Table Of ContentWomen and Health
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Women and Health:
Feminist Perspectives
Edited by
Sue Wilkinson and Celia Kitzinger
t:?\
Taylor & Francis
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LONDON AND NEW YORK
©Selection and editorial material copyright Sue Wilkinson and Celia
Kitzinger, 1994
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otherwise, without permission in writing from the Publisher.
First published 1994
By Taylor & Francis,
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Transferred to Digital Printing 2011
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Library
ISBN 0 7484 0148 2 (cloth)
ISBN 0 7484 0149 0 (paper)
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Typeset in 10/13 pt CG Times Roman
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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
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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
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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.
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