“Perhaps the simplest way to begin is to plunge a knife into the male urethra”

“Anatomy is one of the key sites for the production and maintenance of sex and gender as embodied dualities, as these excerpts imply. It offers an institutionalized discourse rife with vivid representations which claim the body for medicine and then insist on simplification and universalization.”

[Lisa Jean Moore and Adele E. Clarke, "Clitoral Conventions and Transgressions: Graphic Representations in Anatomy Texts, c1900-1991", Feminist Studies, Vol. 21, No. 2. (Summer, 1995), pp. 255-301.]

Inspired by ladoctorita’s “sins and virtues in medical education, part 2: pornification”, I’ve been contemplating genital anatomy as it was taught in twentieth-century medical school.

My medical school used Grant’s Method of Anatomy. A relative of mine went to the same school in the mid-twentieth century, so I have a 1989 edition and a 1958 edition to compare.

1958

The 1958 edition describes the male perineum first. For nine pages. This section isn’t labelled “The male perineum”, however – it’s just “The perineum”. The natural, default body is the masculine body. There are segments on the anal triangle, the urogenital triangle, two pages on the penis, the superficial perineal muscles, the deep perineal pouch, the nerves and vessels, and how to expose the prostate.

“The Female Perineum” follows. (Yes, intersex bodies are invisible.) The female genitalia are described not as anatomical structures in their own right, but as simplified, mutilated male genitalia. Homologous parts in the female are rudimentary, simplified, diminutive. You can’t just describe something like this – so I’ll regale you with the author’s words, and some of the accompanying illustrations:

Filed under: Science, birth, medicine

Fundiewatch: a Catholic prenatal diagnosis “counselling service”

Two of our local Catholic hospital networks have collaborated to offer a new so-called “counselling service, dubbed “Mamreh”. These two hospitals combined have a lot of community credibility already, as they provide the vast majority of private-hospital maternity services in this State. Baby-catching (or baby-cutting-out, for over half the births in these hospitals) is big business around here.

Mamreh has been taking out full-page ads in the local medical rags pushing their “counselling service” to doctors. The advertisements make no disclosure of the Catholic-medicine rider that the service operates under – which means no condoning, recommending, or counselling on termination of pregnancy, except in cases where the mother’s life is at substantial risk.

This service’s stated purpose? Counselling on prenatal genetic screening and diagnosis. Stating the bleeding obvious, the ad I’m looking at says, “Prenatal genetic screening and diagnostic test information can have profound medical, psychological, and social implications”. No kidding. It goes on, “To add to this there is often only a limited time in which to make critical decisions about a pregnancy.”

This window of defencelessness is crucial. Fundies want to ensure that women are rapidly bustled by their trusted doctors or midwives into a “counselling service” whose primary goal is to hide information from them. The ultimate goal of this type of counselling is to obfuscate information on options and to coerce women into continuing a pregnancy whether they wish to or not – or at least, to delay them just long enough so that the window for a readily accessible termination of pregnancy closes.

Fundies have been pulling this crap in Australia for years, first with tacit government approval and now with open government funding and encouragement, thanks to our papist Health Minister. Attempts to get fraudulent “unplanned pregnancy counselling services” to declare their “faith-based” bias up front have thus far failed.

And now these malignant woman-hating godbags are expanding their vile game to even more vulnerable women – those who are in the initial throes of learning that their fetus has a severe medical problem.

The Mamreh ad veers from there into outright sleight of hand:

“Mamreh Counselling Service explores self, motivations, beliefs and faith in the context of a patient’s own personal, cultural and social situation.”

Would you read this as saying that if your belief system allows termination of pregnancy in the event of severe congenital defect, the service would offer unprejudiced counselling on, and referral for, termination of pregnancy? Well, stop right there. This is not the case. Not remotely.

Do NOT go to this service, or any service like it, unless your goal is to be railroaded into continuing your pregnancy come what may. If a friend or relative has been referred to this service, make sure they know what they’re in for BEFORE they cross the threshold and the forced-birther brainwashing and guilt trips begin. A woman in this awful situation needs absolutely unqualified, unconditional support throughout her decision-making process.

Lying lies and the lying liars who tell them. We hatesss them, we does.

Filed under: ethics, fundies, medicine, obstreperation, reproductive freedoms

New Yorkers always tell us not to bother with Long Island anyway

If I never go to Long Island then I never have to worry about some unfortunate accident bringing me or someone I love under the knife of neurosurgeon Michael Egnor, who is a professor of neurosurgery and paediatrics at State University New York (Stony Brook), and who apparently doesn’t accept that the mind arises from the physiological properties of the brain.

Lest someone accuse me of oversimplifying Egnor’s dumbarsery with my summary above, I can’t see any other way to describe his argument: he’s reifying “altruism” as a concrete concept separate from observable altruistic actions taken by a thinking being, and then arguing that if we can’t point to the place in the brain where altruism is situated then something magical happens and then the creationists win. This essentially comes down to arguing that mind is entirely separate from our physical bodies and not actually dependent upon the physiology of the brain.

Yeah, I’d so want him cutting into my grey matter. Not.

I don’t understand how someone like this functions without collapsing under the weight of the cognitive dissonance they have to studiously ignore as they go about their professional day.

