The Medical Gaze and the Matrix of Domination @themedicalgaze-blog - Tumblr Blog

Posts

Sujata, you can click on the different texts above to look at posts that are categorized by different themes and subject matter, as well as our final bibliography.

Hi!

We are three undergraduate students at Middlebury College enrolled in "Foundations in Women and Gender Studies." After reading The Immortal Life of Henrietta Lacks by Rebecca Skloot, we have chosen to take a look at how intersectionality interacts with the medical community. The medical gaze tends to privilege certain bodies over others and pathologize the rest. This blog aims to present and honor the other sides of the story.

#about

SOURCES

Adam, Lee William. “Why Drug Addicts Are Getting Sterilized for Cash.” 17 Apr. 2010.<http://www.time.com/time/health/article/0,8599,1981916,00.html#ixzz2SHsYHSi0>

Caplan, Arthur. “FDA Ban On Blood Donated By Gay Men Upheld.” Interview by Neal Conan. NPR. N.p., 29 June 2010. Web. 29 Apr. 2013. <http://www.npr.org/templates/story/story.php?storyId=128193248>.

Colbert, Stephen. Rebecca Skloot. Colbert Nation. Comedy Central, 16 Mar. 2010. Web. 1 May 2013.

<http://www.colbertnation.com/the-colbert-report-videos/267542/march-16-2010/rebecca-skloot>.

Cook, Kristopher. “Gender Identity Disorder : A Misunderstood Diagnosis.” Marshall Digital Scholar. Marshall University. 2004.

<http://mds.marshall.edu/cgi/viewcontent.cgi?article=1054&context=etd>

“Distribution of the Nonelderly with Medicaid by Race/Ethnicity.” The Henry J. Kaiser Family Foundation. N.p., 2013. Web. 3 May 2013.

<http://kff.org/medicaid/state-indicator/distribution-by-raceethnicity-4/>.

Fausto-Sterling, Anne. “Refashioning Race: DNA and the Politics of Health Care.” Differences: A Journal of Feminist Cultural Studies 15.3 (200) p.1-37. Muse. Web. 1 May 2013.

<http://muse.jhu.edu/journals/differences/v015/15.3fausto-sterling.html>

“History of HIV & AIDS in the United States of America.” Avert. N.p., n.d. Web. 2 May 2013.

<http://www.avert.org/aids-history-america.htm>.

Margonelli, Lisa. “Eternal Life.” Rev. of The Immortal Life of Henrietta Lacks. The New York Times. N.p., 5 Feb. 2010. Web. 29 Apr. 2013. <http://www.nytimes.com/2010/02/07/books/review/Margonelli-t.html?pagewanted=all&_r=0>.

Ms. Magazine. “APA Removes Gender Identity Disorder from DSM-V.” 3 Dec. 2012.

<http://www.msmagazine.com/news/uswirestory.asp?id=14011”New Resource for Providing Transgender Inclusive Healthcare Services.” Planned Moore’s Spleen. UNC Charlotte, n.d. Web. 1 May 2013. <http://www.philosophy.uncc.edu/ghull/Case%20Studies/CSmoore.htm>

Planned Parenthood. Parenthood of the Southern Finger Lakes. N.p., n.d. Web. 1 May 2013. <http://www.plannedparenthood.org/ppsfl/resources-transgender-inclusive-health-services-5156.htm>.

Preston, Julia. “Obama Lifts a Ban on Entry Into U.S. by H.I.V.-Positive People.” The New York Times 30 Oct. 2009: n. pag. The New York Times. Web. 2 May 2013. <http://www.nytimes.com/2009/10/31/us/politics/31travel.html?_r=0>.

Skloot, Rebecca. The Immortal Life of Henrietta Lacks. N.p.: Broadway Paperbacks, 2010. Print.

Spade, Dean. About Purportedly Gendered Body Parts.

<http://www.deanspade.net/wp-content/uploads/2011/02/Purportedly-Gendered-Body-Parts.pdf>

Strangio, Chase. “Debating ‘Gender Identity Disorder’ and Justice for Trans People.” 5 May. 2010

<http://www.huffingtonpost.com/chase-strangio/gender-identity-disorder-dsm_b_2247081.html>

“The Facts on Norplant.” Committe on Women, Population, and the Environment. Adelphi University, n.d. Web. 3 May 2013.

<http://www.cwpe.org/taskforces/dctf/norplant>.

