Save the People, Not the Boobies: The Ethics of Breast Cancer Awareness

Few ad campaigns make me as misanthropic as the breast cancer awareness ones I’ve been seeing at an especially high volume for the past month:

There’s also this video (NSFW).

I hate these campaigns for many reasons. First of all, they make breast cancer all about boobs. Yes, it has “breast” in the name, but reducing an illness as complex and life-shattering as breast cancer into a cutesy “save the boobies!” campaign seems callous and inappropriate.

I’m not sure everyone would even agree that the prospect of losing your breasts is the worst thing about breast cancer, and yet that’s what these campaigns almost universally target. It’s not the “boobies” or “ta-tas” that need to be saved–it’s the human beings who have breast cancer.

It’s even worse when the campaigns are created by and/or targeted at men and involve that hint-hint-nudge-nudge assumption that men should care about breast cancer because men love tits. Never mind that men can get breast cancer too, and never mind that men care about breast cancer not (just) because they care about boobs, but also because they care about their friends, girlfriends, wives, mothers, sisters, daughters, and etc. who might get breast cancer, or who already have.

Campaigns like these also completely ignore women who have chosen (or been forced to) undergo mastectomies. If breast cancer research and awareness is all about “saving the boobies,” does losing your breasts mean you’ve lost the fight?

This preoccupation with breasts is probably what inspires awful ads like this one by the Cancer Patients Aid Association, an Indian NGO:

The text at the bottom reads, “One out of every eight women develops breast cancer in her lifetime. Early detection helps recovery. Get yourself examined before it’s too late.” So there you have it. If you get a mastectomy, you’re “making yourself ugly.”

This is all to say nothing of Susan G. Komen for the Cure, the hypocrisy and reactionism of which should by now be well-known. (Incidentally, the former Komen executive who was responsible for that move was not content with merely that; she just had to write a book-length screed against Planned Parenthood, as well.) This unethical organization seems to be the beneficiary of most (if not all) of the sexualized ads I’ve seen. I still refuse to give them a single cent, which is difficult given how easy it is to accidentally pick up one of those pink-ribbon-branded products at the grocery store.

On the bright side, this is a great opportunity to explain what feminists mean when we prattle on about “objectification” and “sexualization,” which are closely related concepts that often (but not always) occur together. Objectification is the reduction of a person to their body parts (usually the sexual ones; hence the frequent co-occurence of objectification and sexualization). An advertisement that objectifies women might show, for instance, a single female leg in front of a flashy car, or a woman lying in a martini glass–literally like an object to be consumed. Sometimes men are objectified too, but that seems to be rarer. Ads that objectify people often don’t show their faces (or eyes), thus making them seem less like people and more like bodies.

Sexualization, meanwhile, is when a person (again, usually a woman) is represented in such a way as to arouse the viewer or otherwise connote sex when the actual purpose of the representation has nothing to do with sex at all. You wouldn’t call pornography “sexualization” because the purpose of pornography is to depict sexual acts and to be arousing. But when an advertisement designed to sell cars or alcohol–or solicit donations for breast cancer research–portrays women in a sexual way, that’s sexualization.

The objectification and sexualization of women in the media has a great deal of negative effects, both on an individual level–for the people who view them–and on a cultural level. Check out the work of Jean Kilbourne if that interests you.

However, I am not a marketing expert. If I were, and if I were charged with designing an ad campaign that elicits as much attention and donations for breast cancer research as possible, there’s a good chance I would feel compelled to create an ad like this, because there’s a good chance that this is the kind of ad that works best.

Hence the misanthropy I mentioned earlier. Marketing people know what they’re doing. If this is really the best way to get people to pay attention to this important cause, I would say that not using ads like these is even more unethical than using them–at least until we shift our culture enough that we don’t need them anymore. But that still means that we’re choosing the lesser of two evils. I would rather more money went to breast cancer research than less, but I would also rather we stopped reducing women to their erogenous zones in our media.

After all, I don’t agree with this rubbish that men are “programmed” or “hardwired” by biology to be obsessed with breasts, at least not to the level that our society seems to think they are. As I already discussed when I wrote about public breastfeeding, the sexualization of breasts is not universal to all cultures and time periods. Even if “sex sells,” breasts don’t necessarily have to always be part of “sex,” and I think it would be beneficial to our society if they were not.

For the record, whether straight men’s love of boobs is entirely biological or not, I don’t think there’s anything wrong with it, as long as it doesn’t infringe upon public policy or trivialize serious illnesses. Besides, you can totally be an awesome (male) feminist and a boob enthusiast at the same time.

Edit: Here’s a great article that basically makes my point for me.

Save the People, Not the Boobies: The Ethics of Breast Cancer Awareness
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Abortion and Suicide: A Spurious Link

In South Dakota, it is now legal to require doctors to tell women seeking abortions that they are putting themselves at risk for suicide.

This move is brilliant from a PR standpoint. Unlike banning certain types of abortions entirely or, say, forcing women to undergo invasive screenings that are medically unnecessary, this seems completely apolitical when you first look at it. Don’t people deserve to be informed if they may be increasing their risk for suicide? Don’t we all agree that suicide is a Bad Thing?

However, something tells me that this is actually another attempt to scare women out of (what should be) a normal, socially acceptable medical procedure.

First of all, the inconvenient truth here is that credible research consistently shows little or no link between abortion and poor mental health. One 2008 study reviewed the literature and found that the only studies that seemed to show such a link had very flawed methodology, whereas the studies that were well-designed showed no links. (Damn liberal academics!) And here’s another study that showed no such links. And here’s a thorough debunking of a study that did claim such links:

Most egregiously, the study, by Priscilla Coleman and colleagues, did not distinguish between mental health outcomes that occurred before abortions and those that occurred afterward, but still claimed to show a causal link between abortion and mental disorders.

