Everything You Ever Wanted to Know About Having Cancer

[Content note: medical stuff]

A few weeks/months ago (what is time, anyway?) I invited my friends to ask me absolutely anything they wanted about what it’s like to have cancer. The result was this epically-long Q&A, which was actually quite fun for me to compile. Folks have been saying it’s useful and interesting for them too, so I decided to make it public.

If you have questions you’d like to ask and you know me well enough to know how to reach me, feel free to send them my way and I’ll answer them when I update this. Ask anything you want; if I’m not comfortable answering, I won’t. But you can probably tell from this article that there’s not much I’m uncomfortable answering.

The first set of questions is dated November 23, 2017, so some of the details of my treatment have probably changed.

Continue reading “Everything You Ever Wanted to Know About Having Cancer”

Everything You Ever Wanted to Know About Having Cancer
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How to Avoid Giving Your Cancerous Friend a Panic Attack: An Introduction to the Psychology of Pain

Okay, maybe this is kind of turning into a Cancer Blog.

[Content note: medical stuff]

One of the first things my oncologist said to me at the beginning of this whole wild ride was, “Don’t Google.”

Wise words. For the most part, I haven’t. I’ve used some well-vetted websites (such as the American Cancer Society) to help myself prepare for things, but I’ve never intentionally sought out other types of medical information and narratives.

However, Google being how you access legit medical websites as well as blogs, things have nevertheless found their ways onto my screen that shouldn’t have. Some of this was probably unavoidable; some of it definitely wasn’t, especially when people sent me links or I clicked on them.

There’s a lot I didn’t understand about the psychological side of medicine until recently, but once I did, things started to make sense and I started to notice things I’d never noticed before.

For instance, well-trained doctors and nurses who are not characters in TV shows or moralizing children’s books never say “THIS WILL HURT A LOT.” Actually, they don’t even say, “This will hurt.” They say, “You will feel a pinch.” They say, “There might be a burning sensation at first, but it’ll go away in a few seconds.” They say, “You’ll feel a sting when I numb the area, but after that you won’t feel anything. If you do, tell me.” They say, “Some patients find this uncomfortable. If it’s too much for you, let me know and we’ll see what we can do.”

I started to notice that as much as possible, they stay away from words like “hurt,” “pain,” and anything vague or emotionally-charged.

Then I noticed how my doctor responded when I asked about pain management post-mastectomy. He said, “We use a multi-modal pain management protocol. You get four different medications, one of which is an opioid. We find that when patients return for their one week follow-up, the majority of them voluntarily return the opioids to us, saying that they only took a few of them or never needed them at all.”

Next I asked about chemo side effects. He said, “The main side effect patients experience nowadays is fatigue. Everything else is very well-controlled with medication, so if you’re still experiencing nausea or other side effects, let us know and we’ll add medications to control it or reduce the dose of the chemo. Even with fatigue, it varies. The best way to counteract it is exercise. Try to get yourself moving at least a little bit every day. Most of my patients continue to work during chemo, if not full-time. One of them even ran the Columbus Marathon during her treatment.”

Notice what’s going on?

Whenever the question of pain, discomfort, and side effects comes up, good medical providers do several things:

1) They are honest about what most patients can expect, but
2) They don’t focus on the negative aspects or use emotionally charged language to describe it
3) When most patients can expect a positive outcome, they emphasize that
4) When discussing pain or other side effects, they quickly shift focus to what THEY plan to do to address it.

This is very important, and that’s where the psychology of pain comes in. Research shows that expectations of pain play a huge role in our subjective experience of pain—expect something to hurt a lot, and it probably will; expect it to be tolerable, and it’ll hurt less. That doesn’t mean you’re going to magically feel no pain—we have nerves, after all—but there’s a degree of subjectivity to it and we’re learning that it’s a rather large degree.

Unfortunately, once you’ve become convinced for whatever reason that something is going to be very painful, it’s very difficult to un-convince yourself of that, because at that point your brain’s fear response has sort of taken over. That’s why it’s important to manage what information you receive beforehand so you don’t end up with an expectation of intolerable pain.

And that’s why my doctor told me not to google stuff.

Doctors don’t want patients freaking themselves out with graphic descriptions of painful procedures not just because they want to help you avoid panic attacks and unnecessary stress. It’s also because expecting severe pain can lead to experiencing severe pain. More pain means more pain medications, a greater risk of complications and addiction to those pain medications, a longer recovery time, and a generally all-around shitty experience.

A wonderful book I just read, What Patients Say, What Doctors Hear by Dr. Danielle Ofri, describes this phenomenon and cites research dating back decades. From a Washington Post review of the book:

We’ve known for decades that doctors who offer empathy, build trust and set expectations help their patients fare better. As far back as 1964, a study conducted with abdominal-surgery patients illustrated what Ofri calls the “demonstrable effect of the simple act of talking.” Before surgery, half of the patients were visited by an anesthetist who said pain afterward would be normal and would last a limited amount of time, and explained how patients could relax their muscles to lessen the pain. These patients needed half the pain medication of others who didn’t receive a pain talk. If we are an overmedicated nation, better communication would seem an easy and cheap way to relieve that burden — except that listening takes time, and doctors don’t usually have that.

If doctors don’t always have the time to talk to patients about pain in this calming, practical way, we now have the internet to step in and fill the gap. Sometimes it does this well, but often it does it very poorly.

We all know cognitively that you’re likely to find a disproportionate number of negative stories online because people who have a positive or neutral experience are less likely to take the time to describe it, whether that experience is with a restaurant, lawn care service, book, or medical procedure. We know this, but when you’re scared about your upcoming surgery and you stumble upon some first-person accounts, you’re not thinking of it that way and you can’t think of it that way. The fear response takes over.

Even if the experience being described is quite typical and probably fair to expect, it still does patients like me few favors to read those descriptions. First of all, subjective experiences of pain are, well, subjective. One person’s terrible pain could be my absolutely tolerable pain, and there’s no way to know it. Pretty much everyone has pain after surgery; that’s to be expected. But reading about it can still harm me by causing me to expect more pain than I would’ve otherwise had.

