gender: health/medicine

Flashback Friday.

You have likely seen photographs of fetus’ that seem to float in a dark womb.  The first of these were taken by Swedish photographer Lennart Nilsson. One of his photographs graced the cover of Life magazine in April of 1965.

Nilsson’s images forever changed the way that people think about pregnancy, mothers, and fetuses.  Before Nilsson, the visual of a fetus independent from a mother was not widespread. His pictures made it possible for people to visualize the contents of a woman’s womb independently of her body.  Suddenly, the fetus came to life.  It was no longer just something inside of a woman, no longer even in relationship to a woman; it was an individual with a face, a sex, a desire to suck its thumb.

Once the fetus could be individualized, the idea that a woman and her fetus could have contrasting interests was easier to imagine. In many countries even today, the idea that helping pregnant women is helping fetuses and helping fetuses means helping pregnant women is still the dominant way of thinking about pregnancy. Pro-choice and other fetus-defenders, such as those who want it to be illegal to smoke during pregnancy, used these images to disentangle the interests of the woman and the fetus. The vulnerability of Nilsson’s subjects, free-floating in space, made it easier to portray fetuses as in danger.

There is power in visualization and its technological advance and these images were a boon to the pro-life cause. Ironically, it was abortion that made these images possible. Nilsson posed the fetuses to look alive, and gives no indication otherwise, but they are actually photographs of aborted fetuses.

Although claiming to show the living fetus, Nilsson actually photographed abortus material obtained from women who terminated their pregnancies under the liberal Swedish law. Working with dead embryos allowed Nilsson to experiment with lighting, background and positions, such as placing the thumb into the fetus’ mouth.

— Quote from the University of Cambridge’s history of the science of fetal development

Liberal abortion rights laws resulted in a product that was used to mobilize anti-abortion sentiment.  Today it is par for the course to have been exposed to images like this. And the rest is history.

Originally posted in 2009.

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.

In truth, I didn’t pay a tremendous amount of attention to iOS8 until a post scrolled by on my Tumblr feed, which disturbed me a good deal: The new iteration of Apple’s OS included “Health”, an app that – among many other things – contains a weight tracker and a calorie counter.

And can’t be deleted.

Okay, so why is this a big deal? Pretty much all “health” apps include those features. I have one (third-party). A lot of people have one. They can be very useful. Apple sticking non-removable apps into its OS is annoying, but why would it be something worth getting up in arms over? This is where it becomes a bit difficult to explain, and where you’re likely to encounter two kinds of people (somewhat oversimplified, but go with me here). One group will react with mild bafflement. The other will immediately understand what’s at stake.

The Health app is literally dangerous, specifically to people dealing with/in recovery from eating disorders and related obsessive-compulsive behaviors. Obsessive weight tracking and calorie counting are classic symptoms. These disorders literally kill people. A lot of people. Apple’s Health app is an enabler of this behavior, a temptation to fall back into self-destructive habits. The fact that it can’t be deleted makes it worse by orders of magnitude.

So why can’t people just not use it? Why not just hide it? That’s not how obsessive-compulsive behavior works. One of the nastiest things about OCD symptoms – and one of the most difficult to understand for people who haven’t experienced them – is the fact that a brain with this kind of chemical imbalance can and will make you do things you don’t want to do. That’s what “compulsive” means. Things you know you shouldn’t do, that will hurt you. When it’s at its worst it’s almost impossible to fight, and it’s painful and frightening. I don’t deal with disordered eating, but my messed-up neurochemistry has forced me to do things I desperately didn’t want to do, things that damaged me. The very presence of this app on a device is a very real threat (from post linked above):

Whilst of course the app cannot force you to use it, it cannot be deleted, so will be present within your apps and can be a source of feelings of temptation to record numbers and of guilt and judgement for not using the app.

Apple doesn’t hate people with eating disorders. They probably weren’t thinking about people with eating disorders at all. That’s the problem.

