Saturday, June 8th 2013
TRIGGER WARNING. Describes unwanted contact, may be triggering to survivors of harassment or assault.
* * *
No woman is immune.
* * *
“Don’t I know you from the gym?”
A trim, older man is smiling in line in front of me at the allergist’s office. He does look familiar.
I smile a little. I name my gym and he nods. “Yeah, you’re the one who’s always so serious. You work really hard. The rest of us are just there to socialize and be healthy.”
I explain that I play roller derby and need to keep up with my teammates.
“Oh yeah?” He’s standing a little closer to me now. It’s his turn in line and I motion him forward, away from me. He doesn’t move at first, though I saw he noticed my gesture. Then he reaches out to me. His hand clasps my bare upper arm from the inside – his right hand gripping my right arm – then he runs his thumb slowly over the muscle, feeling it. “Guess you need to get these strong to elbow the other guys, huh?”
I do nothing, just stare at his hand on my body, intimate, almost brushing my chest. He pulls his hand away slowly, his fingers remaining on my skin as long as possible. I make some sort of reply, smile frozen on my face. He touches me again, on my other arm this time, before smiling and moving to the next receptionist.
After I check in with a receptionist myself, I rush to the bathroom and stay there for a while so I don’t have to interact with the man in the waiting room. When I come out, he’s gone.
I spend the rest of the day thinking about this interaction and what I could have done differently. I feel like an idiot for doing nothing, then like an idiot for overthinking it. But it doesn’t feel harmless, and I feel the man’s unwelcome touch – the way he lingered on my skin – every time I think about it. I am sick with disappointment in myself and in this man.
* * *
The next day, I quit work a bit early. I’d been burning the candle at both ends for two months, working far too many hours, and I wanted to treat myself to a nice long workout. There’s a part of me that thinks about the man who goes to my gym, and how I probably won’t see him since I’m going on a different day and time than I usually go. I drive over, get changed, and warm up.
I love my gym. I have always felt respected by the men who work out there – they’re meatheads, but they’re my meatheads. I’ve received compliments from the men there several times about whatever workout I happen to be doing, but it’s always felt collegial, like they’re impressed with me rather than looking to sexualize me. They keep their physical distance and we have all sorts of conversations, about exercise, about the weather, about our jobs and of course about roller derby. To some extent, the men who work out at my gym are the reason I keep going back and keep pushing myself.
My heart sank when the man showed up, right as I was starting the first portion of my workout. I was trying to time only one minute of rest between exercises, and I had already gone long once because I wanted to congratulate one of the trainers, a non-traditional student who had just graduated from college.
So of course the man approached me between sets, standing far too close to me, smiling about my serious workout. “What are you doing today?”
“Just trying to fit in some plyo.”
“What’s that?”
“Plyometrics.” I was smiling in a forced way, trying not to be too friendly in the hope that he’d go away.
“Oh, I have a degree in exercise science from back in the day, I never heard of that.” I just nod. “Well, have a good workout.” His hand brushes my arm, then he turns and leaves. We interact a few more times as I head to various parts of the gym for interval training and stretching, and each time I’m careful to only meet his eyes for a second. My seriousness becomes a shield.
* * *
I tell my husband that night – I’m not sure why I kept it from him the day before, except maybe a fear I was overreacting. My husband is more upset than I had been expecting. He asks why I didn’t ask the man to not touch me when I saw him the second time (he asked not in an accusing way, but out of real curiosity).
“Here’s the thing,” I say. “I could be very careful and polite, and try to bring him in as an ally. I could explain why what he is doing is making me uncomfortable. And I could convert him. Or, he could become an enemy, and tell me I’m a bitch, and make my time at the gym hell.”
We talk about discussing the issue with the gym staff, but the worst offense didn’t happen at the gym. What can I really say to them? And would they support me or would they make me feel like I’m overreacting? There’s no code of conduct that I know of, no policy about how to treat others. I probably signed something when I joined a few years ago, but whatever it said is long gone from my memory.
It was only during this conversation with my husband last night, problem-solving, that the ridiculousness of the situation hit me:
I am the principal investigator on a research project on sexual harassment and assault. I am a physically strong, capable, smart woman. I play a full contact sport, and I don’t take crap from anybody. One might think I am one of the least likely targets for harassment or assault… except, of course, for the small matter of being gendered female.
The gendered role into which I’ve been acculturated rendered me completely helpless when that man ran his hand suggestively across my skin. My fear of making a scene in the waiting room, of upsetting who seemed to be an otherwise kind man, of somehow reacting excessively outweighed my physical and mental discomfort. Then, a lack of clear guidelines or reporting mechanism meant that I had nowhere to turn after the fact.
Though I have been harassed and worse before, until this week, there had been a small part of me that thought that working on this research project would render me invulnerable from further altercations. I don’t know if I thought I would just give off a vibe, or if I thought I would suddenly develop a witty repertoire of comebacks.
But none of these things happened. I was just as frozen as every other time.
