Vagina Dentata

I’ve been reading a lot recently about the new book from Barbara Ehrenreich, Smile Or Die: How Positive Thinking Fooled America And The World, and it looks fascinating. I first have to admit to not reading it yet – it’s published in the UK at the end of the week and on pre-order. But the extracts I’ve read have been interesting, disturbing and depressing in equal measure. I’ll do my first book review as soon as I’ve got through it. But here are a couple of my initial thoughts about some of the issues Ehrenreich raises.

Firstly, I’m genuinely very interested in her views on chemotherapy and the science and medicine behind the development of breast cancer treatment. Its not my area of expertise, but I’ll follow up on her sources from the book. If any readers know more please link to studies in the comments. But in summary, here is Ehrenreich talking about her book and why if she ‘had her time again’ she wouldn’t go through chemotherapy:

Plus, she believes (probably rightly) that it was the HRT that she was on that ‘caused’ or increased her risk of getting breast cancer. Certainly, there is increasing evidence for a link between HRT and breast cancer.

The two things that really struck me from the extract from her book in the Guardian was a) the devaluing of negativity and b) the particular reliance on a narrow definition of ‘ultrafemininity’ in breast cancer campaigning.

Ehrenreich’s whole book is about how alienating and divisive the positive-wash that cancer is given can be, how she was encouraged to view her cancer as an ‘opportunity’ or even ‘gift’ and how her anger and frustration were often scorned by others. This kind of approach is something that pisses me off on a far less extreme or important level than Ehrenreich – but I think is part of an approach within Western cultures to gloss over the shite in life.

I agree we shouldn’t wallow in negativity and if we focus on all the bad things in life we become insular, boring Emos, or worse, Goths. But sometimes we need to call a spade a fucking useless piece of shit shovel. Sometimes negativity is a good thing, a real emotion, actually brings perspective to what is positive and denying the steaming piles of turd in life can be hugely damaging.

Ehrenreich points to a few studies in the Guardian column*:

• Emotional well-being does not predict survival in head and neck cancer patients: a Radiation Therapy Oncology Group study. Cancer. 2007 Dec 1;110(11):2568-75.
• Guardian article links to Discover article on the study: Hope may be useless against cancer.
• Tomich, P. L., & Helgeson, V. S.  (2004).  Is finding something good in the bad always good?  Benefit finding among women with breast cancer.  Health Psychology, 23, 16-23. Summary here.
• Optimism and survival in lung carcinoma patients, Cancer. 2004 Mar 15; 100(6): 1276-82.
• Guardian article links to Medical News Today article: A positive attitude does not help cancer outcome.

* See some writers can link to primary sources!!

These studies show that at best “positive thinking” does not affect cancer survival but at worse that it can lead to the “tyranny of positive thinking” which can conceal distress and leave patients feeling worse. So if you’ve got cancer – its alright to feel shit, angry and frustrated. That doesn’t mean you’re allowed to be a full-time arsehole but you can let rip once and while.

The second point that I found striking was the specific type of femininity attached to breast cancer and breast cancer awareness/campaigning and again I don’t think this is a wholly positive thing. Breast cancer campaigning has been incredibly successful, has turned around society’s perception of what was once a hidden and shameful disease and with that has raised phenomenal amounts of money for breast cancer research. But, as Ehrenreich points out, this has been inextricably linked to stereotype of ultrafemininity which is pink, fluffy, appearance-focussed and somewhat reductive of womanhood to boobies.

Possibly the worst example of this, which I have linked to before, is this breast cancer awareness advert for a ‘BoobiBall’ fundraiser:

Breast cancer awareness tends to promote the notion that women are and indeed should be obsessed with their appearance and that the loss of a or both breasts is the worst possible thing that could happen to a woman. Not to mention the hair loss, weight gain or loss, effect on skin etc.

Now there is no doubt that hair loss and mammectomy hugely affect a number of women with cancer and alter their sense of identity or femininity. My concern would be that this emphasis on the femininity of those going through cancer treatment may exacerbate this impact. Ehrenreich talks about the breast cancer marketplace with the prominence of cosmetics and jewellery and websites that talk about chemotherapy helping you to lose weight and smooth out the skin.

What is significant here is that this same femininity is not associated with lung cancer or heart disease – both huge killers of women as well as men. It is associated with uniquely female breasts** and therefore with women’s bodies being the be-all and end-all of their identity.

** I’d be fascinated to know how men with breast cancer relate to breast cancer campaigning.

Breast cancer is seen not only as a disease attacking part of the body but attacking a woman’s identity because women’s identity is so dominated by their physical appearance and attractiveness (with a special focus on breasts). Unfortunately, as with many things, this focus on ultrafemininity is couched in feminist empowerment language and indeed, in America at least, feminism seems to have been replaced by a breast cancer cult.

Maybe less of a focus on how a woman looks during treatment for a life threatening disease is the least we can offer them?

