Tag Archives: Health

Ovaries: Putting Reproductive Health on the Line at Work

I never imagined I’d have to talk to my boss about my ovaries, but that’s just what happened when I came up against a blockade in the insurance system.

I was going through a harrowing few weeks of stress and pain that culminated on my twenty-sixth birthday. My periods had been getting more and more painful for a while, and I got a recurring dull pain at other times in the month, but I self-medicated and continued to ignore it. It took a pain in my abdomen so sharp that a full night of drinking couldn’t take the edge off before I knew I could no longer stand it.

It still took me two weeks to see a doctor.

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“Champ” from Mostly It’s Just Uncomfortable © Zoe Buckman | image from zoebuckman

Should I making this public knowledge?” I cross-examine myself. It’s literally a sensitive issue.

I’ve vowed to myself that my body is my public, political sphere as well as my private, personal sphere. It’s my mannequin on which to display my beliefs, my vehicle in the fight for gender rights, my pathway to strength and to weakness. I’m not afraid to bare the truth to the world.

What doesn’t help is feeling that the system is pitted against me because I speak a different language, because I am a foreigner, and because I am a woman.

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image from pinterest

In September, I’d asked a friend to help me get an appointment at a Chinese hospital where I knew they’d accept my insurance. She had to call for me, because I couldn’t speak enough Chinese to get through the phone system. She was the only friend I felt comfortable asking this of. We discussed dates. She called. We tried and tried to get an appointment. But there were just too many people to get through the system. I kept waiting, trying to ride out the pain.

By the last week of December, I was desperate. I couldn’t wait for the Chinese system to find space for me, and opted for an appointment at an international clinic.

It was New Years Eve when my boyfriend and I finally went to the clinic. I felt frail and scared and lucky to have him there with me. It was a Thursday, so I’d had to teach an 8am class that morning but had the rest of the day free, tomorrow would be a holiday followed by a weekend. I’d done the legwork to ensure a few days’ rest incase something drastic had to be done about whatever was going on inside of me. I was terrified that what I felt was an ectopic pregnancy – an embryo growing outside of my womb, either in the fallopian tube or just floating around between my organs – caused in part by my IUD.

The place was almost empty – a privilege I paid for – and there wasn’t much of a wait before a nurse weighed me, tested my blood pressure, and showed me through to the doctor’s office. I was glad my preference for a female gynaecologist had been heard; she made me feel so much more comfortable. She was gentle but feisty, professional yet funny. I realised I would have been fine if I were on my own. I was in safe hands.

The initial examination didn’t uncover anything but good health, which worried rather than placated me. I insisted that there was something wrong. I had never experienced pain so bad. So she gave me an ultrasound, showing me where my IUD was, and what my ovaries looked like. Then she found it.

It wasn’t an ectopic pregnancy, thank fuck. It was something far more common and much simpler to treat. I had a cyst on my right ovary that was 5 centimetres in diameter (which is pretty huge). She prescribed me three month’s worth of the combined Pill (oestrogen and progesterone) and told me to come back in three months to make sure the cyst had gone.

I left feeling positive about everything but the price. It had cost me 4000 RMB, which is a little under £500 (or $600 US), and about 70% of my monthly salary at the time.

Harking from the UK, I am not used to forking out for my reproductive health. A country where the National Health Service is managing to cling to high-expenditure existence after almost 70 years, women get most forms of protection on the house. My only saving grace was that my job provides insurance. All I had to do was provide our International Cooperation Office with the invoice.

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Uterus Necklace | image from etsy

My Chinese colleague at the ICO took a few minutes to process the number she saw in front of her. She told me she didn’t think the insurance could cover this cost, that she’d need me to get further paperwork from the clinic, and asked why I hadn’t just gone to a “normal hospital”?

Communication across a language barrier, however minimal, doesn’t help when trying to explain that it felt like an emergency, that I’d tried getting appointments in other places, that I worried about having a male doctor, that I couldn’t explain my pain in Chinese.

