GWS Quiz 1
Levels of Oppression- Structural
(SOIL) The ways that society is set up that advantages certain groups & disadvantage others --Phenomena PERVASIVE w/n our society & they STRUCTURE people's experiences of oppression, opportunities for prosperity, and health Ex. might think of rape culture-- dichotomy b/w the "stud" and the "slut" stereotypes, occupational and residential segregation --Also the fact that it is a higher cost to buy health insurance if you're a woman
Genital variation intersex
(clitoris ←→ phallus) (labia ←→ scrotum) (labia open to vagina ←→ scrotum fused, no vagina) - Genital tissue also develops along a spectrum, too. The same tissue can become either labia or a scrotum. The same tissue can become either a clitoris or a phallus, but if the size falls somewhere in the middle of what is considered typical for either one, historically it has been up to individual surgeons to determine what is considered "normal" versus "in need of surgical correction." - In intersex infants we can see different combinations along these spectrums, and almost none of them carry medical consequences. ***The only urgency is if a child is unable to urinate. Outside of that case, any genital surgery on intersex children is enforcing arbitrary notions of "normalcy," when we see that there can be a lot of natural variation.
Chromosomal intersex
(ex. XX, XY, XXY, XO, XXXY)- can be chromosomal, meaning your chromosomes are something other than XX or XY- or that they are different from what is "expected" for your body --So you might have XY chromosomes with a typically female phenotype (physical appearance) or XX chromosomes with a typically male phenotype
Gonadal intersex
(ovaries ←-- ovotestes (combo of tissue) ---> testes (can be internal)) --OR undeveloped streak gonads!! --Gonads are organs like ovaries or testes, but the tissue starts out with the potential to become either type and can also become a combination of tissue types (ovotestes). --Sometimes the tissue becomes a type of gonad that isn't expected based on your external phenotype at birth, for instance someone with a vulva who later discovers that they have internal testes instead of ovaries. ---You can also have tissue that does not develop into either type - called "streak" gonads - that do not produce any hormones
Genital structures begin the SAME in embryos --NOT until when does that embryo start to differentiate??
***NOT until the 7-12 week that the embryo starts to differentiate
M vs F graphs
***See Curves overlap so NOT a binary --Is a lot more overlap of M/F height than areas of separateness- NO BINARIES!! --No such thing as M or F hormones, everyone has both, just in dif proportions - Testosterone and estrogen are NOT opposites - Both testosterone and estrogen do some same functions - some may be thought of as "opposite" (testosterone inhibits ovulation, estrogen triggers ovulation), both T and E support healthy bone density, libido
**Semen and sperm are NOT one and the same Sperm cells between 50 million and 130 million in a given ejaculation are only a small part of what is in ejaculate
***Sperm compose only about 2 to 5 percent of the volume of the semen ejaculated - The rest of semen is composed of fluids produced by the prostate gland and the bulbourethral or Cowper's glands as well as fluids produced by the vas deferens and the seminal vesicles - The prostate gland produces fluids that are about 30 percent of the total volume of semen
Dealing with doctors 1. Choosing a provider 2. What kind of provider do you need (ex. Nurse practitioner or PA?) and how do you access them? 3. Quality healthcare and patient/client agency 4. When you have to educate your own doctor...
***You have agency over your own quality healthcare Many people have to educate their own doctors Ex. minorities and PWDs
Gender and Health Inequities in the US--Gender ALWAYS intersects with:
- Citizenship - Race - Education - Geography - LGBTQ community - Dis/ability - Colonization
Examples of Levels of Oppression in Villarosa Story Interpersonal racism:
- Doctor dismissing Landrum's concerns, not taking her symptoms seriously, recommending Tylenol - Villarosa "hounded with questions about [her] "lifestyle" and whether I drank, smoked
Is Healthcare- a right or privilege? -In the U.S., healthcare is treated as a market commodity versus a basic human right US= the ONLY developed nation that:
- Does NOT guarantee basic healthcare services - AND allows people to go bankrupt over healthcare
Ejaculation and orgasm are NOT the same thing, but they are usually related
- Ejaculation usually happens AFTER the orgasm - Orgasm can occur WITHOUT EJACULATION Although people get erections from infancy on, ejaculation doesn't occur until AFTER puberty has begun, and some people may not even begin to ejaculate until they are in their late teens NOT ejaculating does not mean anything is wrong
Medical and Social Models of health compared: - Social Model
- Health includes social, emotional, spiritual elements - Healthcare prof. = allies - Health is embedded in a social/cultural context - Causes of ill-health are also environmental, social, political, etc.
Medical and Social Models of health compared: --Medical Model
- Health is the ABSENCE of disease - Healthcare prof are all-knowing experts - Health is an ind. phenomenon - Causes of ill-health are biological
Inequalities in health insurance access: Uninsured by Race
- Hispanic people are the highest rate of uninsured Americans - Native Americans are the second highest
Intersex Activism ---Last year, California became the first state to pass legislation on non-consensual genital surgeries (intersex rights)
- In the US, unfortunately, there is currently no ban addressing these surgeries. ---However, in August 2018, interACT and Senator Scott Wiener passed a historic resolution, SCR-110: the state of California is the first U.S. state to acknowledge the harms of non-consensual medical interventions on intersex kids, and encourages their delay.
Doula work like Giwa's resists/transforms some of these levels and kinds of oppression
- Intervened when resident didn't read chart - Fulfills continuity of care - Racially concordant care--Racial continuity b/w provider and patient is seen to increase quality of care - Visualizations for anxiety & to help Landrum tap into her own strength
Examples of Levels of Oppression in Villarosa Story - Structural economic oppression
- Landrum has no ride home from hospital - Landrum and her family have little money for food postpartum
Unlike most other industrialized nations, the United States does not offer universal health care!!!
- Medicare: entitlement program for ppl over 65 or with qualifying conditions - Medicaid: means tested program for low-income individuals and families People can purchase health insurance that complies with the Patient Protection and Affordable Care Act (ACA, known colloquially as "Obamacare") at ACA health exchanges, where they can choose from a range of government-regulated and standardized health care plans offered by the insurers participating in the exchange
The average vaginal canal is about the SAME length as the average penis
- Moreover, the vaginal canal CONTRACTS to hold the size of whatever is inside of it --The first inch or so of the vagina is where most of the sensory nerve endings are (thus, where people are really feeling A LOT of sensation) --AND the most sensitive, sensory-nerve-ending-rich part of sexual anatomy is NOT the vagina at all, but the internal and external clitoris
Gender isn't binary and neither is sex
- No such thing as "female genitals" or "female" bodies - Not all women have a vagina or vulva and some men do! - Also not all pussies are pink
Examples of Levels of Oppression in Villarosa Story Institutional racism:
- Systematically ignoring concerns of Black women as accepted practice (Landrum, Serena Williams) - Over 25% Black women not meeting birth attendant (compared to 18% of white women) - Not reading patient chart as accepted practice—resident thinks it is perfectly OK - No analysis of maternal or infant deaths in most cities, only half of states
**there's NO muscle in the breast
- The parts of the breasts that create their size and shape are fat and glands - Though how much or how little muscle someone has beneath the breast influences how the breasts look on the body - Between the ligaments of the breast are pockets of fat that contain the mammary glands (lobules) and those lead to the lactiferous ducts (milk-carrying)
Penis internal side view --Penis has NO bones
- Urethra runs through corpus spongiosum - Pre-cum usually comes with an erection - prostate= chestnut shaped gland below bladder and toward rectum - Sperm cells mature in epididymis
Things Intersex Children are Often Told:
- You probably shouldn't tell anyone - We did it for your own good - I've never had a patient like you before - You can't have sex without this surgery - OR they were told NOTHING AT ALL!! --Some don't find out they are intersex until late in life!
