In 1985, Zeneca Pharmaceuticals (now AstraZeneca) declared October “National Breast Cancer Awareness Month.” Their original campaign promoted mammography screenings and self-breast exams, as well as aided fundraising efforts for breast cancer related research.  The month continues with the same goals, and is still supported by AstraZeneca, in addition to many other organizations, most notably the American Cancer Society.

The now ubiquitous pink ribbons were pinned onto the cause, when the Susan G. Komen Breast Cancer Foundation distributed them at a New York City fundraising event in 1991. The following year, 1.5 million Estée Lauder  cosmetic customers received the promotional reminder, along with an informational card about breast self-exams. Although now a well-known symbol, the ribbons elide a less well-known history of Breast Cancer Awareness co-opting grassroots’ organizing and activism targeting women’s health and breast cancer prevention.

The “awareness” campaign also opened the floodgates for other companies to capitalize on the disease. For example, Avon, New Balance, and Yoplait have sold jewelry, athletic shoes, and yogurt, respectively, using the pink ribbon as a logo, while KitchenAid still markets a product line called “Cook for the Cure” that includes pink stand mixers, food processors, and cooking accessories, items which the company first started selling in 2001.  Not to be left out, Smith and Wesson, Taurus, Federal, and Bersa, among other companies, have sold firearms with pink grips and/or finishing, pink gun-cases, and even pink ammo with the pink ribbon symbol emblazoned on the packaging. Because breast cancer can be promoted in corporate-friendly ways and lacks the stigma associated with other diseases, like HIV/AIDS, these companies and others, have been willing to endorse Breast Cancer Awareness Month and, in some cases, donate proceeds from their merchandise to support research affiliated with the disease.

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Yet companies’ willingness to profit from the cause has also served to commodify breast cancer, and to support what sociologist Gayle Sulik calls “pink ribbon culture.” As Sulik notes, marking breast cancer with the color pink not only feminizes the disease, but also reinforces gendered expectations about how women are “supposed” to react to and cope with the illness, claims also corroborated by my own research on breast cancer support groups.

Based on participant observation of four support groups and in-depth interviews with participants, I have documented how breast cancer patients are expected to present a feminine self, and to also be positive and upbeat, despite the pain and suffering they endure as a result of being ill. The women in the study, for example, spent considerable time and attention on their physical appearance, working to present a traditionally feminine self, even while recovering from surgical procedures and debilitating therapies, such as chemotherapy and radiation. Similarly, members of the groups frequently joked about their bodies, especially in sexualized ways, making light of the physical disfigurement resulting from their disease. Like the compensatory femininity in which they engaged, laughing about their plight seemed to assuage some of the emotional pain that they experienced.  However, the coping strategies reinforced traditional standards of beauty and also prevented members of the groups from expressing anger or bitterness, feelings that would have been justifiable, but seen as (largely) culturally inappropriate because they were women.

Even when they recovered physically from the disease, the women were not immune to the effects of the “pink ribbon culture,” as other work from the study demonstrates. Many group participants, for instance, reported that friends and family were often less than sympathetic when they expressed uncertainty about the future and/or discontent about what they had been through.  As “survivors,” they were expected to be strong, positive, and upbeat, not fearful or anxious, or too willing to complain about the aftermath of their disease. The women thus learned to cover their uncomfortable emotions with a veneer of strength and courage. This too helps to illustrate how the “pink ribbon culture,” which celebrates survivors and survivorhood, limits the range of emotions that women who have had breast cancer are able to express. It also demonstrates how the myopic focus on survivors detracts attention from the over 40,000 women who die from breast cancer each year in the United States, as well as from the environmental causes of the disease.

Such findings should give pause. If October is truly a time to bring awareness to breast cancer and the women affected by it, we need to acknowledge the pain and suffering associated with the disease and resist the “pink ribbon culture” that contributes to it.