She looked back at the invoice and tried to tell me it was the wrong colour for the university’s insurance provider to accept it. I didn’t have to go to the one they’d recommended, but this international clinic was not registered as a hospital and therefore wouldn’t be covered. Additionally, the amount I’d paid exceeded the maximum insurance payment for the year by double. She might be able to get me 2000 RMB, but there was no guarantee.

She mentioned that next time, I should go to a Chinese hospital, that she would recommend a doctor, and that gynaecologists in China are all female.

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“Heavy flow” metal cast tampons © Zoe Buckman | image from zoebuckman

Two months later, when I’d returned from a vacation feeling stronger and healthier than ever, if haunted by the Pill that I was eager to finish taking as soon as possible, my direct boss called asking me to come over. He needed to talk to me and he couldn’t explain over the phone.

I sat down in a low chair opposite him in his book-strewn apartment, wondering what on earth this could possibly be about. He explained he’d had a long, winding conversation with our female colleague at the ICO (the only female colleague I had any regular contact with, for I was the only woman among the international teachers at the time). He thought it better if he explain the inner workings of the insurance system to me himself, to save time. I believe that was a genuine concern, since our colleague’s English tended to falter when the subject matter got tough. Still, it did not seem fair that my medical issue had been discussed without my knowledge, nor did I want my older male boss involved in this issue.

He essentially repeated what she’d told me two months earlier (I’d gone back to collect 2000 RMB in cash, thanked her for her hard work, and we’d discussed insurance), thinking he was doing me a favour by initiating a tense conversation about my health.

He stressed again that the insurance would not pay anything towards another appointment of any kind at an international clinic within twelve months. He didn’t want to force me into going to a Chinese doctor, if I believed this was a risk to my health, but I really must try to trust the local system. It works for everyone else here, he told me, and my last appointment had been so expensive compared with the salary.

Suddenly this conversation became a way to assess my ability to assimilate with Chinese culture, and being affected by a “woman’s problem” wasn’t helping the case. My boss did not seem to think me capable of making informed decisions about my own health and my own money. Never before had I felt my womanness was an obstacle in this job, despite having only male colleagues and no-one to ask for help. Perhaps he was worried how this health issue could affect my ability to do my job.

I had not foreseen ever talking to my boss about my ovaries, but there I was explaining the pain and the cyst and the stress and the small likelihood that I would need surgery if it didn’t deflate. And there he was, suddenly compassionate.

I didn’t think I was biased against the system. I would go to a Chinese hospital for a problem with my eyes or my kidneys, but this was different. The mainstream system hadn’t worked for me. I had found a (woman) doctor I trusted and liked, at a clinic that provides the full range of healthcare options I expect as a westerner, and that doctor had my medical records so was best equipped to carry out the check-up later.

I did look into other options, but I ultimately decided to go back to the place I knew and trusted. The place where I knew I could communicate, where they knew my medical history, and where I felt comfortable going alone. That second appointment cost me close to 8000RMB – almost £950 (or $1,200 US). But that’s a story for another time.

 

Read on

Mostly It’s Just Uncomfortable is feminist artist Zoe Buckman’s response to the attack on Planned Parenthood in the United States. Check out this and other work on her website.

 

Emma Watson’s Vanity Fair Photo is Exactly What Feminists are Fighting For

British actor and pioneer of the UN’s HeForShe campaign, Emma Watson has faced criticism for the publication of a photo in which her breasts are partially exposed. The image is one of a series taken by acclaimed fashion photographer Tim Walker, with styling by Jessica Diehl. It accompanied Watson’s recent cover story interview for Vanity Fair. Of the shoot and images Watson has said:



It felt incredibly artistic. I’ve been so creatively involved and engaged with Tim and I’m so thrilled about how interesting and beautiful the photographs were.



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The offending image of Emma Watson | image from: vanity fair

As the UN Global Goodwill Ambassador, Watson promotes gender equality while maintaining her career as an internationally renowned actress. She’s a major role model for women, young and old, worldwide.

Watson’s critics argued that by posing for this revealing photo, she betrayed her feminist ideals. Rather than apologise, Watson came back at her critics with a simple explanation of what feminism really means:



Feminism is about giving women choice. Feminism is not a stick with which to beat other women with. It’s about freedom, it’s about liberation, it’s about equality. I really don’t know what my tits have to do with it.



