Feminism and Medicine

[macaroonmunch]

Hi

I'm a frequent lurker on these pages and have learnt a lot from what I've read so I thought this would be a good place to ask what people's thoughts were on how women and women's health issues are seen in medicine. Apologies if I seem poorly informed, I've only recently begun really thinking about feminist issues.

I'm a current medical student and a lot of things in my education so far have just really annoyed me and don't seem right. The norm for all medical examples and anatomy is almost always male and the whole characterisation of some problems as 'women only' just seems odd to me when there is comparatively so little emphasis on 'men's health', as though men's health is the default and women's health problems are a whole other category. Even diagrams and models of the female reproductive system seem odd compared to the male versions- why is the vagina always depicted as gaping open whereas diagrams of penesis are always flaccid?

I don't know if I'm being over-sensitive but I know that the medical profession has not always been known as a bastion of feminism so I just wanted to gauge other people's opinions. What are the main ways in which medicine/medical education are sexist? And why? Sorry for the length of the post, I hope it's not too rambly.

Feminism is about looking for patterns and not assuming that each individual situation happens in a vacuum. It's not "nutso" as you put it messy - talk about shutting the conversation down.

We live in a misogynistic society and medicine reflects that. There are a whole lot of examples already given further up the thread. Why ignore them?

The article I read about drugs such as painkillers only being tested in men made it clear that this was because of worries about hormonal fluctuations would affect the results. If it was because of fears on the effects of early pregnancy this would make sense, but it didn't seem to be what the researchers were saying.

I have no expertise in this area. But I do remember being horrified when a friend who wanted to have kids - she was only 28 - had a hysterectomy on the recommendations of a consultant because he thought she might have cancer - she didn't have. I later read that certainly at the time this was far from unusual. If it was a man I doubt Dr';s would castrate a man because they thought he had cancer. They would do biopsys, etc first and then decide whether castration made sense medically.

I'm not shutting down conversation Nyac and I'm not ignoring examples. In fact I even gave one of my own. Yes you are right that medicine reflects the attitudes in our society and some of those attitudes are misogynistic. Both male and female doctors are trained in a system that was established by men, and it would be surprising if there weren't still some bias, but ..

...I do have an issue with "Women are butchered, prodded and poked for the benefit of the male doctors not the female patients."

It's too extreme to be fair, and it implies that male doctors do not care for the wellbeing of their patients.

I too don't understand Margery's list - smear tests, for example, save lives - women's lives.

Also, if you are searching for discrimination look no further than the elderly.
Breast screening initially stopped at 65 (though now the automatic call up extends to 70) despite the fact that the older you get the more likely you are to get breast cancer. Older people missed out on the opportunity to take part in clinical trials for example (men and women) because there was an assumption that, say, cancer treatment would be too debilitating for them despite the fact that some 70 year olds may be more fit than some 50 year olds.

I think different groups are discriminated against (albeit not deliberately) in different situations.

Even children in the past because there was little research in the past on drug doses needed for their smaller bodies, so it was a bit hit and miss for medical staff doing calculations.

I think there is an interesting debate to be had here.

For those asking, "why are smears bad? They save women's lives!"....I think the point is that there are ways and means of going about saving lives.

Take childbirth. It is pretty well documented that giving birth lying on your back with feet in stirrups is helpful only to the doctor who has a better and more comfortable view of the birth canal. Nowadays, most women in the UK would recognise this and see that a historically male dominated profession could come up with a model of childbirth that is intrinsically beneficial to male doctors, not women in labour.

The same might apply to smear tests. Obtaining cells for analysis by smear test is pretty universally acjnowledged by women as unpleasant, uncomfortable, possibly painful, undignified, embarrassing etc. And yet, because it is convenient and quick, the medical profession does not seek other ways of diagnosing cancers of this type.

'Obtaining cells for analysis by smear test is pretty universally acjnowledged by women as unpleasant, uncomfortable, possibly painful, undignified, embarrassing etc.'

Yes, its convenient and quick, and cheap too, as well as pretty accurate and relatively uninvasive (no needles, no anaesthetic, no having to go to a hospital and hang about)..all those things make it a fantastic screening tool.

I'd be interested in whether other women agree with Greythorne's assessment of having a smear test?

My patients 'opt in' to it, they're not forced to have one, so I'm assuming they don't mind it.....

Your patients "opt in"... But do they have another viabke option? In order to be screened, I mean. Not just to opt out?

If they don't want a smear, what alternative is offered?

Greythorne, what other ways might there be to have a smear test?

I totally agree re. the childbirth position, it seems the most illogical way to give birth, but what evidence is there that this was developed for the benefit of the doctors? Not disagreeing BTW, just asking for more info.

I had a water birth with DS which was a great pain reliever. I thought it was a modern development but when I researched it it turns out quite an ancient one. Is this the kind of thing you're talking about? I think there is a lot of ignorance on how modern lifestyles have affected the female anatomy and this ignorance is compounded by the traditional emphasis on male as the default.

I think smear tests are fine. Although it is only because of lobbying by feminist and others that the leaflet finally says to women talk about your GP about whether you need a smear test if following situations are relevant to you e.g. never had sex with either gender. Elderly virgins have been strongly pressurised for example to have smears when there is no need because the assumption was that all women are or have been sexually active

IMO the two areas where misogyny are most evident are contraception and psychiatry.