In other words, that study actually tried to use mental health pre-abortion to confirm a hypothesis about mental health post-abortion. This is simply not how you do science. And it’s especially bad here, because according to the American Psychological Association, guess what the best predictor of mental health post-abortion is?

Across studies, prior mental health emerged as the strongest predictor of postabortion mental health. Many of these same factors also predict negative psychological reactions to other types of stressful life events, including childbirth, and, hence, are not uniquely predictive of psychological responses following abortion.

That’s right. Shockingly enough, the best predictor of mental health is, well, past mental health. And poor mental health predicts poor response to all sorts of stressful events, of which abortion is only one example. Another one being, for instance, childbirth!

Compounding the bad science here is that, unlike physical side effects,suicide isn’t something that just happens to you suddenly and without warning. People don’t just suddenly wake up one morning and decide to kill themselves. Suicidality is a complex process that involves factors like genetics, family history, environment, social support, mental illness, and life circumstances. For instance, here are some things that, according to research, actually increase one’s statistical risk for suicide:

As you can probably surmise, not all of these correlations are also causations. While mental illness and drug addiction can actually cause suicidal behavior, being intelligent and being LGBT probably cannot. In the latter case, the causative culprit seems to be (surprise surprise) institutionalized discrimination and homophobia. Before I get too off-topic, let me point out the irony in the fact that, despite this well-known risk faced by LGBT youth, I don’t see any of these pro-lifers advocating for an end to homophobia.

That’s why something tells me that nothing about this court ruling actually has anything to do with suicide prevention.

Although the court’s ruling does at least acknowledge that abortion probably doesn’t cause suicide, it nevertheless states that “conclusive proof of causation is not required in order for the identification of a medical risk.” This is probably true, but it only makes sense from a physical health standpoint. If studies show that people who get a certain elective medical procedure are much more likely to, say, experience headaches or nausea or numbness, you don’t necessarily need a causative study to conclude that there’s a reasonable chance that these symptoms were caused by the procedure (assuming, of course, that there was no illness present that might be causing them). Furthermore, there’s a difference between saying “This procedure may cause you to experience cramps and headaches” and saying “This procedure may cause you to kill yourself.”

The truth is, mental health doesn’t work that way. A person who gets an abortion might experience mental side effects because of the stress of having gotten pregnant accidentally and been forced to decide what to do, perhaps without the support of a partner or family. Furthermore, any invasive medical procedure can be stressful and worrying for many people–especially one like abortion, which is consistently portrayed as more painful and dangerous than it really is.

And this is all made even more complicated by the fact that the faulty studies in question were actually studying mental health before the abortion. Perhaps a person with poor mental health is more likely to seek an abortion in the first place–say, if they feel that they aren’t mentally capable of raising a child at the moment.

Ultimately, decisions about what to tell a patient should be left up to the people who know most: doctors (with, of course, a reasonable amount of regulation to prevent malpractice). If a doctor can tell that a person seeking an abortion is going through a lot of mental distress, then that doctor may want to gently recommend counseling and perhaps give out some hotline numbers–and training doctors to recognize signs of mental health troubles is always a good thing.

But doctors should not be mandated to fearmonger to their patients. They should especially not be mandated to serve a pro-life agenda.

Abortion and Suicide: A Spurious Link

[Guest Post] What is Sensible Drug Policy?

It’s another guest post! In this one, my friend and fellow activist Frances discusses the parallels between good sex education and sensible drug policy, and why we need more of both.

Ever since you’re young, you’re taught that sex and drugs are just plain “bad.” Many high school health classes teach you that if you engage in these activities before (or even after) a certain age or point in your life, you are a weak, scumbag failure who will die with a spoiled reputation.

But where the hell is the other side of the story? Why don’t people ever seriously talk about sex and pleasure? Or drugs and fun? Why is it okay for the media to wave it in our face but crazy for our own parents and teachers to give us a healthy dose of balanced information? Our goal is to teach adolescents to “be responsible,” but they’re learning from irresponsible educators.

I founded SSDP (Students for Sensible Drug Policy) and joined SHAPE (Sexual Health and Assault Peer Educators) my first year at Northwestern University to try to get a more holistic view of these taboo topics. Sex and drugs both share intense politicization, widespread ignorance, and unforgiving stigma, but you know what I eventually learned?

Sex and drugs, in and of themselves, are NOT bad! A certain amount of irresponsibility is necessary to turn sex and drugs bad.

Before you start freaking out because you think I’m promoting sexual activity and drug use, let’s get this straight. There are certain “objective ideals” that we, as a society have created based on common sense and cold hard facts. Ideally, teenagers wouldn’t engage in sexual activity before the age of consent (16-18 in the U.S.), due to the fact that becoming sexually active requires a whole lot of responsibility, healthy communication, self-awareness, and maturity—characteristics that a lot of adolescents under the age of 18 haven’t acquired yet. And objectively, the best drug use is no drug use, given that every drug—whether legalized, criminalized, or medicinal—has the power to cause some sort of negative physical, mental, emotional, or developmental effect. Responsibility is key.

However, just because abstinence from sex and drugs is the “objective ideal” in many cases, does not mean that abstinence only is the objectively ideal way to educate people about sex and drugs. “Abstinence only” or “Just Say No” education is bad and irresponsible, because when we say BAD! or NO!, we never teach kids to think for themselves, or give them the proper tools to deal with these situations should they ever arise. Instead, when teens have questions like, “Can I get STIs from oral sex?” or “If Tommy can drink 9 shots in an hour, it should be fine for me, right?” their friends will answer, “I don’t know.”