Biomedical model of health=
- health explained primarily through biology -Causes of ill-health = primarily BIOLOGICAL - Mind/body separation - Solution or "cure" for ill health=thru medical treatment - Treatment of pathology emphasized over prevention - HCP= the all-knowing experts - Health as an INDIVIDUAL phenomenon
Homologous Structures of Human Sexual and Reproductive Systems
- ovary/testicle - uterus/prostatic utricle - Skene's gland/Prostate - Bartholin's gland/ Bulbourethral gland - Labia majora/scrotum - Labia minora/spongy urethra - clitoris/penis - glans of the clitoris/glans of the penis - clitoral hood/foreskin of the penis **These are similar structures in terms of location, purpose and function in the human body, but we assign them very different social meanings
OVARIES
- pair of almond-shaped glands on either side of uterus - lie just below opening to fallopian tubes - produce estrogen, progesterone, and mature ova (eggs)
Intersex people exist! --Even within bodies that are fairly easily characterized as Male or Female, there is what??
--A a great amount of bio variation WITHIN those bodies --This changes over time (ex. During puberty, menopause, aging), some are naturally occurring processes (ie, having a hysterectomy changes a part of your biological sex, but doesn't make you not a woman) sometimes through purposeful processes (ie, medical transition)
Examples of Levels of Oppression in Villarosa Story Structural racism:
--Gov't non-response to Hurricane Katrina --Societal tendency to blame Black mothers --Pervasive white mythology that Black people feel less pain --The overarching social norms that cause weathering upon black mothers --Black doulas making less than white doulas --"the inescapable atmosphere of societal and systemic racism" (Villarosa) Pervasive, big picture- "The air that we breathe" - a systemic factor --Ex. beauty norms, institutional dismissal of concerns
Social-ecological model of health
--macrosystem/policy, --community --institutional --interpersonal --individual Ex. Corporate power, colonization, border enforcement, war, structural racism, citizenship/immigrant status Community resources, nutrition, education Poverty/wealth Relationships Health
How medical schools are failing the LGBTQ community (and a whole lot of other people) •Medical schools are hostile places to LGBTQ students •They don't teach future doctors much about sexual health •....And even less about health needs specific to LGBTQ people •Health research doesn't often ask the right questions •This contributes to:
-Bi folks not disclosing their sexuality to providers -Providers assuming things about the health needs of an individual based on membership in population -No clue how to treat trans patients
Structure of the US healthcare system- where do people receive care? In short, a patchwork of places:
-HMOs -School or workplace clinics -Private practices -Community health centers -Family planning clinics -Other publicly-funded specialty clinics (e.g.: substance abuse) -Complementary/alternative practitioners - -....all with different ways of accessing them
How common is it to be intersex?
0.5-2% of population (as common as twins or naturally born redheads) ---Range b/c intersex is an UMBRELLA term
1 in 2,000 intersex infants are at risk of receiving surgery in infancy to "normalize" genital appearance
1 in 2000 is the approximate number of babies who are born with bodies that look different enough from what is "typical" for a male or female infant that they are at risk for genital-"normalizing" surgery. --Again, these surgeries are cosmetic and not necessary for any medical purpose. Intersex kids still face nonconsensual, medically unnecessary genital surgeries.
There are 2 different arenas of constant hormonal changes in the male reproductive system:
1) there are daily hormonal changes- testosterone levels are usually highest in the morning and decrease throughout the day- that occur in cycles of around 24 hours 2) And then there are additional cycles every seventy-two days in which the hormones FSH and LH are at work, just as they are in the menstrual cycle --FSH and LH regulate the production of sperm!!
Under the Shadows of Tuskegee and Slavery (in-class vid)
399 black men w/syphilis - 40 year experiment - Tuskegee shy study 1932-1972, 399 black men from Alabama denied treatment for syphilis, a common STI that they had contracted. - Funded by US PH service - Untreated even with penicillin already discovered as effective cure
First inequity= It is a well known fact that in WI= black infants are nearly 3X more likely to WHAT?
3X more likely to DIE in their first year of birth than white infants --In Madison this gap is even wider - Over 3X the rate - Does NOT communicate the loss for families, relatives, and communities
Gender is both...
A SOCIAL GROUPING and LIVED IDENTITY - Dif cultures have dif gender systems
Being intersex is NOT the same as being transgender
A person who is intersex was born with a VARIATION in their internal or external sex characteristics A person who is transgender identifies with a different gender than they were assumed to be at birth, but their visible sex characteristics usually fit within what most people think of when they think of M or F bodies Intersex and transgender people may face similar barriers to accessing appropriate medical care and may experience similar discrimination based on their gender ID and expression
The clitoris is NOT a button
A tired joke exists about how hard it is to find the clitoris and that simply locating it releases instant orgasm- FALSE - In reality, it's much BIGGER than most people think About a quarter of it is visible, the rest is concealed - "It's not a button, it's an ICEBERG"
Levels of Oppression- Interpersonal--AKA??
AKA- Personally mediated oppression --the ways that people TREAT each other in one-on-one or small group relationships (Ex. racial slurs, physical violence, gendered norms like birth control being a woman's responsibility) **This is the gardener's PREFERENCE for 1 flower over another (red over pink favoritism)
The binary gender system taught us to assume that biological sex and gender identity ALWAYS do what?
ALWAYS line up in particular ways!! - Ex. that everyone born with a vulva identifies as a woman, and no one with a penis does - Or that those with a penis always identify as a man --While it's true that most people born with a vulva grow up to ID as a woman, some grow up to ID as a man or as nonbinary - The same is true of those born with a penis, and of intersex people born with genitals hard to categorize
Intersex refers to physical sex characteristics that are different from what we usually think of as a typical male or typical female body - it is NOT the same thing as being transgender, but an intersex person can be WHAT??
AN intersex person can be transgender, cisgender, LGB, straight, or asexual - just like anyone else.
Beyond organizational change within healthcare systems, achieving sustainable and comprehensive health equity for LGBT people will require substantial societal change to address a range of adverse LGBT health outcomes driven by WHAT??
Adverse LGBT health outcomes driven by social determinants outside the health-care arena
Systems of Oppression
Ageism, adultism, cisgenderism, sizeism, heterosexism **These systems= PERVASIVE & have everything to do w/ how we experience our identities ***we name systems of oppression AFTER the social identities that they are organized around ***Oppression= about POWER--NOT the same as discrimination
For people of color, a lack of affordable health care and insurance and culturally competent service providers—along with persistent racism in society—are some of the largest causes of health disparities.
An LGBT person of color faces the combined impact of these barriers, increasing the likelihood of negative health outcomes
What level(s) and kind(s) of oppression are at work? Clare- "Supercrip lives inside my body, ready and willing to push the physical limitations, to try the "extraordinary" b/c at the base of the mountain waits a nursing home
Answer: BOTH internalized and institutional/structural - threat of real violence for those deemed "abnormal" or "unfit" Describes a condition that shapes internalized oppression
What level(s) and kind(s) of oppression are at work? G. Sen & P. Ostlin- "Unequal burdens of work and responsibility for the care of the young and old, often means that women are expected to sacrifice their own rest, leisure, and health; women themselves internalize these values, which often mark who is seen to be a 'good woman'.