Different online sources also have different motivations. I’ve read a few blogs by cancer patients and found most of the accounts there to be pretty neutral and even-handed when it comes to describing cancer treatment. Yes, it sucks, but since these bloggers were documenting their journeys overall, they also described the parts that were okay, and the parts that were just boring, and even the parts that were interesting and better than they expected.

But as soon as you get into first-person narratives being published on websites like Buzzfeed and Slate and whatever, you’re going to see a much more skewed version of things because, as I’m furiously finding out, people love a graphic, miserable cancer narrative. People eat that shit up. Painful medical procedures, disgusting post-op symptoms, bizarre side effects, the works. It gets clicks. It infuriates me.

Even if those experiences are very much real, it doesn’t do someone like me any good to read it. Some patients justify it by claiming that it helps us be better “prepared”—I used to do this too—the fact is that it doesn’t make is better prepared. It makes us less prepared, because it makes us expect the worst and therefore ultimately have a worse experience.

So, when you come across these “raw” and “honest” cancer narratives and you feel the urge to send them to your friend with cancer to help “prepare” them or because you think they might find it validating, take a pause and ask yourself 1) who this is primarily being written for and 2) how exactly this will prepare your friend for what they’re about to face. Put yourself in their shoes. Imagine you’re going through treatment for a deadly illness, and you don’t know if the treatment will even work or how much damage it’ll do to you in the process. Would reading this material help you? If not, it won’t help me either.

What I do find helpful is neutral, matter-of-fact explanations of what I can expect. The best of these have come from my hospital itself, which makes tons of handouts available to patients. Here are some pages from the one they gave me about mastectomy and reconstruction surgery:

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Websites like the American Cancer Society, the National Breast Cancer Foundation, and BreastCancer.org also do this well. When I do google, these are the websites I usually click on.

And in terms of speaking to people, two conversations have made a big difference in calming me down and setting more positive expectations for surgery. One was the appointment in which my doctor told me about how most of the opioid medications get returned within a week. The other was when my mom, who had a c-section twice, told me that post-surgery pain just felt like a very strong muscle ache, as if you’d worked out super hard the day before. That was very reassuring. I am no stranger to strong muscle aches.

In my social circles, we generally value sharing and listening to people’s personal experiences, and we emphasize that everyone’s experience is valid and important and so on. I agree with this, generally. But right now, as I’m going through cancer treatment, everyone’s personal experience is not important to me, and I shouldn’t read and give credence to something just because it’s someone’s personal experience. Doing so can not only give me panic attacks, but literally cause me to feel more pain.

So for the time being, I’m trying to stay away from negative and emotionally-charged accounts of cancer treatments, and my friends can help by not encouraging me to read them. If necessary, I’ll “prepare” myself by talking to my doctors. They have yet to make me regret it.


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How to Avoid Giving Your Cancerous Friend a Panic Attack: An Introduction to the Psychology of Pain

The Context of the Thing

[Content note: sexual harassment/assault, victim blaming, racism, police brutality, homophobia, fat shaming]

Many debates in the realm of social justice and politics are debates about context. In what context are certain things said, and can those things ever be divorced from that context? Should they ever be?

Take this Facebook post, made by a New York coffee shop I had heretofore found entirely satisfactory:

A Facebook post by The Bean, including a photo of a NYPD police car and a caption, "Thank you NYPD for protecting our great city."
Image description: a Facebook post by The Bean, including a photo of a NYPD police car and a caption, “Thank you NYPD for protecting our great city.”

 

What is so irritating about this post is the plausible deniability. Surely, a Manhattan coffee shop could just post this image apropos of nothing, perhaps in the holiday spirit, to express gratitude towards the city’s police force. It could just be a matter of city pride; certainly we all like it when there is as little crime as possible. And so on and so forth.

But why post this image now? Why would a coffee shop that has posted nothing but photos, comics, and articles about coffee, store news, six posts about local events, and one cutesy article about Mother’s Day for the entirety of the year 2014 suddenly give a shout-out to the city police department?

I think I know why. But, of course, I can only speculate.

So it is with a lot of other statements that rankle, hurt, or even trigger. “What were you wearing?” Oh, sure, you could just be curious. After all, maybe it was my outfit and not my perceived gender that drew my harasser’s attention that night. Of course, you are very worried about me and just want to make sure that I’m being “smart.” You’re not thinking about the fact that that’s often the first question authorities ask us, and that fashion advice is the only kind of prevention they seem to be able to offer us. You’re not thinking about what happens to women whose outfits were deemed insufficiently preventative. Who helps those women? “Oh, I’m not saying it’s your fault,” you say. “I think anyone who does such a thing is wrong and bad and if it were up to me I would bring them to justice.” Would you? Okay, I’ll grant you that. But historically, that’s not what’s happened, is it?

“What about black-on-black crime?” Certainly it is a tragedy that so many young Black people die at each other’s hands, presumably because of gangs or drugs or one of those other scary things, and really, if a given group wants to stop dying, maybe they should stop killing each other. Never mind that the same ignorance that causes people to ask this question is the ignorance that keeps them from seeing everything that’s already being done, by Black people, to address this issue. Never mind that most white murder victims are killed by other white people, too, because people tend to be killed by those who are near to them and/or have some sort of relationship with them, and our neighborhoods and relationships are still very segregated. Never mind that “black-on-black crime” is a derailment from what is in my opinion a much more preventable issue–the fact that police around the country are killing Black people with virtually no consequences.

Yes, violent crime happens, especially in disadvantaged areas, and that is awful. But that the people tasked with “protecting” us, according to my local coffee shop, are murdering people, especially in a systematically racist way, deserves immediate attention and resolution, because a police officer who murders innocent people is an even greater threat to our society than an ordinary citizen who murders innocent people. Why? That should be obvious: cops have power, weapons, skills, and immunity that ordinary citizens do not. Law enforcement officials can do things like plant meth in the car of a woman who accused them of sexual harassment and then have her arrested on this country’s ridiculous drug laws.

