I didn’t start out wanting to be a gun violence expert, and, arguably, I am not one. But violent events keep repeating and hitting closer and closer to home. My neighborhood grocery store, King Soopers, made headlines 2 years ago when 10 neighbors were killed there. Right now, we are focused on the devastating events in Buffalo and Uvalde and a shooting that killed 4 in Tulsa just yesterday. I can think of little else. I am also increasingly aware of the arguments about gun violence being caused by mental health issues. As a clinical psychologist and recently retired Teaching Professor at CU Boulder, my strategy for dealing with topics that make me uncertain is to look at the science. Today I’ve asked myself to do what I ask my students to do: Look at the science and beware the b.s.  

What are the facts about the supposed correlation between mental health and gun violence? Here’s what I found:

Over and over again, scientific studies have demonstrated that people with mental illness are more frequently victims of violence, rather than perpetrators of violence. Mental illness is not a reliable predictor of violence towards others, but is a predictor of suicide. People with serious mental illness are somewhat more likely than people without such disorders to commit violence, but that rate was only 2.9% in one large scale study. The risk increases to 10% if substance abuse is added. That means 90% to 97% of folks with serious mental health disorders do not commit violence. And some mental health symptoms, including particular symptoms of depression, are associated with lower rates of violence.

Mass murderers are a small but clearly very concerning group. A 2018 Federal Bureau of Investigation (FBI) study of 63 active-shooter incidents between 2000 and 2013 found that 25% of shooters were known to have been diagnosed with a mental illness of some kind, ranging from minor to more serious disorders. But, and this is important, the FBI study concluded that diagnosed mental illness is not a very specific predictor of violence of any type, let alone targeted violence.

In a country that already stigmatizes mental illnesses, blaming gun violence on mental illness further stigmatizes a population that is already struggling. The research demonstrates that it just not helpful from a predictive or explanatory standpoint. But there are other factors, including social, economic, and life history that are contributing factors to violence, including: 

• violent/angry thoughts; history of violence (not a mental health disorder)
• being in an unstable life situation (not a mental health disorder)
• being under stress, such as being bullied, going through divorce, job loss, and unable to cope (also not a mental health disorders)
• history of physical or sexual abuse (not a mental health disorder)
• disinhibition (that could be related to substance abuse, or even neurological immaturity) (not a mental health disorder)

Another factor is domestic violence – also not mental illness. We need to address the fact that 3 out of 5 mass shootings have been DV related and 68% either killed at least one partner or family member or had a history of DV.

A recent study reported that tremendous stressors (fear of death, social isolation, economic hardship, general uncertainty) from COVID-19 seem to have led to an uptick in mass shootings.

But here’s where the mental health and gun violence argument really falls apart: When we look at rates of mental health disorders around the globe about 1 in 7 people have one or more mental or substance abuse disorders. The US is no different – the rates of mental illness in US are comparable to rates in many parts of Europe, and a little lower than Australia, actually, but the rate of gun violence in our society is much higher: 25 times higher than in countries with similar economic development and similar social conditions.    

What’s the difference? Access to guns. This access makes our rates of violence so much more alarming and lethal.

This is not to say that mental health professionals can’t be helpful in this important and tragic problem in our society. How could mental health professionals help? 

• Advocate for increased access to mental health intervention for people who ARE in distress before violence or suicidality emerges. Ideally, these services could be available in schools, and require a significant increase in funding for school counselors and psychologists.
• Move towards models to accurately evaluate risk of violence. This tricky topic has been a focus of many scientific studies recently, because earlier efforts in this line of research were hampered by lack of funding for many years.
• Help individuals cope with after-effects of violence. Seventy-one percent of adults experienced fear of mass shootings as “a significant source of stress in their lives,”, according to a recent survey by the American Psychological Association.
• Help direct survivors of gun violence who exhibit posttraumatic symptoms and may need support for years to come.
• Help shape policy that can alleviate stressors on a broader scale.
• Voice, publicly and repeatedly, that mental health disorders are not THE culprit. They may sometimes be involved, but not in a reliable or predictable way. Instead, social, economic, cultural and psychological variables are in play here. The one thing that all of these instances of gun violence have in common is the availability of guns. Public policy and local ordinances must address this fundamental issue. 

So, that’s my summary of the mental illness argument.  It is a red herring that some folks hope will distract us from the real issue, which is ridiculous production of, access to and support for guns in the public square. I’ll keep studying. But my time—and yours I hope—is dedicated to action.