Answer: INTERNALIZED AND STRUCTURAL/INSTITUTIONAL --Internalized b/c states that women "internalize" values of being a 'good woman' --Structural b/c dealing with norms of heteropatriarchy --Institutional b/c talks about the institution of the family (father ruling household) where these norms are applied
What level(s) and kind(s) of oppression are at work? Cook- "This was one of the painful parts of my midwifery practice in my own community, finding that our proximity to an EPA Superfund site meant that PCBs are now in our bodies, in our mothers' breast milk When one of our babies is born, the cord blood has over 200 industrial chemicals in it
Answer: STRUCTURAL & INSTITUTIONAL STRUCTURAL b/c --capitalist idea that land and water= simply resources to be used for profit - Colonialism- devaluation and violence toward indigenous life, environments, and culture - Norms of gender-based violence- toxins going into pregnant and breastfeeding bodies; no testing done beforehand to check effects- a different sense of "internalized oppression" INSTITUTIONAL b/c-- collusion b/w corporations and national government that made it possible for GE to dump for years even after Cook's community began noticing terrible health effects
What level(s) and kind(s) of oppression are at work? Clare- "Supercrip stories never focus on the conditions that make it so difficult for people to have romantic partners, blind people to have adventures. I don't mean medical conditions, I mean material, social, LEGAL conditions. I mean stereotypes and attitudes. I mean oppression"
Answer: STRUCTURAL and INSTITUTIONAL b/c the passage describes pervasive SYSTEMIC conditions NOT about individual actions- about the WHOLE system
What level(s) and kind(s) of oppression are at work? G. Sen & P. Ostlin- "Sex and society interact to determine who is well or ill, who is treated or not, who is exposed or vulnerable to ill health and how.. And whose health needs are acknowledged or dismissed...gender intersects with economic inequality, racial, or ethnic hierarchy, caste domination, differences based on sexual orientation, and a number of other social markers"
Answer: STRUCTURAL- sexism, in intersection with class, racism, caste hierarchy, homophobia
Take-Home Messages-- Sex, gender identity, gender expression, and sexual orientation are all??
Are all different from each other --None of them are binary --People can have any combination of them
Examples of Levels of Oppression in Villarosa Story ***All of these levels= DEEPLY INTERTWINED!!! Interweaving occurs with levels of oppression Example in the article of intertwining
As seen here: Interpersonal - When Landrum is not taken seriously or assisted in several cases of medical scares by her doctors, stemming from structural and institutionalized racism STRUCTURAL: Societal misogynoir: the anti-Black racist misogyny that Black women experience (Moya Bailey) (Ex. beauty norms_ INSTITUTIONAL: Dismissing Black women's symptoms is implicitly the hospital or clinic policy; residents learn and replicate this devaluation
PHYSICAL features of one's BODY including genitals, internal reproductive organs, chromosomes and hormone levels, along with secondary sex characteristics--this describes what term?
Biological sex
One structural difference b/w the First Nations and other communities is that they still appreciate having CONSCIOUSNESS of what?
CONSCIOUSNESS of Deep History and its relation to what we do today --ex. Delivered by and helped raised by her grandmother **It's our duty as mothers in our matrilineal society to maintain in our children the knowledge systems that come from our ancestors
How is (de)medicalization a "double-edged sword"?
Certain conditions gain attention that they needed to be taken seriously or feel relief that there is a diagnosis BUT in another way, Medicalization can also warrant unwanted medical attention and financial costs ***Just because something is medicalized does NOT mean it is ACCESSIBLE (Ex. substance abuse treatment is hard to acquire)
Opposite of trans, someone whose gender identity basically aligns with what's expected of them based on their assigned sex--this describes what term?
Cisgender
In WI, Native Americans = Less Likely than Whites to Have Health Insurance --Why is this?
Colonial violence manifests through grave health inequalities among native peoples in WI ---according to "Open Letter to Flint"- racism and colonization mean= a disregard for the lives and well-being of black people and native peoples alike --BOTH black and native communities face FATAL oppression in WI - Avg 2014 age at death for native Americans in WI= 63 years compared to 77 years for whites--14 years less!!
Only one of many acts of medical violence Ex. J Marion Sims: Off the Pedestal - 'Father of Gynecology' Who Experimented on Enslaved Women
Completed unanesthetized hysterectomies Gamble writes about J Marion Sims, called by white historians and physicians "the father of modern gynecology" who extracted his knowledge through repeated unanesthetized surgeries on enslaved Black women, including three named Anarcha, Betsey, and Lucy. After years of protests like this one, community members successfully moved to take down the statue and remove it to a distant cemetery. Black women's scholarship and activism forced changes in the way the history of medicine is taught, and made a powerful shift the way that racism is built into the very environment. ***Shows how ingrained racism remains in the medical system even though the Tuskegee and Marion Sims studies have ended --Racism is built into the very environment!
The clitoris has about 8,000 sensitive nerve endings
DOUBLE the amount of a penis. ---But it doesn't stop there: Sensations started in the clitoris can spread across the pelvic area, affecting about 15,000 other nerve endings.
**Oppression= about POWER--NOT the same as what?
Discrimination
An individual therefore, has a sex (male, female, not designated, other); but they ENGAGE with the world via a variety of social, gender conventions
Each individual, thus, manufactures a gender presentation that can feed back on the individual's sex, and is interpreted by others using the specific gender frameworks of an individual's culture Gender then, is definitely in the eye of the beholder ---Sex AND gender presentation are in the body AND in the mind of the presenter
Insurance Provider Breakdown in US
Employer insurance is the majority - Next largest is Medicare- generally covers seniors (older folks) and some PWDs - Third largest is Medicaid- covers low-income people
It is a well known fact that in WI= black infants are nearly 3X more likely to die in their 1st year than W infants Second inequity= officials have not even thought to ask black women themselves, those with the deepest knowledge of the injustice until LAST YEAR
Even as a longstanding issue (Ex. article- "To combat black infant health disparities, new campaign will ask black women to weigh in as the 'primary experts'")
Certain bodies and populations have been more medicalized than others
Ex. cisgender women more than cisgender men, also race and class play a big role here
the medicalization of disability is alive and well
Ex. passage of ADA and programs for independent living --modern-day medicalization of disability necessarily defines the individual out of context of his or her broader social group, and always in relation to the medical community medicalization positions ***medicine as a SOCIAL GATEKEEPER - forcing many individuals with disabilities to acquiesce to diagnostic categorizations to receive work-related benefits, insurance coverage, access to therapies, rehabilitation, or prosthetic and mobility related equipment
People who are intersex= more common than you think!
Experts estimate that as many as 1.7% of people are born with intersex traits (That's about the same number of people who are born with red hair!) --People with intersex traits aren't all the same, and some people may not even know they are intersex unless they receive genetic testing --Intersex people are NOT that uncommon- just have been mostly invisible. But that is changing.
Tophat: T/F- in 2000, the WHO ranked the US in the TOP 10 of all world's health systems?
FALSE!!
Villarosa article For black women in America, an inescapable atmosphere of WHAT can create a kind of toxic physiological stress?? And that societal racism is further expressed in a pervasive longstanding WHAT?
