Medical Misogyny?

While we’re on the subject of terminology…

Here’s a list of some of the actual diagnoses a woman might receive regarding her reproductive system:

  • Diminished ovarian reserve
  • Premature ovarian failure
  • Incompetent cervix
  • Hostile cervical mucus

Yikes. Sounds like a pretty damning list of inadequacy, doesn’t it?

Meanwhile, what do men get?

  • Low sperm count
  • Azoospermia (absence of motile sperm in the semen)
  • Erectile dysfunction
  • Retrograde ejaculation

Still not fun to hear. But at least they’re more or less accurate, fair-enough, scientific-sounding verdicts. If they got the same treatment women get, it’d sound more like:

  • Wimpy sperm count
  • Testicular failure
  • Incompetent penis
  • Stupid semen that gets lost and doesn’t ask for directions

If these were real diagnoses, you’d be forgiven for suspecting the medical profession was made up of a pack of man-haters, wouldn’t you?

Luckily no one would be such a — pardon me — dick as to tag a man with these labels when he’s already dealing with a difficult diagnosis.

Yet women are routinely kicked while they’re down with words like diminished, hostile, failure, incompetent. Why is that, I wonder?

The diagnoses could just as easily be:

  • Low ovarian reserve
  • Early menopausal symptoms
  • Premature cervical dilation
  • Incompatible cervical mucus

Sounds a bit less… how shall I put it… “fuck-you-barren-whore,” doesn’t it?

I think it does.

More sciency, less judgy, please. Whom do I write to to complain about these things anyway?

Was it this guy?
Was it this guy?

Speaking of cervical mucus… If you don’t know what that is, it’s the stretchy, silky, clear liquid that emanates from the base of a woman’s womb around ovulation time, signaling she’s in the middle of her fertile window, and it’s an awesome time to get busy. It’s arguably the sexiest liquid there is, and people who are trying to conceive tend to talk about it a lot because it is important to the reproductive process for many reasons.

And yet it’s named after something that makes people think of infected sinuses.

Not. Sexy.

If doctors must insist on using that term in the interest of technical accuracy or consistency, that’s their problem. The rest of us should be free to come up with our own word in everyday speech.

I tend to call it ‘cervical fluid.’ If we put our heads together, I’m sure we can think of something better. Sexy gloss? Silky stream? Baby glide? Sex river? Sperm slip-n-slide? Leave your suggestion in the comments.

Or just call it ‘cervical fluid.’ Anything but ‘mucus’ for God’s sake.

Uhh... what were we talking about again?
Uhh… what were we talking about again?

Why, yes, I am trying to rethink the terminology surrounding human reproduction to make it more woman-friendly and sex-friendly.

I hope you’ll join me. 🙂

Infertile? Objection!

I really, really hate the word ‘infertile.’

No kidding, right?

But in all seriousness, it’s a sloppy and offensive use of language almost on par with ‘Israeli Defense Forces.’

I understand that, medically speaking, one may need a scary-sounding diagnosis to justify certain prescriptions and (if one is lucky) insurance coverage.

But in day-to-day parlance, the term is not only demoralizing, it’s also illogical.

This post will explain why.

Fert3

Let’s start with the sloppy part. To be diagnosed as ‘infertile,’ a couple has to have had one year of unprotected sex with no baby to show for it. From what I’ve heard, this happens to about one in eight couples trying to conceive. A surprisingly large number, right?

But the majority of them — around two-thirds — will go on to have biological kids.

Call me crazy… but that doesn’t sound very ‘infertile,’ does it?

I mean, if someone has cancer with a 66% chance of survival, should he be diagnosed as ‘dead’?

No.

OK, so what about the remaining one-third of the one-eighth who don’t manage to produce biological kids and decide to build their family in alternative ways or to live childfree? Should they be diagnosed as ‘infertile’?

Not really. Some of them — a minority to be sure — end up having happy surprises. So, extrapolating backwards, it turns out they weren’t infertile after all.

What about the ones who reach menopause without any happy accidents?

Even then you can’t know for sure if they were truly ‘infertile’ or just unlucky.

What about when a woman reaches menopause? Is she infertile then?

No. She’s in menopause.

What if a man or woman’s gonads have been removed or destroyed? Then they’re definitely infertile, right?

No, they’re not infertile. They’re sterile. (Another word with unnecessarily unpleasant connotations, but that’s a post for another day.)

And even if a woman has her ovaries removed, if she has a functioning womb, she can still gestate and give birth to a child. Which doesn’t strike me as a particularly ‘infertile’ thing to do.