Dr. Tina Pittman Wagers is a clinical psychologist and Teaching Professor Emerita from CU Boulder. She taught classes in abnormal psychology, women’s mental health, and evidence-based psychological treatment for many years, and has also published in the area of psychosocial ramifications of Spontaneous Coronary Artery Dissection (SCAD).

Looking ahead to Mother’s Day and Father’s Day, I encourage readers to check out Chloe Bird‘s latest post for The RAND Blog. In “Assessing and Addressing Women’s Health and Health Care,” Bird explains the knowledge gaps and emphasizes the benefits of changing our approach to health research:

Gender-stratified research can produce more effective decision tools and interventions, and in turn improve both women’s and men’s health and health care.

I have featured her work on women’s cardiovascular health in a past post: it’s an excellent example of why we need to pay attention to sex/gender differences when aiming to improve health care.  Bird cautions of the dangers of failing to make the necessary revisions:

Until access, quality, and outcomes of care are tracked by gender, inequity in treatment will remain invisible and consequently intractable.

As we move forward with the Affordable Care Act, it is important to pay attention to the new assessments and tracking of the quality of care.  In the words of Bird, “This tracking should take gender into account so that disparities in health care and outcomes become visible and get the attention they deserve.”

Talk about irony: the same week that Rock Center with Brian Williams aired a story about a growing “concussion crisis” in girls’ soccer, I also got the curriculum for my 11-year-old daughter Maya’s soccer practice: “Heading (attacking and defensive situations, being brave).”

I definitely watched the Rock Center story with concern. Research shows that girls report twice as many concussions as boys in sports they both play.

The report aired Wednesday, and Maya practiced heading on Thursday. On Sunday we sat on the sidelines watching Maya’s team face off against a northern New Jersey opponent. The girls fought to control the ball, with neither team clearly dominating.

Then, as if in slow motion, I watched the ball sail through the air toward Maya at midfield. She stepped into the ball, leaned forward, and headed it toward the goal. Of course, she was fine. I’m sure she felt pleased with herself for putting the new technique into play in a game situation. To be honest, I was pleased myself, although anxious at the same time.

And here are the questions I’ve been turning over since the game: is this “crisis” one that should change the game of youth soccer for girls? Should heading be banned? One expert in the Rock Center story, Bob Cantu, the director of sports medicine at Emerson Hospital in Concord, MA suggests that it should, because “girls as a group have far weaker necks.”

Naturally I take concussions seriously and would not want to do anything that could jeopardize Maya’s health. But I’m not sure I buy this so-called crisis.  For one thing, the research draws on data from high school athletes.  How much can we generalize from that population to the nearly 1.5 million girls who play youth soccer in the US every year?

What’s more, is this thinking about girls’ weakness that much different from earlier arguments suggesting women shouldn’t be educated because our brains are smaller than men’s? Or that women shouldn’t walk alone at night because we face the threat of rape?

It seems to me that ideas about “protection” are often a guise for social constraints on women and girls.  What athletic opportunities would we curtail in the name of “safety” for girls?

For now, at least, I want Maya to practice “being brave,” and if that means heading the ball, I’ll be cheering her on.

But GWP readers, what do you think? How do you think about “risk” and “safety” for your daughters or sons?

What Would Simone de Beauvoir Say? Bringing Up Bébé by former Wall Street Journal reporter Pamela Druckerman is the latest addition to books that highlight our cultural obsession with motherhood, or the failings of American mothers.  Even if you haven’t read the memoir you probably know the gist of the story given the raft of media coverage: after some time spent living in France where she gave birth to two children, Druckerman concludes that French women are superior mothers because they have time for themselves and their children are better behaved compared with her American counterparts.

Plenty of critics have taken aim at Druckerman’s argument but few have spent much time discussing the differences between French (read “extensive and nationalized”) and and American (read “few and individualized”) social supports for mothers and families aside from a quick mention before they move on to tackle other aspects of her narrative.

Surely it’s not so easy to dismiss these massive differences and the social conditions they create for mothers in their respective countries.  As a feminist, I want to focus on these structural problems and solutions, not toss them into a “by the way” paragraph.  I agree with my fellow GWPenner, Deborah Siegel, who argues here that we still need to demand some form of national childcare and better work-life options.

