We acknowledge
Speaking of menstruation…
The UCLA student newspaper The Daily Bruin ran an opinion piece by Zoey Freedman arguing that necessary menstrual products should be covered by health insurance.
The editors attached a stipulation at the beginning:
Editor’s note: This blog post refers to individuals who menstruate as women because the author wanted to highlight gender inequality in health care. We acknowledge that not all individuals who menstruate identify as women and that not all individuals who identify as women menstruate, but feel this generalization is appropriate considering the gendered nature of most health care policies.
Yes, it’s such a shocking generalization to refer to people who menstruate as women.
It has *always* been the case that “not all individuals who identify as women menstruate.” Post-menopausal women don’t menstruate. Women who’ve had hysterectomies don’t menstruate. Many athletes don’t menstruate. Yet SUDDENLY we need to add Editor’s Notes to avoid offending people.
Just think of all the people who were offended until now. What a tragedy.
Imagine an article on prostate health qualified with suchlike craven dithering.
Yes, all these years since my hysterectomy I’ve had to sit fuming in silence because I am a woman and I don’t menstruate. I demand equal time for older women and women who had health problems that had their uterus removed at a younger age!!!
Seriously, this is getting more screwed up all the time.
I don’t understand, is there really anything wrong with this note? It seems pretty spot on to me. It points out that there is gender inequality in healthcare and it seems to imply that sexism is primarily the cause of the inequality while also acknowledging that people other than women also menstruate and some women don’t menstruate.
Matthew Ostergren, the discussion hitherto indicates to me the problem is that the editorial preface is perceived as otiose, at best.
BTW, there is an explicit implication that the “gender inequality in healthcare” is caused by “the gendered nature of most health care policies”, but I see no implication (merely non-exclusion) that sexism is the cause, as you do.
Well, I guess that finally answers my question when I asked back in September if you (Ophelia) think saying pregnant “women, as well as trans men and non-binary people” would be a good compromise over “pregnant people.” It looks like you’d rather that trans men and non-binary people simply never be acknowledged at all in discussions about reproductive healthcare, even if only in a note at the top of the page in which the editors make it explicitly clear that the gendered nature of healthcare policies is a source of inequality and needs to be discussed as such.
There is nothing wrong with this note, and treating it as a source of mockery is really distasteful. Many trans men menstruate. Many trans men can and do get pregnant.
http://www.npr.org/sections/health-shots/2014/11/07/362269036/transgender-men-who-become-pregnant-face-health-challenges
Healthcare professionals are finally starting to recognize that humanity is not so cut and dry, and gender identity is a spectrum and not a binary. Just a little bit of acknowledgement and respect goes a long way, and costs nothing.
This reminds me of the time I flicked on the TV as a 7yo to hear a vague and disturbing warning: I had to have a PAP smear, or else.
I was informed by a sombre voice that if I didn’t have a PAP smear, I could die horribly. I went straight to my mother to urge her to call the doctor and book me in to have an urgent PAP smear. Thankfully my mother set me straight, but the aversion to discussing lady parts on the airwaves created a major anxiety attack for one little boy.
Cressida, iknklast this isn’t about ‘offense’. This is about trans-folk who avoid getting medical care because they fear how they will be treated by providers.
Anat, my comment was not necessarily about offense; it was satirical, so perhaps that was missed. In reality, older women or women who have had hysterectomies often encounter discriminatory treatment from providers.
When I had my hysterectomy, the approach to my care changed from being concerned about my health to not being concerned about my health. I was put on the back burner for appointments, treated as less important than women who could get pregnant, and in general sloughed off. I am assertive, and refuse to take that from providers, so I persevered, changed doctors when necessary, and just basically made my providers acknowledge me as a full human being. I am fortunate that I currently have a group of doctors that do not think a woman ceases to matter just because she is lacking a uterus or post-menopausal, but that took work and effort on my part. I have known plenty of older women who avoided medical care for that reason.
