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Radical Reading: Freeing Ourselves

The following is part of a new regular feature called Radical Reading, which will come out roughly once a month.  I’ll be reviewing books of particular interest to a queer, feminist, radical audience.  If you have a book that you would like me to review or would like to put me on the list of reviewers for your press, please contact me at judithavory [at] gmail.com.

Freeing Ourselves: A Guide to Health and Self Love for Brown Bois, put out by the Brown Boi Project, is a guide to healthy living unlike anything I’ve seen, but quite like guides I’ve imagined.

Focused on MoC (masculine-of-center) people of color, Freeing Ourselves is an accessible, engaging guide to overall health presented in a unique format.  The educational material is interspersed with powerful stories, poetry, and photographs that reflect a wide range of racial and gender identities.

The guide takes self as a starting point, and does an excellent job of framing self in a way that includes, rather than excludes.  It presents self-awareness as a way to fight back against the lack of medical knowledge or outright hostility that many MoC people face.

I particularly liked how this guide acknowledged right up front the way healthy masculinity is defined by the colonial oppressor.  I believe that one of the huge problems marginalized communities face in terms of health care is that racial identity, gender identity, and self-actualization are all problematized.  Medical transition, for example, isn’t available without the othering diagnosis of “Gender Identity Disorder.”  Women are framed as hysterical, black men as dangerous.  The medical establishment doesn’t exist in a vacuum, but is part of an institutional framework that uses gender as a weapon.

When recognizing common threats in people’s lives, the guide lists common mental illnesses such as depression and anxiety alongside structural problems like oppression and abuse.  This guide does the best job I’ve seen so far at acknowledging that structural harms and internal “illnesses” operate in similar and interconnected ways to bring a person down and threaten that person’s health.  It also acknowledges how Western society harms relationships and connections, encouraging men to compete rather than to embrace each other.

There are a number of practical tools and charts included, such as guidance on when to see a health care provider and information about the risk of STIs for different races and genders/sexualities.  The information about sexual and reproductive health is particularly useful, since many health care providers are completely unaware of safe sex practices and risks for non-heterosexual or non-cisgender people.  The information on STIs here is not only focused on penetration, for example.  There is plenty of helpful advice about gynecological exams for those who do not identify as female, and about the risk of breast/chest cancer.  In addition, this guide provides detailed information about transition and the different options available.

I also found the information about pregnancy and forming a family particularly to be done particularly well.  There aren’t any assumptions made about whether and how MoC people might want to form a family.  The guide acknowledges the creativity of individuals to form families in a multitude of ways, as well as providing information about pregnancy and birth options.

The last section, while perhaps not as focused on HAES as I am, did a pretty good job at acknowledging and accepting different body types.  The holistic approach to food and physical practice has a strong ayurvedic influence, with information about “cooling” and “warming” foods.  The suggestions for exercise are varied, though limited attention is paid to people with disabilities.  Finally, this section includes specific information about the physical effects of chest binding and explains STP (stand-to-pee) devices.

Overall, I would recommend this book for any MoC person of color who has been frustrated by the healthcare system.  I also think this book would be an excellent tool for providers, who often seem to be undereducated on some of this issues covered, and for gender non-conforming people generally.  As someone who is neither masculine or feminine of center, but rather a blob off there in the corner somewhere, I still found quite a bit in this guide that is relevant to me.  The guide is available from the Brown Boi Project on a sliding scale, with $20 being the value of the book itself and the rest going to the project as a tax-deductible donation.

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Looking Gay, the Blood Ban, and Anti-LGBT Discrimination

Image: Democracy Forum

You’ve probably heard the story of the straight man in Indiana who’s suing because a blood bank turned him away on account of “looking gay.” I don’t know that he’s a good poster child, but this case is a great illustration of how discrimination tosses logic out the window.

Numerous articles and posts have shown that the lifetime ban on men who’ve had sex with men makes no sense from a public health perspective. I’m very familiar with the FDA from my day job, and I’m convinced that it’s inertia pushing the decision to await further research, as other high-risk groups are subject to a one-year ban. This is a policy that’s a legacy of a gay panic, and it’s time for it to go.

I find it funny, in a sad way, that someone would be excluded for acting gay, a criteria that is obviously illogical for assessing HIV risk, under a policy that itself has no foundation in logic. Justifications boil down to “that’s just the way it is, and how it’s always been.”

Appearance and mannerisms often serve as a proxy for anti-gay or anti-trans discrimination because they are a visible marker of what makes the bigot uncomfortable. That’s why it’s crucial for non-discrimination legislation to address not only members of a group but those perceived as belonging to it. You shouldn’t have to claim an identity to be protected–bottom line, it’s wrong to discriminate against someone because of how they look or act. That’s equality 101.