More Egnorance at the Panda’s Thumb.

Filed under: creationists/ID, medicine, skeptics

Blood on her shoes: hospital safety equipment and embedded sexism

There were no size 5 gumboots on the surgical unit.

I was doing a six-month obstetrics & gynaecology residency. I looked all through the women’s theatre changeroom. I found nothing but single-use elasticated paper shoe covers, and a few pairs of clogs and sneakers. I sneaked into the men’s theatre changeroom. There were lots of pairs of white gumboots, but nothing smaller than a size seven. (This is men’s sizing; my size 5 feet are the average size for a woman). I tried the sevens on, but I couldn’t walk in them safely. Not an option for an OB/GYN resident rushing from place to place.

I asked theatre staff about smaller gumboots.
“All the female residents before you just wore the shoe covers over their street shoes”, came the bemused reply. “Why do you have a problem with that?”

Have you ever been at a C section? Right up close, I mean — assisting? There’s a reason obstetric staff don a huge shin-length plastic apron before putting the sterile gown on. And it’s not just because some surgeries can involve blood splashes. When a women’s uterus is cut open, amniotic fluid gushes – sometimes fountains – out. Typically, it gushes toward the assistant, possibly because the obstetrician isn’t so keen to take a shower in it, and positions the operative field accordingly. Being quick with a suction tube can help, as can leaping away from the table at a strategically-timed moment. But if it’s under pressure in there, and especially if it’s a “crash” section (luckily, we did few of these), the assistant can expect to have bloodied body fluids dripping off the bottom of their gown at least some of the time.

Filed under: medicine, obstreperation

Harradine’s poverty legacy continues

Sue Dunlevy writes an excellent column today on the legacy of Senator Brian Harradine, who held the balance of power in the Australian Senate for long enough to drag our foreign aid policy into a position whereby, Dunlevy argues, we actively perpetuate poverty through being forbidden to provide family planning services as part of foreign aid programs.

Harradine left parliament in 2004 and the Howard Government now controls the Senate in its own right, but Harradine’s legacy lives on. A pity that can’t be said for scores of women worldwide, some 186 of whom die every day – according to one estimate – from unsafe abortions.

Edited to add: I missed the story last week whereby Harradine has denounced plans to lift the Harradine Amendment on funding that promotes family planning to alleviate poverty:

“Any attempts by members of the House of Representatives – (Mal) Washer and (Warren) Entsch – to allow scarce foreign aid funds to be used to, quote promote abortion as a method of family planning, should be condemned,” Mr Harradine told AAP.

More on the Washer/Entsch movement to lift the Harradine Amendment [here].

Dunlevy’s column points to her own family history of women relatives mired in poverty through having too many mouths to feed, and goes on to note

Being able to control our fertility is what has made the feminist revolution possible.

But in hundreds of countries around the world today, still millions of women are enslaved, like my great aunts, by their fertility.

They don’t have access to the contraception which would stop them getting pregnant in the first place.

And when their abject poverty leads them to abort the unwanted babies they can’t support, 13 per cent of them will end up dead.

Aid agencies from the World Health Organisation to the UN now recognise that birth control is one of the primary solutions to world poverty.

As policy currently stands, we are saying to the poor people of our region that we don’t care about promoting a blatant double standard in our foreign policy:

Filed under: activism/charity, culture wars, health, law, medicine, reproductive freedoms

Cancer genes and other factors

There’s been a lot of press this last week about the reported breakthough in genome testing that will pinpoint clusters of imperfectly-copied genes that increase the risk of inheriting breast cancer. Much of the excitement is due to the fact that the technique can be equally well used in testing for other genetic combinations that increase the risk of developing cancers of all sorts, not just the breast tissue.

There’s no doubt that it is an exciting development indeed. There’s been plenty of hoopla, and the scientists who developed this will no doubt do very well from it, and so they should. However, I want to pinpoint one aspect that’s missing or at least glossed over in a lot of the coverage of the original Nature article detailing the new technique: inherited cancer vulnerability doesn’t explain most diagnosed cancers.

Contrast this fairly typical coverage from Business Weekly:

Two of the genetic regions they identified contain genes that are thought to increase breast cancer risk by about 20 per cent in women who carry one faulty copy of a gene and by between 40 and 60 per cent if they carry two faulty copies.

The lifetime risk for women who carry two faulty copies in either of these two genes would rise from one in 11 to around one in six or one in seven, respectively.

With this from Medical Laboratory World:

Breast cancer that is caused by inherited genetic faults is thought to account for around 5% to 10% of the 44,000 new cases diagnosed each year.

They’re both actually saying the same thing about the proportion of inherited gene factors leading to cancer, but one is using obfuscation to glide by it and the other is being clear about how inherited genetic faults are a minority of cancer cases.

Now obviously, if people with a genetic vulnerability know of it and are thus more aware of possible early symptoms and thus seek early treatment, this has the potential to save thousands of lives, or at least to prevent them from having to undergo radical surgery if their cancer can be treated less invasively and still be controlled. But what are the factors thought to be oncogenic amongst the 90-95% of breast cancer patients diagnosed each year who aren’t thought to have a particular genetic vulnerability?

Filed under: health, medicine