For black women in America, an inescapable atmosphere of SOCIETAL & SYSTEMIC RACISM can create a kind of toxic physiological stress, resulting in conditions- including hypertension and pre-eclampsia - that lead directly to higher rates of infant and maternal death And that societal racism is further expressed in a pervasive longstanding RACIAL BIAS IN HEALTHCARE- including the dismissal of legitimate concerns and symptoms- that can help explain poor birth outcomes even in the case of black women with the most advantages (ex. Serena Williams) " Actual Institutional and structural racism has a big bearing on our patients' lives" NOT just terms in the classroom!
A system of CATEGORIZING people according to factors like anatomy, identity, appearance, and mannerisms, and attributing MEANING to those categories--this describes what term?
GENDER
Gender ID is DISTINCT from?
GENDER expression
Intersex kids still face nonconsensual, medically unnecessary genital surgeries. What are some of these unnecessary surgeries, specifically?
Gonadectomy* Orchiectomy of internal testes Clitoroplasty / Clitorectomy Vaginoplasty Hypospadias repair** * in cases where gonads were healthy and producing hormones at puberty ** very high complication rate
Health equality about what? And health equity is about?
Health equality- about "SAMENESS" Health equity- about "FAIRNESS"
Health inequalities vs. health inequities
Health equality- about "SAMENESS" ---Each figure has a box to stand on **But this does NOT yield the same result Health equity- about "FAIRNESS" --Each figure has the number of boxes needed to compensate for the slope of ground and height of the fence
How is health political? Health is connected to your??
Health is connected to SES, your zip code, gender, your sexuality - Health policies dictate access to care, insurance, education and quality to care - Funding for health research determined by people in power
Through both Landrum and Giwa, Villarosa's article shows that health is absolutely WHAT??
Health is overwhelmingly POLITICAL!! --Villarosa shows how racism rooted in slavery and Jim Crow continues to shape the lives and health of Black women like Landrum AND she links Giwa's support back the traditions of midwifery care and healing that helped Black communities survive overwhelming violence.
Colonization and Gender Binary- What type of Native land is WI?
Ho-Chunk - One of the 12 Indigenous nations with sovereign lands
Hormonal intersex
Hormonal (estrogens ←→ androgens) (convert to estrogen (androgen insensitive) ←→ virilize (androgen sensitive) Intersex traits can be hormonal. This is where we get into issues like controversy in athletic testing. - What is a "normal" range for estrogen and testosterone? What does your body produce? - And whatever levels of hormones you produce, how does your body respond? In some intersex variations, your body produces testosterone, but you are completely insensitive to its effects, so you do not develop the typical secondary sex characteristics associated with testosterone, and your body instead converts it into estrogen.
"Sexual orientation"= refers to a person's emotional and physical attraction to others Has 3 dimensions:what are they?
IDENTITY, BEHAVIOR, and DESIRE --sexual behavior may or may not align consistently with identity
The vaginal canal is CURVED- not straight
If you could see inside you'd see an ARC from the vaginal opening to the cervix
Oppression= related to health b/c systems like: racism, sexism, homophobia, and classism impacts WHAT??
Impacts WHO gets to define what health even is! --Also define who has access to the things they NEED to be healthy (ex. Food, clean air, water) --ALSO structure ACCESS TO CARE, the quality of that care, and WHO provides that care as well as what kinds of research on health gets conducted
Intersex genital surgery Sexist ideas about what it means to be a "real" man or woman are also at play here.
In the past, it was common to raise intersex babies as girls even if signs pointed to more likely ID as boys in the future ---Solely on the basis that their phallus size was considered too small to be "adequate" for standing urination and penetrating a vagina. - Similarly, surgeries on children being raised as girls often prioritized vaginal capacity - the ability of the vaginal opening to accommodate an average-sized penis - and ignored considerations of sexual pleasure by, for instance, removing clitoral tissue for subjective aesthetic reasons. As much as doctors who still do these surgeries claim they are for the good of the patient, here are a few quotes that illustrate the perspective from which these treatment decisions are actually made. - "You're not really a boy" - "You can have REAL sex one day. We'll just start you on dilation or do a vaginoplasty when you're ready to start dating boys or when your parents are ready"
Health disparities= ALSO a descriptive term
Indicating a higher burden of preventable disease, illness, and death among certain populations
Social model of health=
Individual health= ENABLED or INHIBITED by social context --Health is CULTURAL & POLITICAL --Acknowl. multiple understandings of treatment Health exists in ALL aspects of human experience --"Dynamic interplay of social structures and health agency" --Meanings of health and disease VARY OVER TIME & SPACE
"The 2nd shift" - is an example of what level of oppression?
Institutional! - the ways that these structural oppressions are BUILT INTO SOCIAL INSTITUTIONS --Like schools, workplaces, and the family At home- the fact that most working women who are also parents and married to a man also work equally to spouse outside the home but are often expected to work additional hours on housekeeping
Sex variance occurs in many forms, but they are NOT random
Intersex conditions= produced by regular patterns of variation in development of one or more of the four parts of the embryonic genitalia:
Intersex is MEDICALIZED
Intersex is medicalized, surgeries reflect social and cultural ideas there are only 2 sexes, that you can't be a man without an "average" size penis through which you can urinate and ejaculate, can't be a woman if you have testes or can't carry a pregnancy
intersex vs transgender--a big difference b/w the 2??
Intersex people often have forced/coerced and medically unnecessary surgeries and medical procedures, whereas Trans people often have to fight to get the medical care they need **Some intersex people also consider themselves trans, but NOT ALL do
Examples of Levels of Oppression in Villarosa Story Interpersonal gender-based violence:
Intimate Partner Violence
Pudendal nerve
Is located in the perianal region at the bottom of the spinal cord It's quite the powerhouse!! - Supplies nerves to the bladder, anus, perineum, penis, areas around the scrotum, and clitoris Divides into 2 terminal branches: the perineal nerve, and the dorsal nerve of the penis or the dorsal nerve of the clitoris --A lot of sensations people experience in their genitals and pelvis during orgasm- including the spasms people often feel with orgasm or ejaculation are b/c of the pudendal nerve as well as the pelvic nerve
The clitoris functions a lot like a penis
It's not really shaped like one, but the clitoris actually has a pretty similar anatomy to a penis- has a GLANS, a FORESKIN (AKA the clitoral hood), and a SHAFT - It also SWELLS when aroused
According to Jones' article (Gardener one) Institutional and structural oppression are what parts?
Jones combines these 2 levels as "structural" These are the separate planters with dif quality soils --These are the SOILS in which the PLANT (metaphor for people) can thrive or not ***Institutional and Structural Oppression work TOGETHER- they are at the HEART of the issue in terms of experiences and outcomes of oppression
**Important to remember- these causes of OPPRESSION are??
MULTIFACTORAL --Many of these are all operating at once AND difficult to tease apart (ex. systems like: racism, sexism, homophobia, and classism)
What is the 3rd leading cause of death in US in 2016?
Medical error!! - iatrogenesis= harm due to activity of actors in the healthcare system
Graph showing a relationship b/w one's completed education and the level of health one reports --Having at least SOME college education might make for what??
