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Women and Health: Feminist Perspectives PDF

216 Pages·1994·3.467 MB·English
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Women and Health Page Intentionally Left Blank Women and Health: Feminist Perspectives Edited by Sue Wilkinson and Celia Kitzinger t:?\ Taylor & Francis ~ Taylor&FrancisGroup LONDON AND NEW YORK ©Selection and editorial material copyright Sue Wilkinson and Celia Kitzinger, 1994 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without permission in writing from the Publisher. First published 1994 By Taylor & Francis, 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN 711 Third Avenue, New York, NY 10017 Transferred to Digital Printing 2011 A Catalogue Record for this book is available from the British Library ISBN 0 7484 0148 2 (cloth) ISBN 0 7484 0149 0 (paper) Library of Congress Cataloguing-in-Publication Data are available on request Typeset in 10/13 pt CG Times Roman by ROM Associates, Lord Street, Southport, England Publisher's Note The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original may be apparent. Contents Introduction Feminist Perspectives on Women and Health 1 Sue Wilkinson and Celia Kitzinger Chapter 1 All in Her Mind! Stereotypic Views and the 7 Psychologisation of Women's Illness Ellen M. Goudsmit Chapter 2 Young Women and Safer (Hetero)Sex: Context, 13 Constraints and Strategies Rachel Thomson and Janet Holland Chapter3 'I'm Not Fat, I'm Pregnant': The Impact of 33 Pregnancy on Fat Women's Body Image Rose Wiles Chapter4 Reproductive Health and Reproductive Technology 49 Pat Spallone Chapter 5 Waged Work and Well-being 65 Lesley Doyal Chapter 6 What Can She Depend On? Substance Use and 85 Women's Health Elizabeth Ettorre Chapter 7 Surviving by Smoking 102 Hilary Graham ChapterS Towards a Feminist Approach to Breast Cancer 124 Sue Wilkinson and Celia Kitzinger Chapter 9 A 'Cure for All Ills'? Constructions of the 141 Menopause and the Chequered Fortunes of Hormone Replacement Therapy Kate Hunt Chapter 10 Widows' Weeds and Women's Needs: The Re- 166 feminisation of Death, Dying and Bereavement Jane Littlewood Chapter 11 Feminist Reflections on the General Medical Council: Recreation and Retention of Male 181 Power Meg Stacey Notes on Contributors 203 Index 205 Introduction Feminist Perspectives on Women and Health Sue Wilkinson and Celia Kitzinger This book began life as a symposium at the 1992 Annual Conference of the British Psychological Society. Entitled 'Women and Health: Feminist Perspectives', this symposium was unusual in at least two respects. First, it included cutting-edge research originating within a variety of disciplines (including cross-disciplinary and multidisciplinary work), not just from within psychology; and, second, its focus was feminist research on health, rather than health research on women (Graham, 1993a). Although there has been a recent upsurge of interest in women's health as a topic within psychology (e.g. Nicolson and Ussher, 1992; Niven and Carroll, 1993; Travis 1988a, 1988b) and sociology (e.g. Abbott and Payne, 1990; Miles, 1991; Stacey, 1988), most of this work has remained within the confines of disciplinary boundaries. Moreover, within psychology, very little of it has been conducted within a feminist framework. Perhaps for this reason, the 1992 symposium attracted a great deal of interest, and we were subsequently invited to guest-edit a Special Issue of Health Psychology Update (Wilkinson and Kitzinger, 1993), focusing on specifically feminist research on women's health. In so doing, we included contributions from researchers in and across a number of other disciplines, in order to exemplify the best of contemporary feminist research in the area. As the project expanded and developed into an edited volume, these two features - a feminist focus and a multidisciplinary range of contributors - remained central to our selection of material. All of the contributors included here acknowledge gender-based inequities in women's experiences of health and health care, and address the need for social and political change.l This volume constitutes, we believe, the most important collection of feminist research on women's health since 1 Sue Wilkinson and Celia Kitzinger Lewin and Olesen's (1985) Women, Health and Healing. It is more comprehensive than that volume (the research represented here spans the disciplines of psychology, sociology, social policy, social anthro pology and economics), and also demonstrates the development of feminist theorising and activism in relation to health over the past decade. Of course, the contributors to this book do not agree on definitions of feminism; nor do they identify the same key issues facing women in relation to health; nor do they advocate the same strategies for change. While recognising external resistance