Thank you, Chair and members of the committee.
My name is Yvonne Osagie. I'm the CEO of Med Melanin. We're a preventative digital health platform designed to support underserved women and caregivers to be better advocates when they go to the doctor and to teach women to be heard in rooms in which they have historically not been heard.
Imagine it's 7:40 in the morning. A woman is on her way to an eight o'clock shift at a long-term care home. She slept for about two hours after waking up at 1:00 a.m. drenched in her own sweat, and then she had to get up at 5:30 to get her kids out the door. This was the fourth night in a row this week. She gets on her feet and then starts her 12-hour shift of caring for other people's parents. She's a bit slower that day; she's been a bit slower for a while, and she has started to notice it. Her supervisor has noticed it as well.
There's nothing in this story that's within the woman's control.
In multinational studies of women aged 40 to 65, Canada has the highest rates of menopause-related sleep disruption measured anywhere in the world, at about 67%. This is where our national numbers go quiet. We say menopause costs the economy about $3.5 billion and 540,000 lost workdays, and those figures are real, but they also undercount. A lost workday is a woman who did not go into the office, but the figures do not count the woman who did go but whose productivity was impacted, the woman who could not afford to miss a shift or the woman who will always have to show up.
The second thing is that this burden is not carried equally. SWAN, the Study of Women’s Health Across the Nation, has followed American women through the menopause transition for about 25 years. It found that Black women reported the longest duration of vasomotor symptoms of any group studied.
We are not without Canadian evidence. A national study of 1,000 Canadian women commissioned by benefits insurer GreenShield found that 40% of racialized women did not know where to seek care, and only about one in three had ever discussed their symptoms with a health professional, compared with roughly half of women overall. She's less likely to know what is happening to her and less likely to raise it, and she will often minimize her own symptoms.
Everything we're discussing about workplace policy resets at an accommodation system level. An accommodation requires a request; a request requires a diagnosis, and a diagnosis requires a clinician. How does she get one? An estimated 5.9 million adults in the country don't have a family doctor or a nurse practitioner. However, for those who do have one, an estimated 41% of Canadian medical schools do not incorporate menopause education. If there's no provider, no diagnosis, no documentation, no accommodation and no data, every line breaks harder for the woman I just described.
There is new research out of Norway and Sweden called “The Menopause ‘Penalty’”. It found that earnings in Norway fall 7.4% by the fourth year after menopause is diagnosed. The same researchers also found something hopeful, which is that awareness and access to care increased in Sweden, with diagnoses rising by 29% and treatment rising by 50% when awareness was at the forefront. The entire benefit went to the women without a college education, which puts into place the socio-economic status.
There are three things I want us to think through.
First, measure it properly. Canada's first national menopause study of real scope is being built. The question for this committee is whether it's designed to disaggregate by race, by immigration status, by occupation or by sector. SWAN's original study excluded women who had surgical menopause, primarily Black and Hispanic women, and had to go back and make that adjustment. As Canadians, we have the opportunity to do that up front.
Second, fix the whole chain, not only the last link. Require menopause education in medical and nursing training. It's not optional. Pay clinicians for the time diagnosis takes, with the right incentives in the system. Cover medication, because the safest forms of hormone therapy are often the ones basic plans will not cover, which makes treatment a benefit of having a good job.
Third, build workplaces that do not require a woman to disclose in order to work while protecting every woman who does disclose with ventilation, cooling, predictable schedules and real breaks for folks who do shift work. Make these available to everyone so that they don't have to be requested by anyone. Create a low-friction route for women who do come forward, because they should not need a specialist letter to get a desk fan.
On the topic of the law, menopause is not named anywhere in Canadian legislation, but the grounds are, and they are the foundation on which we can get started. Sex, age and disability are protected, and the duty to accommodate is already attached to them. The foundation exists. What does not exist is that indication—the precedent of menopause.
The Ontario Human Rights Commission—