WRT contraception - there is the technology to create a male pill but it has never been marketed because it is assumed that men won't want it. Essentially from debates I've seen over it, the hidden attitude is that men's fertility and more importantly their virility are far too important to risk. Asking men to take a pill that might reduce their sex drive is considered foolish. At the same time, it's considered fine for women to take a pill that can cause loss of libido, weight gain, depression, and other nasty side effects. The pill was a great liberator for women but it still means that women are responsible for contraception even at the cost of their health. A greater victory would be a situation where men are just as willing to take responsibility.

Psychiatry has a long and dark history of blatant misogyny. An excellent book on this topic is this book which looks at the history of women's psychiatry from 1800 to the present day. It makes for really chilling reading. Some of it details extreme cases where perfectly sane women were locked up for the convenience of others, but more striking than that is the way psychiatric "expertise" was used a way for making women conform to social norms. Women weren't just rebels or non-conformists, they were mad and unwell if they didn't fit in with how they were expected to be. Motherhood became another stick to beat women with, with mothers being blamed for every psychiatric and behavioural problem a child might have. Fathers, of course, were never even considered.

Interesting you mention libido. I was struck last year when 2 friends were both put on medication that affected libido. The male friend was telling me it lowered his libido he plucked up courage to tell the GP and the GP was keen to look at different medication to solve this side effect. The female friend had the same effect and I encouraged her to talk to her GP. Her GP wasn't interested and just said, well that is a known side affect.

Because men's libido matters, women's not really

Oooh that book looks really good. Here is another one which might interest you OP

trotula

It was the first book, written during the middle ages and by an Italian female physician, about women's "conditions" and how to treat them. It might be interesting for your studies.

Now, FMNistas stop being so bloody interesting as I have work to do...

The dosage of medicines, for adults, is still worked out using an adult males weight and height.
It would make more sense, epscially in the case of antibiotics, if it was worked out on the individuals weight and height. As that would probably be too cumbersome, then there should at least be ranges, rather than one size fits all and that is by default, a mans size.

That's an attitude I've come across too Eats. When I was put on anti-depressants I found the loss of libido a really difficult side effect to put up with, but my psychiatrist brushed it off as "one of those things." When my male friend had the same problem his doctor immediately changed his medication.

It seems bizarre that loss of libido is an accepted side effect of contraception.

There was a brilliant thread about a year ago about SSRIs used for the treatment of female depression (in particular) - really detailed studies into the inherent misogyny in psychiatry. God I wish I could find it.

Alternative to a smear to screen for cancer? I have absolutely no idea, but then I am not a medic!

I am just saying that there is an assumption that a screening tool which (perhaps) a majority of women find unpleasan is satisfactory because it is satisfactory to the medic undertaking the screening. Quick, non invasive, cheap etc. So, once again, the priorities of the (male) medical profession trump the needs of women.t

Quick, non-invasive and cheap are all attributes that benefit the women too though, don't they? The NHS needn't offer the screening at all, there's no obligation to do so, but because it has been proven to prevent deaths it is offered. It isn't a pleasant procedure but then that's true of a lot of medical procedures. The main reason women feel so bad about having smears is the embarrassment they feel around their own bodies. Really, having a smear should be no worse than having a throat swab - a bit yucky but over in a tick and not too painful. But because our society has such taboo around genitals the thought of having a stranger looking at that area is what upsets a lot of women. That's not the fault of the doctors, who are just doing a job and who don't perpetuate that embarrassment.

Oooooh, I love it! More "women are to blame" even here on the feminist board! Bravo, that's quite an achievement. To blame women themselves for the cultural taboo about exposing one's genitalia to strangers.

Let's not examine how doctors could improve cancer screening, let's just blame these silly women for being so unreasonably tetchy about flashing their fannies to random strangers.

I might be talking out of my bum on this but don't most cancers have some sort of effect on hormone/chemical levels in your bloodstream?
So if money was invested in identifying these changes then a blood test could be used?
Though I suppose it might be a case of the cancer being quite advanced before those changes could be found.

Greythorne - you are spot on about medical procedures being for the benefit of the doctor not the patient and when it comes to obstetrics and gynecology it is particularly so.

All those (paid) anaesthetists hanging around (by law) during delivery in France, even when the mother is adamant she doesn't want an epidural? For whose benefit is that?

another input about medical trials:
there are several reasons why it is usually (young) men are doing the first round of trials in humans.

• they shouldn't be pregnant
• they need to be 'naive' (= not taking any other medication, including the pill)

remember the clinical trials in 2006(?) at a london hospital where a few men were seriously ill after administration of the test substance? imagine that were pregnant women...

Cailin - I am not embarassed about having smears, I personally don't find that at all the worst aspect. But it depends on the skill of the person doing it. I have had smears that are fine and very painful smears.

If you reread my post Greythorne you'll see I said "our society has such taboo around genitals" not "women are to blame." Smears are a proven way of detecting cancer. They are a positive thing for women. But they are very unpleasant and that is down to the society we live in, not the doctors or women themselves.

Genitals are highly sensitive and it's very disagreeable having people fiddling with them unless they are trying to pleasure you. I don't think that's a "societal taboo", I think that's biology