Might make increased levels of reported health - Higher levels of education means more comfortable advocating for healthcare - Medical prof who are also highly educated take you more seriously - Also education= correlated with income so you can afford better healthcare as well as more nutritious food, healthier environment - Education is also correlated w/employment and this = correlated with having health insurance
Joan/John Case
Money persuaded the baby's parents that sex reassignment surgery would be in Reimer's best interest. - At the age of 22 months, Bruce underwent an orchidectomy. - He was reassigned to be raised as female and given the name Brenda. - Money further recommended hormone treatment to which the parents agreed. - Money also forced the child and their twin brother to engage in simulated sex acts as part of an attempt at "female role socialization." - For several years, Money reported on Reimer's progress as the "John/Joan case", describing apparently successful female gender development and using this case to support the feasibility of sex reassignment and surgical reconstruction even in non-intersex cases. - In the early 2000s, both siblings committed suicide.
Most systems of oppression have what types of groups?
Most have 1 privileged group and 1 marginalized group (Ex. sexism privileges men and masculinity, racism privileges whiteness)
50 to 75% of women need clitoral stimulation to achieve orgasm
Most women need something MORE than vaginal intercourse to reach an orgasm and the clitoris plays a large role in that
Graph- Percentage of Births to Mothers with Insufficient Prenatal Care in Dane County, WI, and the US Non-hispanic black women= far more likely to receive insufficient prenatal care than white women in Dane County *More broadly, black women= 3X more likely to die during or around the time of childbirth than women in the US --how is this in WI??
Much higher disparity b/w mortality rates among black women in WI even more than in the US more broadly **Note: Being a middle class black woman does not change the numbers much!! Related to: access to care b/c of occupational discrim, residential segregation, less likely to have insurance, more likely to be further from a medical provider, also provider racism
US is or is not fiscally responsible with its healthcare spending??
NOT fiscally responsible - Spends MORE of its GDP on healthcare than other countries --Healthcare spending per capita has SKYROCKETED- yet delivery remains inequitable and uneven Expends the most medical costs
Social determinants PREDICT most of the variation in population health - NOT What?
NOT health behaviors! (i.e. ind. behaviors can make SOME difference, but considered at the pop level, these structural determinants (The physical environment) social support networks, clean air, and water and soil and other factors that are really BEYOND the ind control **REALLY predict health much more accurately than individual behaviors
The anus is unlike the vagina in that it DOES NOT self-lubricate
Nerves and muscles w/n and around the perianal area play a huge part in the genital sensations of sex and sexual response even when those parts might not be directly stimulated --I.E. NOT just anal sex involves this region --ANY kind of genital sex or genital sexual response involves the perianal area no matter what you are (or aren't doing)
One of the ways that medicalization takes shape is by "pathologizing" and gendering WHAT??
Normal life events into disorders or risks that seemingly necessitate medical intervention Ex. Women: infertility, PMS, childbirth, menstrual suppression, Men: Erectile dysfunction, andropause
Levels of Oppression defined-Interpersonal
Occurs when individual members of a structurally advantaged group personally disrespect or mistreat individuals in an oppressed group. **Individual agents and targets CAN be identified. Could be caught on camera potentially --Normalized by and reinforcing of structural and institutional oppressions (Ex. racist, sexist, homophobic or ableist jokes, beatings, sexual abuse, or harassment, misgendering)
There are a lot of different textures w/n the vaginal canal
On the front wall of the vagina- may be able to feel a small spongy or textured area- (kind of like what's on the roof of your mouth) --That is the infamous G - spot or Grafenberg spot- another potential contributor to sexual pleasure and response
Still hear language used that asserts a belief in constructions of "biological gender"
Opposed medical and scientific assertions that affirm the purported health of traditional gender roles and activities and pathologize bodies that defy these norms
Biological sex
PHYSICAL features of one's BODY including genitals, internal reproductive organs, chromosomes and hormone levels, along with secondary sex characteristics like body hair, facial hair, fat-to-muscle ratio, breast development and vocal pitch **Even at a biological level, sex is NOT binary
Evidence is increasingly showing harms of these surgeries when performed without informed consent which can include:
Physical pain, loss of genital sensitivity, scarring, and sterilization, as well as significant psychological consequences and the risk that the sex assigned will not match the individual's gender identity ---B/c of these risks, intersex genital surgeries are now considered HUMAN RIGHTS ABUSES by groups like the UN, WHO, and the Gay and Lesbian Medical Association
What is Medicalization?
Process by which non-medical/social problems become defined and treated as medical problems --Usually as illnesses or disorders (Ex. PMS, birth, baldness, low libido, alcoholism) also as Dasgupta writes, disability became defined as a medical, rather than a social issue in the 19th century ***Shift from a social phenomenon to a medical one
It is a well known fact that in WI= black infants are nearly 3X more likely to die in their 1st year than W infants Broad consensus among public health scholars= these deaths are the result of??
RACISM - Both toxic everyday stresses of racism experienced over their entire lives (structural/institutional racism) AND the medical racism they routinely deal with from care providers
Graphs - Breast Cancer Incidence in US Women by Race & Ethnicity AND Breast Cancer Mortality in US Women by Race and Ethnicity --Black women = slightly less likely than white women to get breast cancer But Black women= significantly more likely to DIE from breast cancer This difference can be explained by a variety of factors linked TO???
RACISM & SEXISM!! (ex. Poorer access to primary healthcare and poorer quality of primary healthcare can both lead to LATER diagnoses)
Medicalization of disability
Refers to how IWDs have been categorized as "sick" and placed under the jurisdiction of the medical establishment and medical professionals ***This model views disability solely through the lens of impairment --Is undoubtedly related to what sociologist Arthur Frank (1995) has critiqued as medicine's investment in the "restitution narrative": the belief that all conditions are "treatable" through medical intervention, which then returns the "sufferer" to the condition of "health" and "normalcy."
Social identities definition
SES, age, body size, sexual orientation, religion, race, family status --Some more salient than others - Some can change over time, whereas others do not - Some may be a matter of choice - Some are heritable, run in families ***BUT for all of these IDs, MEMBERSHIP is NOT CASUAL - Can't just jump in and out of them ***AND they are DENSE with MEANING that comes from our social context **Name systems of oppression AFTER these social identities that they are organized around
All people start out with the same genitals in the womb
Shared embryonic phalloclitoral structures
Certain medicalized categories expand and contract
Shifts over time in the way that they are classified (ex. ASD instead of Autism)
Impact of Colonization: Colonization and the Gender Binary- W. European colonizers imposed a gender binary (with men on TOP) worldwide, including the US- often --inflicted violence on those who resisted Many (though not all) people of Americas, Asia, Europe, etc have a heritage of gender roles BEYOND a M/W binary --some Native Am use what term for such roles?
Some Native Americans use the term "2-Spirit" for such roles, but some don't ---Non-native people should not use the term "2-Spirit" for themselves
You'll see that most oocytes never see the light of day- that's b/c during each cycle about one thousand of them naturally degenerate and the cells are just absorbed by your body
Some ova remain at menopause- so no one runs out of ova before then
•Not until 7th-12th week of gestation does the embryo begin to differentiate, until then the structures are the same.
Sometimes the structures do not neatly develop into either/or categories, we'll talk about intersex conditions later (ex. For the structures on the left to develop (designated male), there needs to be an XY chromosome pairing, higher levels of testosterone For the structures on the right to develop (designated female), there needs to be an XX chromosome pairing, lower levels of testosterone)
Which 2 levels of oppression are at the HEART of the issue in terms of experiences and outcomes of oppression??
Structural and Institutional (Jones combines these 2 levels as "structural") --These are the separate planters with dif quality soils --These are the SOILS in which the PLANT (metaphor for people) can thrive or not
Levels of Oppression
Structural, institutional, interpersonal, and internalized
**Some intersex people also consider themselves WHAT?
TRANS--but NOT ALL do!