Work v. Motherhood Again New research in Gender and Society finds that most moms would work even if they didn’t have to.  According to Karen Christopher’s findings, mothers said they found more fulfillment in paid work than in parenting, and most women (regardless of class, race/ethnicity, or marital status), said they would work even if they didn’t have to.

Mother-readers, does this ring true to you?  Don’t get me wrong: I love my work at the National Women’s Studies Association.  At the same time, I don’t want to have to rank-order work over my role as a mother.  To me this sounds like an either/or choice that we should refuse.

Feminist Ryan Gosling Okay, this isn’t about motherhood, but Feminist Ryan Gosling falls squarely into the “and Feminism” portion of my roundup.  I love Danielle Henderson’s take on “feminist flash cards.”  I also love that Danielle is a graduate student in Gender and Women’s Studies.  I think you’ll love her work and her sense of humor, too!  Check it out and then post a comment here.

I write to share a quick update on a researcher and writer previously featured on Girl w/ Pen: Chloe Bird, Ph.D., a Senior Social Scientist at RAND in Santa Monica, was interviewed about her research on gender and household labor for the episode of Dr. Phil which is scheduled to air this Friday, December 2nd.

The “Chore Wars” episode focuses on three couples, married 4 years, 16 years and 39 years, respectively.  The three wives were in conflict over their husbands’ refusal to do more chores around the house. Dr. Phil counseled the couples, and then turned to Bird, who was sitting in the studio audience, to ask her about her research. She discussed some of the sociological issues as to why the division of household labor is such a challenge and how inequity can impact both spouses.

Bird noted,

In the case of inequity in household labor, the intended audience is individuals and couples seeking to find an equitable way to accomplish all the tasks it takes to keep a household going. So, I greatly appreciate the opportunity to communicate research to such a large and diverse audience.

For more on Bird’s medical sociological research, see my prior Girl w/Pen interview with her and her co-author Pat Rieker about their book Gender and Health: Constrained Choices and Social Policies.

2011 brought us two top-selling autobiographical takes on female aging. Jane Fonda’s Prime Time asks readers to explore everything from friendship to fitness to sex, with a goal of having us accept that “people in their 70s can be sexually attractive and sexually active.”  Betty White’s If you Ask Me (And Of Course You Won’t) offers readers a candid and often humorous take on the last 15 years of her life. White warns of the pitfall of our youth-centric culture: “So many of us start dreading age when we’re in high school. And I think that’s really a waste of a lovely life.”  While these celebrity authors paint provocative personal portraits of aging, I’m drawn to the new book by Colgate sociologist Meika Loe, Ph.D.: Aging Our Way: Lessons for Living from 85 and Beyond (Oxford University Press) charts her three-year journey following the lives of 30 diverse “elders” (women and men ages 85 to 102 years old), most of whom were aging at home and making it work.

Adina Nack: How did your last book on the Viagra phenomenon lead you to your new book on the ‘oldest old’?

Meika Loe: For The Rise of Viagra I interviewed elder men and elder women partners of Viagra users. It became clear that ageism impacted their lives and was a key ideology that propelled the Viagra phenomenon forward. Afterwards, I missed those interactions with elders and wanted to know more about their experiences aging at home. Aging Our Way ended up being a book that focuses more on elder women’s experiences, voices that had been marginalized, if not completely absent, from the media coverage of the Viagra phenomenon.  In the 85+ age group, women outnumber men by almost 3 to 1, and close to 80% of elders living at home alone are women. Too many people assume that research on elders is sad and depressing, in comparison to research on Viagra. To the contrary! I find elders’ stories inspirational. Aging Our Way features the lessons I learned from them – lessons for all ages.

AN: Aside from the Viagra interviews, what inspired you to focus on this group of people who are all more than twice your age?

ML: I was extremely close with my grandparents and great-grandparents growing up. More recently, I rent a room from a village elder in the small town where I work. Living with her, an invisible world opened up to me – a world of widows caring for one another and collectively attending to quality of life, mostly in the absence of biological kin.  Like, Carol, my seventy-something landlady, who gets a check-in call from octogenarian Joanne every morning at 8 a.m. Then Carol calls 98-year-old Ruth. All of these widows have lived alone in their homes within 10 square blocks of each other for decades, and now they constitute a social family. Once in a great while, when Carol cannot reach Ruth, she’ll grab the extra key and head to her home to make sure everything is okay. One time she found Ruth on the floor.

AN: That must have been scary – so, even with this type of ‘morning phone tree’, isn’t isolation a problem for these women and men aging alone?