Feminism is about empowering women to make their own choices. Equality means women have the freedom to choose how their bodies are treated and viewed, in both public and private spheres. This issue is up there with the right to education, the right to equal pay and the right not to be sexually harassed and abused.

Watson’s critics, whether or not they’re aware of it, reinforce the case of people denying women access to reproductive healthcare. The argument against giving women access to abortion and other essential healthcare stems from a misogynistic view that women do not deserve control over their bodies. Access to reproductive healthcare is about allowing women to choose how their body is treated and viewed, in both public and private spheres.

A little glimpse of boob might seem like a drop in an ocean of all the things feminist women have been fighting for for hundreds of years. It might seem like a single image from a fashion shoot is hardly worth all this conjecture. But it is our reactions to these seemingly small issues that snowball until we have an entire woman-shaming culture: by opposing a single woman’s consensual decision to bare her body, we become complicit in preventing hundreds of thousands of women from life-saving healthcare.

As Watson put it, this criticism is synonymous with:

saying that I couldn’t be a feminist and… and have boobs.



Read on

‘Emma Watson on Vanity Fair cover: “feminism about giving women choice”‘, The Guardian

‘Cover Story: Emma Watson, Rebel Belle’, Vanity Fair

May Thant on gender roles in sex and marriage in contemporary Burma (interview: part 2)

Social taboos restrict essential elements of healthcare. Sex education, contraception, and abortion are not available from official institutions like schools and hospitals. Most families are unable to discuss such things, assuming such knowledge is unnecessary until learnt within a marriage. Young people must teach themselves about sex, turning to simple pamphlets for education and unofficial clinics for healthcare. Misconceptions about contraception and diseases prevail, and young women lie to doctors about medical issues resulting from botched back-street abortions. This is sex and marriage in contemporary Burma (Myanmar) from May Thant’s perspective.

Is sex education available before marriage? 

Yes. Not at school but outside, from medical centres. Some girls don’t know about sex exactly, and some girls read a lot and they know about it. These girls find the information in books we have about it in our language [Burmese], published by medical centres. We can buy them easily, at the bookshop. But most Myanmar girls are too shy to talk about sex.

Do parents talk about sex with their daughters or sons?

Here that would be very strange. That’s like an open type of relationship between parents and their children. But most Myanmar children don’t talk about this with their parents. They would never ask them about it. The thing is [there is no need to learn about sex before marriage because] we will know after we are married.

Is there pressure to get married?

Here, people usually get married under thirty. Some girls over thirty don’t get married, they just live with their parents and they don’t get married. There are women who never get married, who never know about sex, never have children.

They will live with their parents or family until old age.

In other countries, you can live alone when you are over 18. But here, we cannot live alone before we are married. After we are married, it is okay if we live by ourselves. But if we never get married, we have to live with our parents.

It is the same for boys and girls. Right now, I live with my aunt. My parents are in my hometown. If I didn’t have any family in Yangon I would have to live in a hostel, or rent an apartment with friends. Many people rent an apartment with friends, but only if there is no family to stay with.

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Rural woman and child in Shan State, Burma (Myanmar), August 2015 © Cas Sutherland

What kind of relationships do people have before marriage? 

Right now, the cities have many [young] couples, and many couples have sex before they are married. We are facing a problem because young adults don’t know how to use condoms, so they don’t use [protection] and the girls get pregnant. They [usually] don’t want to have children before they are married.

For example, in our society, if I got pregnant [or had] children before I got married, then I would get shame. How can I say it? I would get shame, and my parents wouldn’t call me their daughter. I would be cut off from everyone, everything, and it could affect my job too. Maybe I would get fired from my job. But most of the girls [in this situation] don’t want to have the baby, so they have an abortion.

Is it easy to get an abortion?

Yes, very easy. You don’t have to go to the hospital for it. In most of the hospitals here, they don’t perform abortions. At the hospital you have to register and things like that. But there are some places you don’t have to register and it is easy to have an abortion. Some [of these] places are not safe for your health.