Jacqueline Clark, PhD is an Associate Professor of Sociology and Chair of the Sociology and Anthropology Department at Ripon College. Her research focuses on inequalities, the sociology of health and illness, and the sociology of jobs, work, and organizations.

Botox has forever transformed the primordial battleground against aging. Since the FDA approved it for cosmetic use in 2002, eleven million Americans have used it. Over 90 percent of them are women.

In my forthcoming book, Botox Nation, I argue that one of the reasons Botox is so appealing to women is because the wrinkles that Botox is designed to “fix,” those disconcerting creases between our brows, are precisely those lines that we use to express negative emotions: angry, bitchy, irritated.  Botox is injected into the corrugator supercilii muscles, the facial muscles that allow us to pull our eyebrows together and push them down.  By paralyzing these muscles, Botox prevents this brow-lowering action, and in so doing, inhibits our ability to scowl, an expression we use to project to the world that we are aggravated or pissed off.

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Sociologists have long speculated about the meaning of human faces for social interaction. In the 1950s, Erving Goffman developed the concept of facework to refer to the ways that human faces act as a template to invoke, process, and manage emotions. A core feature of our physical identity, our faces provide expressive information about our selves and how we want our identities to be perceived by others.

Given that our faces are mediums for processing and negotiating social interaction, it makes sense that Botox’s effect on facial expression would be particularly enticing to women, who from early childhood are taught to project cheerfulness and to disguise unhappiness. Male politicians and CEOs, for example, are expected to look pissed off, stern, and annoyed. However, when Hillary Clinton displays these same expressions, she is chastised for being unladylike, as undeserving of the male gaze, and criticized for disrupting the normative gender order. Women more so than men are penalized for looking speculative, judgmental, angry, or cross.

Nothing demonstrates this more than the recent viral pop-cultural idioms “resting bitch face.” For those unfamiliar with the not so subtly sexist phrase, “resting bitch face,” according to the popular site Urban Dictionary, is “a person, usually a girl, who naturally looks mean when her face is expressionless, without meaning to.” This same site defines its etymological predecessor, “bitchy resting face,” as “a bitchy alternative to the usual blank look most people have. This is a condition affecting the facial muscles, suffered by millions of women worldwide. People suffering from bitchy resting face (BRF) have the tendency look hostile and/or judgmental at rest.”

Resting bitch face and its linguistic cousin is nowhere near gender neutral. There is no name for men’s serious, pensive, and reserved expressions because we allow men these feelings. When a man looks severe, serious, or grumpy, we assume it is for good reason. But women are always expected to be smiling, aesthetically pleasing, and compliant. To do otherwise would be to fail to subordinate our own emotions to those of others, and this would upset the gendered status quo.

This is what the sociologist Arlie Russell Hochschild calls “emotion labor,” a type of impression management, which involves manipulating one’s feelings to transmit a certain impression. In her now-classic study on flight attendants, Hochschild documented how part of the occupational script was for flight attendants to create and maintain the façade of positive appearance, revealing the highly gendered ways we police social performance. The facework involved in projecting cheerfulness and always smiling requires energy and, as any woman is well aware, can become exhausting. Hochschild recognized this and saw emotion work as a form of exploitation that could lead to psychological distress. She also predicted that showing dissimilar emotions from those genuinely felt would lead to the alienation from one’s feelings.

Enter Botox—a product that can seemingly liberate the face from its resting bitch state, producing a flattening of affect where the act of appearing introspective, inquisitive, perplexed, contemplative, or pissed off can be effaced and prevented from leaving a lasting impression. One reason Botox may be especially appealing to women is that it can potentially relieve them from having to work so hard to police their expressions.

Even more insidiously, Botox may actually change how women feel. Scientists have long suggested that facial expressions, like frowning or smiling, can influence emotion by contributing to a range of bodily changes that in turn produce subjective feelings. This theory, known in psychology as the “facial feedback hypothesis,” proposes that expression intensifies emotion, whereas suppression softens it. It follows that blocking negative expressions with Botox injections should offer some protection against negative feelings. A study confirmed the hypothesis.