ML: Yes, like most of us, elders attempt that delicate balancing act between dependence and independence every day. So, while many of these elders value independent-living, they’re also adept at building social networks. Ruth H. is committed to making a new friend every year of her life: she reaches out to my campus’s Adopt-a-Grandparent group and has five student walking partners this year, all new friends. That said, aging alone comes with its share of isolation and risk, and I’m reminded of Elizabeth, a Navy veteran and high school English teacher who insisted on living alone in her home, amidst her longtime friends and neighbors, despite her children’s pleas for her to move to Georgia. Elizabeth recently passed away during Hurricane Irene. She was inspecting her basement for flooding and must have fallen. This is such a sad story, but Elizabeth would not have wanted it any other way: she said she wanted to die with her boots on.

AN: Do women have an advantage over men when it comes to longevity and aging?

ML: Social epidemiologists Lorber and Moore have shown that women live longer but not necessarily healthier lives. Traditional gender roles take their toll: often, women prioritize caring for others for so long that their own health suffers.  Perhaps as a result, women have higher rates of chronic illness and depression. At the same time, many of the women I followed are enjoying a chapter in their lives where they can focus on themselves, their communities, their gardens, and their own health. Shana, 95, says things like “Now I am finally living for myself. Now I can focus on me.” Most women have lifelong gendered skill-sets for self-care: systems for food preparation, cleaning, bathing, budgeting, and reaching out to others. The men I followed are less adept at those skills: they had never been expected to cook and clean. So men, like Glenn, told me about having to learn these skills after the loss of their spouses.

AN: Does caretaking of others really end at age 85?

ML: Caretaking continues, often in new and familiar ways.  I think of Olga, age 97, caring for her grandson every weekend and putting aside a few dollars every day for her daughter who is battling cancer.  In her subsidized senior housing community, she delivers hot meals, hems pants, and runs errands. By caretaking, Olga feels a sense of community, a web of support. When she needs assistance, she has options and knows where to turn. So contrary to expecting nonagenarians to be sickly and dependent, many not only receive but also give care.

AN: Talk of cutting Social Security and Medicare has been in the news – how did you see these programs impacting elders’ lives?

ML: I have to admit – in my 30s, I see money going out of my paycheck—and I remind myself that that money is put aside for when I need it – I just hope it will be there! Through this research I saw how and why programs like Medicare and Social Security matter. For example, Juana worked in factories her whole adult life, and her small Social Security check keeps her hovering above the poverty line, able to afford rice and beans for the family and to pay for cable TV so she can watch her beloved Yankees.  Medicare covers annual doctor’s visits that likely keep her from spending time in the emergency room, a more expensive cost for society. Like most elders, she depends on Social Security for a significant portion of her income.

AN: Why should we all – not just the elders in the U.S. – read your book?

ML: Undergrads come to my Sociology of Aging course with all sorts of preconceived notions. They dread aging, seeing it as synonymous with depression, disease, and death. Our ageist society has taught them that aging equals loss, and they’re surprised to learn about elders who are aging on their own terms: coordinating self-care, combating isolation and loneliness, and exercising autonomy and control – sometimes in the face of disabilities and chronic illnesses. We all benefit from learning creativity, connectivity and resiliency from our elders. They teach us crucial lessons about all stages in life: living in moderation, designing comfortable spaces, constructing social families, appreciating humor and touch, and building social capital.  And, let’s face it, if we’re lucky, then we will all be elders soon enough.

Is the legality of abortion in the U.S. a moot point if too few ob-gyns are willing to perform the medical procedures?  A recent post on FREAKONOMICS inspired me to find out more about a new article in the journal Obstetrics & Gynecology titled “Abortion Provision Among Practicing Obstetrician-Gynecologists.”

This group of researchers mailed surveys to practicing ob-gyns and reported on the data from 1,800 who responded. The article’s main findings are as follows: “Among practicing ob-gyns, 97% encountered patients seeking abortions, whereas 14% performed them.” Their analysis of the data revealed that male physicians were less likely to provide abortions than female physicians. Age was also a factor, with younger physicians being more likely to provide abortions.

