“It benefits the patriarchy to keep people ill-informed.” Dr. Jen Gunter sits down with Ms. to discuss her new book, BLOOD, which covers everything medicine, misogyny and activism.
Dr. Jen Gunter’s third book, BLOOD: The Science, Medicine, and Mythology of Menstruation, is an accessible look at how the patriarchal control of medicine has allowed misinformation about reproduction, sexuality and anatomy to flourish in a myriad of ways.
The comprehensive volume blends personal stories and hard facts about menstruation into an engaging, and often funny, book that tackles everything from “normal” blood flow, to the latest research and treatments for cramps, endometriosis, menopause, PMS and other gynecological issues.
Politics are ever-present in the text as Gunter assesses gender bias in research, debunks “natural cures,” and addresses pervasive fears about the safety of tampons, hormonal contraceptives and menopause treatments. BLOOD also zeroes in on deficits in medical training and provides clear ideas about improving care.
“Without knowledge, there can be no informed consent,” Gunter wrote. “My goal is to provide a solid background to help you better understand what is happening with your body and why.”
Gunter sat down with Ms. reporter Eleanor J. Bader a week after the book’s release for a wide-ranging conversation about medicine, misogyny and activism.
Eleanor J. Bader: Let’s start with how doctors are trained, since so many people feel ignored or condescended to when they describe gynecological problems.
Dr. Jen Gunter: Communication skills are badly taught in medical school. I was lucky. I’m Canadian and, in retrospect, I realize that my training at the University of Manitoba was special.
As students, we were in the hospital ward where we learned to put classroom knowledge into practice. We were constantly reminded that it is a privilege to provide medical care and that the human aspect of the work needs to be our first-and-foremost priority. It also helped that our classes were pass/fail. Collaboration was valued. Competition was not.
Bader: You also write that your ideas about compassionate care were reinforced when you, yourself, became a patient.
Gunter: My sons were born prematurely and some of the doctors I dealt with in the aftermath of their birth, and my own sepsis, were lovely and some made me cry. It was a lightbulb moment.
I remember one gastroenterologist who talked over me as though what I was telling her could not possibly be right. It was eye-opening to see what it’s like to be ignored. It made me pay greater attention to my patients and I always ask them to go back to the beginning. Not to start with their current symptoms, but to tell me their full history.
This, however, is not encouraged and doctors can lose their humanity when they see person after person, day after day. The fact that private equity firms are gobbling up hospitals makes it unsurprising that doctors can seem dismissive. When your boss tells you that you can’t spend more than 12 minutes with each patient, even the best doctors in the world can seem like assholes.
Add in racism and sexism and the issue is compounded further.
Most upper management in medicine is still male and there is a big glass ceiling. This is true despite half of all medical students now identifying as female.
Another factor is that obstetrics and gynecology require practitioners to not only see patients in the office, but also work in labor and delivery. This makes venture capitalist’s takeover of medicine even more calamitous because gynecological practices around the country are shutting down because they’re not profitable enough. Equity firms want to concentrate on obstetrics because that’s where the money is.
It was eye-opening to see what it’s like to be ignored. It made me pay greater attention to my patients and I always ask them to go back to the beginning. Not to start with their current symptoms, but to tell me their full history.
Dr. Jen Gunter
Bader: The profit motive further collides with sexism when it comes to research, and your reporting on disparities in funding for endometriosis and Crohn’s Disease is shocking. Both disorders impact similar numbers but in 2022 endometriosis research received $16 million from the National Institutes of Health while Crohn’s research received $90 million.
Gunter: When doctors dismiss women’s pain, a disease like endometriosis can seem unimportant.
People with Crohn’s have seen the development of incredible new drugs. It’s wonderful, but medicine has not made the same advances for endometriosis because the pain of people with uteruses is not taken as seriously. Even more egregious, Black people’s pain is typically discounted, leading to well-documented disparities in birth outcomes and maternal mortality.
Schools should prepare students for life, and that means instruction in everything from puberty to menopause. But it benefits the patriarchy to keep people ill-informed.
Dr. Jen Gunter
Bader: You are a firm believer in science and stress that you do not recommend supplements or visits to the chiropractor or naturalist for healthcare.
Gunter: As far as I’m concerned, chiropractic “medicine” is pseudoscience. It concerns me that people spend money and risk their health without evidence that particular “cures” are effective. A study of prenatal supplements by the General Accountability Office, released in December 2023, found that most were contaminated or mislabeled. That’s concerning.
People deserve to know what they’re putting into their bodies. Pharmaceuticals are tested; supplements, for the most part, are not, and consumers pay the price for this lack of oversight.