I am not immune.
Friday, May 31st 2013
I think my umbilical hernia is getting bigger. I’ve had it since my pregnancy over five years ago, the result of diastasis, a situation where the abdominal muscles pull apart from the baby taking up so much darn room. I’ve consulted with a surgeon, and the hernia is tiny, not worth fixing until I’m done childbearing since having another kid would likely open it up again.
But despite a medical professional’s blessing and my own research, I’m staring at this hernia. I think it’s bigger. Or maybe I’m just bloated. Maybe I’m lactose intolerant. Or I ate something contaminated with gluten. Maybe I’m experiencing strangulation of my intestines, right now, and I should be calling the doctor or going to the ER. How long do I have? Could I pass out before getting there? Will my intestines rupture? What if they have to do surgery on me?
How many weeks will I have to stay off my skates?
My brain does this most premenstrual phases over the last year. For three to four days I become a semi-depressed hypochondriac. Because I now recognize that these thoughts increase premenstrually, I’m able to laugh about it a bit, and I’m able to set them aside by telling myself that if I feel the same way in a week, I’ll go to the doctor.
I haven’t needed to go to the doctor.
I don’t know why my premenstrual experience is like this, not exactly. It seems to be context-dependent, because it relates to one of my big fears – getting sick in a way that could derail my busy lifestyle, keep me from doing my job, make me neglect my child, or force me from my sport.
To me, being sick means letting other people down.
Culture- and experience-bound illness
Our illnesses, worries and feelings are all culture- and experience-bound. But alongside illnesses that appear only in certain contexts are very real, physiological phenomena that are influenced by both biology and culture. The two are not mutually exclusive.
I was motivated to write this post because Amanda Marcotte, someone I greatly admire, wrote a piece earlier this week about premenstrual syndrome (PMS) as a culture-bound syndrome. There, Marcotte points to work suggesting that the origin of PMS is in our culture, not our biology, even adding that PMS “panders” to the idea that women are overemotional. She quotes from researchers who discuss women who are “highly resistant” to evidence that PMS is culturally bound, who find PMS “convenient” as an excuse for bad behavior in order to hold on to notions of themselves as good women.
PMS is surely a culture-bound syndrome. However, Marcotte seems to imply that PMS’s cultural origin negates the possibility of there also being a biological or physiological component to PMS, and this is not the case. The definition of a culture-bound syndrome is a cluster of symptoms that appears different among different cultures. The symptoms being bounded by different cultural expectations of how they should manifest doesn’t mean there couldn’t, in some cases, be a biological component as well. There are many physical phenomena that we experience differently based on our culture, but that doesn’t mean the underlying issue isn’t real. Even the way a person responds to a stubbed toe is going to be highly dependent on that culture’s perception of pain, machismo, and a host of other culture- and gender-bound expectations.
We all still stub our toes.
PMS is not universal, but…
All people who have menstrual cycles have a premenstrual phase and thus premenstrual experiences. For some of those people, you can’t identify a difference between the experiences of the premenstrual phase from any other time in her cycle. For others, there is a cluster of symptoms linked to that time period. The biggest problem about the way in which PMS is embedded in our culture, to my mind, is the way it’s situated as a universal and universally negative. The only aspect of premenstrual experience that should be explicitly pathologized is anything that disrupts normal functioning. This is why we have the additional classification of premenstrual dysphoric disorder, or PMDD. Using the criteria of PMDD only 8-10% of reproductively-aged women fall into this category.
As it turns out, there is an enormous literature on the hormonal factors that may explain PMDD. And some of it may even shed light on why there is cultural variation in premenstrual experiences that make it seem as though western women overexpress negative symptoms.
One of the main mechanisms of PMDD is related to progesterone withdrawal. Mouse study after mouse study has shown that if you give a mouse a ton of progesterone, then wait a little bit, that withdrawal period is a time when the mice become depressed. If you hold them up by their tail, they don’t struggle. If you try to get them to swim, they give up (don’t worry, that doesn’t mean they drown, only float). The mechanism is related to the way in which the withdrawal of progesterone (and thus its neuroactive metabolite allopregnanolone) influences GABA receptors in the brain.
Now, all ovulatory cycles should have a midluteal (that’s about three quarters of the way through a menstrual cycle) peak of progesterone, followed by progesterone withdrawal. But not all ovulatory cycles lead to those women experiencing PMDD. What is explaining this variation in experience?
There is growing evidence that women have varying sensitivity to the hormones they produce, such that two could have the same hormone concentrations but one could have a more acute experience from progesterone withdrawal. But the other important factor here, is that because we have a lifestyle that leads to eating more and being less active than most, western, industrialized women have the highest progesterone of all women globally.
So rather than seeing this cultural variation as entirely a product of the culture-bound syndrome, we can also see that it has to do with the ways in which western women are at the farthest end of the spectrum in terms of actual hormone concentrations. We have the highest hormones, so we have the furthest to fall. Our experience of progesterone withdrawal is more frequent and more extreme than probably any other human population on the planet.