Taken together, this works point to some of the principal attractions of Botox for women. Functioning as an emotional lobotomy of sorts, Botox can emancipate women from having to vigilantly police their facial expressions and actually reduce the negative feelings that produce them, all while simultaneously offsetting the psychological distress of alienation.

Dana Berkowitz is a professor of sociology at Louisiana State University in Baton Rogue where she teaches about gender, sexuality, families, and qualitative methods. Her book, Botox Nation: Changing the Face of America, will be out in January and can be pre-ordered now.

Rose Eveleth’s piece for Fusion on gender and bodyhacking was something I didn’t know I needed in my life until it was there. You know how you’ve always known something or felt something, but it isn’t until someone else articulates it for you that you truly understand it, can explain it to yourself, think you might be able to explain it to others – or, even better, shove the articulation at them and be all THAT RIGHT THERE, THAT’S WHAT I’M TALKING ABOUT. You know that kind of thing?

Yeah, that.

Eveleth’s overall thesis is that “bodyhacking” isn’t new at all, that it’s been around forever in how women – to get oversimplified and gender-essentialist in a way I try to avoid, so caveat there – alter and control and manage their bodies (not always to positive or uncoercive ends), but that it’s not recognized as such because we still gender the concept of “technology” as profoundly masculine:

Men invent Soylent, and it’s considered technology. Women have been drinking SlimFast and Ensure for decades but it was just considered a weight loss aid. Quantified self is an exciting technology sector that led tech giants such as Apple to make health tracking a part of the iPhone. But though women have been keeping records of their menstrual cycles for thousands of years, Apple belatedly added period tracking to its Health Kit. Women have been dieting for centuries, but when men do it and call it “intermittent fasting,” it gets news coverage as a tech trend. Men alter their bodies with implants and it’s considered extreme bodyhacking, and cutting edge technology. Women bound their feet for thousands of years, wore corsets that altered their rib cages, got breast implants, and that was all considered shallow narcissism.

As a central personal example, Eveleth uses her IUD, and this is what especially resonated with me, because I also have one. I’ve had one for about seven years. I love it. And getting it was moderately life-changing, not just because of its practical benefits but because it altered how I think about me.

The insertion process was not comfortable (not to scare off anyone thinking of getting one, TRUST ME IT IS GREAT TO HAVE) and more than a little anxiety-inducing ahead of time, but I walked out of the doctor’s office feeling kind of cool. I had an implant. I had a piece of technology in my uterus, that was enabling me to control my reproductive process. I don’t want children – at least not right now – and my reproductive organs have never been significantly important to me as far as my gender identity goes (probably not least because I don’t identify as a woman), but managing my bits and what they do and how they do it has naturally been a part of my life since I became sexually active.

And what matters for this conversation is that the constant task of managing them isn’t something I chose. Trying to find a method that worked best for me and (mildly) stressing about how well it was working was a part of my identity inasmuch as it took up space in my brain, and I wasn’t thrilled about that. I didn’t want it to be part of my identity – though I didn’t want to go as far as permanently foreclosing on the possibility of pregnancy – and it irked me that it had to be.

Then it didn’t have to be anymore.

And it wasn’t just about a little copper implant being cool on a pure nerd level. I felt cool because the power dynamic between my self and my body had changed. My relationship between me and this set of organs had become voluntary in a way entirely new to me.

I feel like I might not be explaining this very well.

Here: Over thirty years ago, Donna Haraway presented an image of a new form of self and its creation – not creation, in fact, but construction. Something pieced together with intentionality, the result of choices – something “encoded.” She offered a criticism of the woman-as-Earth-Mother vision that then-contemporary feminists were making use of, and pointed the way forward toward something far stranger and more wonderfully monstrous.

The power of an enmeshing between the organic and the technological lies not only in what it allows one to do but in what it allows one to be – and often there’s no real distinction to be made between the two. We can talk about identity in terms of smartphones, but when we come to things like technologies of reproductive control, I think the conversation often slips into the purely utilitarian – if these things are recognized as technologies at all.