Irresponsible sex education is what leads to the spread of STIs, unplanned pregnancies, sexual assault, teen-dating violence, unhealthy communication and our slut-shaming, victim-blaming, homophobic, rape culture. An adequate sex education is more than just about putting on a condom and getting tested. It’s about teaching teens to love their bodies, moving past stigma and encouraging an honest discussion so that we can reduce the possible harms of sexual activity. Simply labeling sexual activity as the root cause of all sex-related problems is too simple an approach with such a complex issue.

The same can be said for drugs. We have GOT to stop blaming drugs for drug addiction, DUIs, overdose deaths, academic failure, gang violence, rape, teenage drug dealers, and violent illegal drug trafficking. A “Just Say No” drug education based on scare tactics is too simple an approach with such a complex issue. The more extreme the scare tactics, the less likely it is that teens will respect what the words of their health teacher. The nastier the words we use to label and stigmatize drug users and abusers, less likely it is that people will proactively seek treatment. Alcohol itself is not hurting people, but people who use alcohol irresponsibly and decide to drive? That’s what destroys lives. Heroin itself is not responsible for overdose deaths, but a lack of education and respect for the powerful effects of the drug are fatal. A drug education that eliminates the stigma of drug use, emphasizes moderation and responsibility, offers a balanced “pros and cons” list on recreational drugs, and is truthful about the social norms of drug use is what will actually reduce the overall cost of drug use to society. This is known as “harm reduction,” the idea that with any harmful activity, there are necessary precautions we can take to make it “safer” and reduce harm, like fastening your seat belts before a drive!

Education rather than blame is crucial to changing risky behaviors and the policies that facilitate risky behaviors. Sex and drug education and sex and drug policies have a reciprocal relationship. Sex education that teaches women to “protect themselves from rape” makes it harder for rape victims to achieve justice in the court of law, because women learn to take on the burden of avoiding rape, while men are alleviated from the burden to not rape. As our gay rights policies slowly change, the movement will very likely go on to influence sex education surrounding LGBT issues. Our laws change our attitudes, and our attitudes change the way we educate. With drugs, it’s even more obvious. Drug education promoting the idea that drugs are “just plain bad” reinforces the public belief that drugs should be illegal forever. The criminalization of drugs creates the violent drug market that sucks adolescents into drug addiction and the criminal justice system. And when adolescents are addicted to drugs, engaging in violence, barred from higher education, unable to find treatment, and ultimately a way out of this lifestyle? We teach that drugs are bad.

I became the Drug Policy Dealer on YouTube to serve as the bridge between drug education and drug policy activism, integrating the skills of a peer sex educator, the lessons from countless articles I’ve read regarding drugs and drug policy, and just plain common sense. Northwestern University’s SSDP Chapter and The Drug Policy Dealer will be unique in that the main message we send is that sensible drug policy relies on the assumption that the majority of people will be sensible with their drug use. Like I said, it is irresponsible to only preach the negatives of drug use, without accounting for the fact that safe, responsible drug use does occur everyday. By the same logic, it is irresponsible to advocate for drug legalization without fighting for a more well-rounded, all-inclusive of drug and drug policy education as well.

Stay Sensible!

Continue reading “[Guest Post] What is Sensible Drug Policy?”

[Guest Post] What is Sensible Drug Policy?

A Sacrifice They're Willing to Make: Mississippi's War on Abortion

The last remaining abortion clinic in Mississippi is perilously close to shutting down thanks to a new proposed law, Mississippi House Bill 1390. The law would require that all doctors performing abortions be board-certified in obstetrics and gynecology (reasonable), and that they also have admitting privileges at a local hospital (not so reasonable).

The reason that’s not so reasonable is because Jackson, Mississippi, home of the besieged abortion clinic, has two hospitals with Christian affiliations, and any hospital can refuse to grant admitting privileges to a physician for any ol’ reason, such as that said physician is a godless heathen who wants to help women murder their unborn fetuses babies.

To make it even better, the law would give the clinic’s physicians (all of whom are board-certified OB/GYNs but only one of whom has admitting privileges) less than two months to acquire them. As Evan McMurry writes at PoliticOlogy, “This is part of the pro-life’s recent death-by-a-thousand cuts tactic: if they can’t overturn Roe v Wade outright, they’ll make accessing and performing abortions so onerous that the practice will be effectively impossible.”

But of course, as it usually is with these laws, things get even more ridiculous. From the HuffPo article:

The State Senate voted to pass the bill Wednesday, but it was held for further debate on Thursday, when lawmakers had an odd exchange over the bill on the Senate floor. Sen. Kenny Wayne Jones (D-Canton) asked Sen. Dean Kirby (R-Pearl), who chairs the Senate Public Health Committee, whether ending abortions in the state would force women to resort to dangerous, back-alley abortions.

“That’s what we’re trying to stop here, the coat-hanger abortions,” Kirby replied, in reference to the abortions provided at the clinic in Jackson. “The purpose of this bill is to stop back-room abortions.”

Okay, first of all. No reputable doctor performs abortions with a coat hanger. In fact, I’m just going to go out on a limb and amend my statement to say, No doctor performs abortions with a coat hanger.

All of the physicians in question are board-certified in obstetrics and gynecology–a certification that I’m pretty sure Senator Dean Kirby does not have.

Incidentally, you know when dangerous abortions do actually happen? When abortion is made illegal. Research invariably shows this. (I know, I know, Republicans don’t believe in science anyway, but it was worth a shot.)

The truth is that making something illegal, especially if that thing is considered absolutely necessary by many people, does not mean it won’t happen anymore. It just means that it’ll happen out of sight, and therefore without regulation. This is why countries that are more progressive than ours are starting to experiment with drug decriminalization, but that’s a whole other topic.