“I don’t see anything wrong with gay people, I just don’t see why they have to be in my face about it.” No, you’re right. Perhaps you are a person who believes that sex, love, and relationships should be an entirely private matter. Maybe you’re uncomfortable when your coworker tells everyone about the vacation she’s planning for her and her husband’s anniversary. Maybe it turns your stomach to see free condoms handed out on your campus. Maybe you change the channel every time a guy and a girl kiss in a TV show and you don’t feel that it’s appropriate for children to see a man and a woman holding hands in public. But you don’t mention that because…maybe people would ridicule you for it, whereas publicly stating that gay couples gross you out is still socially acceptable. I don’t know.

Or maybe you have double standards for queer people versus straight people, and you believe that the things straight people get to do–hold hands and kiss in public, chat at work about their anniversary plans, see relationships like theirs on television, access the healthcare that they need–are not things that queer people get to do. Sometimes queer people are loud and in-your-face about being queer because they are fighting against the idea that they should have to be silent when straight people don’t have to be. Your casual remarks about “I just wish they’d keep it to themselves” are telling us to get back in the closet so you don’t have to be uncomfortable.

“Of course it’s wrong to hate people just because they’re fat, but they really need to lose some weight or else they’ll be unhealthy.” You may think that what you’re saying here is commendable. After all, you must really care about this person and have great concern for their wellbeing. Maybe you even have some helpful weight loss advice that totally worked for you. Really, they should be grateful that you’re trying to help them.

Okay, but the idea that “they really need to lose some weight or else they’ll be unhealthy” is the idea that causes people to hate them in the first place. If weight is perfectly correlated to health, and if losing weight is a possibility for everyone, then only those who do not care about their health would allow themselves to be fat, and only an irresponsible person who lacks self-control would refuse to care about their health. Such a person would not make a suitable employee, doctoral student, or partner, for instance. Such a person would be a bad influence for your children. And the idea that fatness is responsible for poor health 100% of the time keeps fat people from getting the medical care they need, because doctors assume that the problem must be their weight.

Plausible deniability is how all of these statements function. We are expected to take them entirely out of context, as isolated thoughts or ideas or feelings or beliefs that have nothing to do with what came before or what will come after, and nothing to do with the horrors that have been committed in their name. You asking me what I was wearing has nothing to do with the systematic refusal to believe and help people who have been harassed and assaulted. You innocently wondering about black-on-black crime has nothing to do with centuries of white-on-black crime, and with the casual dismissal of this crime, and with the fact that it has historically not been defined as a crime at all. You wishing that queer people wouldn’t shove their sexuality in your face has nothing to do with our erasure, metaphoric and sometimes literal. You patronizingly advising bigger people to get smaller has nothing to do with their mistreatment in all sorts of social contexts, including medical ones. Nothing at all!

But that’s not how communication works. If a celebrity becomes the center of a huge controversy and I post about my love for their films or music, that can and should be taken as a statement of support for that celebrity. If a business comes under fire for its practices or policies and I post about how I’m going to proudly patronize that business today, that can and should be taken as a statement of support for that business. (In fact, I once ended a friendship with someone who did this on the day the Chick-Fil-A homophobia thing went viral, and I do not regret it.) There is of course a chance that I had simply not heard of the controversy, but in that case, I should reconsider my support for this person or business once a friend helpfully comments and lets me know about what’s going on. And in most cases people do not do this.

So if you post about your gratitude to the NYPD right after one of its officers has once again gone unpunished for the cruel killing of a Black man, and as protests march right down the block where your coffee shop stands, that has a context, too.

I suppose it can feel like this is all a huge burden. Why shouldn’t you be able to just say what you think and feel without being held responsible for decades or centuries of terrible things done in the service of the beliefs that you are expressing? It’s true that what happened is not your responsibility, and every terrible thing done by people who believe the same things you believe is not your fault.

But that is why what you say hurts people, and that is why they warn you where your beliefs may logically lead. If what women wear has any relevance to their sexual violation, if black-on-black crime is more important and urgent than white-on-black racism, if queer people being open about themselves and their loves is so unpleasant for you, if fat people should lose weight before they are taken seriously–then that has implications for how we treat people and issues. If you take the time to listen to the voices of those most affected by these issues, you might see that these implications are just as horrifying to you as they are to us.

The Context of the Thing

Correlation is Not Causation: STI Edition

I wrote a piece for the Daily Dot about a new study on STI rates among men who hook up with men using smartphone apps, and how easy it is to misinterpret the results.

new study by the L.A. Gay & Lesbian Center and UCLA suggests that men who have sex with men and use hookup apps like Grindr are significantly more likely to have gonorrhea and chlamydia than men who have sex with men but do not use such apps. But before you panic and delete Grindr from your phone lest it give you an STI, let’s look at what the study does and does not actually show.

[…]Careless headline writers frequently mix up correlation and causation, spreading misinformation and stigma. Despite Lowder’s balanced take on the study, the headline of his own piece reads, rather alarmingly, “Study Suggests Grindr-Like Apps Increase Likelihood of Sexually Transmitted Infections.” This wording implies that using such apps increases an individual’s likelihood of contracting an STI, not that, in general, people who use such apps are also more likely to have an STI. It’s a fine distinction, but an important one.

Another important distinction is whether the participants contracted the STIs during the course of the study (while using GSN apps) or just happened to have them at the time that the data was collected. Here Lowder’s article is also unclear: “Specifically, geo-social app users were 25 percent more likely than their bar hopping comrades to contract gonorrhea, and 37 percent more likely to have picked up chlamydia.” And an article about the study at Advocate is headlined, “STUDY: Smartphone Hookup App Users More Likely To Contract Sexually Transmitted Infections.”

However, the actual study notes that the participants were tested for STIs at the same time as they were asked about their sexual behavior, including the use of GSN apps. This means that they did not necessarily contract the STIs while using the GSN apps, or after having used them. The infections could have preceded the participants’ use of the apps.

