More Than Breasts and Babies
Published March 11, 2009 @ 01:42AM PT
If you based your image of the female body on the literature about women's health, you'd come away thinking that the entire female body consists of breasts, uterus, cervix, vagina, and nothing else. Over and over, in research and advocacy efforts, women's health is treated as a reproductive issue. Women's health gets turned into maternal and child health, or reproductive health.
It's true that pregnancy and childbirth are some of the most risky times of a woman's life. But they're not the whole of a woman's life. It's insulting to focus on those experiences at the expense of everything else, and it's bad science to boot.
Women get cancer, and not just cancer of their breasts, cervixes, or ovaries. They get leukemia, lymphoma, malignant melanoma, brain tumors. They get osteoporosis at disproportionately high rates. They have heart attacks, and they respond to cardiac medicines differently than men do. They catch malaria even when not pregnant. Women face domestic violence, greater rates of poverty, and lack political representation. They lack opportunities for employment and education. In some parts of the world, they're not even allowed to leave the house.
In the face of all this, we focus only on the parts we care about, as though the entire field of health is a group of hormonal teenage boys with the Sports Illustrated swimsuit issue under the bed. We focus our health concerns on sexy parts like breasts and labia, and mommy parts like the cervix and the uterus. Genital mutilation is a horror, but it's not the biggest problem facing women. Neither is breast cancer, or for that matter, maternal mortality.
It's time to grow up, and treat women like human beings with more than four body parts.
(image credit: Marylin Shaikh)
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Comments (20)
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Author
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Alanna Shaikh has spent the last ten years immersed in global health; she has worked for NGOs, companies, universities, and the US government on projects that ranged from preventing antibacterial resistance to improving maternal and child health.
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Completely agree that women's health should be more inclusive. Through my consulting work, I advocate strongly in bringing more attention to women's cardiology, in addition to urogynecology, which is a socially difficult field even in highly developed areas of the world. (People generally don't want to talk about fecal or urinary incontinence.)
Posted by Khizer Husain on 03/11/2009 @ 11:03AM PT
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I agree that some issues you mentioned (osteoporosis, heart) should have more research/advocacy effort to explore and correct gender based disparities. And of course, domestic violence, poverty, and political representation deserve more action.
But I'm not sure that the "women's health" focus on reproductive organs and mother-and-child health is misplaced as far as medical research is concerned. Shouldn't all diseases that don't show gender based differences be addressed as "human health" issues?
Finally, I wonder what may have caused this phenomenon. "Growing up" will be easier if we knew what the cause of the current fixation is, and who exactly is fixated.
Posted by Chinmay Soman on 03/11/2009 @ 12:14PM PT
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The problem is, in my opinion, that the programs follow the research. So a project to improve women's health will also focus on reproductive health instead of looking at the whole woman.
Posted by Alanna Shaikh on 03/11/2009 @ 09:33PM PT
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read the part where she says cardiac medicines work differently in women then men. Because there is in fact more biological differenc than just our reproductive organs, and hear problems kill more women than any other health problem, yes, we need to address these as women's health. Because 'human health' generally translates to 'men's health'.
Posted by Navidad Arnett on 03/15/2009 @ 11:18AM PT
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heart, not hear and difference not differenc
Posted by Navidad Arnett on 03/15/2009 @ 11:19AM PT
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Part of the longstanding problem--that calls out "women's health," but rarely "men's health"--is that in most patriarchal societies any thing that relates to the human body was assumed to relate to a male body. Medical research, for decades, was performed only on men. That, of course, led to assumptions that women were reacting differently to medications that worked fine in the male of the species because of their "hysterical" inclination (in the classic sense of the word, having to do with uterii).
So when "women's health" was first called to attention, it was a sub-field of "general health," rather than an equal partner to men's health. Logically--if wrong-headedly--"women's" health was focused on the body parts women had that men did not have.
We know better, now, having studied and found the different drug responses in women and men... seen the different heart attack symptoms... observed and documented different fatality rates, response times, brain workings, etc.
In a sense, we are more equal now that we know how very different we are.
Posted by Laura Marshall on 03/11/2009 @ 03:23PM PT
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Laura, that's a great point.
Posted by Alanna Shaikh on 03/12/2009 @ 08:49AM PT
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I think it might be helpful if we would stop thinking about women's health and start thinking about gendered health (or 'sexed' health for the pedantic, but I for one don't care for the chicken-factory connotations of that one). Not only might this help to avoid the pitfalls that you describe, it might also help to approach gender-related health issues from a gender-neutral perspective: not all gendered health is women's health!
Posted by Michael Keizer on 03/11/2009 @ 09:12PM PT
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That's a great point.
Posted by Alanna Shaikh on 03/11/2009 @ 09:34PM PT
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Your point about objectification of women's body is very true and referrers to the medical sciences' approach towards women's health. The observation is important considering that very few times, social constructs such as patriarchy and caste are analysed for their effects on women's health.
Yet on the other hand, one of the important reasons for continued and constant focus on reproductive health is the fact that reproductive experiences occupy a significant space of overall life experiences of women. If one asks any women about the health issues she will most probably cite a reproductive problem (and most often the root cause of the problem would lie in under nutrition and poverty). Incidentally the very social constructs that objectifies women's body and eliminate her other experiences than those specifically pertaining to having woman's body also exclude her reproductive health issues and experiences from receiving recognition as serious health problems of our society. In my view, both these forces operate simultaneously.