Drug policy is a different ballgame because, while there are many psychological and societal factors that may lead people to become addicted to drugs, most of us can agree that nobody needs illegal drugs in order to have a decent life. Abortion is another matter, however. Unless conservative lawmakers are willing to provide comprehensive sex education and low-cost (or free) birth control (not to mention end sexual assault), there may not be a way to eliminate the need for abortion. For instance, from a comment on the HuffPo article I linked to:

I live in Mississippi. Yesterday I taught classes in the poorest part of the Delta to pregnant or parenting teens on parenting skills. I would much rather teach classes to teens about safe, effective birth control. The state won’t let me. It doesn’t matter how many facts or statistics I roll out…nobody listens. I am frustrated beyond belief.

So that’s what we’ve got.

Anyway, because politicians in states like Mississippi refuse to provide the resources to prevent abortion from becoming necessary, they must face the fact that women are going to get them whether they’re legal or not. But they don’t face this fact.

In the quote from Senator Kirby, which I provided above, he states that his purpose in making abortion unattainable in Mississippi is to prevent women from having dangerous abortions. So basically, his argument is this: we’re going to restrict women’s access to a safe, standard medical procedure in order to prevent them from obtaining the potentially dangerous, unregulated version of that procedure, despite the fact that restricting the safe thing actually leads to an increase in the use of the dangerous thing.

Kirby’s reasoning makes such a mockery of logic and common sense that I had to read the original quote several times before I understood it.

Mississippi’s Republican governor, Phil Bryant, had this to say about the proposed law: “This legislation is an important step in strengthening abortion regulations and protecting the health and safety of women. As governor, I will continue to work to make Mississippi abortion-free.”

Wait a minute. First he wants to merely “strengthen” abortion regulations. But then he says he wants to “make Mississippi abortion-free.” That should convince anyone who wasn’t already convinced that this law has absolutely nothing to do with making sure that abortions are performed safely. Rather, it has everything to do with making Mississippi “abortion-free.”

That’s right, he didn’t even try to pretend this was about women’s safety.

In my opinion, the fact that criminalizing abortion leads to dangerous back-alley abortions is the strongest argument for keeping abortion legal. It’s the strongest argument because it doesn’t lean on emotion or ideology. We can argue left and right about when life begins and when fetuses feel pain and whether or not women have the right to choose what to do with their bodies (hint: yes), but we cannot argue with the preponderance of evidence that shows that criminalizing abortion does not prevent abortion. It merely makes it dangerous.

Pro-lifers’ continued refusal to accept this argument says one or both of these things about them:

1. They are unwilling or incapable of accepting and understanding basic facts about economics and decision-making. That is, despite all the evidence showing the negative consequences of the criminalization of abortion, these politicians (and voters) continue to believe that banning abortion would plunge us all into Fun Happy No-Killing-Babies Land.

2. They understand these facts, but just don’t care. This is undoubtedly the worse alternative, because it means that the pain, injury, and even potential death that will come to women who try to obtain illegal abortions are, to borrow from Shrek‘s Lord Farquad, a sacrifice that Republicans are willing to make.

So, ignorance or malice? Take your pick.

A Sacrifice They're Willing to Make: Mississippi's War on Abortion

Limbaugh Really Should Educate Himself About Birth Control

Up until this week, those of us with a shred of optimism and/or naivete could have pretended that the difference between liberals’ and conservatives’ perspectives on birth control were due to something as benign as “differing beliefs.”

However, now that Rush Limbaugh has run his mouth on the subject, I think we can all agree that much of the conservative opposition to birth control is due not to differing beliefs that are equally legitimate and should be respected, but to simple, stupid ignorance.

The following is probably common knowledge now, but I’ll rehash it anyway:

  • Sandra Fluke, a 31-year-old Georgetown University law student, was proposed by the Democrats as a witness in the upcoming Congressional hearings on birth control. Her history of feminist activism and her previous employment with a nonprofit that advocated for victims of domestic violence made her an appropriate witness for their side.
  • Representative Darrell Issa (R-CA), the chairman of the House Committee on Oversight and Government Reform, turned her down because, he claimed, her name had been submitted too late.
  • The resulting panel of witnesses for the Congressional hearings turned out to consist of absolutely no women whatsoever, which is really funny in that not-actually-funny-way because hormonal birth control of the sort whose mandated insurance coverage was being debated is only used by women/people with female reproductive systems.
  • A week later, she testified for House Democrats, mentioning that birth control would cost her $3,000 over three years. Lest anyone misinterpret her argument as being solely about those slutty women’s desire to have tons and tons of sex, she also mentioned her friend with polycystic ovary syndrome who developed a cyst because she was denied coverage for birth control pills (which would’ve helped because they would’ve reinstated a regular menstrual cycle).

A few days later, Rush Limbaugh decided to insert his expert opinion into the discourse surrounding mandated insurance coverage of birth control. His expert opinion?

What does it say about the college coed Susan Fluke [sic], who goes before a congressional committee and essentially says that she must be paid to have sex? What does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex.

The next day, he clarified his views:

So, Ms. Fluke and the rest of you feminazis, here’s the deal. If we are going to pay for your contraceptives, and thus pay for you to have sex, we want something for it, and I’ll tell you what it is. We want you to post the videos online so we can all watch.

