Bioethics, healthcare policy, and related issues.
Today is International Women’s Day, and for that reason also Blog Against Sexism Day. I want to use the opportunity to take notice of the degree to which sexism is the root of many healthcare ethics issues affecting women, or, to put that another way, how much of women’s health issues arise from or are shaped by sexism and gender oppression.
This list, adapted from the UN’s 2006 Study on Violence Against Women, tells the story as well as anything:
International Women’s Day 2007
Take action to end impunity for violence against women and girls
- Violence against women is the most common but least punished crime in the world.
- It is estimated that between 113 million and 200 million women are demographically “missing.” They have been the victims of infanticide (boys are preferred to girls) or have not received the same amount of food and medical attention as their brothers and fathers.
- The number of women forced or sold into prostitution is estimated worldwide at anywhere between 700,000 and 4,000,000 per year. Profits from sex slavery are estimated at seven to twelve billion US dollars per year.
- Globally, women between the age of fifteen and forty-four are more likely to be maimed or die as a result of male violence than through cancer, malaria, traffic accidents or war combined.
- At least one out of every three women has been beaten, coerced into sex or otherwise abused in her lifetime. Usually, the abuser is a member of her own family or someone known to her. Domestic violence is the largest form of abuse of women worldwide, irrespective of region, culture, ethnicity, education, class and religion.
- It is estimated that more than two million girls are genitally mutilated per year, a rate of one girl every fifteen seconds.
- Systematic rape is used as a weapon of terror in many of the world’s conflicts. It is estimated that between 250,000 and 500,000 women in Rwanda were raped during the 1994 genocide.
- Studies show the increasing links between violence against women and HIV and demonstrate that HIV-infected women are more likely to have experienced violence, and that victims of violence are at higher risk of HIV infection.
Aside from the ghastly statistics, and the obvious impact on women’s health of these crimes and oppressions, notice how much violence against women has medical overtones or involves women’s reproductive functions. A standard tactic, and one of the most vicious weapons, of misogyny is to use women’s bodies against them. This manifests in medical terms as much as it does as direct physical violence. For women around the world, including in the most “advanced” nations, encountering the medical setting, or merely trying to act on their own decisions about their own health or bodies, brings abuse, discrimination, frustration, danger, and not infrequently physical and psychological harm or death.
American women are relatively lucky in that only 25% of them are more than 50 miles from an abortion provider, and only 94% of rural counties lack one; they may be harassed at the clinic and at home and work for seeking abortion, but all deaths so far have been among clinic staff, not patients. They may endure forced pregnancies at the whim of religious extremists ranging from bombers who destroy their only access to abortion services to pharmacists who refuse to fill legal prescriptions for birth control to “sex educators” who provide false information about sex and make birth control unavailable – but at least they’re relatively unlikely to be burned to death for being sterile. Their healthcare may be based on research conducted mostly on men, but it’s generally better – for the 2/3 or so who have access to it – than that in the most repressive countries (for instance, Afghanistan, where women are not allowed to become doctors and male doctors are not allowed to examine female patients – this after it was “liberated”).
Around the world, women’s access to, and autonomy in utilizing, healthcare services is in an even more precarious state. In the poorest countries, families may simply not pay for treatment or medication for women. In other cases, women are not allowed to seek care on their own; they are spoken for by male relatives who decide whether they will use contraception, how many children they will have and when, what and how much food they will be given, and other such basic questions of health. As the UN figures note, genital mutilation and HIV infection are also direct results of women’s oppression and lack of autonomy; sexual abuse is rampant and also contributes to the HIV epidemic.
In addition to this basic, too-familiar direct abuse, the general lack of power, respect, and independence that results from sexism – from refusing to acknowledge and treat women as full and independent moral persons of value – degrades their health in other ways. The sheer psychological toll of putting up with sexist bullshit of every possible kind, almost everywhere you look, day after day, turns up in almost every aspect of women’s lives: from their opting-out of male-dominated fields in which they face discouragement or harassment; the absurd and often deadly struggles to meet external standards of bodily appearance that they are constantly encouraged into; the nagging, bullying, and abuse that discourages women from stepping outside the “feminine” stereotype, sexually, professionally, intellectually, or in any other way; the epidemic of depression found among women locked out of lives and careers of their own choosing; the wave of suicides seen in Afghanistan in response to unbearable religious oppression and abuse, and on and on. The constant encouragement of women to sacrifice themselves for their families, and to treat self-regard as selfishness, leads many to ignore their own health needs even when they become ill. The psychotic level of demonization of women’s sexuality – simultaneously with the social identification of women solely by their reproductive and sexual qualities – creates a climate in which women’s sexuality and sexual health become distorted to almost-unrecognizable degrees. Two female high school students were suspended from school this week for using the word “vagina” (though perhaps this is an example of non-sexist hysteria: a best-selling children’s book is also currently being censored by libraries across the country because it contains the word “scrotum”). There are perennial complaints and crackdowns on women breastfeeding infants in public places. Super-thin models literally die during fashion shows from anorexia. The words “chastity” and “purity” are not only being spoken again without irony, but are accompanied by the usual invective against sexually active women, and a truly creepy movement to make fathers out to be their daughters’ boyfriends and husband stand-ins. Religions of all kinds, despite progress in limited areas, retain a fundamental contempt for women in their teachings and practices, and in the aspects of daily life and social policy that they affect. The most extreme elements of major religions are again on the march, seeking – successfully – to impose the most repressive restrictions on women’s social, familial, sexual, and working lives, and to condemn them to literal purdah, torture, and slavery in some parts of the world; politicians actively cooperate.
In short, disrespect for women invades the body- and health-related aspects of their lives even more than all the rest. A large part of sexism, around the world, simply consists of discomfort with, and disgust at, women’s bodies and their functions. The repression of sexuality and other gendered aspects of normal human life is the universal result. In other ways, the general lack of power and independence most women suffer to some degree, and many women overwhelmingly, makes it impossible for many to maintain their self-esteem and mental health, or to look after their health needs.
In these ways and others, sexism is a bioethics issue. If there were any other aspect of human life that materially degraded the living conditions and mental and bodily health of more than 50% of the world’s population – that systematically resulted in the suffering and death of hundreds of millions of people from one distinct biological group – that barred access to effective care for some or all health concerns of that group – there would be outrage and aggressive action. It is time to recognize sexism and gender discrimination, as well as all forms of gendered oppression and lack of autonomy, as sources of illness and death – among all the other things that is wrong with them. Sexism, besides all else that it is, is a health issue. It causes injury, abuse, diseases, mental illness, and death, in proportions that approach an epidemic. Anyone who cares about the health and safety of human beings in general must care about sexism as a threat to those values for more than half the world.
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