This is important because it can help untangle the question of why this correlation exists, besides the obvious hypothesis that using GSN apps can actually cause people to contract STIs at higher rates than other ways of meeting sexual partners. Perhaps people who already have STIs are more interested in using the apps because of the anonymity—it’s much less scary to tell a random person you’ll never meet again that you have an STI and need to use a condom than it is to tell someone who’s embedded in your social network. Or, on the more cynical side of things, people might feel less guilty about not disclosing an STI to a random app hookup than someone they’ve met in a more conventional way.

Or, maybe people who are attracted to “wild” and “risky” sexual situations are more likely to have STIs and more likely to use GSN apps. The common factor could be impulsivity or recklessness.

Read the rest here.

Correlation is Not Causation: STI Edition

DSW Shoe Warehouse is Promoting Vaccine Denialist Jenny McCarthy

This is a short post to alert folks about a pretty crappy thing that DSW, a place where I ordinarily like to buy shoes sometimes, is doing:

Flyer for DSW's Jenny McCarthy event
Their Facebook post about this is, for whatever reason, visible only to certain Facebook users (weird targeted advertising perhaps?). I can still see it, as can Rebecca Watson, who’s already written a post about it. The DSW post with this image reads:

Hey, NYC—don’t forget!! Tomorrow we’ve got a BIG Shoe Lover party at DSW Union Square. Come shop amazing deals, grab an exclusive offer, and get the chance to meet Shoe Lover Jenny McCarthy!*

Wednesday, April 9 from 5–7 p.m.
DSW Union Square
40 E 14th Street | New York, NY 10003

RSVP and get full details: http://bit.ly/OoAVNt
See ya tomorrow!

*Participation in the event will be on a first come, first serve basis—so get there early! Line starts at noon.

I commented with the following:

Hey DSW, why are you hosting this vaccine denialist? Her continued claims that vaccines cause autism are scientifically incorrect and extremely dangerous. Parents who refuse to vaccinate their children threaten their own children’s health and that of other kids who are unable to be vaccinated for medical reasons. Several cities have already had outbreaks of diseases that are entirely preventable by vaccination and previously much rarer; parents refusing to vaccinate their children is a major cause of this and Jenny McCarthy actively promotes this dangerous idea.

I know your company’s about shoes, not healthcare, but it’s irresponsible of you to promote this person. I’m not shopping here again until this is canceled or apologized for.

They responded:

Hey Miri! We’d like to hear more about your concerns. You can email us at: [email protected]

And I responded again:

Thank you for your response. However, I have already stated my concerns, and I will not do so through private email when your event is *public*. Others deserve to know.

Here is more information about McCarthy and the very real harms she has brought to children and their families:

http://nypost.com/2014/03/18/anti-vaccine-activist-jenny-mccarthy-mother-of-plagues/

http://blogs.seattletimes.com/opinionnw/2014/04/04/anti-vaccine-measles-ignore-jenny-mccarthy/

http://jennymccarthybodycount.com/Anti-Vaccine_Body_Count/Home.html

Those links, by the way, are a great place to get started if you don’t know much about McCarthy and her promotion of dangerous and false vaccine myths.

We’ll see what comes of this, but for now, if you want to help us put some pressure on DSW, please email them at the address they provided ([email protected]), participate in the conversation on Facebook if you can see it, or tweet them @DSWShoeLovers.

As Rebecca also mentioned, Chili’s recently responded really well to a similar controversy. Hopefully DSW shapes up and does the same.

Screencap of the discussion on DSW's Facebook page, which isn't visible to everyone for some reason.
Screencap of the discussion on DSW’s Facebook page, which isn’t visible to everyone for some reason.

Update: Avi weighs in.

DSW Shoe Warehouse is Promoting Vaccine Denialist Jenny McCarthy

Some Evidence Against Shame and Stigma as Weight Loss Motivators

[Content note: weight/size stigma and discrimination]

It is considered self-evident by plenty of people that shaming fat people for being fat gets them to stop being fat. That’s why a common reaction to body/fat positivity campaigns is that they’re going to make people think it’s “okay” to be fat. As opposed to…not okay.

However, even if we begin with the presumption that it’s a net good for fat people to stop being fat, research evidence is rapidly piling up that suggests that shaming and stigmatizing them won’t work. In fact, it may have exactly the opposite effect.

In a paper recently accepted for publication in the Journal of Experimental Social Psychology, the authors provide this overview of research on this topic:

Media attention to obesity has increased dramatically (Saguy & Almeling, 2008), as has discrimination against overweight and obese individuals (Andreyeva, Puhl, & Brownell, 2008). Overweight individuals are often portrayed in the media as lazy, weak willed, and self-indulgent (Puhl & Heuer, 2009), and as a drain on the nation’s resources (Begley, 2012). Because stigma can be a potent source of social control (Phelan, Link, & Dovidio, 2008), some authors have suggested that stigmatizing obesity may encourage people to lose weight (Bayer, 2008, Callahan, 2013 and Heinberg et al., 2001), and policies that utilize potentially stigmatizing elements (e.g., BMI report cards) are becoming more prevalent (Vogel, 2011). Little evidence exists, however, that stigmatizing obesity promotes weight loss. In fact, among overweight individuals, experiencing weight-stigmatization is associated with greater reports of maladaptive eating behaviors (e.g., Haines et al., 2006 and Puhl and Brownell, 2006), increased motivation to avoid exercise (Vartanian & Novak, 2008; Vartanian & Shaprow, 2010), and poorer weight loss outcomes among adults in a weight-loss program (Wott & Carels, 2010; but see Latner, Wilson, Jackson, & Stunkard, 2009). Furthermore, experimentally activating weight stereotypes decreased overweight women’s self-efficacy for exercise and dietary control (Seacat & Mickelson, 2009). Collectively, these findings suggest that stigmatizing obesity has negative behavioral consequences that may increase, rather than decrease the weight of overweight individuals.

The paper also reviews research suggesting that the reason this happens is because of something called identity threat. When an individual has an identity that they know is stigmatized and something happens that triggers their awareness of that (such as a joke about the identity or a person who invokes negative stereotypes about it), the individual may experience negative effects. Some of these are physical, such as increased physiological stress response. Some are psychological, such as feelings of shame or anxiety. The person may try to act in ways that “compensate” for the flaws others may perceive in them or avoid situations in which people might think poorly of them (for an overweight person, this may include eating with people or going to the gym).