This was originally posted at The Lay Scientist.

A while ago I wrote a post at Vagina Dentata about periods. I was sick of menstruation being a hidden and taboo issue and one that we as a Western society fail to talk about. That post got the biggest response I have had both in terms of comments on the blog and in person from women and men alike.

This response included a great post from Arikia (The Millikan Daily) about tampon scarcity in Brooklyn – yep land of the free, with not a red mouse between them.

My main point was that ‘having the painters and decorators in’ was a feature of pretty much every woman’s life for most of her life. We’re all blobbing, so why is it so rarely talked about? Because it’s dirty that’s why – Biblically unclean.

Girls and boys are rarely told about the ‘stuff’ that happens to the opposite sex during puberty and beyond. It leads to fear, misunderstanding, shame and repulsion. The natural functions of women have for millennia resulted in the notion of women as fundamentally filthy (and not in a good smutty way). If you touch a woman during her monthly period you will be unclean till evening (Leviticus, which is all about the periods, and sleeping with animals). It has spawned a fascination and abhorrence with female functions and feminine ‘dirt’.

But this means that an important and recurring aspect of women’s lives doesn’t get discussed. There are gruesome facts about perioding that rarely get mentioned: that you shit differently, sometimes it hurts so much you vomit, it can make you uncoordinated and bump into things/knock things over, your breasts can swell and hurt, you get incredibly hot at night and can’t sleep, you get water-retention and go up a dress-size (BTW these things don’t happen every time or all at once, that would be really inconvenient).

All women have had to make make-shift sanitary towels out of bog-roll at one time or other. We’ve all had to get blood stains out of our favourite pants and jeans. We all have stories about when we found out about what periods were, when we started, the chats with our mothers, sisters or teachers. But those chats were always hushed and never involved men.

But since that blog post I’ve come across some more interesting posts and issues. I was writing from my own experience and so very much contextualised what I was saying as being a ‘Western’ issue. But of course it isn’t. While the period taboo is a pain in the vadge in the UK, it is a serious developmental problem in poorer countries around the world.

This is a brilliant campaigning film by the Sustainable Health Enterprises (SHE) program which helps local women in developing countries “jump-start their own businesses to manufacture and distribute affordable, quality, and eco-friendly sanitary pads.”

So it seems ‘menstrual silence’ can lead to girls missing out on school and women missing out on an income.

This reminded me of the equally excellent Dignity! Period campaign in Zimbabwe where one of the added consequences of the economic crisis is that women cannot afford sanitary products. This in turn affects their health, education and threatens their dignity. For many ordinary women sanitary products are a ‘luxury’ that they can no longer afford or access, as many manufacturers have fled Zimbabwe causing shortages of the products.

The common factor in the UK, US, Zimbabwe and Uganda is the ‘menstrual silence’. How many times do sanitary products get talked about in terms of human necessity? We have broken the taboo on talking about condoms (Vatican notwithstanding) in order to address HIV/AIDs, we need to break the taboo on periods to talk about the very real affect that they have on women’s lives and health and the very real need that women have for sanitary towels and tampons.

These aren’t luxuries. I don’t feel like I’m indulging myself when I buy them (even though I’m likely to be buying 5kgs of chocolate at the same time). And the thought of having to fashion a towel out of leaves and rags while having limited or no access to toilets and/or cleaning facilities is too grim to contemplate.

And if you think I’m being prim by suggesting that tampons/towels are a human necessity – you think about bleeding (including blood clots and womb lining) for a week into what is already a warm, moist, bacteria-loving area covered in hair and consider not being able to keep that clean. Then think about that taking place in a hot climate where you have to walk a lot. Is this seeming like an issue now? If so, go and donate to:

• Dignity! Period
• Sustainable Health Enterprises (SHE) program

I’ve said it before and I’ll say it again, the Society for Menstrual Cycle Research blog is a thing of wonder and introduced me to SHE.

Who can blame pregnant women for being confused and infuriated by the ‘health advice’ they get bombarded with from the moment they announce through tears and gritted teeth that they are up the duff? Women have for a long time had to deal with their bodies being considered public property and no one feels more sanctimonious than pooh-poohing the behaviour of a pregnant woman. “This is not just about you CONSIDER the baby!”

Of course a lot of the advice that women get ranges from the eminently sensible to the morally bigoted and the tales of old wives. Taking drinking for example, the British Medical Association last year recommended that pregnant women should not drink AT ALL. Their evidence for the ill effects of a sly glass of wine on the unborn child? Poor to non-existent. You see they couldn’t trust women to drink in moderation so better tell them not to do it at all. Thing is, you have to drink A LOT for it to affect the foetus and insulting women’s intelligence is hardly the best way to go about public health advice.

All of this misses the fact that most of the time women are too queasy to even think about alcohol during pregnancy. But you know what makes them more sick? Self-righteous, unscientific scaremongering by smug, self-satisfied bigots.