Tong, Rosemarie and Williams, Nancy, “Feminist Ethics”, The Stanford Encyclopedia of Philosophy (Summer 2011 Edition), Edward N. Zalta (ed.),

<http://plato.stanford.edu/archives/sum2011/entries/feminism-ethics>

Weasel, Lisa. “Feminist Intersections in Science: Race, Gender and Sexuality through the Microscope.” Feminist Science Studies 19.1 (2004): 183-93. JSTOR. Web. 30 Apr. 2013. <http://www.jstor.org/stable/3810937.>.

Wingert, Pat, and Barbara Kantrowitz. “The Norplant Debate.” The Daily Beast. The Newsweek/Daily Beast Company, 14 Feb. 1993. Web. 3 May 2013.

<http://www.thedailybeast.com/newsweek/1993/02/14/the-norplant-debate.html>.

#sources #bibliography

Gender Identity [Disorder]?

There are several posts about transgender (and also cisgender) identities as well as issues on this blog because the transgender community is another place where the medical gaze is apparent.

One of the reasons cisgender privileges (when it comes to clinics or hospitals) were added in the blog was because of Dean Spade’s humbling piece titled, About Purportedly Gendered Body Parts. It is embarrassing and also uncomfortable how much of the everyday language that people use is embedded in cisgender privilege. Therefore it felt necessary to include notions and ways society deals or talks about gender identity before diving into how the medal gaze is related to gender identity and also because the society rarely thinks about transgender people’s presence in the medical community in an interconnecting and an intersectional way.

Many transgender people go through medical procedures and also counseling before, during, and after their ‘transition.’ Some doctors and counselors agree to work with transgender or gender queer folks on surgical procedures as means to 'cure' transgender people of their 'disorder.' The idea that transgender folks have a disorder is not a belief held only by medical practitioners but both International Statistical Classification of Diseases and Related Health Problems (IDC) and Diagnostic and Statistical Manual of Mental Disorders (DSM) also labels discontentment with the sex assigned at birth and/or the gender roles associated with that sex as a disorder.

In 1994, the DSM IV entry was changed from "Transsexual" to "Gender Identity Disorder” (GID) and in February 2010, France became the first country to remove transgender identity from the list of mental disorders. Additionally, DSM-V (to be published on May 22, 2013) will remove the categorization of transgender as a disorder. Instead, the term “Gender Dysphoria” will be used to describe emotional distress over “a marked incongruence between one’s experienced/expressed gender and assigned gender.”

Classifying GID as a mental disorder is controversial and problematic as it pathologizes transgender people and also reinforces the idea that gender is binary.

Furthermore, it is also believed that this classification leads to detrimental stigmas attached to transgender individuals. Additionally, many medical insurance companies are willing to cover expenses of sex reassignment therapy and surgery because it is considered a disorder in the DSM. And it is possible that the removal of GID as a medical disorder will lead to defunding of sex reassignment procedures as it can be viewed as a cosmetic procedure rather than a medically necessary treatment.

-Jackie Park

Sources:

Cook, Kristopher. “Gender Identity Disorder : A Misunderstood Diagnosis.” Marshall Digital Scholar. 2004. Marshall University.

<http://mds.marshall.edu/cgi/viewcontent.cgi?article=1054&context=etd>

Ms. Magazine. “APA Removes Gender Identity Disorder from DSM-V.” 3 Dec. 2012.

<http://www.msmagazine.com/news/uswirestory.asp?id=14011>

Strangio, Chase. “Debating 'Gender Identity Disorder' and Justice for Trans People.” 5 May. 2010

<http://www.huffingtonpost.com/chase-strangio/gender-identity-disorder-dsm_b_2247081.html>

#transgender #gender #identity #disorder #DSM #IDC #mental

The medical gaze has turned into a for-profit business, according to Harriet Washington, author of “Deadly Monopolies: The Shocking Corporate Takeover of Life Itself—And the Consequences for Your Health and Our Medical Future.” In her book and in the interview (link for interview above), Washington examined the ways the medical-industrial complex has come to control human life. The medical-industrial complex refers to the health industry, which is composed of a multibillion-dollar collection of doctors, hospitals, researchers, insurance companies, drug manufacturers and many more. In other words, as the title reads, it is the patent, not the patient, that’s at the center of medical research.