In theory, all this stress, anxiety, and effort depletes cognitive resources available for other activities that require what is known as executive function–mental tasks such as regulating emotions, setting goals, using short-term memory, and so on. Research has shown that when people of various stigmatized categories are reminded of those stigmas and stereotypes, their cognitive performance on a variety of tasks worsens.

The researchers in this study hypothesized that feeling identity threat would decrease participants’ ability to subsequently regulate their food intake. Specifically, they tested whether or not exposure to news articles about weight stigma would actually increase the amount of calories participants consumed. They believed that the participants who would be most affected would be those who believe themselves to be overweight, regardless of their actual weight, because they would be the ones who would feel identity threat when reminded that weight stigma exists.

The participants were 93 female college students (45% White, 24% Latina, 18% Asian/Pacific Islander, 3% African American, 10% other races). Prior to the study, they had filled out a survey that included a few questions about weight (the rest were just there to hide the purpose of the survey). When they arrived at the study, they were told that the purpose was “to examine correspondence among verbal, nonverbal, and physiological signals.”

They were randomly assigned to one of two conditions. In the test condition, they read an article called “Lose Weight or Lose Your Job,” which was compiled from actual news stories and described the discrimination that overweight people may face in the workplace. In the control condition, the participants read a nearly-identical article that was about smoking rather than weight.

Afterward, they were led to another room and asked to wait for the experimenter to return. The rooms had bowls of snacks that had been weighed prior to the study, and the participants had the opportunity to eat some of the snacks while they waited for 10 minutes. They were then asked to return to the previous room to complete a final questionnaire.

One of the measures on the questionnaire was called “self-efficacy for dietary control.” Self-efficacy refers to one’s sense of having the ability to do something and control one’s outcomes in that domain. This particular measure assessed the extent to which participants felt they could control their eating, avoid unhealthy foods, and so on. Various studies suggest that having a sense of self-efficacy is more important in terms of actual behavior than other factors, such as believing that the behavior is healthy or important. (For instance, here’s an example involving elderly people and exercise.)

The results were pronounced. In the weight stigma condition, women who perceived themselves to be overweight ate significantly more calories than those who did not perceive themselves as overweight. In the control condition, there was no significant difference:

The interaction between perceived weight and article type.
The interaction between perceived weight and article type.

Furthermore, women who perceived themselves as overweight had significantly lower self-efficacy for dietary control in the weight stigma condition than in the control condition, while women who did not perceive themselves as overweight actually had higher self-efficacy in the weight stigma condition than in the control condition.

This means that, within the context of this experiment, women who perceive themselves as overweight increase their food intake in response to hearing about stigma against overweight people and feel less capable of controlling their food intake. The very people being targeted by this information in ways many people think are helpful are actually being harmed by it, not only in the obvious emotional sense but even in their ability to control what they eat.

One really notable finding in this study is that actual weight did not correlate with either calories consumed or self-efficacy in either condition. Perceived weight was the relevant variable. I’ve often heard people argue against the body positivity movement because but if fat people don’t think they’re fat then how will they ever stop being fat?! Ironically, the women who did not perceive themselves as overweight had higher self-efficacy in the weight stigma condition than in the control condition.

One weakness of this study is that it is unclear whether or not the participants who increased their food intake did so consciously–or deliberately. If it was unconscious and not deliberate, then this finding may fit with previous findings about identity threat. If not, it’s still an important finding, but it’s probably easier to get people to change mental processes that are conscious and deliberate as opposed to those that are subconscious and unintentional. It’s also possible (though probably unlikely) that the women in the weight stigma condition purposefully ate more as a sort of symbolic protest. Oh, you’re going to fire me because of what I do with my own body? Well, fuck you, I’ll eat as much as I want.

Another limitation is that the type of stigmatization invoked in this experiment isn’t quite what overweight people might actually experience in their day-to-day lives. While articles like the one used in the study are common, the idea behind stigmatizing people so that they lose weight is usually more direct: for instance, telling them they need to lose weight, penalizing them for being overweight, and so on. Telling a study participant that they’re fat and ugly and need to lose weight would probably never pass an IRB review, but it would be a more naturalistic scenario, unfortunately.

While the sample used in this study is more racially diverse than many other samples in psychology studies, that really isn’t saying much. The researchers did not discuss any racial disparities in the data, but that would be an interesting direction for future studies. Also, all of the participants were young women, so it’s unclear how well this generalizes to older women and men of all ages.

With research like this, it’s important to remember that the findings should be interpreted much in the way that the statement “consent is sexy” should be interpreted. Namely, you should get consent because it’s the right thing to do, not because it’s “sexy.” Likewise, you should refrain from shaming and stigmatizing fat people because it’s the right thing to do, not because shaming and stigmatizing them doesn’t work anyway. Activists rightly criticize research like this for suggesting the implication that we should stop shaming fat people because it doesn’t get them to lose weight, rather than because it’s a shitty thing to do. That said, I don’t think that’s an implication that the researchers mean to give. We should conduct, support, and read research about how human motivation works (and how everything else works) because it’s important to know. This is just one piece of that puzzle.

It is my hope, though, that studies like this will work where “don’t be an asshole” won’t. The most important thing to me is for people to stop stigmatizing and discriminating against fat people, whatever the reason they stop doing it, because it’s harmful and needs to stop. Then maybe we can make these people understand why they were wrong to do it.

However, this research also opens up a lot of tricky questions. If shaming people who are overweight did actually help them lose weight, would more people think that this is an okay thing to do? If shaming people who do things that most of us would consider Definitely Bad, like rape or theft or even saying racist things, worked, would that be okay to do? Many would probably say yes to the latter but no to the former.

