Learning to Embrace Complexity: Contemporary Issues in Women’s Health

Midterm paper for “Contemporary Issues in Women’s Health” with professor Arisika Razak Spring 2004

Perhaps it is not mere coincidence that the last century has been marked by both women’s growth into their own power, and a scientifically forced paradigmatic shift towards complexity and wholeness, but rather an illustration of the role perspective plays in determining our lived reality. As the powers of feminine holism wax and patriarchy wanes we see greater opportunities for the inclusion of not only women themselves, but also a more general sense of multiplicity, which ushers in care and attention to the voices of the disadvantaged, disabled and disregarded souls oppressed by the hierarchical powers of capitalism and science. However, the “might makes right” attitude that, most likely, ushered in the era of patriarchy will not allow this era’s quiet demise. Power by violence metanarrative will instead exacerbate its attempts to maintain control and certainty in the face of its quiet, steady engulfment by the unavoidable complexities which characterize the subjugated reality of the feminine. The victims are already uncountable, but as we explore the rising tide of the feminine in science with authors Christiane Northrup, Richard Perez-Pena, John Robbins, and Marianne Legato, it is impossible not to note the failings and resulting victims of our continual entrenchment in our own era.

The first two chapters of Christiane Northrup’s classic tome, Women’s Bodies, Women’s Wisdom address the failings of medical science as nested within the addictive system of patriarchy and offer an alternative vision of how medicine might function by honoring the feminine intelligence of holism, universal equality and cooperation rather than violence. Northrup offers a few token statistics which broaden the scope of her inquiry, but for the most part she sticks to the mainstream norm. She notes a study that acknowledged the difference in suicide rate due to spousal abuse for black (one in two) and white women (one in four). (Northrup, 5). By including statistics from other countries such as China (Northrup, 5), she draws attention to the fact that the devaluation of the feminine is global. Unfortunately, however, these were the only two such mentions I came across, and the bulk of her evidence comes from the upper middle class – a lawyer or a graphics designer, her regular patients and friends.

While Northrup profoundly conveyed important information based on her knowledge and experience, one can further draw out the inherent hierarchical structure in which she is embedded by acknowledging what was not readily available for her to include in her research and the connections she didn’t draw out. Specifically we’ll look at her delineation of the three beliefs of the addictive system of patriarchy: “disease is the enemy”, “medical science is omnipotent”, and “the female body is abnormal”.

In the “disease as enemy” section she focuses primarily on military metaphors and “violent” treatments. Another direction this section could have taken would have been to recognize that the war on illness often becomes the war on those people with illnesses. Often illness is a result of the conditions of poverty and powerlessness, and to wage war on people in these conditions is to beat someone when they are down, thus feeding the very culture of abuse and ill health which we seek to avoid in warring with disease.

Secondly, the section on the “omnipotence of medical science” where the doctor is seen as an omniscient God, could have further elaborated on the additional complexities of denial of an individual’s bodily authority when that individual is disabled. When working as a case manager for mentally ill people, one of my clients who was borderline, blind, epileptic, and in a wheel chair, as well as quite cognizant, intelligent, funny and dramatic, continually battled to be listened to by doctors who routinely tried to deny her reports of pain. How were the doctors to know how an IUD device would feel to someone who has spent most of her life in a wheelchair, likely establishing a very different internal arrangement than a walking person upon whom the device norms are certainly based? The realms of uncertainty unattended to when one’s primary concern is maintaining authority widen with greater deviation from the norms of medical research. This yields a high degree of uncertainty to women inhabiting greater extremes of deviation including disability, color, youth, age, various cultural and geographic backgrounds, increasing the likelihood of suffering caused by an authoritative medical structure.

This increase in the inapplicability of medical science as one deviates from the norms of medical research participants, is further exacerbated by the third belief of the addictive system, the “abnormality of the female body.” Perhaps the greater belief here is that abnormality is “bad”. This, once again, when reconstrued with the consideration of power structures reveals the “norm” as defined by those in power, further exercising their ability to disenfranchise and disempower those already on the periphery. Again we see the perpetuation of that which we ignore and fear because of our very attempts to make it go away.
In Northrup’s handling of the utilization of feminine intelligence in healing, she neglects to acknowledge how these practices might or might not work for marginalized women. Do they have the time, energy, or luxury of support systems to be able to face past emotional traumatization? Can they afford not to? Addiction is often a survival method for people. Is there a chance that breaking out of the addictive system might endanger their survival? Perhaps ignoring the messages of pain from one’s body is the only way to make it through the day and get the food on the table. Are their circumstances where the power of the mind can deny the body’s complaints and actually reverse the progress of the physical ailment? Is there a certain wisdom of acceptance evidenced in people who are unaccustomed to being able to control everything in their lives? These are some of the questions which might better serve women whose life constraints prevent them from being able to fully break out of the addictive system. Perhaps there are more feasible ways in which they can integrate a new way of health into their lives.

