Abstract
Maureen C. McHugh and Joan C. Chrisler have gathered together an impressive collection of chapters on the medicalization of women’s normal physical experiences throughout the life cycle. While researchers have been writing about this phenomenon in relation to particular issues for decades, this collection highlights the broader problematic treatment of women’s experiences, exposing commonalities concerning the treatment of the menstrual cycle, pregnancy and birth, infertility, sexual response, menopause, body size and image, and depression. Taken as a whole, the pattern is striking. I was familiar with much of the research on these issues, but reading about these diverse topics reported by multiple scientists emphasizes the magnitude of the influence of the medicalization trend on women at every stage of their physical lives.
McHugh and Chrisler summarize the common themes nicely in their introduction, which could provide a solid introductory reading for a course on women’s health. Medicalization refers to framing everyday experiences and problems as “illness.” Redefining experiences as illness transforms them into treatable conditions that expand the demand for medical–pharmaceutical services and products. Indeed, representatives from these industries participate in defining diseases and disorders for their financial gain. Ramifications include enforcing social norms; increasing health care costs; undermining patients’ agency and choice; ignoring diversity among groups of patients’ and women’s individual physical responses, symptoms, dysfunction, and causes; distorting medical science; and promoting public manipulation though media and advertising.
An example illustrates the effects of these themes, which influence individuals personally and also shape societal attitudes and norms. Emily Breitkopf and Lisa R. Rubin’s chapter on infertility medicine profoundly describes both the personal and societal levels. The medicalization of infertility reinforces a mandate of traditional motherhood, commodifies babies, and creates social pressure by defining infertility as a disease. Distorting the perception of normal declines in fertility through the reproductive cycle, medicalization encourages a sense of loss even among those who may not want children. Along with the implications for individuals, the hugely lucrative reproductive technology industry is troubling. On a societal level, phenomena, such as egg freezing as a solution to timing reproduction with careers, focus on individual solutions rather than on promoting work policies that allow women and men to balance natural reproductive schedules; it implies that employees are obligated to plan life events around their employers’ schedules and delegitimizes other choices such as voluntary child-free lives, adoption, or alternative definitions of family.
Like most reproductive health issues, when societal meanings are distorted, on some level, individual choice is undermined. I encourage women embarking on infertility treatment to read this chapter in order to clarify for themselves the path that will work for them. The authors are careful not to demean individual choices to pursue different treatments, but knowledge of the science can help people understand their own needs with full understanding of the hidden messages that influence them on a deep, personal identity level.
Other chapters make similarly profound arguments about the personal and societal impact of issues such as pathologizing premenstrual moods; medicalizing sexuality and defining intercourse as the norm; relating life circumstances, family context, views of motherhood, and sexism and ageism to feelings about menopause; accepting the mistaken assumption that fat people are more at risk for many health issues than others, exacerbating discrimination related to weight; placing the cause of depression within the person, thereby ignoring alterable external factors that contribute to women’s unhappiness; and describing unrealistic expectations of how to “work through” grief and bereavement “correctly.”
Having experienced myself the pressure to resort to biomedical treatments for many of these issues, I acknowledge that even a dedicated feminist feels the impact of societal norms and is drawn to the hope for an easy resolution of whatever symptoms are bothersome. Because these chapters present research thoroughly, in language that is accessible for lay readers, they will help women to better understand their own life experiences and provide the impetus to think critically about their choices. This volume encourages us to work on the structural societal issues that define natural life events as dysfunction and disease, confront discrimination, and understand circumstances that affect how women cope with normal physical experiences.