Cure or aliment— and why accountability can no longer be avoided.
It takes just one comparison to expose the architecture of gender bias embedded in modern systems. Picture an elite male athlete. His performance load is treated as a national asset. He operates at what the world calls an 80% performance load.
And to maintain that load, he receives:
- physiotherapists
- massage therapists
- dietitians
- strength coaches
- mindset coaches
- sports psychologists
- sleep specialists
- oxygen therapy
- cryotherapy
- funded recovery schedules
- customised nutrition
- rest periods mandated by law
- entire institutions designed around his wellbeing
And if he says, “It’s too much,” what happens?
He doesn’t get diagnosed.
He doesn’t get medicated.
He doesn’t get told he is “not coping.”
He gets more support.
More oxygen.
More specialists.
More resources.
More infrastructure.
Because his performance matters.
Because his labour is seen as valuable.
Because the system recognises the structural load placed upon him and responds structurally, not clinically.
Now compare that to women.
Women carry an actual 80% load every day—measured, documented, and globally recognised—yet operate with none of the infrastructure afforded to elite male performers. The numbers, long ignored, are unequivocal. Women perform between 60% and 80% of all unpaid care and domestic labour worldwide, according to the International Labour Organization and OECD. Australian Bureau of Statistics data shows women perform three times the daily hours of unpaid work compared to men. Unpaid labour contributes an estimated $650 billion to the Australian economy annually, yet remains invisible to GDP. Even the “mental load”—the scheduling, remembering, planning, anticipating, organising—falls overwhelmingly to women, as confirmed in studies from University College London and the ABS.
And yet, when a woman finally says, “It’s too much,” the system responds nothing like a high-performance centre.
Women are twice as likely to be diagnosed with anxiety or depression.
(WHO Mental Health Atlas, 2021)
Women are prescribed psychiatric medication at 2× the rate of men.
(Australian Institute of Health and Welfare, 2023)
Yet none of the standard diagnostic tools used by GPs — GAD-7, PHQ-9, K10, DSM-5 criteria — include a single measure of:
• domestic workload
• unpaid care hours
• cognitive load
• household functioning
• partner contribution
• economic independence
• labour division
Not one.
This is not a medical gap.
This is a structural omission.
Women are performing at elite-athlete load every single day — with zero high-performance infrastructure.
Not a single standard diagnostic tool used in primary care includes questions about unpaid labour load, partner contribution, economic independence, or domestic imbalance. The system asks whether she is coping, never whether the scaffolding around her is collapsing.
This is the dominant narrative that has shaped the modern female experience: when men strain under load, they receive support; when women strain under load, they receive diagnosis. A male athlete operating at perceived elite intensity is given a team. A woman operating at proven elite intensity is given a label. The message is quiet but consistent: his environment must adjust, but she must. And because this has been the norm for generations, the structural reality has gone largely unchallenged.
The CWA lens exposes the truth beneath that narrative with forensic accuracy. Women are not operating at baseline. They are operating at high-performance capacity without high-performance infrastructure. They are the invisible workforce propping up economies, stabilising communities, enabling men’s productivity, and sustaining the daily functioning of society—all without rest cycles, without specialist teams, without professional recovery, and without acknowledgement that their load is structurally unsustainable.
If a male athlete had a workload equivalent to the average Australian woman—paid employment, unpaid domestic labour, caregiving, emotional regulation, cognitive logistics, and financial administration—every sports scientist on earth would shut down his training and demand intervention. Yet women perform this workload daily while institutions continue assessing the strain as individual disorder rather than structural causation.
The reframe is now unavoidable: if systems fail to measure the load women carry, they cannot ethically diagnose the consequences of that load. This is not philosophical. It is measurable. If GPs, clinicians, policymakers, and institutions continue assessing women without assessing the environment, the division of labour, the unpaid care burden, or the household structure, they are not practicing medicine—they are participating in systemic bias. Diagnostic pathways have become the shortcut that prevents systems from facing the structural redesign required. Clinical labels have become the mechanism that shields institutions from accountability.
And the most uncomfortable truth for those institutions? Once the data is acknowledged, they cannot go back. The evidence makes accountability non-negotiable. Women are not “failing to cope.” They are carrying elite-athlete loads with no elite-athlete support. They are sustaining the world with none of the infrastructure that sustains the men we publicly applaud. The hypocrisy is not abstract—it is structural, financial, and legislative. And the moment that hypocrisy is revealed, the system becomes responsible for correcting it.
This article marks the beginning of that correction. Accountability now requires new clinical standards that measure domestic and unpaid labour load. It requires new health pathways that address structural rather than individual causes. It requires policymakers to recognise unpaid labour as economic labour. It requires institutions to acknowledge that women are not the problem—the scaffolding is. And from this moment forward, the burden of proof shifts. Women no longer need to justify their strain. Systems now need to justify their failure to support it.
The sad reality is this is not metaphor. It is fact. But once fact is acknowledged, infrastructure must follow. And this is where it begins.
Read the Full Article:
The Gender Load Gap: Why Unpaid Labour Must Be Counted
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