What is clear, though, is that human motivation (and reasoning in general) often works in ways that seem counterintuitive. You might think that people would respond to the stimulus of “being overweight can cost you your job” with “well I’d better stop being overweight, then!” But that’s not necessarily the case.

~~~

Major, B., Hunger, J.M., Bunyan, D.P., Miller, C.T. (2014). The ironic effects of weight stigma. Journal of Experimental Social Psychology, 51: 74-80.

Some Evidence Against Shame and Stigma as Weight Loss Motivators

Herbal Abortions and Editorial Responsibility

Content note: graphic descriptions of abortions and miscarriages

Being both a feminist and a skeptic means walking the fine line of critiquing the way science and medicine are practiced without denying their importance and validity, of empowering individuals who have faced abuse by these institutions without promoting at-best useless and at-worst dangerous pseudoscience to these individuals instead.

I was reminded of this ever-present tension when I read a book of essays called Listen Up: Voices from the Next Feminist Generationedited by Barbara Findlen. One of the essays was titled “Abortion, Vacuum Cleaners and the Power Within,” and the subject was the author’s negative experiences with what she called “clinical” abortions–that is, abortions performed by someone licensed to perform abortions.

The author, Inga Muscio, describes the several clinical abortions she had: they were painful and terrifying:

Have you any idea how it feels to willingly and voluntarily submit to excruciating torture because you dumbly forgot to insert your diaphragm, which gives you ugly yeast infections and hurts you to fuck unless you lie flat on your back? I had to withstand this torture because I was a bad girl. I didn’t do good, I fucked up. So I had the same choice as before, that glowing, outstanding choice we ladies fight tooth and nail for: the choice to get my insides ruthlessly sucked by some inhuman shit pile, invented not by my foremothers, but by someone who would never, ever in a million years have that tube jammed up his dickhole and turned on full blast, slurping everything in its path.

Muscio, who is very clear about her opinions on “Western medicine” (she at one point refers to it as “that smelly dog who farts across the house and we just don’t have the heart to put out of its misery”), eventually gets pregnant again, and this time she tries something else:

I started talking to my girlfriends. Looking to my immediate community for help led me to Judy, the masseuse, who rubbed me in places you aren’t supposed to rub pregnant ladies. She also did some reflexology in the same vein. Panacea told me where to find detailed recipes for herbal abortifacients and emmenagogues. Esther supported me and stayed with me every day. Bridget brought me flowers. Possibly most important was the fact that I possessed not one single filament of self-doubt. With that core of supportive women surrounding me and with my mind made up, I was pretty much invincible.

So, one morning, after a week of nonstop praying, massaging, tea drinking, talking and thinking, I was brushing my teeth at the sink and felt a very peculiar mmmmbloommmp-like feeling. I looked at the bathroom floor, and there, between my feet, was some blood and a little round thing. It was clear but felt like one of them unshiny Super Balls. It was the neatest thing I ever did see. An orb of life and energy, in my hand.

But lest you think Muscio intends this as a solution just for herself, she concludes, disturbingly:

Concentrating on the power within our own circle of women was once a major focus of the women’s health movement. I think we would benefit from once again creating informal health collectives where we discuss things like our bodies and our selves. If we believed in our own power and the power of our immediate communities, then abortion clinics, in their present incarnation, would be completely unnecessary. Let the fundamentalist dickheads burn all those vacuum cleaners to the ground. if alternative organic abortions were explored and taken more seriously, there wouldn’t be much of an abortion debate. Abortion would be a personal, intimate thing among friends.

Can you say Amen.

I finished the essay feeling confused. Although Muscio explained that “clinical” abortions were painful and felt wrong to her, she did not even attempt to explain her fury at abortion providers (whom she seems to think are all men). She did not explain why (or even whether) a painful and scary medical procedure that aborts a fetus is any different from a painful and scary medical procedure that stops a tooth infection or removes a tumor. Would she advocate “alternative organic” methods for those problems, too?

Her graphic imagery of vacuum cleaners, blood, and gore is never explained or justified in any way. She just doesn’t like the idea of abortions, and this, apparently, is reason enough to let abortion clinics go extinct.

Muscio further erases the fact that women, too, can and do perform abortions, and her implication that only women can understand the female reproductive system is extremely cisnormative (and also simply wrong; any doctor who has spent years studying those organs and operating on them and helping to keep them healthy surely knows more about them than I, a cis woman, do).

But I think I’m most disturbed not by Muscio’s ideas, but by the editor’s decision to publish them in this anthology.

How would a young person, perhaps not very knowledgeable about abortions, perhaps who has grown up being told they are awful and immoral, perhaps in need of (or at risk of needing) an abortion themselves, react to reading this piece? What decisions would they make about their health? I’m wondering if the editor thought about this before choosing to publish the essay.

On one hand, I see the value of publishing and reading all kinds of narratives about reproductive health, including this one. In our rush to portray abortion as a standard, no-big-deal sort of medical procedure, advocates for reproductive rights sometimes lose sight of the fact that, like any other medical procedure, abortion can be terrifying and traumatic completely independently of the fact that it’s so stigmatized.

Fear of medical procedures (and fear of pain) is something that people are expected to magically “outgrow” when they stop being children. Some do, but some don’t. Doctors don’t always know how to respond to adult patients with extreme fear, and often respond without empathy or compassion. This is only one of many reasons some people turn to practitioners of alternative medicine for help.

Understanding this is essential if we are to help people find healthcare that works (both by actually getting them physically better and by treating them with dignity and care). But the essay was presented in the book without any sort of commentary. While the book’s editor isn’t necessarily condoning or supporting the ideas in the essay, she is nevertheless promoting them by giving them wider circulation than they would otherwise have.

People may read the essay and become convinced that prayer and herbal tea can actually abort a fetus, and that getting an abortion performed by a medical professional is always a horrible experience to be avoided at all costs. That someone would end up with an unwanted child is probably the best case scenario of taking Muscio’s advice, as alt-med remedies can be actively harmful and dangerous.

(In fact, in the essay, Muscio elaborates on the specific “herbal remedies” she used. One of them was pennyroyal, which was implicated in the death of a woman who used it to try to induce an abortion. She didn’t know that she had an ectopic pregnancy. In general, the history of herbal abortifacients is, as i09 puts it, terrifying.)

Giving people medically accurate information about reproductive health is a crucial part of progressive activism. While one might argue that left-wing distortions of science and medicine are more well-intentioned than their right-wing counterparts, the end result is absolutely identical: people don’t understand how their bodies really work, how medicine works, which medical interventions are supported by the evidence and which are not. People feel ashamed of seeking out medical care that works.

I know that there are compelling reasons to publish this essay as is. I can understand why the author of this book might’ve done it. But I wouldn’t. It seems irresponsible.

