Happy Valentine’s Day!
I hope you are full of hearts (as my son says). This morning we had heart-shaped pancakes for breakfast and he brought a box of heart-shaped cookies for his preschool classmates. I made dozens of cakes and cupcakes and delivered them to other people’s sweeties around town. It’s a sweet day.
You know what else I love? Organizations that really advocate for women’s health. They deserve your love. They work hard on tiny budgets trying to do things like change Medicare eligibility and revise FDA guidelines for Plan B.
So this Valentine’s day, check out these fantastic organizations. Send them your money, forward the links to your friends, donate your time, subscribe to their mailing lists:
1. Breast Cancer Action. “The Bad Girls of Breast Cancer Activism.” They focus on environmental causes of cancer, refuse to be wooed by the empty promises of the pink ribbon, and create some really thought-provoking materials.
2. RH Reality Check. For when you want a dose of reality with your news about reproductive health.
3. National Women’s Health Network This one’s been around since the 70s and you don’t hear about them enough. They are always working on policy initiatives, and are a great resource for information about women’s health in general.
4. Big Push for Midwives A fantastic grassroots organization that is working tirelessly to pressure states to pass legislation that allows midwives to be certified and practice independently throughout the country.
5. The Mautner Project. Originally focused on providing resources and services to lesbians with cancer, this organization has expanded to address a wide range of health issues and is tailored specifically to the concerns and priorities of women who partner with women.
Share the love!
I don’t read too much non-fiction these days. Right now I’m speed reading Gone Girl . It’s kinda sorta okay but makes me feel like my brain is melting. I don’t really like Gone Girl, but I can’t stop reading it. It’s kind of like my sugar addiction.
To my credit, the last time I went to the library, I checked out Far From the Tree, Buddhism for Mothers and In the House of the Interpreter. But I haven’t read them yet. This summer I read everything Jamaica Kincaid ever wrote (except this one) . She is so perfect. But I also read The Happiness Project. Please don’t let me read Jodi Picoult. If I read Jodi Picoult, it’s all over.
Anyhoo, back when I was a full-time smarty pants, I spent countless hours reading nonfiction, I read about health. Particularly women’s health. There is so much out there, and I feel lucky to have been introduced to it. So in case you’re looking for something to read that’s not a white lady novel, here we go.
Ten great books about women’s health:
1. Killing the Black Body: Race, Reproduction and the Meaning of Liberty. Dorothy Roberts is a great writer. This book will help you understand the racist undertones of much of American political discourse about reproductive health and entitlement programs.
2. How the Pro-Choice Movement Saved America: Freedom, Politics and the War on Sex. Cristina Page. Best title ever
3. Cunt. Speaking of titles… okay, it’s a little crass and the language is tiny bit outdated, but Inga Muscio’s take menstruation, reproductive health and sexual freedom is still empowering
4. A Darker Ribbon. One of the most well-researched critiques of the breast cancer movement that is not preach or overly academic.
5. Reproductive Rights and Wrongs: The Global Politics of Population Control. This should be required reading for anyone working for — or wanting to work for — an international development organization.
6. The Spirit Catches You and You Fall Down : A Hmong Child, Her American Doctors and a Collision of Two Cultures. A can’t-put-it-down kind of read written by a journalist.
7. Testing Women, Testing the Fetus: The Social Impact of Amniocentesis on America. An ethnography of genetic counseling. A little bit on the jargony side, but still a good read.
8. Pathologies of Power: Health, Human Rights, and the New War on the Poor.Paul Farmer will make you want to try and save the world.
9. Safe Food: The Politics of Food Safety. You are what you eat. Marion Nestle.
10. How to Have Theory in an Epidemic: Cultural Chronicles of AIDS. Would get the award for best title if I hadn’t already given it to Cristina Page. Paula Treichler is one of my favorite smarty-pants writers.
And one bonus book…
11. Birth as an American Rite of Passage. Robbie Davis-Floyd. A classic. Read it.
What about you? What are your favorite women’s health books? What did I forget? And hey, what are you reading? I’ll forgive you if it’s Jodi Picoult.
So often, public health interventions are boring — recommend more education, evaluate an existing program, come up with a list of resources….yawn.
But although they don’t always make headlines, there are lots of fantastically innovative people working to improve women’s health. I’m always excited to see these types of projects which have the potential to do so much good.
Here are five truly different approaches to improving women’s health:
- Naturopathic Oncology. Seems like a contradiction, right? Wrong. I’ve been intrigued by efforts to initiate more natural approaches to cancer treatment ever since I researched breast cancer activism in graduate school and met the woman who started this great project. But apparently, naturopathic oncology has started to take hold in the more mainstream medical field, and the Seattle Cancer Treatment and Wellness Center actually has naturopaths on staff.