In the past 30 years, more than 40,000 patents have been granted on genes alone. Washington argues that the biotechnology and pharmaceutical companies patenting bodies and body parts are more concerned with profit than with the health or medical needs of patients. She says, “The Bayh-Dole Act was passed in 1980. Birch Bayh and Bob Dole jointly decided to, you know, write a bill that would allow universities for the first time to legally license and sell the products of research to private corporations.”

(U.S. Army Public Health Command)

Additionally, Washington also mentioned that the medical-industrial complex is not an issue only affecting the people in the U.S., but rather a global issue; Europe and especially the U.S. have moved their experiments and research to poorer parts of the world, including but not limited to most of Asia, Sub-Saharan Africa, Haiti and also parts of Eastern Europe. Most countries are targeted by U.S. medical companies, doctors and researchers because these research studies can be conducted much more cheaply and much more quickly abroad.

Furthermore, U.S. researchers can feel proud that they are aiding the poor, disfranchised people living in many “developing” countries, a phenomenon known as the White Savior Industrial Complex. Washington says, “But the problem is, the people, the subjects of these studies, are not benefiting from the drugs that are developed. Once a drug is developed and tested and found to be effective, they can’t afford it. Not only can’t they afford it, but what’s interesting, and what I think people pay too little attention to, is the fact that pharmaceutical companies don’t even develop medications for the developing world.” It is not just about a group of medical experts who decide to move to another country to conduct studies and experiments but it is about big institutions and businesses that are supporting, funding and validating unfair practices on misinformed patients and people.

The concept of the medical gaze throughout this blog allows for discussion on intersectionality. And it is understood that issues of oppression that deal with race, class, and gender are all interconnected. The medical community’s power extends internationally, allowing ‘nation’ to be another visible social classification when discussing the Matrix of Domination or intersectionality.

A lot of the people who are targeted by doctors and researches are very poor with no or little access to healthcare, so they are willing to receive medical “help,” making them vulnerable to exploitation by medical researchers. These experiments and researches harm and mistreat people who are of a different race than the doctors (who are usually white), poor and from a different nation. Females, especially pregnant women, are also targeted for experiments on gender-specific drugs.

-Jackie Park

Source:

Deadly Monopolies": Medical Ethicist Harriet Washington on How Firms are Taking Over Life Itself

<http://www.democracynow.org/2011/10/31/deadly_monopolies_medical_ethicist_harriet_washington>

Image Source:

U.S. Army Public Health Command

<http://phc.amedd.army.mil/organization/phcrnorth/ehe/PublishingImages/Africa.JPG>

*The link leads to a video of the interview with Harriet Washington.

#monopoly #medical #industry #profit

Bribed and Sterilized: Drug Addicts Targeted for Sterilization

The 20th century bore witness to the many horrors that can arise when humans attempt to create superiority within an equal species. Figures like Dr. Mengele and Adolf Hitler and their eugenics-based ideals come to mind, as well as their horrific attempts to “purify” the human race. Oftentimes, we like to place these events in the past, denying the possibility that they could ever happen again. But US-based Project Prevention shows us that the past may not be entirely behind us.

Barbara Harris is a 57-year-old woman from North Carolina. She is founder of a “charity” that gives drug addicts up to $300 dollars if they choose to undergo long-term birth control or sterilization. The idea behind this project is to avoid unwanted babies from entering a world in which they cannot be properly cared. So far, this donation-based group has made its way to four thousand drug addicts, and is looking to expand to the United Kingdom.

The medical community has heavily criticized this “prevention” group. It thwarts the efforts of those who want to give support and empowerment to addicts. Project Prevention plays heavily into the idea of social engineering, deciding for these addicts that they should not be allowed the right to reproduce. Her past adverts shockingly juxtapose photos of crack rocks and dead infants, with slogans like “Some things just don’t belong together.”

The methods used by this organization are entirely degrading to a group of people who have been determined as lesser than. It calls to question how intersectionality plays a role in this situation. Gender and class are both targeted heavily by this organization’s mission. Of the 4,348 addicts helped, a majority of those are women. Over 1,300 tubal ligations have occurred, a permanent form of sterilization, as well as the mass distribution of IUDs and implanted devices. By incentivizing sterilization, Project Prevention is:

Feeding the flame: drug addicts may not have the autonomy to properly utilize this amount of money, due to their life situations. PP operates under the guise of “caring” for these people, while doing quite the opposite.