~~~

P.S. Many of the other essays in the book were actually pretty cool. Here are my favorite quotes.

Herbal Abortions and Editorial Responsibility

Help Stop Ohio's Terrible New Anti-Abortion Bill

[Content note: abortion]

Note: If you already know all about Ohio’s terrible new anti-abortion bill, scroll all the way to the end to find out how to try to stop it. If not, read on.

Last Tuesday night, I and–at times–150,000 other people stayed up to watch the livestream of the 12-hour filibuster in the Texas state legislature. State senator Wendy Davis and her fellow Democrats helped prevent (temporarily) the passage of what would’ve been one of the most restrictive anti-abortion bills in the country. Davis overcame exhaustion, hunger, and her Republican opponents’ bad-faith attempts to get her to go off-topic (in Texas, filibusters must remain “germane” to the bill at hand), to claim that she was breaking rules, and, when the going got tough, to cheat and try to pass the bill after the midnight deadline.

Unfortunately, Davis’ victory was only temporary, and Texas is only one of the the states where reproductive rights are constantly under assault.

My home state of Ohio (I use the word “home” loosely here) just passed House Bill 200, a bill similar to the one that got filibustered in Texas, except worse. Some of its provisions include:

  • Doctors must explain to patients seeking abortion how their fetus’ nerves develop, and to tell them that, even in the first trimester, a fetus can feel pain. There is no scientific evidence of this.
  • Doctors must also tell patients that abortions are linked to breast cancer. There is no scientific evidence of this either.
  • As in the Texas bill, abortion providers in Ohio must be within 30 miles of a hospital, but here’s the new catch–it cannot be a public hospital. So if there are no non-public hospitals within 30 miles of an abortion clinic, then the clinic must shut down.
  • Doctors must inform patients seeking abortions exactly how much money the clinic made from abortions within the past year, and how much money the clinic stands to lose if the patient chooses not to get an abortion. In case it’s unclear, the point of this is to warn patients that there is a “conflict of interest” involved in providing abortions because clinics can make money from them. This is ridiculous because any medical procedure can make money for doctors and hospitals.
  • Before this bill, patients seeking abortions in Ohio were already required to view an ultrasound of the fetus. Now, the doctor must describe the fetus visually and explain the current development of its features. Although the bill doesn’t stipulate what type of ultrasound it has to be, it does require for it to produce a clear image of the entire body of the fetus, and for first-trimester patients, that probably requires an invasive transvaginal ultrasound. Victims of sexual assault are not exempt, and the patients must pay extra for the ultrasound.
  • The mandatory wait period for an abortion in Ohio used to be 24 hours; now it will be 48 unless there is a dire medical need to terminate the pregnancy. Again, victims of sexual assault are not exempt. While some people may claim that it shouldn’t be a big deal to have a wait a day or two, remember: restrictions like these disproportionately impact teenagers, the poor, and those who live in rural areas. For a teenager to miss school and get a ride to an abortion clinic without their parents’ knowledge is difficult enough already; doing it twice is even harder. Same for a poor person who has to skip work, and for a person living in a rural area who has to drive a long way to get to an abortion clinic (and it’ll be even longer thanks to the closures that will occur as a result of this bill). In any case, having to wait, especially having to wait a longer period of time, causes stress and anxiety. These politicians seem to be hoping that that stress and anxiety somehow dissuades the person from getting the abortion.
  • Before, a doctor could get a medical waiver to bypass these restrictions if the pregnancy was causing health problems. But now, doctors will only be able to get those waivers if the potential health risks are so great that the pregnant person could die. Anything less than death, apparently, is no big deal.

These abortion restrictions are like the proverbial frog in boiling water. They do it gradually–a 24-hour waiting period here, a mandatory ultrasound there. So what if doctors must have admitting privileges at nearby hospitals? Doesn’t that make abortion safer? (No.)

But before you know it, abortion is nearly or completely unavailable in a given state, and the degree to which it is unavailable varies according to how much money, status, and support you have. Those people who will be most harmed by an unplanned-for and unwanted child will also be the ones for whom abortions are hardest to access. This is unconscionable and it must stop.

Furthermore, most of these restrictions are predicated on the belief that pregnant individuals cannot be trusted to make decisions about their own bodies on their own. They need waiting periods. They need to be shown ultrasounds. They need their fetus’ development described to them. They need to be informed, as though they are completely clueless and ignorant, that doctors make money when they perform medical procedures.

Of course, the point of the bills is not to make abortion safer. This must be stressed over and over again. The point of the bills is to make abortion difficult or impossible to access. Do not fall for the Republicans’ paternalistic claptrap about how they’re just trying to keep women (they think everyone who gets an abortion is a woman) safer. They’re trying to outlaw abortion, slowly and surely.

How do I know? Many reasons, and I’ll use the very similar Texas bill as an example. Texas Republican legislator referred to opponents of the filibustered bill as “terrorists.” Texas Governor Rick Perry, defending the bill, said that “the louder the opposition screams, the more we know we’re doing something right.” (Yes, that is as rapey as it sounds.) Texas Lieutanant Governor David Dewhurst said that the protesters who prevented the bill’s passage “disrupted the Senate from protecting unborn babies.” Where’s the compassion and the concern for safeguarding women’s health now?

As I mentioned, the Ohio bill has already passed. It was included last-minute in a state budget bill, leaving reproductive rights advocates no time to organize any resistance like they did in Texas.

However, Ohio Governor John Kasich has until midnight tomorrow (Sunday) to veto any or all of the bill’s provisions. Kasich, a Republican, has said that he opposes abortion, but maybe even he will realize that this is just too much.