Additionally there is the consideration of the intersection of patriarchy with, not only science, but capitalism. As Northrup’s book was written for an educated audience who could understand it and afford it. Her readers are more likely to be closer to the “norm” because they have been rewarded, to a certain extent, with education and jobs for conforming to the center. Thus it addresses the concerns of this particular audience. There is no obvious reward for addressing marginalized peoples, for researching their particular needs, for considering their deviation from the norm, or for entertaining their authority over their bodies. The intersection with capitalism is also an issue with Marianne Legato’s book Eve’s Rib. The only reason she was able to do the valuable research that she did was the existence of a vested interest in marketing products specifically for women, thus providing the motivation to fund her research. Though the funders, Proctor and Gamble, pay lip service to women’s health, not profit, being the bottom line, research which may begin broadly will undoubtedly focused in on that which can be sold and on those who have the means to buy. Luckily the value of the research is not limited by these less noble intentions.

One huge benefit of the gender differences explicated by Legato in Eve’s Rib is the continual discovery of evidence which contradicts the belief in omniscient medical authority, as identified by Northrup. Legato does a fantastic job of bringing the feminine honesty of uncertainty to the forefront. She admits that there is a lot we don’t know, like how the effects of drugs change with a woman’s menstrual cycle. And in recognizing this limitation she suggests that women monitor the changes themselves! What an improvement from the previously held attitude of “women are too complicated, so we’ll just assume they’re the same as men.”!
While Legato focused mainly on the differences between men and women, her findings suggest that there is a wealth of undiscovered variety within the human population. Her research offers legitimacy to the claims of individuals whose medical issues and responses fall outside the “norm”. Her example may be followed in the development of similar in-depth research which might be done on the differences across age, race, and even attitude. She shows how medical research on difference can serve to empower rather than oppress.

One of the main failings of Legato’s work is its lack of perspective regarding the relationship between patriarchy and women’s health. She notes than men produce 50% more serotonin than women and that serotonin is produced when one experiences success. But then she goes on to say, “ The fact that women are, on the whole, twice as likely as men to be depressed may account for their relatively less important place in many societies.”! (Legato, 13) She is so rooted in the unidirectionality of cause and effect from body to behavior that she neglects the obvious. Not only do bodies shape our circumstances, but circumstances undoubtedly shape our bodies. Could it be that women’s lower serotonin levels are a result of their societal devaluation, rather than the cause of their lower status?! Further, her suggestions to treat depression with therapy or a new job that allows more independence and control, rather than antidepressants, seems to lack an understanding of the complexities of depression that often prevent one from making these changes in their lives.

Legato again demonstrates a lack of societal context in her discussion of differences between men and women after a stroke. “Women seem to do worse than men: they have more impaired intellectual function, are less able to care for themselves, and have a higher rate of suicide. In one study of more than 37,000 stroke patients, the suicide rate was twice as high in the female victims, particularly the younger ones.” (Legato, 35) While Legato does not have a physiological explanation for this disparity, she doesn’t seem to consider women’s social role and value as a variable contributing to the results. The fact that the woman is typically the primary caregiver in any family lends itself to the likelihood that her husband would not be able to be as attentive or adept at caring and rehabilitating his spouse as a woman would be for her husband. Furthermore the devaluation of women’s work and being may also lead to a decreased care even in a nursing facility, where the emphasis may fall to rehabilitating men so they can get back to work and provide for their families.

Both of the limitations I addressed in the first two readings were well handled in John Robbins’ book Reclaiming Our Health. Specifically, he brings a holistic perspective involving environmental, social and cultural attitudes to discovering the root of many health problems. Robbins’ elaborates beautifully in two examples on Northrup’s “disease as enemy” model exactly as I had hoped she would. He makes the connection between “disease as enemy” and “diseased person as enemy” and the use off this as another mechanism to control the already suffering, exacerbating the disease in the process.