TopHat Q: T/F- the clitoris is comparable in size and structure to the penis
TRUE - (Heather Corinna reading)
Who is the gardener in the Gardener's Tale?
The GOVERNMENT - Power to make decisions, to act, control resources, not concerned with equity
social determinants of health
The STRUCTURAL conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels --includes factors like SES, education, the physical environment, employment --also access to healthcare, clean water ***Includes really much of what is going on in one's life
The only function of the clitoris= PLEASURE
The clitoris has absolutely zero reproductive functions ONLY exists to make you feel good - It's such a one-note organ that it should usually be left alone after an orgasm- with nothing left to do, stimulation on a now exhausted clitoris can lead to pain
Many people experience the frenum/frenulum and the glans as the most sensitive areas of the penis
The foreskin= FULL of sensory nerve endings and looks a lot like a turtleneck sweater for the penis
Gender and inequalities in the healthcare system 40% of hospital beds in WI= Catholic hospital systems- especially in rural areas!! Article: "Catholic Rules Forced This Doctor to Watch Patient Sicken" The issue here is about WHAT??
The issue here is about policies that result in bad medical care and increase suffering and death—not an individual person's religious beliefs. The Catholic hospital didn't carry the drug, which is commonly used for medication abortions—a failure Ralph believes was religiously motivated and needlessly prolonged her patient's labor. And in one of the country's most segregated cities, the residents said, the impact of these religious restrictions often fell most heavily on low-income patients of color. St. Joseph, which is located in a mostly Black neighborhood, and the other Catholic hospital, St. Mary's, both see a higher share of Medicaid patients—and spend a significantly higher percentage of time caring for Medicaid patients than other hospitals.
Levels of Oppression defined- institutional
The policies and practices WITHIN and ACROSS institutions like schools, hospitals, prisons that, intentionally or not, produce outcomes that chronically favor one identity group and harm or disadvantage others. --These manifest, reflect, and reinforce structural oppressions. ***reinforces structural oppression NOT individual intention at work here (Ex. disparities in incarceration of black and latinx people, Little to no medical school education on LGBTQ health, only men and women's bathrooms, no accessible bathrooms)
Since sperm cells do not thrive under acidic conditions, pre-ejaculate helps to make the conditions in the urethra favorable for the sperm to survive
The same fluid is also a component of semen itself
The average penis is a little over three inches in length
The size of a flaccid penis does not dictate the size it may be when erect - The average erect penis of a fully grown person is about five to six inches long and four to five inches in circumference - Genetics dictate size just like breasts
The clitoris is usually the most sensitive spot of the WHOLE vulva, and much more so than the vulva
The tiny glans of the clitoris alone has more sensory nerve endings than the penis or any other part of the human body --And the clitoris is the only organ in the human body whose ONLY known purpose is to provide sexual pleasure --It's attached to ligaments, muscles, and veins that become filled w/blood during sexual arousal and that contract during orgasm
All fluids from the penis, including urine come through the urethra
The urethra has BOTH a urinary function AND a reproductive one --Semen and pre-ejactulate come out through the urethra too
The vulva and vagina are NOT the same thing!!
The vulva is all of the EXTERNAL ANATOMY which includes the mons pubis, clitoris, labia minora, labia majora, urethra, vagina, perineum, and the anus The vagina is a muscular tube that leads to your uterus.
Levels of Oppression defined- Structural
The ways in which history, culture, ideology, public policies, societal values, and norms interact to maintain a hierarchy based on race, class, gender, sexuality, and/or other group identities, such that the privileges associated with the dominant group and the disadvantages associated with the oppressed group endure and adapt over time. (ex. White supremacist beauty ideals, rape culture, the narrative that Europeans "discovered" America, "supercrip" mythology, heterosexual male breadwinner as "normal" family structure)
Levels of Oppression- Institutional
The ways that these structural oppressions are BUILT INTO SOCIAL INSTITUTIONS --Like schools, workplaces, and the family Ex. Boys often get taken more seriously in STEM courses - Things like sexual harassment in the workplace - V. high rates of suspension and expulsion of B students --"The 2nd shift"
Levels of Oppression --Internalized
The ways that we begin to BELIEVE these harmful ideas within ourselves (ex. "I'm not lovable b/c I'm fat, queer, brown, etc") --Come to believe something is inherently "better" about the red flowers ***This devaluation of self can lead to RISK behaviors This is the pink flowers telling the bees that the other color is better and should be pollinated
Katsi Cook, "Women are the first environment" Cook offers a critique of the interviewer's use/conventional colonial notions of "tradition":
There are LAYERS of tradition: ancient, historical, and contemporary ---Cook emphasizes that Indigenous traditions are LIVING, DYNAMIC systems specific to each people in their ecosystem and political situation- NOT ancient, unchanging codes to be romanticized **BOTH rooted in ancestral teachings AND resilient and responsive to changing circumstances, surviving and strengthening in resistance to continuing colonization
the anatomical structures we are about to review started off how??
They started off the same in every fetus!! Genitals come in all shapes, sizes, and colors, and that's awesome!
After the public disclosures of the Tuskegee Syphilis Study, Congress passed the National Research Act of 1974 was established
This act, established to protect subjects in human experimentation, mandates institutional review board approval of all federally funded research with human subjects
At birth, Money and his colleagues pointed out, the adults surrounding the newborn identified sex based on their perception of EXTERNAL genital anatomy (genital dimorphism)
This identification initiated a social response that began the gender socialization of the newborn ***Note the hand off from sex to gender
Money contributions The theory, however, stuck. Intersex children are still operated on with the belief that it will make it easier for them to accept their gender assignment and psychosocially adjust,
Though there has never been any proof that this is the case.
Why focus on sexual and reproductive anatomy? ---Because it's political! Why learn the scientific terms?
To be able to communicate with providers, have a somewhat common language, but you should use the words that you feel are best for your body ***Also- sexual and reproductive anatomy are NOT the same things....
When a person's gender identity does NOT match up with their body in the ways demanded by the binary gender system, they might be described as WHAT term??
Transgender (or trans)--someone whose gender ID differs from what is expected of them in their culture and/or the dominant culture ---May have some kind of TRANSITION experience of going from living as one gender to living as another gender: can be social, medical, and/or legal
Medicalization and the Healthcare System Gamble argues that Tuskegee is or is NOT the primary reason for B distrust of the healthcare system?
Tuskegee is NOT the primary reason - it is only one major issue that is part of many other acts of medical violence against AAs
The Structure of the U.S. healthcare system: outcomes
US ranks 34th in life expectancy at birth Worse for marginalized groups This is for all in the US; much lower ranking for Black, Native American, Undocumented Latinx, and a number of other groups.
Graph- LGBTQ Health Inequalities --Lower rates of health insurance coverage --Lack of competent care --Homophobic and transphobic stigma --Outright violence --Lack of research at the ind and pop level --Higher rates of stress due to systematic harassment and discrimination Despite recent progress in legal equality, members of LGBTQ community continue to experience WHAT?