Similarly, the acupuncture studies I’ve seen are of low quality, but if people want to try it, so be it. Everyone needs accurate information in order to make empowered decisions.
To me, being a feminist means demanding proof, hard facts, so that we have real agency over our bodies and health.
@drjengunter #stitch with @New Society Podcast ♬ The Great Gig in the Sky – Pink Floyd
Bader: You also provide a sobering warning about online period trackers. What worries you about them?
Gunter: It takes very little to track the information that’s stored. If you live in a state where abortion is illegal, there are possible risks of having this information readily accessible.
In addition, these apps are not always accurate and people blame themselves if their period does not come when the app predicts. I think it’s best to use a calendar, marked with X’s and O’s. You can use paper records, or can use your phone as long as the data does not end up on the cloud.
And remember, apps that are “free” are selling your data. There is no such thing as a free app. It makes sense to be cautious.
Bader: So much of the information included in BLOOD could and should be taught in sex education classes. Unfortunately, the U.S. rightwing has kept the material under wraps. Is there momentum to change this?
Gunter: Sex education is a joke in most school districts and focuses only on abstinence. If we stepped back and framed education around biology, healthy relationships, and honest conversations about good sex and pleasure, we’d be a healthier society.
Schools should prepare students for life, and that means instruction in everything from puberty to menopause. But it benefits the patriarchy to keep people ill-informed.
There is also still squeamishness. Neither of my previous books got me onto the morning talk shows. I’ve been told this is because viewers do not want to hear the word vagina on television since young children might be watching. This is how we stigmatize a body part.
Filling knowledge gaps is a form of advocacy. Basically, I want my work to democratize knowledge and make a difference in people’s lives.
Dr. Jen Gunter
@drjengunter If you have a uterus and are taking menopausal hormone therapy, you need a progestin or progesterone otherwise there is a significant risk of cancer! This doesn’t apply to vaginal estrigen meant to stay in the vagina #menopauseminute #menopause #menopausemanifesto ♬ original sound – jennifer gunter
Bader: BLOOD identifies numerous myths around menstruation, including the idea that bleeding should happen every 28 days and that tampons cause infections.
Gunter: I don’t know where the 28-day idea originated, but a “normal” cycle is 24 to 38 days. We now know that there’s a range of normal.
“Purity culture,” the idea that all chemicals are harmful and that the body should remain free of them, promotes many tall tales. There is no asbestos in tampons. They can’t make your uterus fall out and they don’t increase menstrual flow or cause endometriosis.
The fallacy that the HPV vaccine will wreck future fertility has also been promoted and it, too, is untrue. If all children got the vaccine at 12 or 13, cervical cancer would be eliminated. But anti-vaxxers and those who want to control the sexual behavior of youth, have kept this from happening.
Then there’s menopause. Once we enter menopause and can no longer breed, we’re generally treated as valueless. Many of us enter menopause and are clueless about it.
One of the dirty secrets of OB-GYN training is that many doctors are not taught about office gynecology, or the instruction they receive is poorly taught. It goes back to what we talked about earlier, money, profit, and the fact that conversations are not money makers. Of course, this extends beyond gyn care.
Years back, the U.S. had fantastic county health offices and clinics to treat sexually transmitted infections, but most have been closed down. The result is that we’re seeing increasing numbers of babies born with congenital syphilis, which has lifelong health consequences.
We no longer invest much in public health, but public health matters. The government should be funding clinics as well as vaccines, and promoting models of wellness. Instead, it’s fallen to entrepreneurs like Dallas Mavericks Owner Mark Cuban and his Cost Plus Drugs to make prescription medications more affordable.
Bader: Your books make clear that doctors can be powerful advocates, but very few have stepped up. Why is this?
Gunter: Not everyone likes to speak publicly, and I don’t think we can expect every doctor to do everything. Those who are comfortable about being outspoken should do so.
At the same time, many doctors are afraid to speak up due to a concern about their job or even personal safety, and possibly even criminal prosecution (regarding abortion). Gun violence has made some inroads in changing this, so perhaps we’ll see more down the road.
On a visceral level, I think we all want to believe that there are simple fixes for complex problems and that someone else will handle it.
For me, it’s about promoting honesty. People deserve to know the truth about their bodies and learn to value those who are born female as much as they value those who are born male.
Filling knowledge gaps is a form of advocacy. Basically, I want my work to democratize knowledge and make a difference in people’s lives.
You can find BLOOD: The Science, Medicine, and Mythology of Menstruation by Dr. Jen Gunter online and in bookstores today.
Tallulah Costa provided editorial assistance with this piece.
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