Permanently Changing Life Paths: A person with little funds to subsist on cannot undo the effects of these contraceptive methods. Therefore, what may seem like a temporary solution may turn into a permanent one.

Promoting a culture of “otherness”: Drug addicts do not need to be robbed of their ability to reproduce. This does not help them with the problem they are facing. Instead, these bonuses could be put towards helping them out of their situation.

Henrietta Lacks’ story shows us how misinformation can hurt the lives of others. Her family is still feeling the sting of not being told the whole story. This organization is taking advantage of an entire group of individuals.

-Priscilla Odinmah

<http://www.time.com/time/health/article/0,8599,1981916,00.html>

#Norplant #henrietta lacks #lacks #sterilization #reproductive

Norplant: Sterilization and policing of young, poor women's bodies

In the early 1990s, the medical gaze turned its attention to young mothers and especially poor, urban women with the introduction of Norplant. This was a new, implantable contraceptive consisting of six hormone-releasing sticks placed in the upper arm. In January of 1993, Paquin School in Baltimore, an alternative middle/high school for pregnant teens and new mothers, became the first school to offer Norplant to its students, without parental consent. In the same month, Maryland Governor Donald Schaefer suggested requiring mothers on welfare to use Norplant in order to trim state costs. Other state's legislators proposed similar bills in the early 90s that would pay women on welfare to get Norplant and give them a small amount of money each year it's kept in place.

Since Norplant cannot be removed without a practitioner's assistance, it is perhaps the only reversible birth control that can be manipulated to serve the purpose of sterilization. According to Julia Scott of the National Black Women's Health Project, "Folks have seized on this and tried to impose it on the women who have the least power in our society. They see it as a social control for those women who they believe are responsible for all of our social issues." And who are those women, exactly? Since half of the 500,000 Norplant users (at the time of the Paquin controversy) were Medicaid recipients, the answer seems to point to those such women. And since, nationally, 68 percent of Medicaid recipients identify as "Black," "Hispanic," or "Other," it is women of color who are especially targeted by these kinds of policies and incentives ("Distribution of the Nonelderly with Medicaid by Race/Ethnicity"). Young women who already have children are further stigmatized and encouraged to go on this contraceptive too, as evidenced by the Paquin case.

Norplant is such an excellent case of the medical gaze and its role in the matrix of domination because it demonstrates whose bodies we legislate and seek to control and what groups/classes of people we seek to eradicate. While Medicaid often covers the costs of Norplant's insertion for poor, working-class mothers, it does not necessarily have to cover the costs of removal (which, in several states, it does not), and physicians can easily refuse to remove the device for mothers on Medicaid if they so choose. Additionally, many of the young mothers who will be recommended to use Norplant will not only be poor women of color, but also uneducated about which form(s) of birth control best fit their lifestyle and state of health/well-being ("Facts on Norplant"). In this way, the medical gaze has decided what bodies deserve to procreate and which do not.

This type of control has been exercised by the medical community many times before, as in the case of Henrietta Lacks. It is unethical for a community of doctors to target a person or group and make decisions regarding their treatment. Oftentimes, they work under the claim of helping an entire ethnic group or particular race. Though certain races may have certain medical concerns to prioritize over others, this should be tackled systematically rather than individually. Doctors should critique the institutions that are causing these trends in people, so that different behaviors and results may come of it. Rather than use government funds to lure young women into potentially becoming sterilized, they could redirect those funds towards education and prevention. Attack the problem, not the person.

-Alex Strott and Priscilla Odinmah

Sources:

"Distribution of the Nonelderly with Medicaid by Race/Ethnicity." The Henry J. Kaiser Family Foundation. N.p., 2013. Web. 3 May 2013. <http://kff.org/medicaid/state-indicator/distribution-by-raceethnicity-4/>.

"The Facts on Norplant." Committe on Women, Population, and the Environment. Adelphi University, n.d. Web. 3 May 2013. <http://www.cwpe.org/taskforces/dctf/norplant>.

Wingert, Pat, and Barbara Kantrowitz. "The Norplant Debate." The Daily Beast. The Newsweek/Daily Beast Company, 14 Feb. 1993. Web. 3 May 2013. <http://www.thedailybeast.com/newsweek/1993/02/14/the-norplant-debate.html>.