Until a government agency offers a compelling reason to apply the laws differently based on someone’s queer identity, and to use appearance or perception as a judge of that identity, I’ll be opposed to this policy and others like it. There are logical, public safety-based ways to screen blood donors, and it’s time we relied on those alone. The FDA has offered no compelling state interest to justify this type of discrimination.

Hormones and Gender Identity

For a long time, I’ve wondered if there is any connection between my PCOS (polycystic ovary syndrome, a condition that produces excess androgen and thus affects my hormonal balance) and my gender identity.  I would be really curious to see some research into PCOS and gender identity, but I can’t imagine such a thing ever actually happening, because the idea that something like PCOS might affect someone’s gender is such anathema to many people.  When you have a syndrome that affects things like your body hair growth and your period (or lack thereof), doctors are very quick to say “don’t worry!  You’re not any less of a woman!”  Honestly?  I wasn’t worried.

I think it’s a sign of how invested we are in gender that doctors would automatically consider the possibility of hormones affecting gender identity an insult.  Maybe it’s just a value neutral thing that might happen to some people.  I would like to see some research on it, and understand it a little better, while knowing that in the end the labels that apply to me and how I experience gender are my own personal choice and no one else’s.  I’m curious what impact not menstruating, having excess androgen, etc., has on me.

I also find it interesting that when it’s the reverse–hormones going along with the gender everyone assumes you are–those hormones are celebrated and praised.  Whoo hoo, all women menstruate, blood is the tie that binds us, we all understand that monthly “curse,” and other variations that I am oh so sick of.  When I identified as a woman, I found that refrain extremely isolating.  Now, it’s more of a physical confirmation that I’m not female, and I’m okay with it.  But it doesn’t really mean anything, nor should it.  Same deal with hormones, which are the explanation for pretty much everything under the sun when it comes to women.  I don’t think it’s all that simple.

Alliance for Justice Panel on Healthcare Reform

This morning, I went to a breakfast hosted by Alliance for Justice that featured a panel on applying the lessons of the healthcare reform debate to other progressive causes.  I was disappointed by how little the panel focused on the application to other causes part, but it was an interesting summary of how to organize for a huge systemic change like healthcare reform.

The panelists were all part of H-CAN, and so their remarks were particularly useful for coalition organizing and well-funded movements.  Big takeaways were: get the funding moving, bring in lots of people (not just those willing to sign on but also organizations that are partially in line with your cause and willing to help tangentially), respect history and don’t back down just because it’s slow, use creative strategies, don’t get too hung up on “purple” states.

I really liked what Ethan Rome said about defining the debate.  Using the public option as an example, he suggested that what you have to do as a progressive organization or movement is to take a concept that’s seen as being “on the left” and make that the center of the debate.  If you can manage to get people talking about an issue like that, then you’re not playing defense the whole time.  I found this particularly relevant with reference to feminism and especially feminist bloggers.  When I think about “feminism,” my mental picture is far different from what the big feminist organizations like FMF and NOW give you.  That’s because my feminism is centered around bloggers, and it’s about the opinions of people of color, people with disabilities, queer people, trans people, people in the developing world, etc. etc.  So for me, a big part of what I think we need to do is to get our online activist messaging into the organizational/political part of the movement.  We want people to think about issues like immigration, disability rights, hate crimes, etc. when they think of feminism.

Another point that Rome made was that although the victory wasn’t perfect for health care reform, it was a starting point.  I don’t love the actual bill that was passed, but he does make a good point.  You take what’s passed and you go from there.  Once the system in this bill becomes the norm, then the debate is whether to keep it or whether to have more.  Building blocks, basically.  I can get down with that.

On a tangential note, I think this event was actually a really good example of how to have an event!  I’ve been to a number of panel discussions, and this was one of the better ones.  First, the Alliance for Justice host kept it short and sweet, which is exactly what an introduction should be.  Second, the panelists were concise, funny, and practical.  They were all fairly dynamic presenters.  They told stories and they made jokes and they didn’t ramble on.  They gave some concrete advice that was relevant to the people in the room.  They may have gone a bit long on answering questions, but they answered the questions and they did so with good, practical advice.  I think a lot of speakers could learn a lesson from that!

Finally, since we’re on a practical activism roll here, I just wanted to share a few points I learned from the Robert Wood Johnson Foundation’s webinar yesterday on the social determinants of health.  One, appeal to emotions.  Know your audience’s metaphors and use those, even if they feel general.  Phrases like “a family doctor for every family” work better than ideologically loaded and less descriptive terms like “universal health care.”  Two, on a related note, avoid acronyms.   Educated people may know what they mean, but to those who aren’t familiar, you just sound like you’re playing inside baseball or trying to show what you know.  And three, if you’re trying to sell a point to people on both sides of the aisle, you can actually do so by aiming the same message at both left and right.  For example, “of course everyone should be responsible for their own healthcare, but it’s not fair if some people don’t have access to healthcare because of where you’re born or how much money you make.”  The first part of the sentence reassures conservatives, and the word “fair” appeals to the conservative value of equity, while the second appeals to the liberal value of equality/opportunity for all.  Good things to keep in mind when crafting a message, methinks

World AIDS Day: Where Do We Go From Here?