- Cultivating and caring for “mad gifts”. The Icarus Project has a completely unique approach to mental health. Rather than calling it “mental illness” they “envision a new culture and language that resonates with our actual experiences of ‘mental illness’ rather than trying to fit our lives into a conventional framework.” So important, and so rare.
- Midwifery and fertility services for the rest of us. Not surprisingly, most prenatal care is very straight-oriented. But Maia Midwifery takes a different approach, prioritizing the needs of queer families. I love that the approach is so radically different from some of the overly granola earth-mama stuff that is part and parcel of most midwifery practices. Also in California is ReCLAIM Midwifery, which focuses on transgender health. This is true innovation, but it will probably be a very long time before this approach is incorporated into mainstream prenatal services.
- Real sex education. Rather than the lip service paid to sex education that happens in schools, Scarleteen is a resource for teenagers that provides a wide range of resources. Created in response to 1998 abstinence only policies, the site uses message boards, tweets, Tumblr feed, SMS (and Facebook and even Pinterest) to connect with its audience, and has zillions of real life questions and answers. I hope it’s still around when my four year old is a teenager.
- Telling and talking. Speaking of four year-olds, after a completely useless preschool lesson on Martin Luther King Jr. (my son learned that King “changed our world” but had absolutely no idea why or how) he told the teacher that he would like to learn about where babies come from. Awkward. We took a trip to the library afterwards, and I satisfied his curiosity with a picture book called It’s so Amazing. But this isn’t the end of these types of questions, so I’m excited about this series of books developed specifically for families with children conceived with donor assistance.
What about you? Have you heard of exciting, cutting edge programs or innovations in women’s health?
So, I went to this yoga class a couple months ago at my local YMCA. The quality of the classes there is not consistent, but this particular one was pretty great. The teacher gave a very insightful talk about self-care. Why, she asked, don’t we take better care of ourselves? Even when we have the tools?
It’s a good question. A new study about baby boomers and their health reveals that even though folks in their sixties have a lot of the tools they need to stay healthy, they’re taking scads of medications. Only 13 percent say they are in excellent health, a sharp decline from just a generation ago.
Why is this? One explanation might be that they have high expectations of health, and this shapes their perceptions.
How we define health is so crucial. Is it the lack of pain? The lack of illness? Is it the seemingly unattainable way the World Health Organization defines it? If you feel healthy, are you healthy?
I’m not feeling that healthy.
I have no chronic health problems, I’m not on any medication, and I know how to cook healthy food. I don’t have health insurance. If I had health insurance, would I feel healthier? Maybe.
But really, my main health problem is that I’m almost 40 years old and I still don’t know how to take care of myself. I mean, sure, I know how keep myself alive, but making my health a priority is a major struggle.
When I was experiencing post-partum depression, I had to practically be dragged to the doctor’s office. Doing yoga is perpetually on my to-do list, but I only actually practice once or twice a month. I know meditation and breathing exercises are important, but I don’t make the time.
And my eating habits are terrible.
I am a lapsed vegetarian who used to be very health conscious about food. But over the past couple of years, I’ve hit new lows. Greedily wolfing down the occasional cheeseburger. Settling for turkey hotdogs and mac and cheese for lunch. Pepperoni pizza at a friend’s house, because hey, it’s a birthday party! I’ve even flirted with a Diet Coke addiction. And yes, I’ve indulged in way too much cake.
Let’s just say I’m not experiencing quantum wellness.
Last month I did my own version of an elimination diet to establish why the skin on my hands was acting crazy. Actually, I already knew why. It’s because I love butter. I have a love/hate relationship with butter, ice cream and cheese. I love it, my skin hates it.
But on the off-chance that it was gluten or sugar or eggs or turkey hotdogs, I cut out all animal products, gluten and sugar for an entire week. What happened next was not pretty. As much as I wanted to be peaceful and calm while I sipped my vegan smoothie and did breathing exercises, the perceived deprivation drove me batty. I paced the kitchen like a caged animal most afternoons, stuffing my face with almonds and dates even though I wasn’t at all hungry.
At the end of the week I realized two things:
- I am totally addicted to sugar. I should probably quit eating it–I could even buy a new cookbook (I love cookbooks)– but I’m afraid I wouldn’t want to live if I couldn’t eat sugar.
- I am definitely allergic to dairy products. After one week, the eczema on my hands went away. I started eating bread, eggs and meat and my hands were just fine. So I had some butter, and just an hour later, the eczema was back.
So, having figured this out, you’d think I’d just cut out dairy. And I did, for about one more day. But then I fell off the wagon. I realized that I have no commitment to the dairy-free goal. Yesterday I ate cookies made with butter, cream cheese on crackers, and even pancakes made with whole milk. And now my skin is suffering again.
Yes, butter is good, but it’s not that damn good.
