feminist blogs

The New York Times has an interesting video up about increasing numbers of med students going into more lifestyle-friendly fields like dermatology. It’s made even more interesting by the woman featured in it, who, in addition to being my college room mate’s older sister, has some good insights into how the male-dominated medical profession has pushed top female students (and male students who put their families first) down certain paths. Check it out, if only because it shows Meena’s two daughters, who are the cutest things ever.

I saw the AP version of this article yesterday*, and I was immediately struck by what was missing. Sad to say, the Times version isn’t any better:

Weight-loss surgery works much better than standard medical therapy as a treatment for Type 2 diabetes in obese people, the first study to compare the two approaches has found.

The study, of 60 patients, showed that 73 percent of those who had surgery had complete remissions of diabetes, meaning all signs of the disease went away. By contrast, the remission rate was only 13 percent in those given conventional treatment, which included intensive counseling on diet and exercise for weight loss, and, when needed, diabetes medicines like insulin, metformin and other drugs.

The study was done in Australia, on patients who had had lap-band surgery (more popular there than gastric bypass). Lap-band surgery involves putting a band around the stomach to create a small pouch rather than removing parts of the stomach and intestine. In theory, it’s less invasive and risky than gastric bypass, and reversible. In reality, it carries a number of risks, such as erosion of the stomach (rendering the procedure irreversible) and death.

In the study, the surgery worked better because patients who had it lost much more weight than the medically treated group did — 20.7 percent versus 1.7 percent of their body weight, on average. Type 2 diabetes is usually brought on by obesity, and patients can often lessen the severity of the disease, or even get rid of it entirely, by losing about 10 percent of their body weight. Though many people can lose that much weight, few can keep it off without surgery. (Type 1 diabetes, a much less common form of the disease, involves the immune system and is not linked to obesity.)

What’s interesting about this bit is that the AP article mentioned that the diabetes often went into remission within days of the surgery. Which tells me that maybe the effects are due not to weight loss itself but to some other factor. One not mentioned in the article, perhaps. What could it be? (more…)

If you’ve kept track of the scant number of posts I’ve contributed to Feministe over the past half-year, you may have realized that I get very irritated when I come across blatantly misleading “science” reporting. (I guess it must come from being raised by scientists, then working in the media.) So my eyeballs bulged and turned a hilarious shade of pink when I came across this lead for a “Health” story on the BBC News site courtesty of Feministing:

Humour ‘comes from testosterone’
Men are naturally more comedic than women because of the male hormone testosterone, an expert claims.

Men make more gags than women and their jokes tend to be more aggressive, Professor Sam Shuster, of Norfolk and Norwich University Hospital, says.

The unicycling doctor observed how the genders reacted to his “amusing” hobby.

Women tended to make encouraging, praising comments, while men jeered. The most aggressive were young men, he told the British Medical Journal.

Previous findings have suggested women and men differ in how they use and appreciate humour.

Women tend to tell fewer jokes than men and male comedians outnumber female ones.

What we really need to do is find out the gender of whoever research and wrote this story for the BBC, because few things are funnier than someone who’s supposed to be a journalist, working for the largest broadcasting company in the world, making a complete ass out of themselves. Not to mention spreading the story to all sorts of other news services that seem to be taking the story seriously.

So, the first thing I always do with these science stories is find the original study: Sex, aggression, and humour: responses to unicycling. It turns out that Sam Shuster is a retired professor of dermatology. (Note to BBC researchers: this means he studied skin, not hormones or psychology.) Shuster wrote about reactions to his unicycle for the traditional end-of-year issue of the British Medical Journal. This season, the BMJ also features densely written scientific papers on which brand chocolate bar doctors ought to use to demonstrate bone fractures and whether magical powers are heritable, based on an analysis of Harry Potter novels. In short, it’s clearly a joke. I would blame the notoriously dry wits of the British for the confusion, but it seems all too likely that the BBC reporter is… also British, albeit maybe not a doctor with enough time on hand to write witty, self-referential papers about the statistical mistreatment of orthopedic surgeons in medical journals.
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…several commenters in the AMA thread mentioned drug costs, and Anna applauded one academic center’s banning of drug reps. Thanks for the segue, people! (more…)

I just created a new chart on my electronic medical record. I typed in the patient’s name, her date of birth and her phone number, and then I chose from the dropdown menus for sex and marital status. The blanks are automatically filled in, but this patient is a married woman so I had to change both, because the default option is male, single. And I can’t change the defaults.