This is a problem of misogyny, as nearly as I can tell. Not being a man, I can’t speak for older men, but I have never heard any of them complain about the same thing happening. My father has received high quality care, has never been dismissed as too old to bother with (he is, of course, much older than I am), or treated as though his concerns didn’t matter because he was beyond the age of being fully human. It’s possible that may happen; there is a lot of ageism in our culture. If it does, I am not aware of it through any of the men I have known well enough to be aware of their medical treatment (my husband is also treated as though he is important enough to listen to when he goes to the doctor; he was not treated as less human after he had his vasectomy).
iknklast, would an acknowledgement from the medical profession that not all women menstruate – ie that not menstruating doesn’t make one a non-woman improve your trust of the profession? Or at least give you hope that there is a chance that poor treatment by providers is going to be addressed?
Yet another case of women not getting to use words that have a particular meaning to them for fear of reprisal.
Don’t worry though, if you’re a dude you can say whatever transphobic thing you like with almost zero retaliation.
iknklast – Re: ageism in medicine – I have heard of the reverse problem – doctors insisting of treating older patients aggressively when the expected benefit may not be worth it. It took my father a long time to get doctors to leave his prostate alone. And it took some convincing to get my grandmother’s doctor to stop recommending pretty harsh weight-loss diets when my grandmother was in her eighties. Yes, she was morbidly obese. But even if she had followed the diet and managed to loose weight successfully, how much would she have lived past 90 (when she ended up dying, and as it was, not from anything related directly to her weight)?
Anat – This disclaimer was evidently designed to deal with trans issues. It specifically deals with the gendered nature of health care. While it does state that not all people who identify as women menstruate, the final sentence makes it clear this deals with transwomen and not older women.
Yes, I think there are problems. But I think the proliferation of disclaimers on everything is not the way to solve the problems.
Anat @13 – you’re talking above very old women. I’m referring to women that are still younger, but no longer reproductive. I was 40 when I had my hysterectomy. Is it likely that aggressive health care would be no use to me? My mother was 35 when she had her hysterectomy. My sister was 19. Were any of us going to not benefit from the aggressive care we didn’t get?
And I think the treatment your grandmother got is part of the same problem. There is a tendency to push older women to weight loss the same way as younger women (in most cases, too skinny even for the younger women). Fat women are considered a disgrace to society, no matter what their age (and even when they’re not actually fat, they just happen to be not skinny).
I don’t have a problem with the disclaimer as written (apart from the “well…duh” aspect of it). What does bother me is that this type of constant (and relatively recent) approach of qualifying and broadening anything to do with women to be as inclusive as possible is simply not applied to the same extent to the ‘male’ sphere of our cultural life. When did we get the same kind of statement about prostate cancer? I’ve read three articles about prostate cancer in the last two months. Not a single disclaimer or qualification anywhere.
I would like a perfect world in which gender and sex did not matter as defining articles of how we are treated. A world devoid of body shaming and self hate. The discussions of the last few months have brought the plight of trans folk into sharper focus for me (I have long known about the issues). To that end I’m happy to work in my small way to improve understanding and attitudes. Societal change is built from baby steps. The more people feel a given way the easier change is (see the expansion in gay rights in the west).
What I’m not happy to see is the fight for womens rights watered down in the process. I know the argument is that fighting for both trans inclusiveness and womens rights can be done together. I agree. It should be possible to do so. Instead we see the typical human response of a hard core of opposed idealouges on both sides polarising the middle. I don’t see that diluting the ongoing fight for rights for the 99.5% of women actually helps the other 0.5% (or whatever the numbers are) in the long run. Fight for trans rights by all means. Also accept that any improvement in womens lot in general will have spin off benefits for trans people as well.
OT – on the subject of sexism and age in health care raised above in the comments. My mother in law was recently diagnosed with a complex and difficult to treat cancer. She is elderly, but until recently quite fit and mentally sharp. She is also a very unpleasant person with some sort of personality disorder (opinions range from narcissism to aspergers – but she has never been diagnosed). At a recent meeting with the surgeon to discuss options she did her typical thing of seizing the conversation and taking it off onto an irrelevant tangent. Utterly typical of her behaviour for her whole life. You could literally see the surgeon loose interest in her on the spot. He closed the meeting, said the risks of surgery outweighed the benefits and left. in short he wrote off as an old women suffering dementia. Why bother adding a few months or even a couple of years to her life.