Here’s what you can do: call Gov. Kasich at (614) 466-3555 or email him here and let him know you oppose House Bill 200. I just did. Remember what I wrote about online activism? We can make a difference.

Help Stop Ohio's Terrible New Anti-Abortion Bill

Correlation Is Not Causation: The Marriage Edition

Steven Crowder–that guy who wrote an article on Fox News’ website gloating about his “perfect wedding” and sanctimoniously censuring people who have sex before marriage or *clutches pearls* drink at the wedding–is back. (Actually, he’s probably been back; I just haven’t been following his pearl-clutching screeds.)

This time, Crowder, who presumably still has that newlywed glow, wants to tell you why you should get married. Yes, you!

Crowder runs through the typical list of established correlations about married people. They make more money. They have more money. They have more and better sex. It’s better for the children. They’re more productive at work (crucial in our capitalist society). They’re healthier.

Crowder is writing this article because he seems to be under the impression that there is a War on Marriage going on:

Sadly, marriage has become a punchline in today’s society. From referring to the wife as “the old ball and chain” to nearly every poorly written sitcom that we watch, the message we’re sending to today’s generation is clear… Marriage = no fun.

Men on TV constantly joke about how wives are incredibly expensive, demanding and overall vacuums of all things fun. By that same token, the women complain about their fat, lazy, insensitive husbands as they swoon over their trimmed, manicured and chest-waxed Hollywood counterparts.

[…]I know plenty of people my age that will never get married because they genuinely believe the false cultural meme that marriage has sadly become.

Although marriage is certainly portrayed as boring in pop culture, the reality is that, especially among Crowder’s ilk, marriage is still largely considered the only acceptable choice for straight people (gay people, on the other hand, need to either choose to be straight, live a life of celibacy, or have those adorable cute little gay relationships in which they live together and have cats but never actually do anything annoying like ask for the right to get married).

Aside from the fact that this article is completely unoriginal and pointless–there is no war on marriage, people–Crowder displays an incredible lack of intellectual curiosity. That is, he fails to ask where all of these wonderful benefits come from.

Where do they come from?

Are married people healthier, richer, and more productive than straight people because marriage is “naturally” the best state of adult humans to be in? Or might it be because of all the benefits our society has conferred to married couples, the privilege that we have afforded to the status of being married?

And what about that awkward moment when most of the correlations Crowder mentions are just that–correlations? Do married people get richer, or are rich people more likely to be able to afford marriage? Does marriage make people healthier, or are healthier people more likely to find and keep partners?

Actually, these are not rhetorical questions. I really am curious. But because the only studies Crowder linked to were correlative studies (and they were all found on websites like the FRC and FamilyFacts.org, but whatever), I don’t actually know the answers.

In his rush to prescribe marriage to every single person man in America, Crowder overlooks quite a few things. Some of the oversights are quite callous:

Okay so you may not want kids. You may despise them. I get it. Sticky hands. Let’s say you’re just another selfish, narcissistic bachelor (or bachelorette) who quite frankly, isn’t deserving of the unconditional love you may oh-so-luckily find. You just want the sex. Statistically, not only do married people have more sex, they have better, more satisfying sex. If the two of you should hold off on sex until marriage, those statistics become even more promising. Here’s a perfect example of where Hollywood gets it wrong. In the real world, while Alfie fruitlessly toiled away at picking up harlots from the bar, suffering a mean case of whiskey-wiener, Mr. Cleaver was getting busy on the regular. Them’s the real breaks.

It appears that Crowder is totally okay with the idea of a man pretending to be invested in marriage and family for the purpose of getting regular sex. (Also, “picking up harlots from the bar”? What century is this?)

The rest of the piece, too, is infested with sexism, from the implication that wives are supposed to keep husbands in line down to the pointless and tacky sandwich joke at the very end. For example:

Married men in particular, have higher employment rates, work longer hours and receive better wages. It’s time to stop wading through puddles of your own filth as you reach for the hotpockets and have a dame whip you into shape. You’re welcome.

Why the hell is that a woman’s job? I don’t want to get married if it means “whipping” some lazy slob into “shape.” This, by the way, is a perfect example of the fact that it’s conservatives, not feminists, who have the most sexist and unflattering opinions of men. I at least accept the remote possibility that a man might, you know, not be a lazy slob who needs to “stop wading through puddles of [his] own filth.”

Crowder also correctly notes that married people “qualify for more benefits/financial incentives than lonely, single folk,” but fails to explain how the fuck this is fair, and why exactly the government is in the business of encouraging procreation when we’ve got plenty of humans on the planet as is. Big Government is totally okay with this Republican when the purpose is to encourage procreation.

Before the icky sandwich joke, Crowder closes his screed with this:

Picture coming home every night to your best friend, your greatest fan, and your number one supporter. She (or he) makes each good day better, and each bad day good again. Every day, you get to live what is essentially a 24/7 sleepover party with the greatest friend you’ve ever had.

That does sound like a pretty awesome deal–for me, because I do happen to be a person who wants a stable, long-term relationship. Believe it or not, not everyone does!

But notice how nothing in that paragraph requires a certificate from the government saying that you are married. Nothing in it requires standing in front of all of your friends and family wearing fancy clothing and vowing to love and cherish each other till death do you part.

Edit: My friend Michael has also written a post about this that’s making me guffaw loudly. A snippet:

Regarding this whole “It’s even better if you wait!” thing, though, I’m a bit more skeptical.  The trouble with measuring sexual satisfaction is that it’s entirely subjective, and based on comparison within your own experience.  If you’ve only ever had sex with one person, then that’s the best sex you’ve ever had.  Add onto that the fact that people who wait until marriage to have sex are routinely told that theirs will be the best sex ever, and all those filthy fornicating whores out there will never truly be happy, of course they’re going to say that their sex lives are great (and hey, if it’s working for them, whatever).  If you only ever give someone an Oreo, and make sure that you talk up Oreos all their life and stress to them that all other cookies suck, then they’ll probably think Oreos are the best cookie, too.

Correlation Is Not Causation: The Marriage Edition

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