#Norplant #Medicaid #sterilization #Paquin #Baltimore #reproductive

Does Skloot Deserve to Go Scot-Free?: A Critical Look at Rebecca Skloot’s Approach in The Immortal Life of Henrietta Lacks

Henrietta Lacks’ story has been tainted in many ways. A woman who should have received objective treatment for her critical condition did not due to factors out of her control. Henrietta’s race, class and gender all played into how she was treated as a human and patient, which still poses a problem today. Rebecca Skloot, author of The Immortal Life of Henrietta Lacks, attempts to tell a story about this dynamic woman. She details in the first part of her book how much of a struggle getting to the right sources was. As a researcher and author, her efforts are venerable and worthy of acknowledgement. Much like the scientists who cultured Henrietta’s “HeLa” cells, their accomplishments are worthy of recognition. However, the perspective in this book is skewed. Skloot plays into the traditional researcher/subject roles, which is an anti-feminist approach to Henrietta Lacks’ story. Her framing of Lacks’ life and the lives of her descendants emphasizes their struggle and hardship, creating a narrative of pity rather than one of empowerment. Her implicit storytelling ways place her as the authority in this scenario, when that should no longer be the case.

When Rebecca Skloot embarks on her adventure to unearth the Lacks’ story, she appears to be an honest, informed reporter. Her values and perspective seem right, her heart in the right place. She is seeking justice for Henrietta’s story. However, as the research unfolds, we see her pushing a family that simply wants space from the many media that has exploited them in the past. She encounters resistance from many different voices before finally pushing her way through.

As she meets friends of Lacks family, she is met with hostility and apprehensiveness. At many points, these individuals demonstrate discomfort with divulging information on the topic. She is the “other” that has disenfranchised Henrietta and her story many times in the past. Eventually, she gets the information she needs, and continues along her way. This methodology is somewhat problematic.

Feminist ethics are founded upon the idea of total inclusivity and equality. Information should be dealt with equitably, rather than compared against a golden patriarchal standard. Value should be placed on the information shared, rather than on its packaging. When Skloot spends expendable time describing how foreign and simple Henrietta's cousin Cootie was to er, or writing Deborah’s words in a way that depict her as lower class, is she not tainting this story with a skewed narrative once again?

Skloot is cognizant of her privilege as a white woman while interacting with the African American community in this story. She senses her otherness, and makes remarks on it at many points in the book. Skloot may appear to be cavalier in her intentions, but at the end of the day is still an author trying to do her job and is not entirely transparent in her research. However, upon closer inspection one cannot help but see the underlying white savior narrative that is found in this piece. Henrietta Lacks’ story may be immortal, but what can we do to change the way it is preserved?

-Priscilla Odinmah

Sources:

<http://plato.stanford.edu/entries/feminism-ethics/>

#skloot #Rebecca Skloot

Similar to the FDA's ban on men who have sex with men from donating blood, until 2009 there was a travel ban prohibiting non-Americans who have tested HIV-positive from entering the US. Although public health officials "have long said there was no scientific or medical basis for the ban," it had been in place for 22 years. The ban not only turned many educators away from even attempting to enter the country, but also specifically targeted tourists and foreigners hoping to live in the US (Preston). Part of the reason the ban was enacted in the first place may have been because it took so long for the medical community to do the necessary research to prove how HIV is transmitted. As Dr. Joel Weisman (one of the early physicians to study AIDS) recounts, "I remember calling a person [in infectious diseases] to describe what was occurring. He said - and this was a theme very early on - 'I don't know what you're making such a big deal of it for. If it kills a few of them off, it will make society a better place’." And it wasn't until 1987 -- five years after the CDC first used the term AIDS and after it had been called GRIDS/"gay cancer" for some time -- that the first antiretroviral drug to counter HIV/AIDS was introduced ("History of HIV & AIDS"). Clearly there had been some stigma attached to the disease, but what is even more interesting in terms of the travel ban is how the two identities of non-American and HIV-positive interact and intersect with one another. A certain stigma against both is critical in explaining why the ban took over two decades to abolish. It was not only a policy rooted in fear of and stigma against the unknown but also truly "othering" in the process.

-Alex Strott

Sources: Preston, Julia. "Obama Lifts a Ban on Entry Into U.S. by H.I.V.-Positive People." The New York Times 30 Oct. 2009: n. pag. The New York Times. Web. 2 May 2013. <http://www.nytimes.com/2009/10/31/us/politics/31travel.html?_r=0>.