Well the fact that nonsense isn’t done to men is one reason I do have a problem with it, so saying “what does bother me” is a little odd.
But that aside – why don’t you have a problem with taking an issue that’s about women and interrupting it to make an announcement about trans men? As you say, it’s “well, duh,” so then why say it at all? Other than to derail a discussion of a women’s issue yet again?
Ophelia, The ‘well duh’ is because it is (or should be) such an obvious statement that it doesn’t need to be said. The fact it is not is not for some people is of course an issue.
I thought the major point of my comment – that an article about womens health (and this could just as easily be extended to the numerous other similar instances) is diluted and deflected in this way, is a problem – was pretty damn obvious. I apparently need to work on expressing myself more clearly.
I’m not sure why you find ‘what bothers me’ odd to be honest. I could say “It is a problem that…” and the meaning and intent would be the same. Suggestions welcome (I mean that).
The problem/issue/frustration (?) with so many human rights issues is that once you understand them the whole statement seems pretty ‘well… duh’ because it is so fucking obvious. Except that it isn’t to many people. Hence I don’t really have a problem with the basic intent of the disclaimer, but I do have a problem with the fact that this only ever seems to happen with issues that affect women.
Clear?
Rob, the reason I said ““what does bother me” is a little odd” is because the “does” implies that the rest doesn’t bother you. It was the “does,” not the “bother[s] me.”
You seem to have the same objections I do, so I’m not clear on why you started with “I don’t have a problem with the disclaimer as written.” But it’s not a big deal. I didn’t mean to be annoying; sorry.
Ophelia, I understand now. I agree that we have the same objections. I’d rather clarify the uncertainties for sure and I have no problems with you being annoying.
Perhaps my comment would have worked better starting as “My problem with this disclaimer is more about context than content…” and continued “What bothers me…”. :-)
Soooooo much better. :)
@Falcon #7
Have you ever seen an article about men’s health introduced with such an apology?
If not, why do you suppose that is?
Bonus questions, for anybody interested in answering:
What is wrong with trans people accepting the fact that they belong to a tiny minority (<.5% of the population) and that not every article/clinic sign/whathaveyou will acknowledge them? What is wrong with trans men, for example, acknowledging that in terms of reproductive health, they may need the services of a gynecologist?
Does anyone think the classification of menstrual products as luxuries originates in anyone’s attitudes to trans people? No. It originates from male attitudes towards women. In that context the disclaimer reads as a derail, not a helpful contribution to anything.
I don’t think there’s anything grovelling about the disclaimer, and I think the facts it mentions about gender and menstruation do need to be said or at least it is advantageous to do so. If ‘woman’ is used in the article to refer to people who menstruate, then this unnecessarily misgenders menstruating people who don’t identify as women, and the disclaimer is just an attempt to acknowledge this fact and give it appropriate respect. The fact that trans people make up a tiny minority is no more justification for us to be disrespected than the fact that gays make up a tiny minority is justification for a presumption of heterosexuality or erasure of homosexuality in medical or other discussions of sexuality.
There may be a double-standard wrt the treatment of menstruation vs. prostate cancer, but it’s not obvious that this is out of disrespect for females. Among the groups that might end up being offended are trans men and non-binary female-bodied people, and these groups are comprised of people of the female sex. Maybe menstruation has become a focus for this sort of thing in a way that prostate cancer hasn’t because menstruation is more of a ‘feminist issue’ than prostate cancer, and feminism is concerned with the sex/gender distinction and with sex- and gender-based oppression.
It doesn’t “misgender” anyone to talk about women when talking about menstruation. Menstruation, like pregnancy and abortion, is an issue for women. There’s zero need for disclaimers saying otherwise.