And the next day (allow me to shamelessly quote Wikipedia):

The following day Limbaugh said that Fluke had boyfriends “lined up around the block.”[18] He went on to say that if his daughter had testified that “she’s having so much sex she can’t pay for it and wants a new welfare program to pay for it,” he’d be “embarrassed” and “disconnect the phone,” “go into hiding,” and “hope the media didn’t find me.”[19]

I’m not going to waste anyone’s time by explaining how misogynistic Limbaugh’s comments were, especially since plenty of excellent writers have done so already. However, it continually shocks me how he gets away with saying things that are not only offensive and inflammatory, but simply inaccurate.

First of all, a primer for anyone who’s still confused: except for barrier-based forms of birth control (i.e. condoms and diaphragms), the amount of birth control that one needs does not depend on how much sex one is having. Hormonal birth control works by preventing ovulation, and in order for it to work, it has to be taken regularly and continually. For instance, you take the Pill every day, or you apply a new patch every week, or you get a new NuvaRing each month, or you get a new Depo-Provera shot every three months. You stick to this schedule whether you’re having sex once a week or once a day or ten times a day. You stick to it if you’re having sex only with your husband, and you stick to it if you’re having sex with several fuck buddies, and you stick to it if you’re a prostitute and have sex with dozens of different people every day.

Same goes for IUDs, which last for years.

Therefore, when Limbaugh says that those who support mandated insurance coverage of birth control are “having so much sex [they] can’t pay for it,” he’s not merely being an asshole. He’s also simply wrong.

And for the record, he didn’t even get her name right. It’s Sandra, not Susan. One word of advice for you, Limbaugh: if you’re going to call someone a slut and a prostitute, at least use their correct name. But I guess we should give him credit for knowing which letter it starts with.

I don’t care what your views are on mandated insurance coverage of birth control. I don’t care what your views are on how much or what kind of sex women should be allowed to have (as much as they want and whichever kind they want, in my opinion). Because whatever your views are on these things, you have to agree that these questions should not be getting answered by people who have absolutely no understanding of how these things actually work.

For instance, Limbaugh completely ignored the part of Fluke’s testimony in which she described the problem faced by her friend with polycystic ovary syndrome. This friend’s predicament has nothing to do with sex. Absolutely nothing. For all we know, she’s a virgin.

After all, polycystic ovary syndrome isn’t caused by anything that involves sex. The current medical opinion is that it’s probably caused by genetics.

Unlike some feminists, I don’t think that men should be excluded from debates about women’s health. But men (and women) who show little or no understanding about women’s health should absolutely be excluded from these debates.

You wouldn’t let a doctor who believes that babies come from storks deliver your baby. You wouldn’t let a mechanic who doesn’t know how an engine works work on your car. And you shouldn’t let politicians and commentators who think that you need more birth control if you have more sex decide whether or not birth control will be covered by your insurance.

And, for the record, I also don’t think that Congressional hearings on birth control should look like this:

Limbaugh Really Should Educate Himself About Birth Control

"If You're Fat, Then What Am I?"

There are a lot of misconceptions out there about body image and eating disorders. I can’t even begin to address all of them here. But there’s one I’ve been thinking about lately–that problems with body image are caused solely by comparing yourself to unrealistic standards, and can be solved by simply comparing yourself to the “real” bodies around you instead.

First, a disclaimer–I’ve never had anorexia or bulimia. However, I’m not entirely out of my depth here. Had I gone to see a psychiatrist at some point prior to this year, he or she would probably have taken note of my obsessive calorie-counting, severe dietary restrictions, compulsive weight-checking and fat-pinching, and general conviction that I was “fat,” and diagnosed me with something called “eating disorder not otherwise specified,” or “EDNOS.” This means that one doesn’t meet the diagnostic criteria for any of the eating disorders, but is definitely disordered nonetheless.

(For the record, I’m much better now.)

Anyway, one thing I remember very vividly from my years of thinking I’m fat was one particular response that I often encountered. Some people (mostly other girls), upon learning how I felt, would respond with this: “If you’re fat, then what am I?”

Now, I understand exactly where this comes from. Many of my peers were probably insecure, too, and it makes sense that they would be reminded of their own insecurity once I mentioned mine. Since I was indeed thinner than many other people, that response makes sense on some level. If I’m fat, they must be obese!

But it doesn’t really work that way. It would certainly be convenient if people’s self-concepts were always rational and based on reality. But the very definition of mental problems is that they’re distortions of reality–they’re unrealistic. That’s why grief after the death of a loved one isn’t considered a mental disorder, but depression is.

And that’s exactly why “If you’re fat then what am I” is not an effective response. At the time, I didn’t give two shits what other people were. It didn’t enter my thought process. In my case, my conviction that I was fat was mostly caused by cultural factors; namely, the fact that Russians are fucking preoccupied with beauty and weight. Absolutely preoccupied. It was also caused by years of ballet lessons, my depressive personality (which magnifies personal flaws), the belief that I could lose 10-20 pounds and still be healthy, fear that guys wouldn’t find me attractive if I had folds on my stomach, and many other causes.

For other people with body image and eating issues, the causes may be different. Some people develop the feeling that they’re unable to control their environment, so they control the only thing they can–their body. Others may start out actually overweight, start to diet and lose weight, and find that they’re addicted to the feeling of getting thinner. Others develop an overwhelming guilt whenever they eat, especially when they eat unhealthily, and they start to purge after eating. Some may have friends who constantly talk about their bodies’ flaws (remember Mean Girls?) and start to think the same way.

Whatever the causes are, these issues are much too complicated to be defeated by a simple glance at someone who weighs more than you.

Of course, “If you’re fat then what am I” also fails one of the most basic requirements of being a good listener–don’t change the subject to yourself. If your friend feels crappy and needs to talk to you, don’t make it about you. If your own issues are making it difficult for you to listen, tell your friend that. Sure, they might be disappointed that you can’t listen to them, but that’s much better than how they’re going to feel when you take their pain and turn it into a conversation about you and your weight.