The places are not like clinics. It is just… how can I say? Just a house, just a nurse doing abortions for money. [They go to] a nurse’s house, with a nurse who is not working anymore – like a retired nurse, or the nurse’s daughter [who] the nurse is teaching how to make an abortion. Something like this. They don’t always know what they’re doing.

But girls get an abortion from [these places] outside, and if it is not good for their health, like there is too much bleeding, and they go to the hospital. The doctors will scold them and ask: “why did you do this?” but they don’t perform abortions [at the hospital].

The patient won’t tell the doctor she had an abortion. The patient will just say, “I have this problem.”

Do women tell anyone if they have an abortion? 

They don’t find out. She doesn’t tell anyone. It can be very dangerous. But mostly, her mother will know. [Young women] are scared of their father, and they talk about everything with their mother. Most girls talk to their mother every day; they talk about everything together. Some mothers help their daughters to have an abortion because it affects your reputation [if people find out about the pregnancy or abortion] and the mother worries that the daughter could be poor if it affects her reputation.

Women can talk about an abortion with their mother, but they won’t talk about sex.

Yes. [laughter]

When do married couples usually have children? 

They don’t have to. [Usually] they don’t want children for one or two years after marriage. After two years, they start to have babies. Some marriages [happen] to have a baby. For example, if a girl had sex with her boyfriend and got pregnant, then her house[hold] know she got pregnant, and they talk to her boyfriend’s house[hold] or mother, like this. They get married so they [can] have the baby after the marriage. About thirty to forty percent of marriages start like this in our country.

[May laughs when I explain the phrase ‘shotgun wedding’.]

Is contraception available for couples who don’t want to have a baby?

Condoms and pills are easy to buy and easy to get. But I think some boys don’t like to use condoms, and some girls won’t take the pills after sex, because they forget or they don’t want to.

Traditionally, the wife’s role is to make the husband’s life easy. Is that true?

Men are taught that women are for sex and cooking and children. Women think they cannot find money for their family, and they obey their husband like a king for finding money to support the family.

Men always want to be higher than their wives or their children. But women are more intelligent than men or boys. Women always treat their husband like a king, and men are proud to be themselves.

For example, my grandmother treated my grandfather like a king. For breakfast, she will ask what time he wants it, and she will make sure it is ready for him when he wants. At lunchtime, it will be ready for him when he asked for it. It is the same for many other things. They make sure everything is ready for the man.

Now, some educated women don’t think like this. They can do anything like a man and it is the same for them as a woman.

Some men will not allow their wives to use contraception because they believe contraceptives have dangerous side effects.

Yes. In our country we don’t have enough knowledge about sex. Here we’re a cultural country. Many religious people don’t know about [contraception]. Some educated people will give them knowledge of sex, but they won’t accept it. They say, “it’s a very personal problem and you don’t need to talk about it in public.” Even now, it is like this.

But times are changing. In a big town like Yangon, Mandalay, and places like this, most teenagers have enough knowledge of sex and they can accept [education]. But in a small place they don’t have enough knowledge of sex. There they look down on people who have HIV and AIDS, and [doctors] will not treat these patients. They don’t have enough knowledge of the disease to know it can be contracted by other’s blood. Most people think it is only about sex, so they look down upon it.

Read on:

May Thant on Facebook trolls, gender inequality and Burma’s first woman President (interview: part 1)

May Thant works as a receptionist at a popular backpacker’s hostel in downtown Yangon, Myanmar (Burma). She spoke to me in February 2016.

Words and Women: Gloria Steinem

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image from: mogul

What would happen if suddenly, magically, men could menstruate and women could not?

The answer is clear – menstruation would become an enviable, boast-worthy, masculine event: Men would brag about how long and how much. Boys would mark the onset of menses, that longed-for proof of manhood, with religious ritual and stag parties. Congress would fund a National Institute of Dysmenorrhea to help stamp out monthly discomforts. Sanitary supplies would be federally funded and free.

– Gloria Steinem, extracted from her 1978 essay If Men Could Menstruate, first published Ms. magazine.

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image from: gloriasteinem

“Honey, if men could get pregnant, abortion would be a sacrament.”

