physical symptoms, has experienced it.

“I've got even less of a period for the past few months, like nothing, but I have been having insane period symptoms, like, almost every day,” she told VF. “I'm like, Oh God, I've got to be starting my period. And then I haven't, and then I just, I just cramps, like everything.”

She lives in a firmly red state, and says of her election anxiety, “I feel it in my body.”

“You can’t tell me that a Trump presidency isn’t a trauma,” she said.

Beginning the day Roe was overturned, Hart recalled, “We were putting IUDs in like crazy. You put 90 a day in. I had young women coming in saying, ‘I want my tubes tied.’”

M says she called her own gynecologist immediately for an appointment, “literally that day,” to get her Mirena renewed two years early.

“She said, Well, you're not really due for one. And I was like, given the landscape... And she was like, Oh, I get it, yeah. Here we go,” M said. “Thank God for sympathetic providers.”

She was warned that she was subjecting herself to “kind of an unnecessary medical procedure.”

“I was like, I might be, I might not be. It's too scary being here and wondering if even the Mirena is going to be at risk.”

Kate Clancy, a professor of anthropology at University of Illinois Urbana-Champaign and the author of Period: The Real Story of Menstruation, described the election cycle to VF as “months and months of incredible stress,” and pointed out the scientific links between chronic stress and inflammatory responses like elevated cortisol levels. “That kind of heightened stress just sort of chips away at your well being,” she said, taking energy away from other systems, like reproduction. And the end of that stress isn’t necessarily in sight.

“I think a large number of us are going into this Tuesday knowing that regardless of what the actual electoral college says is who the winner is, that doesn't mean the next couple months are not going to be scary as shit,” Clancy said. “So we've been enduring months of stress, but we also have the anticipatory stress of looking ahead to the next several months and not knowing what that brings either.”

Cecile Richards, the former president of Planned Parenthood who is continuing her reproductive freedom advocacy as the co-creator of Abortion in America and the co-founder of abortion access bot Charley, called the election “a long-haul fight.”

“There's so much on the line in this election,” she wrote in an email to VF. “So, yes, millions of women—and their family members and doctors and community members—are incredibly anxious about the results of this election. Because it's deeply personal.”

“As women recognize what some of the symptoms are and that they can relate it to, you know, election stress or concern, then that also helps to say, ‘Okay, I'm not crazy,’” Rohr-Kirchgraber said. “When Trump started running, the division that has happened, the anger, the hate, the animosity, I just had never seen before. The stress that they came in with.”

Again and again, I saw people shift from skepticism to realization while we spoke about this phenomenon. I repeatedly heard the word “crazy” used as a self-descriptor when connecting their physical symptoms with their emotional state, a self-undermining tendency with deep historical roots. The word “hysteria,” after all, originated in the female belly: It comes from the Greek hysterikós, meaning “suffering in the womb.”

Hart voiced concern that the repeated blows to the state of public health, including contentious elections, restrictive policies, and the impact of COVID-19, will be something from which the population can never fully recover.

“I don't know if things will get better, if things settle down, if things really start to move forward, I don't know,” she said. “Or have we really just broken people in a way that, like, we can't get it back?”

“[I’m] definitely seeing kind of these changes over this last year of just a lot more anxiety, a lot more fear, and even this week, these last couple of days, everyone just seems to be holding their breath waiting,” she said.

Rohr-Kirchgraber, too, expressed frustration at legal limitations about care that she’s able to provide, where “first, do no harm,” butts up against the threat of losing a medical license or facing jail time.

“I feel like [politicians are] standing in my exam room, telling you what to do. And they didn't go to medical school, [they’re not in] health care,” she said. “Why are they here with me? I don't need them, and neither do my patients. They need to be able to make the appropriate decision that works for them, and I need to be able to get them to the care that they need.”

“I feel like a part of my joy and my optimism was kind of destroyed” by the results of the past two elections, said Katie, the mom whose ovarian cysts ruptured. “I can't imagine it being worse than it is, which might be why my uterus decides to explode every time there's the possibility of it getting worse.”

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