Eveleth notes that “technology is a thing men do,” and I think the dismissal of female bodyhacking goes beyond dismissal of the utilitarian aspects of these technologies. It’s also the dismissal of many of the things that make it possible to construct a cyborg self, to weave a powerful connection to the body that’s about the emotional and psychological just as much as the physical.

I walked out of that doctor’s office with my little copper implant, and the fact that I no longer had to angst about accidental pregnancy was in many respects a minor component of what I was feeling. I was a little less of a goddess, and a little more of a cyborg.

Sunny Moraine is a doctoral candidate in sociology at the University of Maryland and a fiction author whose work has appeared in Clarkesworld, Lightspeed, Shimmer, Nightmare, and Strange Horizons, as well as multiple Year’s Best anthologies; they are also responsible for both the Root Code and Casting the Bones novel trilogies. Their current dissertation work concerns narrative, temporality, and genocidal violence. They blog at Cyborgology, where this post originally appeared, and can be followed on Twitter at @dynamicsymmetry.

Last week PBS hosted a powerful essay by law professor Ekow Yankah. He points to how the new opioid addiction crisis is being talked about very differently than addiction crises of the past. Today, he points out, addiction is being described and increasingly treated as a health crisis with a human toll. “Our nation has linked arms,” he says, “to save souls.”

Even just a decade ago, though, addicts weren’t victims, they were criminals.

What’s changed? Well, race. “Back then, when addiction was a black problem,” Yankah says about 30 years ago, “there was no wave of national compassion.” Instead, we were introduced to suffering “crack babies” and their inhuman, incorrigible mothers. We were told that crack and crime went hand-in-hand because the people involved were simply bad. We were told to fear addicts, not care for them. It was a “war on drugs” that was fought against the people who had succumbed to them.

Yankah is clear that this a welcome change. But, he says, for African Americans, who would have welcomed such compassion for the drugs that devastated their neighborhoods and families, it is bittersweet.

Lisa Wade, PhD is a professor at Occidental College. She is the author of American Hookup, a book about college sexual culture, and a textbook about gender. You can follow her on Twitter, Facebook, and Instagram.

Earlier this year Brandy Zadrozny interviewed me for a Daily Beast story about the new CDC guidelines for alcohol consumption by women. It caused an outcry because it advised all women who could potentially become pregnant to completely abstain from alcohol as a way to prevent fetal alcohol spectrum disorders.

Responses across the blogosphere included several objections, including the fact that research shows that alcohol alone is not sufficient to cause fetal harm (enter poverty as a major confounding factor) and paternal drinking prior to conception is believed to contribute to incidence of these disorders, too, despite no advice to men of fertile age to refrain from any alcoholic consumption.

Interesting points, but an argument made by Renée Ann Cramer in Pregnant with the Stars gave what I thought was some interesting historical perspective.

Until feminists fought to make it otherwise, she explains, it was perfectly legal in America to refuse to allow women access to certain jobs because they might get pregnant. If the working conditions were too challenging or involved exposure to dangerous chemicals, women were considered unfit for the work by virtue of their always-potentially-pregnant status. And if they did this work and harm did come to a child, it was considered a failure of the state to adequately protect her.

Feminists fought to make this “protectionism” illegal, demanding that women themselves have the right to decide, alongside men, if they wanted to take occupational risks. And they largely won this fight.

In turn, though, women themselves came under scrutiny. They were no longer excluded from certain jobs, but if they chose to do them, it was reasonable to judge them harshly for doing so. Cramer calls this the “responsibilization” of pregnancy. Now that women had the right to handle their pregnancy (or pre-pregnancy) however they wished, they (and not the state) would be held responsible for doing so in ways that society approved or disapproved.