Then this weekend another post caught my attention: The Health app doesn’t include the ability to track menstrual cycles, something that’s actually kind of important for the health of people who menstruate. Again: so? Apple thinks a number of other forms of incredibly specific tracking were important enough to include:

In case you’re wondering whether Health is only concerned with a few basics: Apple has predicted the need to input data about blood oxygen saturation, your daily molybdenum or pathogenic acid intake, cycling distance, number of times fallen and your electrodermal activity, but nothing to do with recording information about your menstrual cycle.

Again: Apple almost certainly doesn’t actively hate cisgender women, or anyone else who menstruates. They didn’t consider including a cycle tracker and then went “PFFT SCREW WOMEN.” They probably weren’t thinking about women at all.

During the design phase of this OS, half the world’s population was probably invisible. The specific needs of this half of the population were folded into an unspecified default. Which doesn’t – generally – menstruate.

I should note that – of course – third-party menstrual cycle tracking apps exist. But people have problems with these (problems I share), and it would have been nice if Apple had provided an escape from them:

There are already many apps designed for tracking periods, although many of my survey respondents mentioned that they’re too gendered (there were many complaints about colour schemes, needless ornamentation and twee language), difficult to use, too focused on conceiving, or not taking into account things that the respondents wanted to track.

Both of these problems are part of a larger design issue, and it’s one we’ve talked about before, more than once. The design of things – pretty much all things – reflects assumptions about what kind of people are going to be using the things, and how those people are going to use them. That means that design isn’t neutral. Design is a picture of inequality, of systems of power and domination both subtle and not. Apple didn’t consider what people with eating disorders might be dealing with; that’s ableism. Apple didn’t consider what menstruating women might need to do with a health app; that’s sexism.

The fact that the app cannot be removed is a further problem. For all intents and purposes, updating to a new OS is almost mandatory for users of Apple devices, at least eventually. Apple already has a kind of control over a device that’s a bit worrying, blurring the line between owner and user and threatening to replace one with the other. The Health app is a glimpse of a kind of well-meaning but ultimately harmful paternalist approach to design: We know what you need, what you want; we know what’s best. We don’t need to give you control over this. We know what we’re doing.

This isn’t just about failure of the imagination. This is about social power. And it’s troubling.

Sarah Wanenchak is a PhD student at the University of Maryland, College Park. Her current research focuses on contentious politics and communications technology in a global context, particularly the role of emotion mediated by technology as a mobilizing force. She blogs at Cyborgology, where this post originally appeared, and you can follow her at @dynamicsymmetry.

While there has been significant attention to recruiting women into STEM fields, what about the converse – recruiting men to female-dominated fields?  My recent article in Gender & Society analyzes the recruitment strategies of key health care players, examining themes of masculinity in text, speech, and images.

Some recruitment items, like this early poster from the Virginia Partnership for Nursing, asked viewers “Are you man enough to be a nurse?” Aspects of hegemonic masculinity — characteristics associated with being the culturally defined “ideal man” — are common themes in the poster, including sports, military service, risk-taking, and an emotionally-reserved demeanor:

Since the “Are You Man Enough?” campaign in the early 2000’s, nurse leaders have tried to make recruitment messages less ostensibly gendered. In discussing the American Assembly for Men in Nursing’s (AAMN) new campaign, Don Anderson notes:

Nursing recruitment efforts needed to evolve from asking men if they were masculine enough to be a nurse to something less gender specific

Despite the effort to “de-genderify” nursing (Anderson’s word), masculinity is still front and center. Though the slogan is different, materials continue to emphasize culturally idealized forms of masculinity. One of the AAMN’s newest posters, “Adrenaline Rush,” avoids the “man enough” rhetoric, but maintains the theme of a stoic, emotionally-detached masculinity through visual cues.  Most of the nurse’s face is covered – limiting emotional expression—while risk-taking is emphasized.