The disclaimer stands out for the fact that it has been known for the entire existence of humanity that not all women menstruate. It is only very recently that disclaimers such as this have become a thing worth bothering about, and it is quite evident that they refer primarily to the trans subset of women-that-don’t-menstruate. It has been considered fine all this time to never bother with such disclaimers for the post-menopausal, or those that are infertile from birth or injury or surgery or…; only trans people have prompted this consideration.
(Oops, did I say trans people? I should have said trans women, because as noted by multiple commenters, trans men sure as shit aren’t included in this sudden concern.)
And the thing is, the association between being female and experiencing menstruation is pretty reasonable. The vast majority of people that menstruate are female, and the vast majority of females will, are currently, or used to experience menstruation. Then along came the recent marriage between feminism and trans women (but not trans men!) activism, and suddenly the association needs to be thrown out, even though the most generous estimate over at wiki suggests 1 in 500 women are trans, or 0.2%. For some reason this tiny discrepancy warrants throwing out all such assumptions, even though the other reasons a woman might not menstruate are vastly more common yet never warranted such consideration.
Lady Mondegreen @22
My guess is this from Komal @24:
I haven’t actively gone searching for examples, but if I did see a note on an article about prostate cancer to acknowledge the fact that prostate cancer affects trans women too, then cool, what would be the problem?
That’s still about 700,000 individuals in the United States alone. Many trans people are treated with hostility and suspicion from their healthcare providers – a little more awareness and exposure helps to reduce that hostility and providing more sensitive, caring treatment. Here is one man’s perspective on how the clinic categorizing him as female (even though he identifies as and is legally male) impacted his healthcare:
Yet transgender people oftentimes have difficulty getting the right sexual health services—if we get any sexual health services at all. In my case, I’ve been denied full-panel STD testing because I was categorized as female at a clinic I attended. I’m legally male—am listed so on my passport and driver’s license—and have sex with cisgender gay men. Because of this, it makes sense for me to get regularly tested for STDs and HIV—every 3 to 6 months as typically recommended for men who have sex with men. But as a gay trans man, I’ve had to fight tooth and nail for this basic sexual health care far more often than not. I’m not alone in this. One survey of over 6,000 transgender and gender non-conforming people called the U.S. National Transgender Discrimination Survey (NTDS) found that 19% of respondents had been denied service altogether in a doctor’s office or hospital because of their gender. And over a quarter (28%) reported being verbally harassed in a medical setting. My experiences speak to these statistics.
At one point, the health care provider told me outright that I was not eligible to receive the full panel of STD tests because they were only available for “real men” who have sex with men—and that I wasn’t “high risk” enough to justify spending testing funds on.
These types of experiences—when the wrong gender pronoun is used, when a medical file is mislabeled with the wrong gender marker, when a health professional belittles a patient or denies their identity—have a discernable effect on the willingness of transgender people, who are disproportionately affected by HIV, to seek testing, prevention and medical treatment. And out of all the challenges that transgender people face, discrimination in health care settings is linked with an especially high rate of reported suicide attempts. Among respondents to the NTDS who have been denied medical care due to their gender identity, 60% have attempted suicide.
http://betablog.org/better-sexual-health-care-for-trans-men/
The fact that trans people make up a small percentage of the population is no more of a justification for discrimination or lack of acknowledgement from clinics than the fact that gay and lesbian people also make up a small minority.
Holms @26
The note did actually acknowledge that “not all individuals who menstruate identify as women.”
That is a serious problem.
Agreed.
The question is, is this sort of apologia for use of the word “women,” the way to spread awareness?
Here’s a crude thought experiment:
Imagine that there is some rare physical condition, not involving sex or gender, which must be treated using the same techniques used to help ease gender dysphoria.
Such treatment accounts for, say, one out of every 500 courses of treatment–at very most.
Should “trans people” and related terms be erased in clinic names, literature, and the tweets of medical professionals, because they don’t acknowledge people with Condition X, who also experience discrimination and also would like to spread awareness? Would notes justifying the use of the term “trans people” before an article about a trans-health-related issue be considered necessary and appropriate?
Correction: I should have said, not involving gender. If surgical changes to the genitals are involved, Condition X would involve sex by definition.