gender: health/medicine

Flashback Friday.

The term “fetal alcohol syndrome” (FAS) refers to a group of problems that include mental retardation,  growth problems, abnormal facial features, and other birth defects.  The disorder affects children whose mothers drank large amounts of alcohol during pregnancy.

Right?

Well, not exactly.

It turns out that only about 5% of alcoholic women give birth to babies who are later diagnosed with FAS. This means that many mothers drink excessively, and many more drink somewhat (at least 16 percent of mothers drink during pregnancy), and yet many, many children born to these women show no diagnosable signs of FAS. Twin studies, further, have shown that sometimes one fraternal twin is diagnosed with FAS, but the other twin, who shared the same uterine environment, is fine.

So, drinking during pregnancy does not appear to be a sufficient cause of FAS, even if it is a necessary cause (by definition?). In her book, Conceiving Risk, Bearing Responsibility, sociologist and public health scholar Elizabeth M. Armstrong explains that FAS is not just related to alcohol intake, but is “highly correlated with smoking, poverty, malnutrition, high parity [i.e., having lots of children], and advanced maternal age” (p. 6). Further, there appears to be a genetic component. Some fetuses may be more vulnerable than others due to different ways that bodies breakdown ethanol, a characteristic that may be inherited. (This may also explain why one fraternal twin is affected, but not the other.)

To sum, drinking alcohol during pregnancy appears to contribute to FAS, but it by no means causes FAS.

And yet… almost all public health campaigns, whether sponsored by states, social movement organizations, public health institutes, or the associations of alcohol purveyors tell pregnant women not to drink alcohol during, before, or after pregnancy… at all… or else.

The Centers for Disease Control (U.S.):

The National Organization on Fetal Alcohol Syndrome:

Best Start, Ontario’s Maternal Newborn and Early Child Development Resource Centre:

Nova Scotia Liquor Commission:

These campaigns all target women and explain to them that they should not drink any alcohol at all if they are trying to conceive, during pregnancy, during the period in which they are breastfeeding and, in some cases, if they are not trying to conceive but are using only somewhat effective birth control.

So, the strategy to reduce FAS is reduced to the targeting of women’s behavior.

But “women” do not cause FAS. Neither does alcohol. This strategy replaces addressing all of the other problems that correlate with the appearance of FAS — poverty, stress, and other kinds of social deprivation — in favor of policing women. FAS, in fact, is partly the result of individual behavior, partly the result of social inequality, and partly genetic, but our entire eradication strategy focuses on individual behavior. It places the blame and responsibility solely on women.

And, since women’s choices are not highly correlated with the appearance of FAS, the strategy fails. Very few women actually drink at the levels correlated with FAS. If we did not have a no-drinking-during-pregnancy campaign and pregnant women continued drinking at the rates at which they drank before being pregnant, we would not see a massive rise in FAS. Only the heaviest drinking women put their fetus at risk and they, unfortunately, are the least likely to respond to the no-drinking campaign (largely due to addiction).

Originally posted in 2010 and developed into a two-page essay for Contexts magazine.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

The ideology of intensive motherhood is a cultural approach toward parenting that suggests that competent childcare demands “copious amounts of time, energy, and material resources” and that providing such childcare should take priority over everything else a mother might like or need to do.  In South Korea, this imperative is at work even before babies are born and the practice is called tae-gyo. A reporter for the Korea Herald, a local newspaper, explains:

Since over 600 years ago, expectant mothers in Korea have been practicing taegyo, a series of prenatal routines aimed at nurturing a healthy, virtuous and skilled child. They try to see and hear only the most pleasant things starting from three months of pregnancy.

Koreans believe that a mother’s state of mind and ongoing education during pregnancy determines a baby’s prospects. Their educational and occupational future, even their personality, is dependent on what their mothers do while they’re pregnant. A reporter, below, quotes a South Korean figure who claims that “nine months of prenatal education is more valuable than nine years of post-natal learning.”

Interest in tae-gyo is escalating thanks to declining birth rates and hyper-competition. Fewer Korean couples are having more than one child and they want to give these “single” children an edge by helping them from the womb.  They want their children to survive in a hypercompetitive educational environment.

Accordingly, while the most common tae-gyo used to be listening to classical music, women are facing increasing pressure to do more and more for their child before it is born. During the past 20 years, tae-gyo has incorporated learning calligraphy or floral arrangement, crafts like knitting and sewing, and doing yoga. Expected mothers are doing English and math tae-gyo, meaning that they study English and do math for their unborn children to ensure that they will excel in those skills. Korea’s tourism industry have developed a “taegyo travel package,” which is supposed to be beneficial for babies in the womb.