"History of HIV & AIDS in the United States of America." Avert. N.p., n.d. Web. 2 May 2013. <http://www.avert.org/aids-history-america.htm>.

#HIV #immigrants #Obama #medical gaze #discrimination #AIDS

Moore v. Regents of the University of California

(CBC The Nature of Things, 2007)

John Moore was diagnosed with hairy cell leukemia in 1976 and was referred to a specialist named Dr. David Golde in Los Angeles. He underwent surgery to remove his spleen, which had swollen because of the disease. Moore lived in Seattle, and Golde was flying Moore to Los Angeles for monthly visits over a period of seven years. To Moore, nothing occurred during these visits that seemed to require his presence at Golde's clinic. In addition, he was asked to sign a consent form releasing the rights to his genetic material at each visit. Moore assumed the samples were being disposed of, so he changed his “yes” to “no” (Skloot, 200).

Moore learned Golde had developing a line of cells grown in culture named “Mo” because Moore’s cells had unique qualities. They could produce rare proteins and carried HTLV, which is related to HIV; both of these could make the cells useful for studying and developing treatments (Skloot, 200). Moore was not pleased, and decided to sue Golde in 1984 in a case called “Moore v. Regents of the University of California” with the intent of halting Goldes work or realizing a share of the profits. His claim was that the blood and cells that Golde had collected were his personal property

Dr. David Golde (Academic Senate of University of California)

Moore ultimately lost his case. It was decided that a person’s bodily tissue is not considered “stolen” when obtained by a doctor through blood and tissue samples, as the person is not expecting to keep that material. However, the court did agree there should have been better informed consent and that better regulation of patient protection in the area of research was needed.

Although John Moore's story is mentioned in The Immortal Life of Henrietta Lacks, Skloot fails to create any kind of dialogue or discussion about the implications that is presented with writing about John Moore. The last sentence of Chapter 26: "Who Told You You Could Sell My Spleen?" ends with Skloot talking about while John Moore filed a lawsuit, Lacks family was fighting the same battle merely through newsletters and verbal communication (Skloot, 2010, p. 206). The two events seem separate and unconnected from each other besides the fact that they were both mistreated by the medical community. However, the case of John Moore and his spleen exemplify that medical community does not only exploit on the basis of race and gender; it is clear that the story of Henrietta Lacks and her family as well as her cells are a story about race and gender and it is easy to fall into the idea that what happened to Henrietta Lacks was allowed to happen because she is a black woman. The exploitation of people and their body parts by the medical community have not and are not only affecting people of color and also women; it connects to a larger social issue about the misuse of power and access of human body [parts]. Moore’s case was different in that he was able to hire a lawyer and file a lawsuit but the conclusion for Moore and Lacks were the same: people became more aware of the medical gaze but nothing really improved and the medical gaze continues to target patients and people.

John Moore is neither black nor female but he was still mistreated and misinformed by the medical community. While the situation and how things ended up for Henrietta Lacks and her family might have been different if they were white, or upper/middle class, it is still clear that the lessons learned from Skloot's book about the medical gaze affects no particular race, gender, class and sexuality. However, it is important to note that the subject of the medical gaze can also occur because of a person's race, gender, class, sexuality and more.

-Jackie Park

Source: Philosophy Department at University of North Carolina at Charlotte, Moore's Spleen. UNC Charlotte, n.d. Web. 1 May 2013. <http://www.philosophy.uncc.edu/ghull/Case%20Studies/CSmoore.htm>.

Image Source:

http://senate.universityofcalifornia.edu/inmemoriam/davidwgolde.htm

#John Moore #Moore #Rebecca Skloot #Skloot #Henrietta Lacks #Golde #consent #spleen #property #court #treatment

Gendered Body Parts

I have posted several posts on transgender identities because cisgender privilege is extremely apparent in medical fields, yet people rarely discuss problems and issues surrounding transgender identities and the practice of medicine.

Transgender people have been denied access to health services and their identity is marked as a mental problem; DSM-V labels trans-people Gender Dysphoric, a label contested by many people. Yet, the trouble begins with just our language and words. In "Of Body Parts," Dean Spade talks about the way people, especially health practitioners, use their language is heavily associated with gender norms. Spade address that people need to work towards the belief that body parts are a "true" marker of who we are. He provides some suggestions as an alternative to the language so vested in the biological binary gender.