This is what the CDC guidelines are doing. It’s not legal to “protect” women from harming her not-yet-existing fetus by refusing to serve her alcohol. Women have the same rights as men. But with rights comes responsibilization and if women don’t make the choices endorsed by their communities, the health industry, and even the federal government, they can expect to be surveilled, judged, and possibly bullied into doing so.

Cross-posted at Pacific Standard.

Lisa Wade, PhD is a professor at Occidental College. She is the author of American Hookup, a book about college sexual culture, and a textbook about gender. You can follow her on Twitter, Facebook, and Instagram.

Flashback Friday.

A study by doctor Ruchi Gupta and colleagues mapped rates of asthma among children in Chicago, revealing that they are closely correlated with race and income. The overall U.S. rate of childhood asthma is about 10%, but evidence indicates that asthma is very unevenly distributed. Their visuals show that there are huge variations in the rates of childhood asthma among different neighborhoods:

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The researchers looked at how the racial/ethnic composition of neighborhoods is associated with childhood asthma. They defined a neighborhood’s racial make-up by looking at those that were over 67% White, Black, or Hispanic. This graph shows the percent of such neighborhoods that fall into three categories of rates of asthma: low (less than 10% of children have asthma), medium (10-20% of children have it), and high (over 20% of kids are affected). While 95% of White neighborhoods have low or medium rates, 56% of Hispanic neighborhoods have medium or high rates. However, the really striking finding is for Black neighborhoods; 94% have medium or high prevalence. And the racial clustering is even more pronounced if we look only at the high category, where only a tiny proportion (6%) of White neighborhoods fall but nearly half of Black ones do…a nearly mirror image of what we see for the low category:

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Rates of asthma and racial/ethnic composition (the color of the circles) mapped onto Chicago neighborhoods (background color represents prevalence of asthma):

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Asthma rates don’t seem to be highly clustered by education, but are highly correlated with overall neighborhood incomes:

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It’s hard to know exactly what causes higher rates of asthma in Black and Hispanic neighborhoods than in White ones. It could be differences in access to medical care. The researchers found that asthma rates are also higher in neighborhoods that have high rates of violence. Perhaps stress from living in neighborhoods with a lot of violence is leading to more asthma. The authors of the study suggest that parents might keep their children inside more to protect them from violence, leading to more exposure to second-hand smoke and other indoor pollutants (off-gassing from certain types of paints or construction materials, for instance).

Other studies suggest that poorer neighborhoods have worse outdoor environmental conditions, particularly exposure to industries that release toxic air pollutants or store toxic waste, which increase the risk of asthma. Having a parent with asthma increases the chances of having it as well, though the connection there is equally unsure–is there a genetic factor, or does it simply indicate that parents and children are likely to grow up in neighborhoods with similar conditions?

Regardless, it’s clear that some communities — often those with the fewest resources to deal with it — are bearing the brunt of whatever conditions cause childhood asthma.

Originally posted in 2010.

Gwen Sharp is an associate professor of sociology at Nevada State College. You can follow her on Twitter at @gwensharpnv.

Monday marked the 50th anniversary of the intervention of the birth control pill. There is no doubt that the pill has had a huge influence on sexual attitudes, sexual activity, and how much control women had over their own fertility. The pill, although it may not be the right choice for everyone, should be celebrated for these reasons. But there is something else to consider here: how did the invention of the pill shape the way that women (and the medical community for that matter) view periods?

When you think of the pill, the first image that comes to mind is that iconic little container of pink and white pills that represents one menstrual “cycle.”

In Malcolm Gladwell’s fantastic article, John Rock’s Error, Gladwell explains how the invention of the pill was heavily influenced by the Catholic Church. One of the creators of the pill, a devout Catholic, wanted it to be viewed as “natural” since it used chemicals that naturally occur in the body to prevent pregnancy. It was necessary, then, for women to continue to have their period regularly to show that the pill did not interfere with a woman’s menstrual rhythm.