It’s easy to resent people who, according to you, “should” be perfectly happy with their weight but are not. I can’t say I don’t get a twinge of annoyance whenever I witness a girl much smaller than me freaking out about her weight. But then I remind myself that she’s not me. Poor body image seems almost like a cliche among young women these days, but it’s so much more complex than you might think.

"If You're Fat, Then What Am I?"

Everyone Should Go to Therapy

Recently I wrote a post about why some people might choose psychiatric medication over seeing a therapist. (Fine, so it wasn’t that recent. >.<) I promised a followup post about a belief that I hold concurrently–everyone should see a therapist.

Now, before everyone freaks out, let it be known that I say “everyone” only in the most theoretical of ways. Meaning that, I recognize that as things are today, what I’m proposing isn’t really possible. But in the Happy Fun Miriam Land of the future, where stigma against mental healthcare is gone, insurance coverage is reasonable and available to the majority of people, and research has identified effective therapeutic interventions for most mental problems, everyone should and would be able to go to therapy.

For now, I’ll qualify what I’m saying with this: if you are able to see a therapist, you should, and if you are able to take your children to see a therapist, you should.

Why?

Well, why do we have regular dental and physical checkups? Why do children receive vaccines? Why do we make an appointment with a doctor when we think we’re coming down with something serious?

Hopefully the answers to those questions are self-evident.

Clearly, it is acceptable–and even expected–that people seek two types of healthcare throughout their lives: preventative and palliative. We should see a doctor regularly to make sure that nothing’s going seriously wrong with our bodies, and we should see a doctor when we suspect that something IS going seriously wrong with our bodies.

This much isn’t in dispute. But what about our minds?

For the most part, people wait until things are really, REALLY wrong with their mental state before they go see a psychologist. (And some don’t go even then, but that’s a different story.) For instance, I didn’t see a psychiatrist for my depression until I wanted to kill myself. People with eating disorders typically don’t receive care until they’re dying, or close to it. People with anxiety issues don’t get help until their anxiety is preventing them from having any semblance of a normal life.

Like most physical maladies, mental illnesses don’t just come out of nowhere. They usually develop from years and years of poor coping strategies and maladaptive beliefs. For instance, I remember being as young as 6 and constantly thinking that everyone secretly hates me, nobody wants to be my friend, and everyone’s talking behind my back. Guess what? When I was 18, I still basically believed that. Except by then, my beliefs had become self-fulfilling prophesies, and they had reinforced themselves until it became nearly impossible to get rid of them. Wouldn’t it have been so much easier if a child psychologist had helped me get over them 15 years ago?

My little brother, age 10, thinks he’s ugly. He has adorable curly hair, itty-bitty freckles on his face, and beautiful blue eyes. He’s thin and athletic, but thinks his stomach is fat and sometimes does crunches in his room. He hasn’t really learned how to make friends yet, and he has nobody to teach him. As a result, he thinks nobody will ever want to be his friend, and he chooses to brag and show off for attention rather than try to make other kids want to be his friends.

My brother does not have depression, an eating disorder, or even–believe it or not–a serious case of narcissism. What he also doesn’t have, however, are effective mental tools for interpreting the world and for being happy. And he’s not going to find these tools on his own.

What if, in addition to physical checkups to make sure that kids’ bodies are developing correctly, that they’re learning good hygiene, and that they’re eating well and exercising, we also had regular mental checkups to make sure they’re developing good mental habits?

Clearly, not everybody is going to need constant mental healthcare like I do, and like everyone else with a serious mental illness does. Most people would be totally fine checking in with a trusted family therapist every once in a while. But others, like my brother, would seriously benefit from catching the problem before it mushrooms into the sort of thing that I went through.

Even if people never do develop diagnosable mental illnesses, unhappy children often grow into unhappy adults. Ever had a boss who made your life miserable by demanding constant ass-kissing to protect her fragile ego? Ever dated a guy whose fear of commitment destroyed the relationship? Ever had a bully in high school whose inability to relate to others in a positive way greatly affected your own life?

These people have psychological issues. I’m not saying that in a degrading way at all; many people have issues. But because most people don’t think that they should see a therapist unless they want to off themselves, people like these usually don’t get help.

Although I strongly despise the mindset that people with mental problems should be treated as personal inconveniences, the fact is that people do affect each other emotionally. Imagine if every time someone got a contagious illness, all they could do was just continue going about their daily lives until it passed, infecting everyone they came into close contact with. Luckily, that’s not how it works; most people go see a doctor when they realize they’ve come down with something. What if people did the same for mental problems?

I think that’d be a much more pleasant world to live in.

And I promise I’m not just saying that because I’m going to be a therapist and want money.

Everyone Should Go to Therapy

The Complete Idiot's Guide to Breast Cancer Awareness

If you have ever seen a bunch of women posting Facebook statuses with a random color, or a location where they “like it,” and felt a mix of confusion and frustration, you are not alone.

These memes are part of an effort for breast cancer “awareness,” a word that I use cynically here and only in quotation marks. The color meme referred to women’s bra color, and the location one referred to where they like to put their purses. Of course, they made it sound sexual to attract more attention: “X likes it by the bed”, “Y likes it in the closet,” etc.

Now, an acquiantance of mine (who also happens to be the Director of Health Promotion and Wellness at Northwestern University, and therefore isn’t entirely ignorant about these things) has reported that this stupid trend still has not died.

Perhaps even less sensically, the latest iteration of this meme is people posting stuff like “is going to New York for five months” or “is going to Las Vegas for twelve months,” and this, too, is supposed to elicit friends’ queries and be met with the response that it’s for breast cancer “awareness.”