Why do I have a feeling that the people who designed this program are male, single? It’s a small thing, but every time I create a new chart I am reminded that “female” is considered an aberrant state of being.

Live in the US? Uninsured? Underinsured? In the Medicare donut hole? Stuck in a job you hate because you need the benefits? Thank the AMA.

Medicare was proposed in the 1930s when Social Security was enacted. You may have noticed that Medicare didn’t actually exist until the 1960s.  That’s in large part because the AMA spent millions of dollars fighting it. Can’t have the government telling doctors what to do, or how much they can charge. It’s an article of faith with the AMA that doctors must be allowed to do their work without any pesky oversight at all.

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Kat passed along this story from CNN that brings up all kinds of disturbing questions about bodily autonomy and disability and medical interventions:

LONDON, England — A mother is seeking to have the womb of her severely disabled daughter removed to prevent the 15-year-old from feeling the pain and discomfort of menstruation.

Doctors in Britain are now taking legal advice to see if they are permitted to carry out the hysterectomy on Katie Thorpe, who suffers from cerebral palsy.

But a charity campaigning for the disabled said on Monday the move could infringe human rights and would set a “disturbing precedent.”

Andy Rickell, executive director of disability charity Scope, told the Press Association: “It is very difficult to see how this kind of invasive surgery, which is not medically necessary and which will be very painful and traumatic, can be in Katie’s best interests.

Painful, invasive surgery on a disabled teenage girl to spare her from the “pain and discomfort of menstruation.” That, to me, sets a terrible precedent. There’s not much in the article that indicates that her periods are unusually heavy or painful, or that she’s got fibroids, or that she’s unable to take any sort of hormonal birth control. In any event, there are nonsurgical alternatives, or even less-invasive surgical interventions, like uterine cauterization.

I’m not really sure, in fact, what’s going on here. The mother swears it’s not about her:

Katie’s mother Alison Thorpe, who lives in Billericay, southern England, said the operation was in her daughter’s best interests.

“First of all, this is not about me. If it was about me, I would have given up caring for Katie a long, long while ago,” she told GMTV.

“It is about quality of life and for Katie to not have the associated problems of menstruation adds to her quality of life. It means she can continue with the quality of life we can give her now.

“Katie wouldn’t understand menstruation at all. She has no comprehension about what will be happening to her body. All she would feel is the discomfort, the stomach cramps and the headaches, the mood swings, the tears, and wonder what is going on.”

Thorpe said an operation would be best for Katie, despite the initial pain it would cause.

She added: “The short-term pain and discomfort we can manage with painkillers. We will be able to manage that pain much better than menstruation once a month, when Katie cannot tell us ‘I’m in pain.’”

So the solution is to put her through severe pain now to spare her cramping later? Can’t you give her painkillers once a month later, or Depo shots, or what have you? Something just seems sort of off to me with this whole thing.

I don’t want to minimize the burden that Allison Thorpe will have in caring for Katie over a lifetime, nor her awareness of Katie’s limited ability to comprehend and communicate that she’s in pain. However, given a range of alternatives, I can’t help but think that there’s a pretty big factor of not wanting to deal with the mess every month here.

The question, of course, is whether this decision will be for Katie’s benefit. And I just can’t say for sure, with such limited information. But I can say for sure that this case raises a lot of red flags for me. There’s also the issue of bodily autonomy, which is a particularly fraught subject in the disability-rights context, one that was argued with a great deal of intensity in the case of Ashley, a Seattle girl referred to as a “pillow angel,” whose growth was stunted surgically (which included the removal of her uterus and breast tissue so that they would not interfere with the hormone therapy or cause her discomfort) so that she could remain a size that would allow her parents to care for her at home and be able to transport her easily so she could be included in family activities. (For some perspectives on the ethics of this choice, see Blue and Planet of the Blind and Lindsay Beyerstein).

Thoughts?

Evil.

The Bush administration has extended its global gag rule to international AIDS prevention funding, according to the Maryland-based Center for Health and Gender Equity. The gag rule will affect a $193 million, five-year project for AIDS-HIV prevention programs in Kenya and requires organizations that seek funding to adhere to the administration's policy that the health organization not provide abortions, provide any information about safe abortions to women or lobby for change in their nation's abortion laws. In Kenya, complications from illegal abortions are a leading killer of married women in their 20s and 30s.

Family planning, maternal and child health programs are the "first responders" for women and girls who have HIV-AIDS, who make up 60 percent of infected cases in sub-Saharan Africa, said the center's executive director, Jodi Jacobson. "The administration has broken its own written commitment not to subject global AIDS funds to these onerous restrictions."