Spade suggests:

We can talk about uteruses, ovaries, penises, vulvas, etc. with specificity without assigning these parts a gender. Rather than saying things like “male body parts,” “female bodies” or “male bodies” we can say the thing we are probably trying to say more directly, such as “bodies with penises,” “bodies with uteruses,” “people with ovaries” and skip the assumption that those body parts correlate with a gender. Examples: “Unfortunately the anatomical drawings in this book only represent bodies with penises and testicles, but I think this picture can still help you get a sense of how the abdominal muscle is shaped.” “People with testicles may find this exercise easier with this adjustment.” “Some people may feel a sensation in the ovaries during this procedure.”

The term “internal reproductive organs” can be a useful way to talk generally about ovaries, uteruses, and the like without calling them “female reproductive organs.” Example: “The doctor might think it is necessary to have some ultrasounds of the internal reproductive organs to find out more about what is causing the pain.”

We can use “people who menstruate” or “people who are pregnant” or “people who produce sperm” or other terms like these rather than using “male,” “female” or “pregnant women” as a proxy for these statuses. In this way we get rid of the assumptions that all people who identify as a particular gender have the same kind of body or do the same things with their bodies, as well as the mistaken belief that if your body has/does that thing it is a particular gender. Examples: “This exercise is not recommended for people who are menstruating.” “People who are trying to become pregnant should not take this medication.” “People who produce sperm should be warned that this procedure could effect their fertility.

When we want to talk about someone and indicate that they are not trans, we can say “not trans” or “non-trans” or “cisgender” rather than “biologically male,” or “bio boy,” or “bio girl.” When we talk about someone trans we should identify them by their current gender, and if we need to refer to their assigned gender at birth we could say they were “assigned male” or “assigned female” rather than that they are “biologically male” or “biologically female.” These “bio” terms reproduce the oppressive logic that our bodies have some purported biological gendered truth in them, separate from our social gender role. Our bodies have varying parts, but it is socialization that assigns our body parts gendered meaning.

It is clear that there is a lack of conversation about transgender identities in Rebecca Skloot's The Immortal Life of Henrietta Lacks. However it is important to include transgender bodies and issues because the story of Henrietta Lacks is not only about race. It is also not only about gender. Lacks' story should allow readers to look critically at an whole institution of hospitals. We also need to look at how race, gender as well as class and sexuality work as a hairball (unable to separate from one another) in medical institutions.

-Jackie Park

Source: Dean Spade. “Of Body Parts.”

#transgender #intersectionality #hairball #race #gender #class #sexuality #identity #Rebecca Skloot #Henrietta Lacks #Lacks #institutions

Small things health centers and providers can should do to become more trans-inclusive:

Combining male and female forms for health history into one form will allow a transgender client to fill out all portions that are appropriate for them, and ease the pressure on staff to guess gender identity

Providers should have a space for ‘preferred name’ on all forms, and use this name when talking to or about any client.

Unisex bathrooms.

For a transgender individual, it may be difficult to acknowledge or come to terms with biological body parts that are in conflict with their gender. Healthcare providers should be sensitive to this possibility, and if necessary ask the client how they would prefer to talk about medical issues (through different language, slang, pictures, anatomical models or other methods).

Politely ask the client what their ‘preferred pronoun’ is, and to have a space for preferred pronoun on forms. DO NOT ASSUME.

Educate all providers on array of transgender issues and health concerns.

Providers should have a general understanding of how drugs and medical procedures may interact with hormones, or be willing to research this information. Providers should also be aware of potential side effects associated

-Jackie Park

Source: "New Resource for Providing Transgender Inclusive Healthcare Services." Planned Parenthood of the Southern Finger Lakes. N.p., n.d. Web. 1 May 2013. <http://www.plannedparenthood.org/ppsfl/resources-transgender-inclusive-health-services-5156.htm>.

#transgender #provider #health #health care

Check Your Cisgender Medical Treatment Privilege

Forms

Some health centers have separate male and female health history and intake forms, which can cause confusion for both staff and transgender clients.

Staff may not know (and should not assume) the gender of a client, and may be uncomfortable asking their gender to figure out what form they need.

Clients may have health concerns that are not included on the form they are given especially for gendered health concerns. .

Preferred Name vs. Legal Name

For insurance and billing purposes health centers may need a client’s legal name, even though clients may not use their legal name. Being called by their legal name, rather than their preferred name, can be distressing to any client, particularly if the client associates their legal name with a gender they don’t identify with.