As anyone with even a modicum of critical thinking skills can tell you, such a status, when finally deciphered, tells you exactly one thing: “There is a thing called breast cancer and you should know about it.”

Yes, yes there is. But could we finally get beyond that?

For instance, here are some actual facts about breast cancer:

If you’d like to do some actual good, why not spread this information around?

Besides that, here are some other ways you can help:

  • Volunteer to provide support for people battling breast cancer. (This is even easier if you know of such a person. You can help by driving them to doctor’s appointments, making them meals if they’re too tired, babysitting their kids, or just being there to listen.)
  • Donate to charities that provide such support, or to organizations that fund research on breast cancer. Here are some to get your started: Susan G. Komen for the Cure, the National Breast Cancer Foundation, and the National Breast Cancer Coalition. With a quick Google search, you could find local charities, charities that cater towards a particular demographic that you belong to, and so on.
  • If you want to go beyond simply giving money, participate in charities’ fundraising events, such as Susan G. Komen’s Race for the Cure. That way you get to raise money while meeting other people who care and physically showing your support for survivors and people battling breast cancer.
  • If you’re politically liberal, be an activist for government initiatives that fund cancer research, education initiatives, support for cancer patients, expanded insurance coverage, etc. One good place to start: ask your representative to support H.R. 3067, the Accelerating the End of Breast Cancer Act of 2011, which proposes an initiative to end breast cancer by 2020.
  • If you’re studying medicine or biomedical engineering, consider making cancer research your focus. Or work as a research assistant in a lab that studies cancer.
  • Buy products from companies that donate to breast cancer research (but beware of pinkwashing).
  • Similarly, if you happen to own a business or want to start one (and I know many of you Northwestern students do), consider donating a percentage of your profits to breast cancer research.
  • If you’re going into journalism and you’re interested in health, consider writing about breast cancer. Not everyone has enough knowledge to decipher academic articles; you can be the one who makes that information accessible to those who need it.

As you can see, some of these require your time and money. Others do not. The few seconds that it takes you to type your stupid status could be better spent posting a link to an important recent article about breast cancer.

And now, I get it. Cancer is a terrifying thing. The amount of information available about it could fill books upon books, and some of it is constantly going obsolete or being revised. Even I felt a bit overwhelmed just looking at the few websites I looked at to research this article.
I also get that when your friends are posting oh-so-funny things on Facebook, you want to join in the fun. Trust me, I was in middle school once, I know.

But I have some unfortunate news for some of you: neither I, nor breast cancer survivors, nor families of breast cancer victims give a flying fuck what color your bra is or where you like to put your purse, cutesy sexual innuendo notwithstanding.

If you’re old enough to make sexual innuendo, you’re old enough to educate yourself and others about breast cancer (and, for that matter, anything else you think people should be educated about). Let’s stop selling ourselves short here.

*edit* Another reason I just thought of to hate these memes–they are generally restricted to women only, and women aren’t “supposed” to tell men what they mean, thus constructing breast cancer as a “girl thing.” Not only do men witness their friends, girlfriends, wives, mothers, daughters, sisters, etc. fighting breast cancer, but some men actually get breast cancer, so it’s not only a women’s problem.

Anyway, there is enough of a stigma placed on men who get breast cancer without its promotion through this meme.

Update (2/2/2012): In case anyone’s going through my archives and reading old posts, let it be known that I officially withdraw my support for the Susan G. Komen Foundation in light of its defunding of Planned Parenthood.

The Complete Idiot's Guide to Breast Cancer Awareness

Yes, We Need Psychiatric Labels

Recently I stumbled upon a Huffington Post article by one Dr. Peter Breggin, who lists himself on HuffPo as a “reformed psychiatrist.”

This should’ve told me everything I needed to know, but I read on.

The article is titled “Our Psychiatric Civilization” and tries to make the tired point that in this day and age, we are defining ourselves by our psychiatric diagnoses and not by anything else. It’s difficult to fully dissemble this argument because Breggin unceremoniously shoves so many unrelated arguments into the same sad little article, but his main points seem to be:

  • Psychotropic medication is overprescribed.
  • Psychiatric diagnoses (i.e. major depression, bipolar disorder, ADHD, etc.) oversimplify the human condition.
  • Back in the good ol’ days, people apparently did a lot of spiritual soul-searching rather than resorting to all those damn pills.
  • The way people connect in our culture is through their psychiatric diagnoses.

I honestly don’t know which planet Breggin is living on, but it’s certainly not mine. I’ve addressed the overprescription crap elsewhere so I won’t talk about that now.

As for the second point, this is, to a certain extent, true. Psychiatric diagnoses DO oversimplify one’s psychological state, but that’s because you have to have a starting point. If you’re diagnosed with ADHD, you know that, some way–whether it’s through medication, therapy, or some combination of the two–you need to learn how to focus your attention better. If you’re diagnosed with major depression, you know that you need to somehow learn how to fix your cognitive distortions and become more active. If you’re diagnosed with seasonal affective disorder, you know that you need to do things that counteract the shortening of the days–use a full-spectrum lamp, take vitamin D supplements, etc.

Just as knowing that I have, say, asthma or the flu doesn’t describe the full state of my entire body, a psychiatric diagnosis isn’t meant to describe my entire psychological condition. Breggin seems to think that we live in a world where all we know about each other is what pills we’re popping, and nothing else. This is ludicrous. In fact, that’s something we don’t often know, given the stigma that still exists regarding mental illness.

Breggin goes on to claim in a condescending way that there’s no reason for people to connect with each other based on psychiatric diagnoses at all:

Patients ask me, “Should I join a bipolar support group?” If I were flippant, which I never am with patients, I could respond, “Only if you want support in believing you’re bipolar and need to take psychiatric drugs.”