But not all recruitment materials employ a macho form of masculinity. Johnson & Johnson’s 30-second clip “Name Game” portrays a caring and emotionally competent nurse:

Key health care players, including an international organization (Johnson & Johnson), urban hospital systems, nursing programs, and organizations like the American Assembly for Men in Nursing (AAMN) have devoted resources to recruiting men into nursing. Analyzing their recruitment strategies reveals as much about contemporary tensions within masculinity as it does about the profession’s push for gender diversity.

Check out more of the recruitment materials and a more in-depth analysis in the article, “Recruiting Men, Constructing Manhood: How Health Care Organizations Mobilize Masculinities as Nursing Recruitment Strategy.”  For a free copy, contact me at cottingham@unc.edu.

Marci Cottingham is a postdoctoral fellow in the department of Social Medicine at the University of North Carolina – Chapel Hill. She received her Ph.D. in sociology from the University of Akron. Her research spans issues of gender, emotion, health, and healthcare. For more on her work, visit her site.

Cross-posted at Pacific Standard.

I’ve written extensively — not here, but professionally — on the ways in which Americans talk about the female genital cutting practices (FGCs) that are common in parts of Africa.  I’ve focused on the frames for the practice (common ones include women’s oppression, child abuse, a violation of bodily integrity, and cultural depravity), who has had the most power to shape American perceptions (e.g., journalists, activists, or scientists), and the implications of this discourse for thinking about and building gender egalitarian, multicultural democracies.

Ultimately, whatever opinion one wants to hold about the wide range of practices we typically refer to as “female genital mutilation,” it is very clear that the negative opinions of most Westerners are heavily based on misinformation and have been strongly shaped by racism, ethnocentrism, and a disgust or pity for an imagined Africa.  That doesn’t mean that Americans or Europeans aren’t allowed to oppose (some of) the practices (some of the time), but it does mean that we need to think carefully about how and why we do so.

One of the most powerful voices challenging Western thinking about FGCs is Fuambai Sia Ahmadu, a Sierra Leonan-American anthropologist who chose, at 21 years old, to undergo the genital cutting practice typical for girls in her ethnic group, Kono.

She has written about this experience and how it relates to the academic literature on genital cutting.  She has also joined other scholars — both African and Western — in arguing against the zero tolerance position on FGCs and in favor of a more fair and nuanced understanding of why people choose these procedures for themselves or their children and the positive and negative consequences of doing so.  To that end, she is the co-founder of African Women are Free to Choose and SiA Magazine, dedicated to “empowering circumcised women and girls in Africa and worldwide.”

You can hear Ahmadu discuss her perspective in this program:

[youtube]https://www.youtube.com/watch?v=mV6UfEaZHBE[/youtube]

Many people reading this may object to the idea of re-thinking zero tolerance approaches to FGCs.  I understand this reaction, but I urge such readers to do so anyway.  If we care enough about African women to be concerned about the state of their genitals, we must also be willing to pay attention to their hearts and their minds.  Even, or especially, if they say things we don’t like.

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.

Thanks to advances in early diagnosis and treatment of breast cancer, white women’s survival rates have “sharply improved,” but black women’s have not.  As a result, white women are more likely to be diagnosed with breast cancer, but black women are more likely to die from it.  Researchers from the Sinai Institute found that Black women are 40% more likely to die from the disease than white women.

Experts trace the majority of the widening gap in survival rates to access, not biology.  Black women are more likely than white to be low income, uninsured, and suspicious of a historically discriminatory medical profession.

From Tara Parker-Pope for the New York Times.  Hat tip @ProfessorTD.

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.

Sociologists like to say that gender identities are socially constructed. That just means that what it is, and what it means, to be male or female is at least partly the outcome of social interaction between people – visible through the rules, attitudes, media, or ideals in the social world.

And that process sometimes involves constructing people’s bodies physically as well. And in today’s high-intensity parenting, in which gender plays a big part, this includes constructing – or at least tinkering with – the bodies of children.

