When the System Hurts: Medical Trauma, Pelvic Pain and Reframing Distress in Emergency Care
Tracks
Ballroom 1
| Monday, August 31, 2026 |
| 1:25 PM - 1:45 PM |
| JW Grand Ballroom |
Overview
Haddy Hughes, NSW Health
Three Key Learnings
1. Recognise distress in chronic pelvic pain as a contextual and adaptive response to prior healthcare experiences, rather than intrinsic pathology.
2. Identify how emergency department systems and biases contribute to medical trauma and diagnostic overshadowing.
3. Apply trauma-informed, patient-centred strategies to reduce re-traumatisation and improve care in acute settings.
Speaker
Dr Haddy Hughes
Emergency Medicine Specialist
NSW Health
When the System Hurts: Medical Trauma, Pelvic Pain and Reframing Distress in Emergency Care
Abstract
As both an emergency physician and a woman with chronic pelvic pain, I have seen how quickly distress is labelled, and how rarely it is understood.
Patients presenting with chronic pelvic pain to emergency departments are frequently labelled as “anxious”, “frequent presenters” or “difficult”. These labels often obscure a more important truth: for many, distress is not pathology, but a rational and conditioned response to repeated experiences of dismissal, disbelief and inadequate care.
This presentation explores medical trauma and system-related distress through a dual lens: as an emergency physician and as a healthcare consumer with lived experience of pelvic pain. Drawing on clinical practice, patient narratives and emerging evidence, it examines how emergency care environments can inadvertently reinforce distress through time pressure, diagnostic uncertainty and implicit bias, particularly in the context of gendered pain.
Reframing distress as contextual rather than intrinsic allows clinicians to better understand patient behaviour, reduce diagnostic overshadowing and avoid re-traumatisation. In high-pressure settings such as the emergency department, even brief interactions can either perpetuate harm or create psychological safety.
This session will provide practical, trauma-informed strategies that can be applied in time-critical environments to improve communication, validate patient experience and support more equitable care. It will also invite reflection on how clinicians can shift from asking “what is wrong with this patient?” to “what has happened to this patient within our systems?”
Patients presenting with chronic pelvic pain to emergency departments are frequently labelled as “anxious”, “frequent presenters” or “difficult”. These labels often obscure a more important truth: for many, distress is not pathology, but a rational and conditioned response to repeated experiences of dismissal, disbelief and inadequate care.
This presentation explores medical trauma and system-related distress through a dual lens: as an emergency physician and as a healthcare consumer with lived experience of pelvic pain. Drawing on clinical practice, patient narratives and emerging evidence, it examines how emergency care environments can inadvertently reinforce distress through time pressure, diagnostic uncertainty and implicit bias, particularly in the context of gendered pain.
Reframing distress as contextual rather than intrinsic allows clinicians to better understand patient behaviour, reduce diagnostic overshadowing and avoid re-traumatisation. In high-pressure settings such as the emergency department, even brief interactions can either perpetuate harm or create psychological safety.
This session will provide practical, trauma-informed strategies that can be applied in time-critical environments to improve communication, validate patient experience and support more equitable care. It will also invite reflection on how clinicians can shift from asking “what is wrong with this patient?” to “what has happened to this patient within our systems?”
Biography
Dr Haddy Hughes is an Emergency Medicine Specialist practising on Gadigal land. She is passionate about advancing equity in healthcare, with a focus on improving emergency care for patients with chronic pelvic pain, including endometriosis. Her research explores patterns of emergency department use among patients with pelvic pain and co-existing mental health conditions. Haddy holds certificates from Harvard University in Reducing Racial Disparities in Healthcare and Effective Writing for Healthcare, and has published on FGM/C, endometriosis and patient-centred care. She is an executive member of the Advancing Women in Emergency Medicine Network and advocates for more inclusive, trauma-informed healthcare systems.