In August 2003, the Bush administration exempted AIDS funds from is called the global gag rule, although most other women's health programs overseen by the State Department are included.

I wasn't aware that groups that are earmarked as AIDS/HIV prevention programs were exempt from the gag rule, though I guess it makes sense, since you usually see the gag rule described as being for family planning organizations. This particular expansion of the global gag rule should lay to rest any quarrel that "pro-life" is anything but a code word for "anti-woman at any cost", since the obvious result of this gag rule is that effective health organizations will have that many more hoops to jump through to save lives, which will cost lives.

What is especially maddening is that these regulations like the gag rule create a sense in the general public that abortion can be reached in and excised out of the general health care that is offered to women, no problem. But health care providers have to open to discussing a variety of things with their patients and crippling them in one area probably has ramifications across the board for the level of care they can provide. This is a first class example of faith-based instead of reality-based thinking--if we just make everyone quit saying the word "abortion", that makes it go away, doesn't it?

There's evidence now linking HPV and mouth cancer. Not much to add to Ezra's rant here, except of course to say that since mouth cancer is an equal opportunity risk for men and women, this might calm down the "But the girls...and the sex....and the nooooooo!" reaction to the HPV vaccine somewhat.

Whilst sitting around this weekend leafing idly through the classifieds of the Austin Chronicle, I saw this ad.

HERPES PREVENTION STUDY, FEMALE VOLUNTEERS NEEDED Benchmark Research needs women who are 18 to 30 years of age and in general good health to participate in a clinical research study to evaluate an investigational vaccine for genital herpes. In order to be eligible to participate in this study, participants must not have previously been diagnosed with either oral or genital herpes. Compensation up to $450 will be available to eligible participants for their time and travel. Participation in a research study is always at no cost to the participant. FOR MORE INFORMATION, PLEASE CALL 1-800-369-2875

For those who don't know, they do a lot of medical testing here in Austin, taking advantage of all the broke college students with flexible schedules. Anyway, this made my day. Herpes may not be as common an STD at HPV, but it's still extremely common and unlike HPV, it's hugely stigmatized. On top of that, there's versions of herpes that aren't STDs, but are still pretty miserable when you break out nonetheless. A vaccine against it would absolutely be a godsend. And it will absolutely make the wingnuts shit a brick, since the huge stigma attached to herpes is one of their most potent weapons in passing along their sex-phobia to teenagers.

When I was in high school, the Just Say No crowd that came in to tell us to never, ever have sex or *someone* (not god, of course, since this is a secular high school) would rain boils and frogs onto our bodies absolutely relished the presentation on herpes. Sure, showing slides of people who have out of control gonorreha and telling us that syphilis would cause blindness, insanity and death were fun, but those presentations were completely undermined by the ugly fact that both those diseases can be treated with a dose of penicillin. Chylmadia is much more dangerous but for some reason didn't have the glamorous grossness they wanted to scare us with in these presentations. And AIDS? Well, when I was in high school, the vast majority of AIDS victims were men and the teachers were a little more interested in installing sex-phobia in the half of the class whose sexuality has caused mankind to flip shit since they first wrote that Bible story about an apple and a snake.

So herpes it was. You couldn't beat it for scaring the living daylights out of girls. First of all, they implied that once you got it, you could count of the fact that your ordinary genitals would be a non-stop, continous blister that would probably bring your entire life, not to mention your sex life, to a screeching halt. We were also told that if you had it, you couldn't have children because if you did, they would be deranged and blind or even die during delivery. (How you got pregnant with herpes when it apparently shut down your sex life permanently, I'll never understand.) The icing on the cake was when they told us that it was really contagious to the point where a lot of women got it from sitting their naked fannies onto places where other women had set their naked fannies, like locker rooms or public bathrooms, so that was to be avoided at all costs as well. (The motivation behind that no doubt being to convey a general sense of panic about the plague of disgusting, diseased women who have Teh Sex that surrounds us godly folks.)

As you can imagine, I was surprised to grow up and discover that herpes is common and a lot of people I know have it and while it sucks to get an outbreak and needs to be avoided if at all possible, it's also not the absolute end of the world if you get it. And also that you could have sex before marriage and still manage to avoid getting herpes and having a litter of blind kids that you have to haul around with you everywhere like a big sign around your neck that says, "I'm a diseased whore." Still, the threat of the disease is real enough and it's definitely unpleasant enough and that alone is going to cause the wingnutteria to freak out if in fact a vaccine to prevent it goes on the marker.