Bathroom

In any setting where bathrooms are separated by sex, transgender people may feel uncomfortable and/or unwelcome in both bathrooms.

Medical/Anatomical Language

Some transgender clients may be uncomfortable using ‘anatomically correct’ terms to describe their body parts, and may be uncomfortable hearing medical providers talk about their body parts.

For instance, someone who identifies as a man may not want to acknowledge or talk about having a vagina.

Pronouns

It may be unclear to staff which pronouns (he/she, him/her) to use when speaking to or about a transgender client.

Providers

Transgender clients may feel pressured to educate their health care providers about an array of transgender issues and health concerns.

The pressure to explain oneself, or the frustration of encountering medical professionals who don’t know about transgender issues may keep transgender people from visiting the doctor when they need care.

It can be very tiring to constantly have to explain one’s identity, especially if it is not directly related to the medical issue at hand.

It is not fair to expect that clients educate staff, nor is it fair to expect any one transgender client to speak for all transgender people.

Providers may refuse medical services based on someone’s gender identity and they also make discriminatory or disparaging remarks.

Drugs/Medication

Some transgender clients may be on hormones. Many providers (and transgender clients themselves) don’t know how hormones will interact with other drugs or medical procedures.

-Jackie Park

#transgender #privileges #cisgender #gender #health care #health #medical

An example of how sexuality intersects with medical ethics and alleged malpractice can be found in the Food and Drug Administration's ban on men-who-have-sex-with-men (MSM) from donating blood. The ban was enacted in 1983, before the installation of sufficient HIV testing, and bans men who have had sex with other men since 1977 from donating, effectively targeting all male homosexuals. Arthur Caplan, professor of bioethics at the University of Pennsylvania, calls the ban an "outdated discriminatory and not scientifically based policy." Similar to how Henrietta Lacks' cells were taken without her permission because the medical system was not designed to empower the poor, the black, or the female, the blood of homosexual men (and even men who have had just one homosexual encounter) has been denied for two decades now because the medical system is run by primarily white men who live with an irrational fear of homosexuality (Caplan). Just as Henrietta's "madly proliferating cells, now verging on becoming a separate and inferior species," have been attributed to what must have been her rampant sexuality -- since she was a black woman and her cervical cancer was caused by HPV, a sexually transmitted disease that happens to be extremely common -- the gay male has been painted sexually deviant, as if he is inherently high-risk, regardless of what levels of safe-sex he practices (Weasel 190).

-Alex Strott

Additional source:

Caplan, Arthur. "FDA Ban On Blood Donated By Gay Men Upheld." Interview by Neal Conan. NPR. N.p., 29 June 2010. Web. 29 Apr. 2013. <http://www.npr.org/templates/story/story.php?storyId=128193248>.

#FDA #MSM #blood ban #Henrietta Lacks #homosexuality #bioethics #Arthur Caplan #Weasel #HIV

This video clip from the Colbert Report not only serves as an introduction to HeLa cells for the uninformed viewer, but it also addresses the absurdity of the fact that the Lacks family has been so disenfranchised throughout the entire process of Henrietta's cancer and even after her death. HeLa cells, which were taken from Henrietta's body without permission in 1951, are responsible for the polio vaccine, cloning, gene mapping, and many other scientific advancements (Colbert). As a New York Times article notes, HeLa cells have also led to the creation of thousands of scientists' careers and research studies. However, Henrietta's family never received a cent for the contributions her body made to science. Her cells were the first ever to be commercialized, yet her family still can't afford health insurance and seems only to be approached by the medical community when someone wants to conduct further research on them -- or write a book about their story, for that matter (Margonelli).

-Alex Strott

Additional sources:

Margonelli, Lisa. "Eternal Life." Rev. of The Immortal Life of Henrietta Lacks. The New York Times. N.p., 5 Feb. 2010. Web. 29 Apr. 2013. <http://www.nytimes.com/2010/02/07/books/review/ Margonelli-t.html?pagewanted=all&_r=0>.

Colbert, Stephen. Rebecca Skloot. Colbert Nation. Comedy Central, 16 Mar. 2010. Web. 1 May 2013. <http://www.colbertnation.com/the-colbert-report-videos/267542/march-16-2010/rebecca-skloot>.

#Rebecca Skloot #HeLa #Henrietta Lacks #Colbert #Skloot

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