The new article’s abstract states, “…physicians with high religious motivation were less likely to provide abortions.” I wonder if the large numbers of ob-gyns who do not provide abortions speaks to moral judgments that this medical procedure is a sin. So, the legality of abortion may be rendered pointless by physicians who may be making decisions based on religious doctrine? Access to abortion remains limited by the willingness of physicians to provide abortion services, particularly in rural communities and in the South and Midwest.” Does a woman’s geographic location doom her to restrictions on her ability to obtain a medical procedure that is protected by law?

During my study of women and men living with genital herpes and HPV/genital warts infections, I coined the term moral surveillance practitioner to describe the doctor-patient interaction style of health care providers who conveyed a sense of disapproval, judgment, condemnation, and even disgust to their patients who had sought their sexual health services.  In the case of STDs, these practitioners tended to blame their patients for having contracted a medically incurable infection because of their own “bad” and sinful sexual behaviors.

It would be interesting to see if a companion study to the newly published one, perhaps a qualitative interview study, would reveal a more nuanced understanding of the attitudes and values that ob-gyns hold about their female patients who seek abortion services.  With women’s physical and/or mental health often hanging in the balance of the ability to receive a legal abortion, we deserve to know more about the large number of ob-gyns whose moral opinion may be taking precedence over their ethical obligation to, in the words of the Hippocratic Oath, “First, do no harm”…in this case, to do no harm to their female patients who may be harmed by not having a medically safe, legal abortion.

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Note: If you’re curious about physicians’ insights and experiences in providing (or not providing) abortion care, then check out two recent books: Carole Joffe’s Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us and Lori Freedman’s Willing and Unable: Doctors Constraints in Abortion Care. And, for more of the latest research on reproductive health care and policy, explore the work of UC San Francisco’s reproductive health think tank ANSIRH.

Okay, I’ll admit it – ever the STD researcher, I was tempted to focus on the recent NYT article, “A Vaccine May Shield Boys Too.”* Instead, I dedicate this month’s column to a recent news item that has not attracted a lot of attention: the FDA issued an advisory warning against the use of mesh implants that are routinely used for surgical repairs of pelvic floor damage.  Warning: This post contains medically accurate language which some readers might find disturbing. (It also contains new medical findings that all readers should find disturbing!)

First, it’s important to know what the pelvic floor is and what functions it serves: in addition to this image from 1918’s Gray’s Anatomy, check out a newer medical illustration included in a recent LA Times article.  This muscular structure has the demanding job of supporting the uterus, bladder, urethra, the walls of the vaginal canal and rectum. In other words, it’s pretty darn important.  Without functional pelvic floor muscles, women can experience urinary incontinence, fecal incontinence, and uncomfortable/painful sexual intercourse.  (Not to mention, it’s more than a little disconcerting to have to manually push your prolapsed organs back into place.)

Surgical repairs of this type of damage are often done to correct prolapses of the uterus and surrounding organs which, to put it bluntly, can feel “as if something is falling out of your vagina.”  The problem is that the mesh devices used in many of these surgeries may be harming the sexual and reproductive health of many of the tens of thousands of women who have surgery each year for prolapse.

You might be wondering, how many women are at risk for pelvic organ prolapse?  Cigna say the top risk factors are full-term pregnancies (which stretch the pelvic floor), the strain of childbirth, and having a hysterectomy (surgical removal of the uterus).  On a recent episode of his TV show, Dr. Oz shared the estimate “almost 50% of women will experience some form or prolapse in their lifetime.”

Thousands of women opt for prolapse surgery every year, and many of these surgeries have involved the use of mesh implant devices to support torn/damaged pelvic floor tissue.  As noted in a July 14^th LA Times article, “The advisory was issued after an increase in reported complications involving the device.”  This article also describes complications as including “pain and urinary problems,” as well as, “erosion, when the skin breaks and the device protrudes, and contraction of the mesh that leads to vaginal shrinkage.”  Back in 2008, the FDA’s Public Health Notification and Additional Patient Information documents cited 1,000+ reports of these kinds of serious complications but considered them to be rare.  Fast forward to 2011 when these serious complications “have jumped fivefold,” no longer rare.

So, how does this impact a woman’s sex life?  The FDA notes, “Both mesh erosion and mesh contraction may lead to severe pelvic pain, painful sexual intercourse or an inability to engage in sexual intercourse.”  And, male partners of these women are also at risk: “men may experience irritation and pain to the penis during sexual intercourse when the mesh is exposed in mesh erosion.” 