WORSE health outcomes than heterosexual cisgender counterparts --b/c of these, LGBTQ members are at a higher risk of cancer, mental illnesses, and other diseases ***More likely to drink, use drugs, smoke AND engage in other risky behaviors ***Members of BOTH LGBTQ & Racial Minority will often face the HIGHEST level of health disparities Ex. a black gay man faces disparities common to BOTH black and gay communities
Binary gender system
Way of thinking that says there are exactly 2 types of people existing in the world (men and women) - assumes no categories/ experiences of gender beyond M&W- no one who's both ***AND that which category you belong to says EVERYTHING anyone needs to know about your gender - No spectrum or other type
Purportedly Gendered Body Parts (Spade)
We can talk about uteruses, ovaries, penises, vulvas, etc. with specificity w/o assigning these parts a gender. - The term "internal reproductive organs" can be a useful way to talk generally about ovaries, uteruses, and the like without calling them "female reproductive organs." - We can use "people who menstruate" or "people who are pregnant" or "people who produce sperm" or other terms like these rather than using "male," "female" or "pregnant women" as a proxy for these statuses. ***Friendly reminder: Some women have a penis, some don't
Just like there's no one way to be "male" or "female," there is no one way to be intersex, either! There are lots of different kinds of traits that can cause someone to have a variation in their sex characteristics, but what intersex people have in common is WHAT??
What intersex people have in common is that their differences are either present at birth or manifest spontaneously at puberty!!
Only ¼ of the clitoris is outside the body
What most people refer to as the clitoris is generally a small hooded part of it that protrudes above the opening of the clitoral glans which are attached to the labia minora --The rest of the clitoris- usually about ¾ of the whole thing- are inside your body
The clitoris grows throughout your lifetime
When puberty begins, the clitoris starts to INCREASE in size - Usually getting 1.8 times larger by the time puberty ends - But it can grow even MORE after menopause- as much as seven times the size at birth! - These changes are relatively unnoticeable since it's so small to begin with
***Members of BOTH LGBTQ & Racial Minority will often face WHAT??
Will often face the HIGHEST level of health disparities (Ex. a black gay man faces disparities common to BOTH black and gay communities)
Many folks make assumptions of gender based on PHENOTYPE But Shlasko tried to communicate
You CANNOT make assumptions respectfully based on one's physical appearance- so ask them instead
Oppression
a SYSTEM that maintains advantage & disadvantage, is based on SOCIAL GROUP MEMBERSHIPS - Can substitute any "ism" in this definition **What is not in this definition= INTENT (doesn't care if someone is a "good" person) It's about the IMPACT--the advantage and disadvantage, NOT the INTENT
A Bit of History John Money- who was he?
a psychologist and sexologist who est. the Johns Hopkins Gender Identity Clinic in the mid 1900s - NOT a good dude --Cont. to scientific validity of idea that gender is LEARNED not innate - Also conducted terribly unethical experiments that formed basis for future ubiquity of intersex surgery - Responsible for "Joan and John case"- sex reassignment surgery in a non-intersex case --The Johns Hopkins Gender Identity Clinic became model for early treatment of "gender dysphoria", but in a pathological and difficult to access way
Gardener's Tale: Institutionalized Racism
about SYSTEMS "Systemic inaction in the face of need- that is, governmental and policy inaction" --NOT about the actions of a single individual SYSTEMIC privilege that is often or usually invisible: like white folks NOT getting followed around in stores, given the benefit of the doubt in the legal system, NOT stopped and frisked Differential access: to health care, good schools, good nutrition White people's sense of entitlement Gov disregard for clean water among Black and Native communities ***This corresponds to the soil in the planters. The very CONTEXT in which each of us lives our life.
Assigned sex
an administrative (and arbitrary) category of many institutional gateways (ex. Public bathrooms, birth certificates, passports)
Intersex
an umbrella term that refers to people who have one or more of a range of variations in sex characteristics that fall outside of traditional conceptions of male or female bodies. For example, intersex people may have variations in their chromosomes, genitals, or internal organs like testes or ovaries. an UMBRELLA term for a variety of physical traits that do not fit into the gender binary imposed on us AKA- "disorders of sex development" or "differences of sex development" Intersex is NOT the same as transgender People who are intersex are more common than you think
Idea that menstrual flow is all blood is WRONG-
average menstrual flow is only about 35 percent blood- the rest of its contents are endometrial tissue and other vaginal and cervical secretions
**Even at a biological level, sex is NOT
binary! - Among all of these factors fall along a RANGE ***even separating sex and gender isn't totally accurate b/c understandings of gender affect understandings of sex and vice versa
Common slang names for the vulva:
cuntt, puss, twat, coochie, muff, and snatch
**This paper places the syphilis study w/n a BROADER historical and social context to demonstrate WHAT?
demonstrate that SEVERAL factors have influenced and continue to influence B attitudes toward the biomedical community
Mythical norm
describes the idealized characteristics of society that hold power and bring about oppression. --America's "mythical norm" includes those in society who are "white, thin, male, young, heterosexual, Christian, and financially secure"
Gender and sex are NOT interchangeable
even though people often use them that way
Fallopian tubes (aka oviducts)
extend from uterus to ovaries (~3 inches) - site of fertilization - end closer to ovary à funnel-like divided into finger-like projections called fimbria- coax mature eggs into fallopian tubes
What is the site of fertilization?
fallopian tubes!! (AKA oviducts)
The clitoris = under-appreciated b/c most of it is NOT VISIBLE!!
glans: visible part, most sensitive (like penis), covered by hood, pokes out when more aroused shaft, or body: extends back into body crura, or "roots," "legs" flare out along pubic bone firmer erectile tissue; less sensitive bulbs underneath labia majora - spongier erectile tissue; more sensitive
health inequities
health differences that are avoidable, unfair, and unjust
Superfund Sites
in US, site contaminated by hazardous waste and identified by the EPA as a candidate for cleanup b/c it poses a risk to human health and/or the environment General Electric dumped PCBs into the St. Lawrence River upstream from Akwesasne Mohawk land for many years
Unfortunately, very few representative health-related surveys ask questions about a person's sexual orientation in addition to??
in addition to race or ethnicity --NO surveys ask similar questions about gender identity --Lack of data severely hampers efforts to serve all LGBT populations
Biomedical enhancement
includes drugs, surgeries, and other medical interventions aimed at achieving goals of the self, of bodily performance, or of appearance (ex. Aesthetic (cosmetic) surgery
"The 2nd shift"
institutional level of oppression --at home- the fact that most working women who are also parents and married to a man also work equally to spouse outside the home but are often expected to work additional hours on housekeeping
Sex differentiation
is the development of cells and tissues into various configurations of internal and external structures that we typically assign male or female This occurs at several levels: - chromosomal (XX, XY) - gonadal (testes & ovaries) - Genital structures
The myometrium is the middle layer of what??
is the middle layer of the uterine wall, consisting mainly of uterine smooth muscle cells (also called uterine myocytes), but also of supporting stromal and vascular tissue. ***Its main function is to induce uterine contractions
***our bodies have varying parts, but it is WHAT that assigns our body parts gendered meaning?
it is SOCIALIZATION that assigns our body parts gendered meaning
Epithelium = layered lining of what??
layered lining of vagina like skin but with no hair follicles, sweat glands, or sebaceous glands to weaken it **thus very resistant, protective lining! --works with acidic (pH) vaginal discharge to protect vagina from infection --home to lactobacilli à normal, essential, healthy bacteria that live in the vagina
health disparities
means that there are DIFFERENCES ATTRIBUTABLE to SYSTEMATIC DISADVANTAGES that are NOT inevitable ***They could be PREVENTED and are UNFAIR
Genital Mutilation Surgery --Although far from the only risk of these surgeries, there is a significant chance that any surgery performed to make the child's body conform more closely to the sex assigned might end up HOW??
might end up enforcing a sex assignment the individual later rejects. "If one time in 20 you're cutting a little boy's penis off, is that a risk worth taking?" Depending on the diagnosis, this risk may be relatively low, around 5 percent - but see the first quote. Is it worth it to not wait until the individual can decide for themselves? Even if the assignment ends up being "correct," having tissue non-consensually removed or altered will change the way it looks, feels, and functions in ways the individual might not desire, and these changes cannot be undone. Other studies have acknowledged rates of incorrect sex assignment up to 60%. Up to 40% of these surgeries have complications. Many require multiple follow-up surgeries.