to change from organised medicine and other interest groups (see, for example, Meg Stacey's chapter in this volume; Walsh, 1977), the women's health movement is divided internally over inequities due to differences between women (including 'race', class, sexual identity, age and (dis)ability), and the specific priorities and forms of intervention these require. In this volume, we have not addressed such differences as discrete categories,2 but have asked our contributors to weave considerations of difference throughout their chapters. Mindful of major national differences in historical and political context between western industrialized countries, and, particularly between British and North American feminist campaigns on health related issues (see Lewin and Olesen, 1985, pp. 3-7), we invited only British contributors to this volume. We asked contributors to reflect on cross-Atlantic, and broader international, differences (see, in particular, Doyal, this volume) wherever appropriate; however, such reflections come from a British perspective on these issues. We do not even begin to address the task of major cross-cultural comparison, nor do we survey the issues relating to women and development, although there is a growing literature in these areas: e.g. Jacobson, 1990, 1991; Koblinsky et a/., 1993; Whelehan, 1988. In contrast to a number of books on women's health (e.g. Roberts, 1978, 1992; Graham, 1984), we have not placed any special emphasis on women's traditional, particularly reproductive, roles- the chapters by Wiles and Spallone are the exceptions. 3 Rather, the eleven chapters included here consider the issues surrounding women's health and wellbeing across a broad range of activities and different stages of the lifespan. The first and last chapters 'frame' the more specific considerations of particular health issues with a general analysis of the operation of male power in organised medicine - a theme which also threads through a number of other chapters. Ellen Goudsmit's opening chapter 2 Feminist Perspectives on Women and Health considers the ways in which women's health problems have often been trivialized or dismissed by - mostly male - health care practitioners as 'all in the mind', while Meg Stacey draws on her personal experience as a member of the General Medical Council to expose the ways in which one of the statutory bodies of British medicine creates and maintains its deeply patriarchal power base. In both analyses, the actual experiences of women - as medical 'consumers' or as Council members - are shown to be conspicuously absent. The remaining chapters are organised -loosely- on a 'lifespan' basis. Chapters two, three and four deal, respectively, with early (hetero)sexual experiences, pregnancy and body image, and the impact of reproductive technologies. Rachel Thomson and Janet Holland look at young women's practice- or otherwise- of 'safer' (hetero)sex in the context of gendered power relations, and offer suggestions for services and education in sexual health which are more appropriate to women's needs. Rose Wiles's chapter reports a study of 'fat' women's feelings about changes in their weight and body image during and after pregnancy. Most of these women reported feeling more satisfied with themselves and more socially acceptable during pregnancy, and Wiles locates these findings within the context of the prevailing ideal ized/sexualized images of femininity produced by men, and accepted by the majority of women. The formal operation of male power is the focus again in Pat Spallone's contribution. She examines how scientific priorities shape the medical development of new reproductive technologies, largely ignoring tQe specificities of women's bodies, and promoting the ideology of the heterosexual nuclear family, with scant assessment of the long-term health risks entailed. The next three chapters look, broadly, at work and at activities construed by some women as 'leisure'. Lesley Doyal provides a broad overview of the relationship between work outside the home and women's health, focusing on the physical and psychological hazards which reflect sexual divisions both in the structure and organisation of waged work and in the wider society. Elizabeth Ettorre's and Hilary Graham's chapters both consider women's use of substances. Ettorre provides a feminist critique of much traditional work on substance use (including food, alcohol, cigarettes, tranquillisers and other drugs), and Graham focuses specifically on the relationship between gender divisions, poverty and smoking. Drawing on women's own reported experiences of smoking, she considers the extent to which this 'habit' may offer an antidote to the boredom, isolation and stress that can accompany full-time caring for young children on a low income. 3

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