The bottom line is, you can’t prove a negative. So it makes little sense to describe a couple as ‘infertile’ pretty much ever.

But especially after only a year or two of trying.

Fertile

So, we’ve established that the term is illogical and inaccurate. Now let’s talk about how demoralizing and offensive it is.

Many years ago, I was watching a TV show with my mom, and there was some kind of drama going on that I didn’t quite understand. I asked my mom about it.

“That woman is barren,” my mom explained.

“Barren?”

“She can’t have kids.”

“Oh.”

The woman in question was a doctor, petite and strong-willed, one of my favorite characters. As soon as this label was attached to her, I remember seeing her differently. Images came to mind of a dry field, like the Dust Bowl in Oklahoma. Something post-apocalyptic. Pitiable.

This beautiful strong-willed professional woman was reduced, with one word, to something dried-out and useless.

As if a woman’s worth is measured by her reproductive capacity.

It wasn’t my mom’s choice of word, by the way. It was the accepted parlance of the time. Thankfully that particular label has gone out of fashion. But ‘infertile’ is barely one step removed from ‘barren’ in terms of being insulting and diminishing. It’s at least as cruel as labeling someone ‘lame’ or ‘crippled’ if they have a problem with their legs. Especially if they’re actively working on healing their leg issue.

Not to mention there are so many ways to be ‘fertile’ in this world that don’t involve producing a biological child. Some of the most fertile people I know — fertile with creativity, generosity, compassion — don’t have biological children.

And even though I know better than to define myself by my timely reproductive capacity, a lifetime of social conditioning dies hard. I didn’t exactly feel ashamed as I became incrementally aware that I might have a tough time getting pregnant. But there was definitely a sense of not wanting to tell people because I was afraid they would think of me differently. The way I thought differently about the doctor woman on TV back when I didn’t know any better.

And it was hard to know how to talk about it at all without resorting to a label that made no sense to me. I didn’t feel like salted earth, and I was actively trying to get pregnant. If I was ‘infertile,’ why was I even bothering?

But there was no other commonly-accepted language with which to discuss it.

It was really helpful for me when I finally realized I could come up with my own language.

Painting

So what term do I use instead of ‘infertile’?

To be honest, I’m still working on it. Suggestions are welcome.

But it should imply an empowered state of action, not a static state of being. It should be more accurate and less discouraging. And it should put things in a medical rather than judgmental context.

So here’s what my husband and I are currently up to (among many other things):

We’re dealing with reproductive issues.

That’s it. Just like any other body part — the arms, the heart, the spleen — things can go a little wonky with any of the scores of components and processes that make up the incredibly complex human reproductive system. Like cancer or asthma or a car accident, it can happen to anyone. And we’re doing our best, as active adults, to overcome our particular difficulties with the help of modern medicine.

We are lucky to live in an age with so many treatment options, and so many wonderful possibilities for building a family if the bio-route doesn’t work out. We can’t wait to meet our child(ren), however they come to us.

I don’t say any of this to minimize how painful it can be to deal with reproductive issues. There are difficult days to be sure, and lots of time and money spent that we’d much rather dedicate elsewhere. (Like to raising a kid, for example.) I’ll write a post later about all the reasons why it’s so tough, quite apart from the labeling issue. And then another post about some of the unexpected blessings of it.

But while we’re in the limbo of not knowing exactly how or when our kids will arrive, I won’t be using the word ‘infertile’ to describe myself.

And I think it’s only a matter of time before it’ll be phased out of polite usage entirely.

Prologue to the Blog

So, as some of you may have guessed, my husband and I aren’t in Istanbul just for fun…

cropped-img_0588.jpg

In short, I have some otherwise minor medical issues that are making reproduction a bit of a challenge. And treatments cost roughly 25% as much in Turkey as they do in the US.

I’ll post more details later about our specific situation. (The main problem seems to be endometriosis, if you’re curious.) For now I’ll just say that we’re doing well, hopeful for the future (we’ll become parents one way or another), and counting our many blessings in the meantime. (Is that enough clichés for one paragraph?)

I didn’t want to bring this up earlier for a few reasons. One, most people aren’t that familiar with Planet: Dealing with Reproductive Issues, and there are a lot of misconceptions surrounding it — many of which I used to have myself. I didn’t want to have to explain everything forty bazillion times, or feel rude when I didn’t feel like explaining.

It’s kind of like Palestine in that it’s not something you can explain in five minutes (or an hour) to someone who’s never been there. Yet countless people with no clue are eager to offer advice like, “Why don’t the Palestinians try nonviolent resistance? If only there was a Palestinian Gandhi!”

Right.