"Shadow of Tuskegee" from the Northington Gamble article?
might impact black women's health as physicians still often stereotype, disbelieve symptoms, and otherwise mistreat and abuse black patients
The powerful legacy of the Tuskegee Syphilis Study endures, in part, because the racism and disrespect for Black lives that it entailed mirror WHAT??
mirror Black people's contemporary experiences with the medical profession.
Uterus
muscular, hormone-responsive reproductive organ ~3 inches long, but expands greatly during pregnancy - lined with the endometrium, which grows and changes over menstrual cycle, then sloughs off ***uterus essential in sexual response - directs blood flow to pelvis and external genitalia
Cisgender= one identity under or NOT under the trans umbrella??
one identity NOT under the trans umbrella ---Cisgender is not BAD, just a descriptive term to not "other" trans people
Cervix
opening to the uterus- about 4 cm long - Projects about 2 cm into vaginal cavity - Internal and external aus - Firm in a non-pregnant person
Cisgender
opposite of trans, someone whose gender identity basically aligns with what's expected of them based on their assigned sex
Corinna reading - Hymen (aka corona)
over vaginal opening- very rarely that it completely covers it- almost always slightly perforated - No known physiological function But STRONG CULTURAL meanings "Popping one's cherry"
***Cook emphasizes SURVIVAL & CONNECTION TO THE LAND and its plants But that people and environment also face WHAT?
people and environment also face the terrible ongoing effects of colonialism (ex. PCBs in pregnant mother's breast milk)
Intersex
ppl whose bodies are not easily categorized as simply M/F Sometimes is apparent at birth, other times not until puberty **Many dif reasons a person's body might be difficult to categorize (ex. unusual chromosomes (e.g. rather than XX or XY, people can have XXY, XXX) to hormone levels that differ from pop. averages, to genital anatomy that doesn't look like what we're used to.
paraurethral glands (Skene's glands):
produce clear moist fluid to lubricate urethra source of ejaculation
Gardener's Tale: Personally Mediated Racism
racism from teachers and peers; can be INTENTIONAL OR UNINTENTIONAL---*****What counts is IMPACT - Ex. could be a white prof asking a student of color to be a spokesperson for their racial or ethnic group - This communicates there is no single point of view among a community of color, but not among white folks --Also o puts the community of color under the microscope to be looked at and picked apart, while white people are the ones who get to do the looking. - Also medical racism, like doctors disbelieving Black women when they report their symptoms—something that almost killed Serena Williams (gardener's preference for one kind of flower over another)
Down-fending
ritual seclusion (mother and fetus together) --this idea of down fending and of our first environment being projected through the life cycle, come to us from our Mohawk creation story. Main message to MOON magazine readers is that you should learn the ecosystem of which you are a part, where you live now --Think of the region where you live as a biosphere idea of biospheres that are protected and maintained by the indigenous people of that region
Transgender
someone whose gender identity differs from what is expected of them in their culture and/or the dominant culture ---May have some kind of TRANSITION experience of going from living as one gender to living as another gender: can be social, medical, and/or legal
Urethral Sponge, AKA "The G Spot"
spongy cushion of tissue and blood vessels on urethra side of vagina ---erectile tissue that surrounds urethra; swells during arousal to feel: hook fingers in vagina, curl toward belly button feels different than other surfaces in vagina ***area known as G-spot ~ pleasurable for some, painful for others
Gender
system of CATEGORIZING people according to factors like anatomy, identity, appearance, and mannerisms, and attributing MEANING to those categories - Diff cultures have dif gender systems (men, women, & other categories) - Varies over time, space, and cultures
"Supercrip"
term from critical disability studies and activism --Stereotype of PWDs who is "overachieving, possesses a "can-do" attitude, and does AMAZING! And INSPIRING! Things and can thus "overcome" his or her disability... ---Supercrip's main function is to serve as inspiring to the majority while reinforcing the things that make this majority feel awesome about itself. ***In short: Supercrip provides a way for non-disabled folks to be "inspired" by PWDS w/o actually questioning- or making changes to- how PWDs are treated in society.
The Tuskegee Syphilis Study-
the 40-year government study in which 399 black men from Macon County, Alabama were DELIBERATELY denied effective treatment for syphilis in order to document the natural history of the disease ---The study has come to symbolize racism in medicine, misconduct in human research, the arrogance of physicians, and government abuse of Black people.
"restitution narrative"
the belief that all conditions are "treatable" through medical intervention, which then returns the "sufferer" to the condition of "health" and "normalcy."
Why America's Black Mothers and Babies Are in a Life-or- Death Crisis" NYT Sunday Magazine (CANVAS) The answer to the disparity in death rates has everything to do with what??
the lived experience of being a black woman in America - symptoms were associated with stress of racism in her life
Medicalization
the process by which non-medical (or social) problems become DEFINED and TREATED as medical problems, usually as illnesses or disorders --Historically, women's life experiences have been more medicalized than men's ***gendered undercurrent still usually exists
Inguinal canals
the two passages in the anterior abdominal wall which in people with testes house the spermatic cords and in people with a uterus the round ligament of uterus. -- Larger in people with testes. Also, Hernia: protrusion of abdominal-cavity contents through the inguinal canal
Gardener's Tale: Internalized Racism
the ways we begin to believe these harmful ideas w/n ourselves: feeling that one is not lovable b/c one does not conform to racist, ableist, and sizeist beauty standards, b/c one is queer --Corresponds to the PINK flower's preference for red pollen
Health inequalities-
there is a difference in EXPERIENCE or outcome when comparing one or more populations --Just means a DIFFERENCE in outcomes
Which part of female anatomy = essential in sexual response??
uterus!! essential in sexual response ---directs blood flow to pelvis and external genitalia
Internal Anatomy Full of mucous membranes
vagina= a flexible muscular tube to the uterus at a 45 degree angle cervix= opening to uterus Rugae in vagina
The ovaries produce hormones estrogen and progesterone
which are responsible for the development of sex characteristics, ---but which also keep the genitals flexible, elastic, and lubricated and help keep the vaginal lining healthy Some estrogen is also produced by fat tissue ---The ovaries ALSO produce the hormone testosterone (and the adrenal glands in the body elsewhere produce this hormone too)
Inequalities in Health Insurance Access Fewer US women of reproductive age were uninsured in 2015
women much more likely to be uninsured or underinsured than men - 19 million uninsured women in US in 2014 - 24% of pop'n of adult women occupations less likely to provide benefits - primary caregivers ~ work part time
List some terms under the Trans Umbrella
•Transsexual, Transgender, Genderqueer, Gender fluid, Bigender, Agender, Gender-questioning, Gender-nonconforming, Cross-dresser, Trans woman, Two-Spirit