October is Black History Month in the UK, and the 2026 theme, Honouring Our Communities, invites us to recognise the people whose everyday contributions shape, support and sustain Black life across the country (Black History Month UK, 2026). For people living with endometriosis, that includes the community organisers, peer supporters and researchers who are documenting something many Black patients already know from experience: being believed about pain is not evenly shared.

Endometriosis is now understood as a chronic systemic inflammatory condition that affects the reproductive system, with effects on metabolism, inflammation and pain processing that reach well beyond the pelvis (Taylor et al., 2021). The same review notes that diagnosis is typically delayed by years and that misdiagnosis is common. For people from ethnically diverse communities, the evidence suggests the wait is longer still.

In March 2026, Cysters and Endometriosis UK published Disbelieved, Dismissed, Delayed, drawing on 351 survey respondents from ethnically diverse communities in the UK and ten in-depth interviews. Respondents waited an average of 11 years for a diagnosis, compared with a UK-wide average of 9 years and 4 months, a difference of 1 year and 8 months (Cysters & Endometriosis UK, 2026). More than two thirds (68 percent) believed their ethnicity had played a role in their diagnosis, had been a barrier to it, or had prompted assumptions by healthcare practitioners, and only 11 percent felt that healthcare providers were culturally sensitive and responsive to their needs. The report covers ethnically diverse communities as a whole, so these figures should not be read as specific to Black respondents.

Part of the problem is that the evidence base itself is uneven. Endometriosis UK’s 2023 diagnosis survey received 4,371 responses, of which 79 percent were from White respondents and 2 percent from Black or Black British respondents, a profile the charity described as not illustrative of the ethnic diversity of the UK (Endometriosis UK, 2024). The 2026 report was designed to begin closing that gap.

A systematic review and meta-analysis of 20 studies found that Black patients had lower odds of an endometriosis diagnosis than White patients (odds ratio 0.49), while the authors cautioned that research on race, ethnicity and symptoms, treatment access and treatment response remains scarce (Bougie et al., 2019). A lower diagnosed prevalence is not the same as a lower occurrence. When a diagnosis depends on being listened to, examined and referred, who appears in the statistics depends on who is heard.

Research outside endometriosis shows how this can happen. In a study of White medical students and residents in the United States, around half endorsed at least one false belief about biological differences between Black and White people, and those who did rated a Black patient’s pain as lower and made less accurate treatment recommendations (Hoffman et al., 2016). That study used patient vignettes rather than endometriosis care, but it shows how assumptions can shape clinical judgement about pain.

Experiences of NHS primary care, which is typically the first point of contact for people seeking a diagnosis, point in the same direction. A 2025 NHS Race and Health Observatory report found that 49 percent of respondents felt treated differently by primary care because of personal characteristics, that around half of Black Caribbean and Black Other participants reported discrimination based on ethnicity, and that approximately one in five participants rarely or never trusted primary care to meet their health needs (NHS Race and Health Observatory, 2025). This report was not specific to endometriosis, but it describes the setting in which many diagnostic journeys begin.

My own doctoral research, which is not yet published, explores these questions through the experiences of minoritised participants with endometriosis. I will share what we find once it has been through peer review.

Cysters is a community-led charity founded by Neelam Heera-Shergill, which works to challenge cultural taboos and systemic inequalities by creating safe, inclusive spaces that bring together lived experience, education and advocacy (Cysters, n.d.). Its partnership with Endometriosis UK is an example of what the Black History Month theme asks of us: recognising and resourcing the people who are already doing the work.

The 2026 report makes recommendations that deserve wide support. These include a maximum diagnosis time of one year by 2030 with equity-focused measures, research funding that represents ethnic diversity, equitable access across specialist centres, and mandatory, ongoing cultural competency training for the NHS workforce (Cysters & Endometriosis UK, 2026).

Being believed should not depend on who you are. This month, we are honouring the communities working to make that true, and we are committed to listening.

Black History Month UK. (2026). Black History Month 2026.

Bougie, O., Yap, M. I., Sikora, L., Flaxman, T., & Singh, S. (2019). Influence of race/ethnicity on prevalence and presentation of endometriosis: a systematic review and meta-analysis. BJOG: An International Journal of Obstetrics and Gynaecology, 126(9), 1104-1115. https://doi.org/10.1111/1471-0528.15692

Cysters. (n.d.). About.
https://www.cysters.org/about

Cysters & Endometriosis UK. (2026). Disbelieved, dismissed, delayed: Endometriosis diagnosis inequalities in ethnically diverse communities. Endometriosis UK. https://www.endometriosis-uk.org/sites/default/files/2026-03/Cysters%20Endo%20UK%20Report%20A4%20v3.1%20interactive.pdf

Endometriosis UK. (2024, April 15). Endometriosis diagnosis delays in People of Colour. https://www.endometriosis-uk.org/endometriosis-diagnosis-delays-people-colour

Hoffman, K. M., Trawalter, S., Axt, J. R., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between Black and White patients. Proceedings of the National Academy of Sciences, 113(16), 4296-4301. https://doi.org/10.1073/pnas.1516047113

NHS Race and Health Observatory. (2025). Patient experience and trust in NHS primary care. https://www.nhsrho.org/wp-content/uploads/2025/03/TRUST-IN-PRIMARY-CARE-REPORT.pdf

Taylor, H. S., Kotlyar, A. M., & Flores, V. A. (2021). Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. The Lancet, 397(10276), 839-852. https://doi.org/10.1016/S0140-6736(21)00389-5