The whole experience catapulted me into the painful admission that I’m bad at taking care of my own health. It’s a complicated thing, with psychological as well as physical elements. I can find a million ways to justify abdicating responsibility for my health: Self-care is just a first-world indulgence. Becoming vegan is just way too bougie. I don’t have time. It’s no big deal. I have other priorities. I like to have the freedom to cook whatever I want. My family doesn’t want to give up dairy.
But in the end, all this rationalizing is really about avoiding self-care. I’m cringing as I type. I hate self-care. It seems so corny. But hey:
Self-care is not self-pampering .
Self-care is not self-indulgence.
Self-care means choosing behaviors that balance the effects of emotional and physical stressors: exercising, eating healthy foods, getting enough sleep, practicing yoga or meditation or relaxation techniques, abstaining from substance abuse, pursuing creative outlets, engaging in psychotherapy.
Um, yeah. Choosing healthy behaviors is not exactly my strong point. Put like this, it makes me wonder, why am I so resistant to choosing healthy behaviors?
Apparently I think I need butter (and sugar) to survive. I really am afraid to give it up, because what the hell will that mean? That I’m a person who practices self-care? Will I even recognize myself in the morning?
I’m not ready to define health as a complete state of social, mental and physical well being, since I doubt I (or anyone else, for that matter) will ever achieve that goal. But maybe it means choosing behaviors that are good for you more often than choosing behaviors that are bad for you. I’m starting to realize that actually, it’s impossible to be healthy without some good old self-care.
What do you think? How do you define health? Are you good at taking care of yourself?
For almost two decades, breast cancer has been a very visible public health issue. Women over the age of 40 (or sometimes 50) are pressured by doctors, health advocacy organizations, friends, family and pop culture to submit to a yearly mammogram. It could save your life, we’ve been told.
We’re told not to worry about the discomfort or pain, the strangeness of having your boob squished like a pancake in a giant X-ray machine, the possibility of false positives. We’ve been reassured that the level of radiation to which we are exposed is minimal.
This insistence on yearly screening has seemed problematic to me for many years, in part because of my own observations working in the healthcare industry.
For a year, I had a job at the Family Medicine clinic at the University of Washington. My job was to check in patients, call in referrals, file their paperwork and be the friendly face they saw at the front desk.
One of the things I noticed was the number of scans that women were being asked to undertake. Full body bone density scans. Mammograms. Abdominal x-rays. Pap tests. The doctors offered (and sometimes directed) women toward an onslaught of screening tests. On the other hand, male patients were rarely sent for routine screening exams.
It doesn’t take a genius to guess that this might be an issue. After all, we have no reason to think that researchers or clinicians take women’s health more seriously than men’s health. Yet there is a history of putting women’s bodies under the microscope, of seeing them as breeding grounds for disease, of poking and prodding and monitoring.
This annoyance and irritation at the way female patients were treated by the medical field t propelled me into graduate school. Why was there such an interest in promoting mammography? What were women really getting out of it? What did the pink ribbon really mean?Do mammograms really save lives?
Turns out, the answer is no.
A new observational study published in the New England Journal of Medicine oncluded that mammograms don’t work. In his beautifully argued op-ed in the NYT yesterday, David Newman points out that although observational studies are not the gold standard, in this case the approach was strategic. The study confirms the conclusions drawn from a series of clinical trials: Mammograms might increase diagnoses and may increase treatment, but they don’t save lives. You’re just as likely to die from a breast cancer detected from a mammogram as you are from breast cancer you detect yourself.
So why do doctors and health advocates persist in pushing women to get the test?
Newman puts in this way:
[T]he trial results threatened a mammogram economy, a marketplace sustained by invasive therapies to vanquish microscopic clumps of questionable threat, and by an endless parade of procedures and pictures to investigate the falsely positive results that more than half of women endure. And inexplicably, since the publication of these trial results challenging the value of screening mammograms, hundreds of millions of public dollars have been dedicated to ensuring mammogram access, and the test has become a war cry for cancer advocacy. Why? Because experience deludes: radiologists diagnose, surgeons cut, pathologists examine, oncologists treat, and women survive.
While Newman doesn’t bring in a feminist or gendered analysis of this issue, it’s sitting right there, the pink elephant in the room. Just like the continued marketing of hormone replacement therapy, or the lack of non-invasive methods to detect cervical cancer, mammography has been accepted practice for so long because culturally, it’s perfectly fine to expect women to submit themselves to poking and prodding and examination.
What do you think? Have you had a mammogram? Will you get one (or stop getting one) after hearing about this study?
Back when I was young and idealistic, there was nothing I loved more than a good protest.
I vividly remember the first time I attended a demonstration — it was on Parliament Hill in Ottawa, Canada and were were protesting the incarceration of Nelson Mandela. After that, I was hooked.
