Everything Below the Waist: Why Health Care Needs a Feminist Revolution

by Jennifer Block

A 2013 Institute of Medicine report found that even as women’s life expectancy has risen overall, U.S. women are “dying at younger ages” than our international peers, a trend that has been worsening for three decades.4 And the quality of those years we are living is worse than men’s,

In 42 percent of U.S. counties, women’s life expectancy is decreasing.

We live in a more toxic environmental “soup” now than in our parents’ and grandparents’ day, and the lack of guaranteed health care is a unique driver in the industrialized world. Another explanation, to be blunt, is racism. Black women are more likely to die of heart disease, breast cancer, and pregnancy, and when researchers drill down to determine why, the salient factor is the stress caused by the daily wear and tear of being a woman of color in twenty-first-century America. Health disparities hold true for men of color as well.

autoimmune disorders affect a stupefying 10 to 20 percent of the population (depending on how many diseases you put under the umbrella) and some 75 percent of sufferers are women, yet these diseases claim a fraction of investigative efforts.

recommended that women get fewer mammograms. The announcement came in the midst of a 15-year-long breast cancer awareness campaign. Pink ribbons were everywhere and the “early detection saves lives” mantra had been burned into the public consciousness. Despite this, the USPSTF announced that, based on epidemiological evidence, women would be better off if they held off screening until age 50 (rather than 40) and screened every two years rather than annually.

In the case of mammograms, Calonge explained, the problem was that for every handful of lives saved, thousands of women were getting unnecessary, potentially harmful treatment. Years of annual screening, he said, had not delivered a net benefit.

We’re recommended bone density scans and then prescribed drugs to treat “osteopenia,” though the machines, diagnosis, and treatments were all manufactured by the pharmaceutical industry—and it turns out these drugs often lead to bone loss and fracture.10

Routine thyroid cancer screening came into vogue in the 2000s, though now we know that some 80 percent of the resulting surgeries, in women specifically, were done unnecessarily.11 Men and women are equally obese, yet women are more often recommended bariatric surgery. We’re more likely to be prescribed antidepressants and antipsychotics and recommended electroconvulsive therapy.12 We’re also more likely to be prescribed opioids, and 40 percent more likely to become dependent on them.13 We are prescribed more drugs and are recommended more surgery in general.

In particular, we endure a lot of surgery on ...

There is a statistical threshold at which the harms outweigh the benefits, and public health authorities agree that at our rate of 32 percent cesareans, we’re well above that threshold.

The cesarean rate is now a public health crisis—a likely contributor to the rising number of maternal deaths.

In this book, I ask similar questions about everything from fertility treatment to contraception to pelvic surgery to the way miscarriages are handled. In many cases, we’re being denied the most appropriate treatment.

removing the organs is generally the treatment protocol.” The second most common major surgery after the C-section is hysterectomy—it is estimated that one-third of women in the United States will lose their uterus before age 60.15

Over at the hospital, common GYN surgeries are hysterectomy and transvaginal mesh for pelvic prolapse and incontinence, and more and more women are choosing to have prophylactic breast and ovary removal based on genetic testing.

The routine manual pelvic exam (often conducted by doctors in concert with the Pap) has been found over and over again to deliver only discomfort, anxiety, and a 98 percent false-positive rate.17 In 2014, the American College of Physicians reviewed seven decades of studies and recommended that physicians stop doing them without cause.18 The

don’t comport with the dominant narrative.