But, speaking from an evolutionary standpoint, there is nothing natural about having a menstrual period every month because it is not natural to limit fertility. Our female ancestors spent a good portion of their reproductive years pregnant and not having a period. And, in fact, having a period every month can be dangerous. Every time a woman has a period, tissue lining sheds and new cells must grow to replace it. And every time there is cell regrowth there is a new chance for mutations to occur. This leads to an increased risk of cancer and cysts.

It may be healthier (and more natural), then, for women to suppress menstruation (the way pregnancy used to). But because the idea of a natural rhythm is now synonymous with monthly periods, introducing pills with alternative cycles has proven difficult. Pills that allow for four periods a year (like Seasonale, Seasonique, and Yaz) have come on the market. But instead of discussing the medical benefits of fewer periods, they are marketed in a woman-on-the-go sort of way, as a way for women to “take back” their lives by avoiding an inconvenience.

Marketing the pill in this fashion has created push back by women who think this method this pill is all about suppressing “natural” womanhood, but it is a falsely constructed version of womanhood to begin with.

Sources: NY Times, LA Times, Planned Parenthood, WebMD, No Period, and Annals of Medicine. Originally posted in 2010.

Lauren McGuire interned for Sociological Images in 2010. See more posts from Lauren on social psychology and policing by race and the evolution of Cosmopolitan magazine.

4One of the first things other academics ask me is “why are you interested in toilets?”

For the vast majority of people, the biological function of waste excretion is an after thought, an activity that nobody wants to talk about, and often times, the mere thought of talking about shit grosses them out. I, however, am fascinated by the human and political dimensions of human waste and the challenges that solving the global sanitation crisis presents. More than excrement itself, I’m interested in a holistic view of sanitation (waste disposal, transportation, removal, treatment and reuse). This interest stems primarily from my training as a chemical engineer, my work experience as a sanitation engineer and researcher, and my interest from my doctoral studies in understanding the politics of policy intervention.

Contrary to what one might think, toilets are political. Owning a toilet will become a necessary prerequisite for politicians to run for office in Gujarat, India. The new Prime Minister of India, Shri Narendra Modi, has made ending open defecation and increasing access to toilets one of his campaign promises and a crucial component of his political and public policy agenda. Modi’s “toilets first, temples later” has been seen as a strong statement in favor of increasing toilet and latrine access in India.

In my own work I have emphasized that even if we have the technical capabilities to increase access to toilets, latrines and sanitation infrastructure, often times we see lack of progress because institutional, cultural, behavioral and societal barriers have been erected through time. I have shown that the behavioral determinants of sanitation governance are complex and multicausal, and also have multiple effects. Not having a toilet in your own home or easily accessible can lead to violence and physical/sexual assault. Lack of toilets affects women disproportionately and leaves them vulnerable to physical violence. Earlier this year I wrote about the complex linkages between menstrual hygiene management, access to toilets, and violence against women.

To end open defecation and increase sanitation access, we need a set of policy strategies that aren’t solely focused (individually) on cultural practices, or access to latrines, or poverty alleviation. All these factors must be tackled simultaneously.

World Toilet Day takes place on November 19th. This year finally the United Nations named World Toilet Day an official UN day, although for all the noise it has been making, we are WAY behind the target for the Millennium Development Goals. If we really want to end open defecation by 2025, as the UN indicates, we are definitely going to need a better approach. In my own research, I have found that institution- and routine-based strategies help increase access to sanitation. I have also argued that access to toilets can be used as a political manipulation strategy. We should be interested in the global politics of sanitation because the crisis is far-reaching and widespread.

Today, I encourage you to reflect on the fact that over 1 billion people defecate in the open because they lack the dignity of a toilet, and that 2.6 billion people don’t have access to improved water and sanitation sources.

Think about it. It IS political. Because we can’t wait to solve the global sanitation crisis.

Raul Pacheco-Vega, PhD is a professor of Resource Management and Environmental Studies with a specialty in the global politics of sanitation. You can follow him at raulpacheco.org, where this post originally appeared, and on Twitter and Facebook.