This can all be quite intensive, as you might imagine, as women are expected to personally practice all of the skills and traits they hope their baby will have. Intensive mothering in South Korea, then, starts before the baby is born.

[youtube]https://www.youtube.com/watch?v=YX2C1ueBxY4[/youtube]

Cross-posted at Pacific Standard.

Sangyoub Park, PhD, is an associate professor of sociology at Washburn University, where he teaches Social Demography, Generations in the U.S., and Sociology of East Asia. His research interests include social capital, demographic trends, and post-Generation Y.

Medical professionals often have the final say in deciding what counts as a “defect.” Often, their decisions exceed the bounds of medicine, addressing bodies that may deviate from “normal” or “average,” but do not actually cause medical problems.

An alternative might be to allow the patient to decide if his or her body is acceptable, but in doing so they risk allowing people’s deeply subjective and often dysmorphic perceptions of their own bodies determine whether they undergo a risky procedure.

Is there another way?

Pediatric surgeon Norma Ruppen-Greeff and hers colleagues thought so. Pediatric physicians often correct hypospadias: a condition in which the meatus, or opening of the urethra, doesn’t quite make it to the top of the penis during fetal development, such that the urethra exits the penis somewhere along the shaft. This is generally corrected surgically, but physicians found that some men returned to them as adults with concerns that their penis still appeared abnormal.

Instead of dismissing men’s concerns or jumping with a knife, they decided to ask women if they noticed. They had 105 women fill out a questionnaire and rate which aspects of penile appearance were important to them. And, lo and behold, the shape and placement of the meatus was the least important. No need for surgery, plus they can reassure the guys that they’re okay. (Someone should follow up and ask gay and bisexual men; anyone for an awesome senior thesis?)

This is a great way to measure the sociocultural value of a surgery. Whereas we’re used to thinking about surgical issues as psychological (someone wants it) or medical (someone needs it), these physicians asked a distinctly sociological question. They measured how penises are widely perceived and which parts are socially constructed as important. That’s a pretty neat way to incorporate sociological realities into surgical practice.

Cross-posted at Pacific Standard.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

According to the U.S. Bureau of Labor Statistics, fully employed women earn $0.81 for every dollar men make. Some of this discrepancy is due to women working in male dominated occupations, but when men work alongside women in female-dominated occupations, they still earn more.

Nursing is this week’s example. According to a new study in the Journal of the American Medical Association, male nurses out earn female nurses in every work setting, every clinical setting, and every job position except one.

On average, male nurses make $5,100 more a year than female ones. In the specialty with the biggest discrepancy, nurse anesthetists, they out earned women by $17,290. More at NPR and the New York Times.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

This week the New York Times published an interactive that illustrates the likelihood of pregnancy despite contraceptive use. Risk is divvied up by method, for perfect and typical use, and added up over ten years. The results are a little terrifying (click to see larger or go here to explore):

Somewhere around half of all pregnancies are unintended.  This is why. It’s hard enough to use contraceptives perfectly but, even when we do, the risk of failure is very real.

Male condoms are the safer sex favorite. But, even when used perfectly, almost one in five women will get pregnant over a ten year period. With typical use, more than four out of five. Withdrawal, one primary foil against which male condoms are usually recommended, is only slightly less effective at preventing pregnancy, as typically used.

The favorite of Americans — The Pill, as well as some other hormonal methods — is more effective than the condom, but not nearly as much as we think it is. Under ideal conditions, only three in 100 will get pregnant over ten years; in reality, almost two-thirds — 61 in 100 — will end up pregnant.

Only the most human-error resistant methods — the IUD, hormonal implants, and sterilization — near 100% effectiveness. These are permanent or semi-permanent and not real options for a large proportion of sexually active Americans during at least some parts of their lives.

Discussions of the right to an abortion and the ease with which they can be attained needs to be had with this information at the forefront of the discussion. Unintended pregnancies happen all the time to everyone.

Cross-posted at Pacific Standard.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Lotion is socially constructed as feminine in the U.S. and so some men, attempting to avoid the prevailing insults of our time — gay, fag, bitch, pussy, douche, girl, and woman — are disinclined to use it.

Eeeew, lotion!

You know who you are, guys.