Likewise, I wasn’t looking forward to dodging well-meaning bromides like “Just relax!” or “Just adopt!” While relaxing is great and to be recommended in general, it unfortunately does not treat endometriosis (or most other medical conditions). And we may adopt, but that’s a very personal and immensely consequential decision — not something you “just” do. Plus it costs about $25,000. So. If you want to offer that advice AND give me $25,000 (or if you’ve actually adopted a child yourself), then I promise I’m all ears.

This isn’t a fast or simple process, and we’re trying to stay calm and centered during what mostly consists of a lot of waiting while doing research, staying healthy, taking supplements, and sometimes stabbing myself with needles — and of course enjoying beautiful Istanbul. Meaningful updates are relatively few and far between. So, just for the record here at the beginning: When we have news we wish to share, we’ll be sure to share it. 🙂

One thing that’s been really helpful over the past few months has been reading blogs by other couples who’ve gone through similar things. They get it, they have knowledge and wisdom (and humor) to share, and you feel less alone with doubts and questions and feelings you never imagined you’d have.

A few days ago I thought, well, I’m a writer. Maybe I have a little something to contribute, too, about an incredibly intense and surprisingly common human predicament that’s both ancient (Abraham and Sarah, anyone?) and, with all the latest technology, utterly new.

And then, if people ask me what’s going on, I can just send them a link!

(Yeah, writers can be kind of lazy and anti-social like that…)

So, over the course of two days, I spewed out ten blog posts’ worth of material that tells our story while breaking down misconceptions and generally sharing all the things I wish I could Vulcan mind-meld to anyone who asks. I’ll edit each post and upload a new one every few days.

It’s a surprisingly colorful and multi-faceted reality I find myself in. It’s caused me to think hard about things I had always taken for granted. It’s forced me to face deeply-held beliefs about myself and the world, to stir up dark murky layers that can be cleansed in the light of day, and to learn things about life experientially that you simply can’t learn — not really — any other way. I almost feel bad for people who reproduce so easily they barely even have to think about it.

Almost.

Another reason I want to be open about this (other than being tired of answering evasively when people ask why we’re in Istanbul) is that this particular medical issue not only causes major disruptions in life plans, it can also come with a boatload of stigma, shame, and loneliness. I’m personally not ashamed that I have a medical condition. Would I be ashamed if I got cancer or broke my leg? Of course not.

And yet one reason I didn’t want to talk about this was because I was afraid people might feel shame or even pity on my behalf.

So please, don’t do that. 😉 I have a charmed life, a wonderful husband, overall excellent health, loving friends and family, and on top of all that, I will be a mom before too long, one way or another.

That’s not to say it doesn’t suck sometimes. Sometimes it really, really does suck.

And for many people, it would suck a lot less if some of the shame and stigma could be removed from an already tough situation. Hopefully by being open about this, I can do my little part to help that happen.

So here it is, the good and the bad, the truth of what’s happening in my life at the moment. I hope it’ll be a very short blog. But even if I’m knocked up in a couple of months followed by a boringly healthy pregnancy, I will always have gone through this particular part of my life, and I’m glad for the chance to document and share it.

If you’re going through something similar, I hope it helps you feel less alone. If you’re not, welcome to a human experience many people around you have had (roughly 10-15% of couples) and may or may not have ever talked about.

Here’s a preview of posts that are coming soon:

Infertile? Objection!

Lady Parts are Badass

Stigma, Shame, and Stereotypes: The Second Arrow

Our Story, in a Nutshell

Why This Sucks So Much — An Unpacking

Silver Linings

Top Ten Things Not to Say to People Dealing with Reproductive Issues

Wait, Do I Really Want Kids?

On Donors, Adoption, and IVF

It’s the Wild Wild West Down There

Treatment in Turkey

The last post will finally discuss what we’re up to now. I felt like I needed nine posts’ worth of prelude before I could talk about it in an intelligible way.

And now, I’ll let Samuel L. Jackson sign off for me. (For the record, we’ve been ‘trying’ for two years.)

Haha

P.S. I just remembered another reason I initially didn’t want to talk about this: I don’t want people to feel weird about posting adorable pictures of their kids or sharing awesome news about their own growing families. The universe is not a zero sum game. Your gain is my gain. Plus I will be a parent sooner or later, and when I am, I fully expect Facebook to fawn over my kids just as much as I’ve fawned over yours!

So please, post and announce away, and don’t hesitate to invite me to baby showers or birthday parties. For some people, that’s really tough. For me, for whatever reason, it’s not.

Unless it’s Bristol Palin or any Duggar. I really don’t wanna hear about that… 😛