A decree updates the catalog of medical exclusions for applicants who want to join the National Police Corps: it is the first time that endometriosis appears as a veto for those who want to join the National Police. In previous years, her medical exclusions did not include this gynecologic disease.
The measure of the Ministry of the Interior is unprecedented, since other bodies and security forces of the State do not prevent access to women with this pathology. The Mossos d'Esquadra, for example, vetoed endometriosis for the last time in 2017, but in their subsequent calls -in 2019 and 2021- they eliminated this impediment. In the case of the Civil Guard and the Army, endometriosis is considered as a cause of medical exclusion, although only in those cases where it is "incapacitating", a nuance that the recently approved regulation on the National Police does not contemplate.
A chronic problem that affects many women
Endometriosis is caused by the growth of the endometrium outside the uterus, that is, outside its usual place. During menstruation, it is shed, causing bleeding, regardless of where the tissue is located, which can cause pain, the main symptom of endometriosis. Other patients, who do not experience pain, discover that they have the disease when they cannot become pregnant. However, many cases tend to go unnoticed, partly due to the lack of social knowledge about endometriosis. Myths don't help either: sometimes it's considered normal to have severe pain during menstruation, when it shouldn't be. This creates a serious problem: according to the Asturias Health Observatory, the diagnosis of the disease can take almost a decade.
Usually, the causes of medical exclusion are regulated in the regulations on admission to certain public jobs, such as the National Police, the Civil Guard, the Army or the regional police, among other bodies. With these vetoes, it is sought that the candidates demonstrate an ideal state of health for the position they aspire to. But, sometimes, the medical exclusions contemplate impediments that are outdated or not adapted to the available scientific evidence, as various experts have criticized in the past. This is also the case with the veto now imposed by the Ministry of the Interior, according to sources consulted by Civio.
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“It's a real outrage,” says Maribel Acién, head of the Gynecology Section at the San Juan University Hospital (Alicante) and professor at the Miguel Hernández University. “That they put it as a general exclusion seems demeaning to me. Endometriosis affects a large number of the female population. It is as if they said that they exclude blondes, ”he says by phone. Various estimates suggest that 10% of women of childbearing age suffer from endometriosis -some two million people in Spain-, although a recent review indicates that the percentage affected is around 1-5%. For the gynecologist Juan Antonio García Velasco, "it makes no sense that 'endometriosis' in general is a reason for exclusion." “Lots of women have the disease, but most are not disabled. Some may even be completely asymptomatic, and others with medical treatment can lead an absolutely normal life”, explains the director of IVI Madrid and professor of Gynecology at the Rey Juan Carlos University. “It is not reasonable that such a frequent disease, so diverse and with such variable affectation, should be considered universally, it is clear that it is due to a lack of information”, he affirms.
“There are many women who can lead a normal life”, corroborates Emi Escudero, spokesperson for the EndoSpain collective, which brings together patients with this disease. At present, according to Acién, there is no treatment that cures endometriosis, but it is common for those affected to take anti-inflammatories to relieve pain, which can appear in different degrees. Sometimes the birth control pill is also prescribed, in order to keep your hormone levels relatively low. "When all else has failed, there may be some cases that end up in the operating room," adds the gynecologist, who points out that the percentage of patients who see their quality of life as highly conditioned is low, less than 3%.
To the problems that women with endometriosis can suffer is now added a decision that, for Emi Escudero, supposes "absolute discrimination" since it "leaves many women out". In addition, according to the EndoSpain spokesperson, the measure is discriminatory "because of the double yardstick" of public administrations. “The medical courts tell the patients who are worse off that they are fit to work in anything, and yet the National Police directly rule you out,” he criticizes. “Women with endometriosis should have the same opportunities, they should be the ones who decide to access the body or not. Otherwise their rights are limited”, explains Teresa Ruiz Cantero, professor of Preventive Medicine and Public Health at the University of Alicante. In the opinion of this health and gender expert, the approved measure is not equitable. At the time of writing this article, neither the Press Office of the National Police Corps nor the Ministry of the Interior had responded to Civio's questions.
The update also brings with it the disappearance of some diseases from the National Police's catalog of medical exclusions. For example, headaches are no longer considered a veto, while bronchial asthma is no longer an impediment for those who wish to access it, except in cases in which the disease is persistent, that is, in those patients who suffer asthmatic attacks. Frequently. Finally, the decree also vetoes all those who have phakic lenses. In practice, the measure excludes from the National Police those who suffer visual problems, such as myopia, to a high degree or have a very thin cornea, so that laser surgery is contraindicated. In these cases, the operation to correct vision consists of implanting intraocular lenses, now considered as a cause of medical exclusion to access the National Police Force. For the Unified Police Union (SUP), as published by El Norte de Castilla, the measure is understandable for security reasons. Less understandable is the decision for those who have paid for an operation that is around 6,000 euros and now see their professional aspirations frustrated overnight.