My first thought upon reading this drivel was, Thank G-d he doesn’t say this to patients. My second was more like, What the fuck?

The idea that seeking support from others who face similar issues as you is somehow disempowering and promotes seeing oneself as a victim is quite possibly the most batshit stupid thing I’ve ever heard from someone whose profession is helping the mentally disordered. Shockingly enough, people like to feel like they’re not the only ones with problems. Perhaps this has truly never occurred to Dr. Breggin.

Quite the contrary, I have benefited immensely from connecting to other people who have depression and other mental disorders. Many of my friends have one, and together we’ve formed a sort of support network. All of us can always count on having someone to talk to, and those of us who aren’t as far along in the process of recovery as others can ask friends for advice. I don’t know where I’d be right now without that.

(Maybe in a perfect world, we could just have support groups called “Fucked-up People Support Group,” but somehow this seems counterintuitive.)

Anyway, psychiatric diagnoses can also be immensely helpful in explaining to healthy friends and family what the deal is. While Breggin seems to think that “depressed” is some sort of insulting, disempowering label I ought to reject, let me tell you some of the labels that my close friends and family described me with before they knew I had depression:

  • overdramatic
  • overemotional
  • bitchy
  • attention whore
  • immature
  • insensitive
  • selfish
  • crazy
  • weird
  • fucked up

Yeah um, I’d take “depressed” over that any day.

Not surprisingly, you don’t make a particularly strong case for yourself when you try to insist to people that, no, it’s not that you’re really overdramatic, it’s just that you have this problem with, well, being overdramatic, and you’re trying to work on it, you promise!

Trust me, that doesn’t work. What does work is saying, “I have a disorder called depression that distorts my thinking and sometimes makes me act in a way that seems overdramatic. With therapy and medication, it’ll improve.”

Apparently, though, Dr. Breggin is much too intent on destroying his own profession to allow those with mental illnesses even that small comfort. After all, he makes it pretty obvious that the reason he hates psychiatric labels so much is because they make it possible to prescribe medication, and that, of course, is a big no-no.

If I got a dollar every time some well-meaning fool tried to inform me that the medication that saved my life is unnecessary, I would have enough money to actually afford a therapist.

Yes, We Need Psychiatric Labels

Obama the Patriarch

I usually stay away from commenting on Obama’s presidency because, to be honest, I was just a kid during all the previous presidencies I’ve lived through and really have no comparison to make.

However, a recent statement by Obama has caused me to come out of my apolitical cave and rage. After the FDA made a recommendation that Plan B One-Step, a form of emergency birth control that is available over the counter to anyone over 17, be available to girls under 17 without a prescription as well, Kathleen Sebelius, Obama’s secretary of health and human services, overruled the FDA’s recommendation. This is disappointing enough as is, but then Obama came out in support of her and said the following:

“I will say this, as the father of two daughters: I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine….And as I understand it, the reason Kathleen made this decision was she could not be confident that a 10-year-old or an 11-year-old going into a drugstore should be able — alongside bubble gum or batteries — be able to buy a medication that potentially, if not used properly, could end up having an adverse effect.  And I think most parents would probably feel the same way.”

As usual when I write about women’s issues, I literally don’t even know where to start with this. First, and perhaps most obviously, I don’t understand why we’re having all this conversation about 10- and 11-year-olds. The change would have applied to all girls under 17, and the majority of teenage girls who might need to buy Plan B are not 10 and 11. Try 15 and 16. If Obama and Sebelius are that concerned about 10- and 11-year-olds specifically, they could’ve asked the FDA to recommend allowing only girls 12 and over to get Plan B without a prescription.

Second, and also very tellingly, if the FDA has deemed Plan B safe for over-the-counter use, who are Sebelius and Obama to assume they know better? Sebelius has a BA in political science and an master’s in public administration; Obama has a BA in political science and a law degree. Unlike many cynics, I don’t necessarily doubt that these two have the knowledge and ability to perform their respective jobs, but I would not trust them over the doctors and researchers who staff the FDA when it comes to medical issues.

Third, Obama immediately reveals what this is really about when he says, “as the father of two daughters…” Understandably, Obama would be worried for his two daughters if they were ever in a position to need Plan B. However, for all of the battling that Obama has had to do with the Far Right of this country, he clearly doesn’t seem to realize that many girls don’t have daddies like Obama who would care for them, be able to afford doctors’ appointments, support their right to get an abortion, and guide them through a decision. For many girls, it would be a choice between obtaining Plan B on their own or being shamed, abused, disowned, and/or forced to carry a baby to term.

Finally, I’m disturbed by the ageist and patriarchal notion that young women are somehow incapable of making their own decisions about sexual health. Yes, children need and should have access to guidance from adults. In a perfect world, every girl would be able to go to her parents for help with something like this. But that’s not the world we live in, and we must make do accordingly. Not only has the FDA already determined that Plan B is safe, but, unlike many medications that are available over the counter to children, you can’t overdose on it or otherwise fuck it up–when you buy it, you only get one.

Furthermore, there are other ways to make sure young teens know what they’re doing when it comes to emergency birth control. For instance, mandate pharmacists to provide an option for girls to privately ask them questions about how to use Plan B. Pharmacists know a lot. Why not use them as a resource?

Much has been made of Obama’s failure (or lack thereof) to support women’s rights, and it’s a debate I don’t normally follow because one can really spin it either way. On this issue, however, I would argue that Obama has definitively failed to support women and girls. Instead, he has promoted the antiquated notion that beliefs trump science when it comes to reproductive rights.

Obama the Patriarch