But there is one more key that may be the most important factor of all, according to Jonathan Mann, founding director of the world Health Organization’s global Program on AIDS, and director of the International AIDS Center. People who are infected with HIV, or who have AIDS, must not be discriminated against. ‘Discrimination simply drives AIDS underground ,’ he said repeatedly, ’The epidemic doesn’t go away; it simply becomes harder to see, more alienated from public health. If you drive it underground, you guarantee its spread.’ The last 15 years have shown, he says, that the marginalization and stigmatization of those who are at risk insure that the disease will spread. ‘The failure to realize human rights and respect human dignity has now been recognized as a major cause – actually, the root cause – of societal vulnerability to AIDS.’ (Robbins, 352)

Robbins goes on to draw the connection between the spread of disease and the subjugation of women. “Is it coincidence that it is in those very parts of the world where human rights are least respected, where women are regarded as beasts of burden, playthings, or childbearing machines, that AIDS is spreading the fastest?” (Robbins, 352) He cites examples and statistics from Tanzania, Nairobi, East Africa, US, Germany, and India, leaving no doubt of his global perspective.

Robbins also masterfully illustrates the link between population growth and the education of women. In the same way, he points to a number of instances of disease and identifies their roots in ecological imbalance. He offers truly holistic vision of the complex variables intertwined in scientific analysis of health issues and must be especially commended for his breadth of global perspective and for bringing to light issues which pertain specifically to peoples of the periphery including women, Navajo, people with AIDS, and populations of the ¾ world. It is only through this sort of perspective on the roots of health issues as systematically embedded in our culture that we will ever begin to develop a complete and effective understanding of our world and our health.

This shift toward an appreciation of complexity and holism, often considered female tendencies, might be linked to a resurgence of the voice and authority of the female, even in the midst of continued systematic hurdles. Robbins details the painful history of the eradication of women’s wisdom from the witch burnings through the persecution of midwives still going on. He focuses mainly on the persecution of midwives by the medical field, but I recently came across an article detailing a threat from another front, monetary constraints of the insurance industry.

In New York City after several years of increasing popularity, midwifery is on the decline due to astronomical increases in malpractice insurance premiums and the fact that a mother’s insurance often covers a smaller fraction of a midwife attended birth than that of one attended by a doctor. This New York Times article, written by a Latino, did note the relationship between the increase in midwifery and the influx of Latin American immigrants accustomed to birthing with a midwife rather than a doctor. Would this connection have been made by an author of another ethnicity? The article does not, however, make the further connection that because the practice of midwifery can be linked with a specific segment of the population, the inability for birthing centers to stay afloat can be construed as a type of systematic racism preventing people from a cultural practice. Based on this article, one might assume that the insurance industry has valid reasons for the limitations imposed upon midwifery. But when viewed in conjunction with Robbins article this rationalization takes on new meaning. He clearly illustrates the safety and superiority of midwifery over the medical model of childbirth and draws attention to a long history of systematic oppression of women’s wisdom, from witch burnings to the Medical Board’s current persecution of capable midwives while criminal doctors are left to continue practicing.

The increase of women’s voices, education and involvement in shaping the health sciences serve to open the field to new levels of accuracy and effectiveness by the inclusion of understanding the situatedness of health within complex wholes. These new understanding serve to bring medicine based not in avoidance, fear or authority, but in helping people to meet their true needs of healing, preventative health and happiness. This new openness is still in its infancy, however, and there are still an infinity of ways in which it can and will expand its appreciation and applicability to marginalized peoples. The fact that the injustices of medical science are increasingly attended to and resisted, offers hope for the turning of the tide toward a feminine influence, which will effect not only those doing research, those who are researched, and who has access to the knowledge uncovered, but also to the larger systems of science, government and capitalism. Slowly, with great resistance and many more victims, change will prevail.

Sources:

Legato, Marianne J. Eve’s Rib: The New Science of Gender Medicine and How it Can Save Your Life. New York: Harmony Books 2002.

Northrup, Christiane. Women’s Bodies, Women’s Wisdom: Creating Physical and Emotional Healing. New York: Bantam Books,

Perez-Pena, Richard. “A Childbirth Phenomenon Fades.” The New York Times, A21. March 15, 2004.

Pert, Candace B. Molecules of Emotion: The Science Behind Mind-Body Medicine. New York: Touchstone, 1999.

Robbins, John. Reclaiming Our Health: Exploding the Medical Myth and Embracing the Source of True Healing. Tiburon, CA: H.J. Kramer,

Shepherd, Linda Jean. Lifting the Veil: The Feminine Face of Science. Boston: Shambala, 1993.

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