– Gloria Steinem, in 1996 HBO film If These Walls Could Talk 

Read Steinem’s 1978 essay in full here: If Men Could Menstruate


Words and Women is a regular feature that spotlights short quotations from influential women activists, artists, and authors.

My experience of: Endometriosis

In my first few days of university I met a bright, bubbly girl while I was out on a pub-crawl. She had crazy hair, wore glasses and she was on the same degree course as me. We spoke at high speed back and forth for hours that night, and became great friends very quickly. We took several classes together and would sit in one of our dormitory kitchens, which were almost identical except hers was purple and mine was green, and drink tea (hers weak, mine strong) while we discussed poetry.

By the time we reached second year, the two of us were virtually inseparable. We didn’t live together but we might as well have. We continued our tea-drinking tradition (we could share a teabag and both get a perfect cuppa, exactly how we liked it) and chat for hours about novels and boys and plays and roommates and exams and lecturers.

There was something, though, I didn’t quite understand about my best friend. This friendly, outgoing woman would disappear for a few days every so often – I would come to the end of a week having not seen her since Monday and wonder where she’d been. Had she been hibernating? In a way, yes. She’d been in bed, not feeling well, most of the week. But she felt better now… My slight but strong-minded friend would be unable to move for pain for several days, but she put on a brave face.

What I didn’t know was that she had endometriosis. But she knew. She had known for years. She knew why she would be floored for several consecutive days every single month of her life. She knew the reason she had to ask favours of friends visiting the USA because she couldn’t buy strong enough painkillers in the UK. She knew because it is a hereditary condition that both her mother and aunt suffered from. She knew. But the doctors refused to help in any way; they refused to treat her, they refused to diagnose her, they simply refused to examine her. They heard what she said but would not listen. The more help she tried to get, the more she was pegged as a complainer, a whinge, a hypochondriac.

Watching a friend go through the same process described by many women with endometriosis – the constant misdiagnosis, the refusal to take women’s pain seriously, the continued allusion to some modern form of hysteria – is painful in itself. Knowing that she knew precisely what was wrong with her but no medical professional would take her seriously was angering, upsetting, depressing. I couldn’t pretend to understand what she must have felt.

Her inexhaustible determination, humour and ability to get better grades than everyone around her belied her condition. I often found it hard to believe that the feistiness and strength I saw in her every day would be stripped away with the pain, which would leave her weak, dizzy, and often had her fainting in agony. She once arranged to spend the night with her very new boyfriend and, instead of the romantic, cuddly evening she’d had planned, she fainted and he panicked. He had no idea what was wrong. He had no idea that a woman’s pain could be so serious an issue. Once she’d come to and explained, he was sensitive and understanding. He became a new recruit in her small but determined army of support.

Doctors often recommend that women with endometriosis take the contraceptive pill. My friend had allergic reactions to the several varieties of the pill that she was told to try. The only other suggestion for easing the pain that medical professionals made was to have a baby. The first time she heard this, my friend was 17. Way to encourage an intelligent young woman to take charge of her health, NHS!

I cheered her up by calling all the awful people in her life “cunts” (a word I had just discovered in earnest) and making her more tea, but that didn’t solve the problem. About half way through our second year of uni, she confided that she’d finally found a medical professional who took her and her illness seriously. She had to have surgery simply to find out whether she had endometriosis. She missed the last week of term, spent the entire four weeks of Christmas in bed, and had to apply to get extensions for all her deadlines. She recovered slowly but healthily and things got better. But while the surgery helped for a little while, it did not improve things permanently. My friend still suffers from endometriosis now.

This all came flashing back upon reading Lena Dunham’s article The Sickest Girl  published in Tuesday’s Lenny update. Lenny have put together an entire issue on endometriosis because, while one in ten women in the USA suffer from this major health problem, very few will ever be diagnosed. In other words, the majority of women are unaware that endometriosis could be affecting them. I heartily believe that that should not be the case. So spread the word.

I implore you to read the Lenny-letter articles, including an interview with Padma Lakshmi, co-founder of Endometriosis Foundation of America and A.N. Devers who shares the reality of what this pain can do to women, even if it is diagnosed.