Biocultural approaches to the premenstrual experience
Therefore, there is both a cultural and biological component to the premenstrual experience that makes western women more likely to experience clusters of negative symptoms during this phase. I think it’s worth noticing the many important feminist contributions to our understanding of PMS and premenstrual experiences. These critiques of cultural norms that limit women’s expression have done a good job making sure that medicine better bounds the definition of PMDD, rather than pathologize all women.
At the same time, these cultural constructions need to be viewed alongside the equally important evidence that the frequent cycles and steep progesterone withdrawal produced by our energy surplus environment, individual variation in sensitivity, and individual variation in other important contexts are going to lead to diverse experiences of the premenstrual phase. Because these symptoms (positive and negative) can manifest so differently for different women, it makes sense that meta-analyses like the one Marcotte cites did not find a relationship between the premenstrual phase and low mood.
Western women live in a culture that promotes overwork; Emily Martin has pointed out that experiences of PMS may be a result of women chafing against flaws in our culture, rather than PMS representing a flaw in our bodies (1980). And so again we can see not that culture and biology are disparate, but that they can influence each other: overwork can contribute to consumption of energy-dense food and low physical activity, which drives progesterone concentrations up, which makes that withdrawal curve so steep.
In the end, it doesn’t make sense to view the biology and culture of premenstrual experiences separately. Biology and culture aren’t two sides of a coin, but the two massive and overlapping components of the feedback loop that helps us understand human motivations, behaviors, and physiology.
References
Martin E. 1980. The Woman in the Body: A Cultural Analysis of Reproduction. Boston: Beacon Press.
Addendum (6/1/13, 10pm CST)
I realized I should have provided some citations for the relationship between progesterone and mood. Here are a handful of papers that folks may find interesting:
Beckley, E. H. and D. A. Finn (2007). “Inhibition of progesterone metabolism mimics the effect of progesterone withdrawal on forced swim test immobility.” Pharmacology, Biochemistry and Behavior 87: 412-419.
Brinton, R. D., R. F. Thompson, et al. (2008). “Progesterone receptors: Form and function in brain.” Frontiers in Neuroendocrinology 29(2): 313-339.
Dantzer, R. and K. W. Kelley (2007). “Twenty years of research on cytokine-induced sickness behavior.” Brain, Behavior, and Immunity 21(2): 153-160.
Espallergues, J., L. Givalois, et al. (2009). “The 3[beta]-hydroxysteroid dehydrogenase inhibitor trilostane shows antidepressant properties in mice.” Psychoneuroendocrinology 34(5): 644-659.
Frye, C. A., A. A. Walf, et al. (2004). “Progesterone enhances motor, anxiolytic, analgesic, and antidepressive behavior of wild-type mice, but not those deficient in type 1 5[alpha]-reductase.” Brain Research 1004(1-2): 116-124.
Reed, S. C., F. R. Levin, et al. (2008). “Changes in mood, cognitive performance and appetite in the late luteal and follicular phases of the menstrual cycle in women with and without PMDD (premenstrual dysphoric disorder).” Hormones and Behavior 54(1): 185-193.
Sulak, P. J., R. D. Scow, et al. (2000). “Hormone Withdrawal Symptoms in Oral Contraceptive Users.” Obstetrics & Gynecology 95(2): 261-266.
Thursday, May 30th 2013
A new post coming shortly, but in the meantime read these other posts. A rather specific set of links this time, because there has been some pretty good ladybusiness writing in the last month.
“Why do women try to get ahead by pulling men down?” On escalators, elevators, and running as hard as you can.
Why do men keep putting me in the girlfriend zone? A great piece playing around with the “why do girls put me in the friend zone” Nice Guy trope.
‘We have always fought:’ Challenging the ‘Women, Cattle and Slaves’ narrative. On writing women and realizing the many spaces they occupy, and the stereotypes that limit our awareness of this.
Evolution, sexism and racism: why definitions matter. A succinct, thoughtful post.
24 Lies People Like to Tell Women. Because you should read it.
Women are bitches. Oh, this piece is just so lovely. On the way men talk about women, and what this reveals about what they think of them.
Cultural sexism: What if Amanda Knox had been Andrew Knox? Barbara King’s great piece on the way we think about sexuality and gender.
Exclusive: meet the woman who kicked off Anonymous’s anti-rape operations. Justice for Rehtaeh.
Elaine Morgan and the Aquatic Ape. I really enjoyed this. It’s important to remember the contributions Morgan made to try and subvert some of the sexism of her time, even though aquatic ape will never be supported by evidence. Margie Profet’s hypothesis on sperm-borne pathogens driving evolution of menstrual will also never be supported, and yet the way she pushed against the “women are dirty” cultural conditioning was important for the field. Sometimes scholarly contributions are less about whether their prime mover hypothesis is right, and more about what it forces us to confront about our biases.