Today’s example: braces. In my Google image search for “child with braces,” the first 100 images yielded about 75 girls.

Why so many girls braced for beauty? More girls than boys want braces, and more parents of girls want their kids to have them, even though girls’ teeth are no more crooked or misplaced than boys’. This is just one manifestation of the greater tendency to value appearance for girls and women more than for boys and men. But because braces are expensive, this is also tied up with social class, so that richer people are more likely to get their kids’ teeth straightened, and as a result richer girls are more likely to meet (and set) beauty standards.

Hard numbers on how many kids get braces are surprisingly hard to come by. However, the government’s medical expenditure survey shows that 17 percent of children ages 11-17 saw an orthodontist in the last year, which means the number getting braces at some point in their lives is higher than that. The numbers are rising, and girls are wearing most of hardware.

A study of Michigan public school students showed that although boys and girls had equal treatment needs (orthodontists have developed sophisticated tools for measuring this need, which everyone agrees is usually aesthetic), girls’ attitudes about their own teeth were quite different:

Clearly, braces are popular among American kids, with about half in this study saying they want them, but that sentiment is more common among girls, who are twice as likely as boys to say they don’t like their teeth.

This lines up with other studies that have shown girls want braces more at a given level of need, and they are more likely than boys to get orthodontic treatment after being referred to a specialist. Among those getting braces, there are more girls whose need is low or borderline. A study of 12-19 year-oldsgetting braces at a university clinic found 56 percent of the girls, compared with 47 percent of the boys, had “little need” for them on the aesthetic scale.

The same pattern is found in Germany, where 38 percent of girls versus 30 percent of boys ages 11-14 have braces, and in Britain – both countries where braces are covered by state health insurance if they are needed, but parents can pay for them if they aren’t.

Among American adults, women are also more likely to get braces, leading the way in the adult orthodontic trend. (Google “mother daughter braces” and you get mothers and daughters getting braces together; “father son braces” brings you to orthodontic practices run by father-son teams.)

Teeth and consequences

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Today’s rich and famous people – at least the one whose faces we see a lot – usually have straight white teeth, and most people don’t get that way without some intervention. And lots of people get that.

Girls are held to a higher beauty standard and feel the pressure – from media, peers or parents – to get their teeth straightened. They want braces, and for good reason. Unfortunately, this subjects them to needless medical procedures and reinforces the over-valuing of appearance. However, it also shows one way that parents invest more in their girls, perhaps thinking they need to prepare them for successful careers and relationships by spending more on their looks.

When they’re grown up, of course, women get a lot more cosmetic surgery than men do – 87 percent of all surgical procedures, and 94% of Botox-type procedures – and that gap is growing over time.

As is the case with lots of cosmetic procedures, people from wealthier families generally are less likely to need braces but more likely to get them. But add this to the gender pattern, and what emerges is a system in which richer girls (voluntarily or not) and their parents set the standard for beauty – and then reap the rewards (as well as harms) of reaching it.

Cross-posted at Family Inequality, Adios Barbie, and Jezebel.

Philip N. Cohen is a professor of sociology at the University of Maryland, College Park, and writes the blog Family Inequality. You can follow him on Twitter or Facebook.

No costume could more perfectly capture this October at SocImages.  From The Ethical Adman’s collection of the worst sexy costumes of the year, this breast cancer-themed, absurdly sexy, looks-nothing-like-a-leopard costume.  Posts collide.

When I clicked on the link, they tried to give me a free pair of panties.  Maybe you’ll get lucky.

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.

We originally posted about this six years ago.  But, yep, they’re still selling it: The “Anna Rexia Dreamgirl” costume.

Copy reads: “You can never be too rich or too thin.”  Costume comes with a measuring tape belt.  In 2007, it was also featured in “plus size”:

H/t @RGWonser.

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.