Moreover a developing country like India cannot afford to forget that women still continue to die in a perfectly normal process like giving birth due to sheer negligence and apathy of the society towards women's health. We have a MMR of 407!!!
Posted by Satlaj Dighe on 03/12/2009 @ 08:07AM PT
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Well put. Women's problems are seen as entirely reproductive and then reproductive problems are marginalized.
Posted by Alanna Shaikh on 03/12/2009 @ 08:51AM PT
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While you make very valid points towards your position, I worry that you are only arguing semantics. I believe the term "women's health" came to fruition during a period of time when people were really uncomfortable talking about issues relating to female reproductive health. The expression "women's health" was more socially acceptable. Remember, it would be years before one would see tampon commercials on TV, and even today the commercials are more comical or distracting than direct and to the point. The medical community has branded these concerns as "women's health" but it does not stop them from looking at other issues that affect the health of women. You may be right in wanting a different term for female reproductive health, but I don't agree that it really has any bearing on what research is done. Both general female health and reproductive health need to be studied, and I don't share the concern that there is a focus only on issues relating to reproductive parts of women. It's a false statement in my opinion.
Posted by Katie Huber on 03/13/2009 @ 09:22AM PT
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A woman's body is meant to be bathed, cared for and have sex regularly
Posted by Otto VonAuchvetter on 03/13/2009 @ 11:01PM PT
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As is a man's body. Well, mine in any case.
Posted by Michael Keizer on 03/14/2009 @ 02:10AM PT
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The point of this article is well made, and highlights a larger problem with funding for health and other sciences. The cause or issue that garners the most press gets the most money. Large organizations exist to feed these money machines. These causes, though well meaning, have highlighted the need for their cause to have money at the expense of other equally or more worthy and fruitful avenues. Funding decisions should not be made on what is most popular, but instead should be made on scientific merit.
Posted by Chris Deckrow on 03/14/2009 @ 05:08AM PT
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Funding is an important way to look at what happens in medical research. With men, through male dominated corporate endities control the money needed for research. If two projects are presented to a board composed almost entirely of men and one is for prostate or erectal dysfunction while the other on women's coronary issues which do you think will get the funding?
Posted by Peggy Bell on 03/14/2009 @ 09:57AM PT
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As a woman who has Turner Syndrome, I particularly see this. I get constant mailers about 'reproductive' health, when all I want is basic gynecological care. But 'making babies' for the more wealthy is where the money is. It's always about the money. Money = research dollars.
Posted by Pamela Lieber on 03/14/2009 @ 05:00PM PT
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Most of your points are valid, but I think that the link between the reproductive system, hormones like estrogen, and their effect on women's health is not just something that men use as a method of gaining power over women. As a woman and a member of a family with several generations of doctors, (including my mother, who is an obstetrical gynecologic surgeon) all of whom follow the osteopathic line of thought, I believe that much more of women's health is directly related to reproduction than men's health is. Between puberty and menopause women's bodies have constant influxes of hormones that make it possible for them to support new people growing inside of them.
After menopause women's bodies change and they are more prone to osteoporosis, as you mentioned, and a this is directly related to the drop in hormones. Also, as commenter Laura Marshall mentioned, the term "hysterical" comes from a word for "uterus" because so many of women's mental health issues are related to their reproductive systems.
So, yes, men historically think of their health as "true health" and women's health as "sub-health" and sexism is an issue. Yes, women can get all of the same non-reproductive diseases as men can.
Yes, we should try to help every single woman in the world be more free in "opportunities for employment and education" and "political representation" and should find a way to allow all of them to leave their houses without thier husbands' permission.
However, if there is only one aspect of life that we can help these women with, I think it should be reproductive health. Dying in childbirth is still an issue, as is genital mutilation. If the world's attitude would just change a little bit, and if we didn't automatically think of Sports Illustrated when we think of women, then we could really grow up and look at the matter more objectively.
Posted by Erin Hoffman on 03/15/2009 @ 09:36PM PT
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I think your point is valid but dated. The idea that "women's health" is entirely focused on reproduction is rooted in old patriarchal thinking, but nowadays, I think it's just a semantic issue. If you want to talk about equal treatment, then we should have a "men's health" concern as well, and I would suspect that men's health would focus on reproductive issues too. If anything, "women's health" should not be its own specialization and should be grouped with reproductive medicine. We *do* look at women's health in every other organ system; we just don't put a label to it. If we did, then that would sound sexist too, as if the female body is so alien and different from a man's that it needs its own brand of medicine. Furthermore, when you consider the differences in light of clinical research or medicine, it's rare to see any statistical significance.
Posted by Beverly Tchang on 03/16/2009 @ 11:47AM PT
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In the developed world, heart disease kills more women than all the reproductive diseases combined. In the developing world, women often do not live long enough to develop heart disease. There are many more women living in poor countries than those living in the developed world. Risk is relative. HPV, pandemic in the world and several strains are responsible for cervical cancers, yet women in the developing world rarely even have access to basic screening.
Posted by R Gomez on 03/22/2009 @ 08:06PM PT
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