With the FDA deciding to not remove the mesh implants from the market, did they do enough to protect patients?  Some experts say, “No.”  Dr. Diana Zuckerman of the National Research Center for Women & Families points out that these mesh implants have been used, “despite no clinical trials, no testing on humans to see if they’re actually safe and effective.”  It is time to advocate strongly for research and development of pelvic floor surgical repair techniques which do not involve the use of synthetic mesh implants.

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*This article sheds very little new light on a topic I wrote about over a year ago forMs. Magazine and blogged about back in 2009 – Gardasil is not simply the ‘cervical cancer’ vaccine its initial branding advertised; it also offers several potential health benefits for boys and men. 

Yesterday marked the one-year anniversary of President Obama signing the Affordable Care Act.  I encourage everyone to become familiar with what the Act has already accomplished, as well as the plans through 2015 (see an interactive timeline online).

Today, I dedicate this month’s column to reflecting on one of the new consumer protections that is scheduled to become effective January 1, 2014, No Discrimination Due to Pre-Existing Conditions or Gender:

Before the Affordable Care Act became law, insurance companies selling individual policies could deny coverage to women due to pre-existing conditions, such as cancer and having been pregnant. 

A WhiteHouse.Gov fact-sheet describes the ways in which, “The Affordable Care Act Gives Womem Greater Control Over Their Own Health Care.”  When I first read it, even as a feminist medical sociologist familiar with health care inequities, a few lines jumped out at me:

Right now, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man.

Less than half of women have the option of obtaining health insurance through a job.

Today, maternity benefits are often not provided in health plans in the individual insurance market.

I appreciate the many positive effects this law has on women, men and children, but I find myself asking: why did the Affordable Care Act not include this provision — to eliminate discrimination to due to gender — among its original 2010 provisions?  A comparable provision was effective as of September 23, 2010 for children:

…health plans that cover children can no longer exclude, limit or deny coverage to your child under age 19 solely based on a health problem or disability that your child developed before you applied for coverage.

Now, don’t get me wrong, I’m all for protecting children’s rights to receiving coverage.  As a mom, I understand the instinct to want to protect one’s child before one’s self.  However, it feels like the policy-makers did not take into account the body of research on the direct correlations between maternal health and child health.  To put it simply, an unhealthy mom is not good for the health of her child — whether or not her child has excellent or poor health care coverage.

For example, a 2005 article in the journal PEDIATRICS documents research findings that,

“Maternal depressive symptoms in early infancy contribute to unfavorable patterns of health care seeking for children.” 

Another 2005 article examined the psychological and physical health of adult caregives of children with cerebral palsy and found that:

The psychological and physical health of caregivers, who in this study were primarily mothers, was strongly influenced by child behavior and caregiving demands…These data support clinical pathways that require biopsychosocial frameworks that are family centered, not simply technical and short-term rehabilitation interventions that are focused primarily on the child.

It’s easy to imagine the ways in which a child’s health might suffer if her/his primary caretaker has poor mental and physical health.  And, solely providing health care to the child did not necessarily improve the health outcomes of the caregiving moms.

One more example along the lines of the effects of maternal depression is the case of pediatric asthma.  A 2007 article in the Journal of Health Economics reports a study which shows:

…treatment of mother’s depression improves management of child’s asthma, resulting in a reduction in asthma costs in the 6-month period following diagnosis of $798 per asthmatic child whose mother is treated for depression.

Our health care system will likely save more money once we end insurance company discrimination on the basis of sex/gender.  Now, I recognize that not all women are mothers, but the overwhelming majority of mothers are women.  So, if the gendered division of labors in most families remains such that moms are primarily in charge of maintaing and protecting the health of their children, then wouldn’t we want these caregivers to have access to affordable, quality health care before 2014? 

That said, I am grateful that this law passed and hope that we will continue to work on ways to strengthen coverage for all Americans.

For this month’s column, I had the pleasure of emailing with Chris Bobel, Ph.D. about her new book which deftly tackles a taboo topic.

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You explore new feminist activism that focuses on menstruation. Historically, how have feminists viewed menstruation, and why menstrual activism now?

The issue of menstruation has not been a top feminist priority, though, since at least the 1970s, a few bold feminists have recknoned with socio-cultural and political dimensions of the menstrual cycle. I argue that the menstrual taboo–which impacts us all, even feminists–often puts the issue off-limits. In mainstream culture, the only menstrual discourse that gets any play is making fun of women with PMS. I studied menstrual activists who want to widen and complicate the conversation. Menstrual activism is part of an enduring project of loosening the social control of women’s bodies, moving women’s bodies from object to subject status–something absolutely foundational to addressing a range of feminist issues, from human trafficking to eating disorders to sexual assault.