I’ve marched against police violence in Seattle, white supremacy in Montreal, and sexual assault in Iowa City. I’ve taken back the night more times than I can count, and I’ve faced off against loggers (one of whom was wearing this T-shirt) in British Columbia’s Clayquot Sound as part of a protest against clearcutting.
I once demonstrated against impending restrictive abortion regulations in Seattle, and carried this sign:
On my way home, a young boy stopped me and asked me to explain what the sign meant. Awkward.
I used to get goosebumps and a thrill at the first sound of a good chant. I loved rousing speeches promising social justice, peace and equality. During the Bush
reign of terror administration, I took a bus from Iowa to Washington,DC to protest the invasion of Iraq. The experience was thoroughly exhilarating at the same time that it was extremely depressing. Enormous demonstrations were held all over the world, but we all know what happened in the end.
It was this lifelong interest in social justice that propelled me to seek employment in the non-profit women’s health field. When I finally got a full-time job writing for a major reproductive health and HIV organization, I was beyond excited.
But instead of rousing speeches and radical movement toward social justice, I found career climbers and male dominated board rooms. Public health initiatives seemed top-heavy and destined to fail, success was measured in tiny percentage points. People talked about “stakeholders” and “gender champions” and said things like “scale-up” and “roll-out” and “capacity building.”
The employees at this non-profit didn’t protest, in fact, they found protestors to be quite threatening. I was enlisted to help write a paper about the travesties committed by ACT-UP. And yes, dear readers, I did it.
This morning, there was an article in the L.A. Times about a group of young people disrobing in front of John Baynor’s office in protest of cuts to domestic AIDS funding. I found myself thinking about the importance of this type of dramatic, confrontational action. There’s no worry about funders disapproval or concern that you might be burning bridges with potential allies. This kind of action reminded me that there are still plenty of people who are able to concoct creative ways to engage with the political process, to express rage at inequality, and yes, even to demand social justice.
I’m not much of a sign-holder anymore, perhaps those kinds of actions are best left to the young and idealistic. But while I might not be one of the people who strips naked on Capitol Hill, I’ll always be sitting on the sidelines, silently cheering them on.
What do you think? Do you go to demonstrations? Do you think that protests like these are good tools for political change, particularly when it comes to health policy?
Yesterday was Veterans Day, and President Obama marked the event by laying a wreath at Arlington Cemetery.
The rituals of Veterans Day are all very scripted, solemn and patriotic. There are always serious faces, the requisite honoring of old men, the sporting of uniforms, remarks about freedom and sacrifice and America being great.
All in all, it’s a very male event.
But the military is changing. Since 9/11,over 200,000 women have served in Iraq and Afghanistan.
This means that there are a whole host of health issues that are now part of the military that weren’t before, and the VA medical system is struggling to keep up. According to the Service Women’s Action Network (SWAN):
Only 15% of women veterans use VA facilities. VA culture is still rife with male-bias, leading many women veterans to feel that the VA cannot properly attend to their gender-specific health needs […] Furthermore, VA healthcare is characterized by its “fragmentation,” meaning that women are not able to access comprehensive health services from their primary providers but rather must be referred elsewhere or travel enormous distances for routine services such as gynecological exams. Additionally, VA hospitals often foster uncomfortable, unwelcoming or hostile environments for women.
The VA is doing some work to address this, and for that they should be commended. The VA has initiated “Culture Change Campaign” complete with PSAs:
Still, the biggest health challenge faced by female veterans, however, is not figuring out where to get a Pap test, it’s dealing with the aftermath of sexual assault, often perpetrated by their own colleagues. As many as one out of three (!!) women leaving military service have reported being the victim of some kind of sexual assault. Rape and sexual assault continues to be a huge problem for women in all branches of the US military.
Part of this is because of the nature of military culture. To a significant extent, constructs of masculinity, of what it means to be a man, are built on domination of women. And the military is nothing if not a masculine institution. In her book Earth Follies, Joni Seager points out the “surprisingly transparent phallic imagery” that pervades military language: “soft laydowns, deep penetration, hard missiles.”
Is an army without rape even possible?
Even more disturbing is the fact that this epidemic of sexual assault is unequally distributed across the population, given that the US Army consists of an all-volunteer force. According to the Population Reference Bureau, while the most powerful predictors of who will serve in the military are survey responses indicating that people want to serve, or expect to serve, in the military, enlistment is also highly contingent on social class.
Children of college educated parents are less likely to serve. Those with higher high school grades are less likely to serve. African Americans and Hispanics are more likely to serve than whites. That means that an African American woman whose parents do not have a college education is more likely to enlist and be at risk for sexual assault than a white woman from an affluent family whose parents have a college education. Once again, health disparities are contingent on income and social class.
It’ssomething to think about amidst all the parades and noble speeches about the greatest generation.
What are your thoughts? Have you been in the military? Known someone who is? What do you think are the most pervasive issues female soldiers and veterans face?