There’s been a bit of radio silence here, as you may have noticed, though I’m still blogging fairly regularly with my ladies at the F-Wave. I wanted to break that silence, though, to make a comment on World AIDS Day.

Last year this time, I was on the floor of my apartment in Iowa City with my friend Rita, researching and creating a poster presentation to mark the day at our law school. I remember thinking as we did that presentation how many populations are affected by AIDS, and also how much AIDS is tied in with legal/political issues in various tangential arenas. Take a moment today to think about some of these, and add your own in the comments:

  • Funding for development, both HIV/AIDS related and generally
  • Laws that criminalize/penalize sex workers and those who work with them
  • Sex education, especially focused on sexual violence prevention
  • Marginalization of women of color and women generally worldwide
  • Laws that keep HIV positive people and people living with AIDS from adequate health insurance coverage, work, travel, and giving blood
  • Sodomy laws that make it difficult to work with men who have sex with men and provide proper prevention and treatment, as well as endangering unknowing wives
  • The use of rape as a weapon of war in Darfur and elsewhere

Construction of the Female Body in Gynecology

I attended an interesting talk today at the CRT at 20 conference on the topic of medical education and cultural competency, focusing especially on women of color’s experiences with gynecology.  I started thinking about a tangential topic that I think is sometimes overlooked in LGBT studies: lesbians’ experience with sexual and reproductive health care services.  

Later I will probably post some comments on how lesbians experience sexual and reproductive health care generally and differently from heterosexual women.  Just now, though, I had a thought about the construction of the female body and how badly this jives with feminism and with lesbianism.  

There has been a lot of talk among feminists about how the female sexual organs are reduced to their reproductive function, and how women’s sexual pleasure can be effectively erased from a discussion about women’s anatomy.  My thought is that the woman’s body is sexualized, but it is sexualized only with reference to the man/the male body.  

When you think about this part of the body, it’s likely that one of your first thoughts concerns the vagina.  My guess is that gynecologists and other health care professionals see the vagina in two ways: as a receptacle for the penis (focusing on sexual health, contraception, disease, etc.) or as a passageway for a child (focusing on pregnancy, fertility, etc.)  I think this is also true of the culture in general.

One problem is that the vagina is, for many women, not the site of sexual pleasure (or not the sole site), and so there is a separation between health and pleasure.  I would posit that it is difficult to celebrate and enjoy the experience of health and health care when it is separated in this way from sexual pleasure.  I think most of us experience our body in vastly different ways in the bedroom and in the doctor’s office.  Another problem is that it makes the healthcare experience irrelevant for lesbian women, especially lesbian women not interested in giving birth.  Our concerns may be difficult to express because society and our health care experiences have not given us a language to express them.  I know that I find the gynecologist fairly irrelevant to me – I get an annual pap smear and I get birth control for migraines, but that’s it.  My doctor is not necessarily someone I trust, nor do I associate him with my overall health.

I think that this disconnect may also have something to do with why lesbian women often do not go in for services such as pap smears, mammograms, and STI tests.  STIs are often conceived of as a penis-in-vagina consequence.  Even if we know that STIs can be transferred through any fluid contact, the lesbian community tends to see barrier methods as weird.  If not weird, they’re just a pain.  I’d guess that many of us haven’t asked our health care provider for advice concerning sexual health.  I’ve had experiences with a female gynecologist who told me I only needed pap smears if I were having sex with a man, and a female resident whom I asked about sexual health and she said she didn’t know anything about STI risks.  I’ve also had a lot of frustrating experiences when I’m talking with a health care professional about PCOS and he or she tells me repeatedly about my fertility options and forces literature on me, even though I say that I am not interested in having children, ever.  I was even once told “oh, you’ll change your mind.”  I find this condescending, and the lack of agency makes me fearful of healthcare. 

I’m not sure exactly how this could be fixed, but I do think that in anatomy courses and wherever else medical students learn about the female body, the woman should be construed as a whole person, and her experiences of her body considered fully.  I want health care professionals to think of women’s sexuality in terms of her own body, and all of it – not in terms of a penis and a vagina, plus possible “alternatives.”  I also think that healthcare professionals need to learn how to have effective dialogues that do not make assumptions about sexual practices or reproductive choices.  I don’t know how we get there, but I hope it’s where we’re going.