What do you think of Kotex’s new ad campaign “Break the Cycle,” which lampoons traditional menstrual product ads?

The new campaign could be a game change, but I’m doubtful. First, the campaign only works as long as the menstrual taboo persists; otherwise, their frank talk doesn’t stand out, does it? While I can join in the joke of the industry poking fun at itself–and I love the message of “no more shame”–in the end, it’s the same, just repackaged.

Second, I resent this campaign for exploiting shame to sell product for nearly a centuray and then exploiting THEIR overdue pronouncement–“enough with the euphemisms, and get over it”–to sell product.

Also, you’ve got to wonder if not only Kotex but their whole industry is now pulling out all the stops to try to hold onto its market share as menstrual suppression drugs–like Seasonique and Lybrel–are gaining interest.

So, what do you think of pharmaceutical industry arguments that support these menstrual suppressants?

Their quasi-feminist arguments co-opt feminism to push drugs. Big Pharma is marketing suppression as a ‘lifestyle choice’, but what most don’t realize is that “menstrual suppression” is actually cycle-stopping contraception that does not only reduce or eliminate menstrual bleeding but also suppresses the complex hormonal interplay of the menstrual cycle. We don’t yet have adequate data to really show if this is a safe long-term practice for otherwise healthy women. Check out this position statement.

Furthermore, ad campaigns represent the menstrual cycle as abnormal, obsolete, and even unhealthy. These messages underscore that women’s natural functions are defective, dysfunctional and need medical intervention. This can lead to negative body image, especially in young women. How is this feminist? ‘Choice’ without good, fact-based information based on thorough medical studies isn’t real choice, and a campaign that exploits women’s negative attitudes about their bodies isn’t feminist either.

Your work uses menstrual activism as an analytical lens through which to view continuity and change in the women’s movement, from what some call the “second wave” of feminism through the “third wave.” So, given that the ‘wave’ distinctions are not without controversy among feminists, what do you see as setting third wave feminism apart? Is it truly unique, or is it merely a label that recognizes the next generation?

There’s a lot of continuity between the waves–mostsly in the tactical sense. Today’s feminist blogs are yesterday’s zines, which reflect earlier mimeographed manifestos; radical cheerleading recalls street theater and public protests, like early second-wavers at the 1969 Miss America pageant. Second-wavers practiced what third-wavers call DIY (Do It Yourself) healthcare when they modeled pelvic self exams. But, most third-wavers depart from most (but not all) second-wavers by troubling the gender binary. For example, the radical wing of menstrual activism movements reers to “menstruators”, instead of assuming that everyone who menstruates gender-identifies as a woman.

Tell me more about that!

Most assume that a female-bodied person, with breasts and a vulva, is a woman, and usually that’s true. We also assume that menstruation is a near-universal experience for women. Radical menstruation activists question these assumptions. Menstruation is not and has never been EVERY woman’s experience. Women don’t menstruate for lots of reasons, and they don’t menstruate their whole lives. Also, some transmen and intersex people DO menstruate. So, equating menstruation with womanhood is problematic. Saying “menstruators” makes room for more people, more experiences. This linguistic move is boundary smashing, inclusion-in-action and bodes well for feminism’s future.

But, you’ve written that menstrual activists are not successful at all attempts at inclusion.

The first face of the feminist movement may have been white and middle class, but poor white women and women of color across the class spectrum have always been there, often toiling in relative obscurity. This could be the case with menstrual activism, too. However, I’m a white, privileged academic, and this biases my world view. I looked for women of color doing this work and found a few. But, was I looking in the right places? Was I using the right language? One activists of color said that I was likely missing Black women because I wasn’t clarifying how race and gender intersect in menstrual health. Also, menstrual activism is risky business for all, and especially for women of color, whose bodies have been denigrated throughout history. Taking on the menstrual taboo can make others see you as nasty, gross, improper…and if you’re already struggling to be accepted and taken seriously, then why go “there”?

Well, I and many other women’s health activists appreciate that you ‘went there’!

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For more on this topic and her research, check out Chris’s new book — New Blood: Third-Wave Feminism and the Politics of Menstruation (Rutgers University Press, 2010), previewed in the Our Bodies, Ourselves blog and in a provocative article in the Guardian last fall.