Sunscreen is a category of lotion and so putting on sunscreen is equivalent to admitting you’re the sun’s bitch.  Men are supposed to let the sun bake their face into a tough, craggy masculinity that says “yeah, I go outdoors and, when I do, I don’t give a shit.”

Because caring about one’s health is for pussies, some scholars argue that being male is the single strongest predictor of whether a person will take health risks.  In fact, thanks in part to the stupid idea that lotion carries girl cooties, men are two to three times more likely to be diagnosed with skin cancer.

So, fine dudes, here’s some sunscreen for men.  For christ’s sake.

Thanks to @r0setayl0r and @ryesilverman for sending along the product!  Check it out on our truly humorous pointlessly gendered products Pinterest board.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

My sister-in-law Charlotte was recently loudly admonished by a flight attendant on an international flight for allowing her “breast to fall out” after she fell asleep while nursing her baby. A strong advocate for breastfeeding, Charlotte has shared with me her own discomfort with public breastfeeding because it is considered gross, matronly, and “unsexy.”

I heard this over and over again from women I have interviewed for my research:  Women who breastfed often feel they have to cover and hide while breastfeeding at family functions. As one mom noted, “Family members might be uncomfortable so I leave room to nurse—but miss out on socializing.”  This brings on feelings of isolation and alienation. Because of the “dirty looks” and clear discomfort by others, women reported not wanting to breastfeed in any situation that could be considered “public.”

Meanwhile, I flip through the June 2012 issue of Vanity Fair and see this ad:

We capitalize on the sexualization of the breast to raise awareness about breast cancer. Yet, we cringe at the idea of a woman nursing her child on an overnight flight.

What’s happening here? These campaigns send contradictory messages to women about their breasts and the way women should use them, but they have something in common as well: both breastfeeding advocacy and breast cancer awareness-raising campaigns tend to reduce women to body parts that reflect the social construction of gender and sexuality.

Breast cancer awareness campaigns explicitly adopt a sexual stance, focusing on men’s desire for breasts and women’s desire to have breasts to make them attractive to men. Breast milk advocates focus on the breast as essential for good motherhood. Breastfeeding mothers sit at the crossroads: Their breasts are both sexualized and essential for their babies, so they can either breastfeed and invoke disgust, or feed their child formula and attract the stigma of being a bad mother.

Both breastfeeding advocacy programs and breast cancer awareness-raising campaigns demonstrate how socially constructed notions of ownership and power converge with the sexualization and objectification of women’s breasts. And, indeed, whether breast feeding or suffering breast cancer, women report feeling helpless and not in control of their bodies. As Jazmine Walker has written, efforts to “help” women actually “[pit] women against their own bodies.”

Instead, we need to shift away from a breast-centered approach to a women-centered approach for both types of campaigns. We need to, as Jazmine Walker advocates, “teach women and girls how to navigate and control their experiences with health care professionals,” instead of pushing pink garb and products and sexualizing attempts to raise awareness like “save the ta-tas.”  Likewise, we need to support women’s efforts to breastfeed, if they choose to, instead of labeling “bad moms” if they do not or cannot. Equipped with information and bolstered by real sources of support, women will be best able to empower themselves.

Jennifer Rothchild, PhD is in the sociology and gender, women, & sexuality studies departments at the University of Minnesota, Morris. She is the author of Gender Trouble Makers: Education and Empowerment in Nepal and is currently doing research on the politics of breastfeeding.

In her provocative book, The Technology of Orgasm, Rachel Maines discusses a classic medical treatment for the historical diagnosis of “hysteria”: orgasm administered by a physician.

Maines explains that manual stimulation of the clitoris was, for some time, a matter-of-fact part of medical treatment and a routine source of revenue for doctors. By the 19th century, people understood that it was an orgasm, but they argued that it was “nothing sexual.” It couldn’t “be anything sexual,” Maines explains, “because there’s no penetration and, so, no sex.”

So, what ended this practice? Maines argues that it was the appearance of the vibrator in early pornographic movies in the 1920s.  At which point, she says, doctors “drop it like a hot rock.” Meanwhile, vibrators become household appliances, allowing women to treat their “hysteria” at home. It wasn’t dropped from diagnostic manuals until 1957.

Listen to it straight from Maines in the following 7 minutes from Big Think:

Bonus: Freud was bad at this treatment, so he had to come up with some other cause of hysteria. After all, she says, “this was the guy who didn’t know what women wanted.” No surprise there, she jokes.

Cross-posted at Pacific Standard.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.