Out of Time, Out of Place: Premature Ovarian Insufficiency and the Experience of Gen- dered Ageism Special Issue: Gendered Ageism in Healthcare: A Critical Analysis of Structural Inequities

Background Premature ovarian insufficiency (POI) confronts cisgender women with menopause before the age of 40, placing them outside normative temporal expectations of the female life course. While its biomedical and psychosocial dimensions are well documented, less attention has been paid to how POI is shaped by age- and gender-based assumptions embedded in healthcare systems. Methods This qualitative study draws on a constructivist grounded theory approach based on narrative interviews with eight women who entered menopause between the ages of 24 and 38. Informed by feminist phenomenology, the analysis examines how embodied experiences, social norms, and healthcare encounters intersect in shaping interpretations of POI. Results POI emerges as a profound temporal dislocation, with participants describing their bodies as ageing “out of sync” with their chronological age and social environment. This desynchronization disrupts biographical expectations and contributes to internalized ageism and feelings of un/belonging. Biomedical frameworks offer limited interpretive resources beyond deficit-oriented understandings, while healthcare encounters are frequently marked by misrecognition and epistemic injustice, as POI falls outside age-normative clinical expectations. Conclusion The study conceptualizes POI as a site of gendered ageism, showing how intersecting age- and gender-based norms shape women’s experiences of their bodies, identities, and life trajectories. Ageism operates less through overt discrimination than through internalization and structural invisibility. Addressing these inequalities requires more inclusive clinical frameworks, improved psychosocial support, and greater recognition of diverse temporalities of ageing across the life course.