Complaints and Disorders

But in our concern to understand more about our own biology, for our own purposes, we must never lose sight of the fact that it is not our biology that oppresses us—but a social system based on sex and class domination.
This, to us, is the most profoundly liberating feminist insight—the understanding that our oppression is socially, and not biologically, ordained. To act on this understanding is to ask for more than “control over our own bodies.” It is to ask for, and struggle for, control over the social options available to us, and control over all the institutions of society that now define those options.

It is easy enough to say that we must recognize the diversity of women’s needs, and that the demands we make of the medical system must represent the broadest possible range of women’s experience. But once we begin to talk about needs beyond the most minimal survival services (contraception, cancer screening, etc.), we are no longer on very firm ground. How much of our “need” is manufactured, and how much is real?

Self-help is not an alternative to confronting the medical system with the demands for reform of existing institutions. Self-help, or more generally, self-knowledge, is critical to that confrontation.

So we seem to be caught in a contradiction: there is something in the medical system that we want, that we cannot live without, but is there any way to get it on our own terms? When we make demands of the medical system, or of a particular health institution, just what is it that we want? Do we want just “more services”—when every one of them is loaded with a message of oppression? When these services may have little to do with our real needs, and may in fact discount our real needs or substitute medically manufactured needs?

So for most of us, the intimate, paternalistic doctor-patient relationship of the nineteenth century is little more than a historical curiosity. Being sick is no longer consistent with our social roles nor is it a practical possibility, given the doctor shortage. Our medical image has come almost full circle from the days of female invalidism. Because women have longer life expectancies than men, with lower risks of heart disease, stroke, and lung cancer, we are considered the “stronger” sex, and the popular health books eagerly advise us how to keep our husbands alive and well. Just as surely as ever, our medical care does serve to enforce our social role, only now that role is to be workers (domestic or otherwise), not pampered invalids.

The fragmented pattern of public health services for low-income women—here a VD clinic, there a Planned Parenthood clinic, almost nowhere a low-cost comprehensive care center—shows that they are still treated more as public health problems than as human beings needing individualized medical care.

The progressive achievements of these movements are obvious: legal contraception, free garbage removal, compulsory immunization, to name just a few. But their story as social movements is somewhat more ambiguous: both mobilized large numbers of middle- and upper-class women in a way which solidified their new relationship to working-class women—not as sisters, but as uplifters.

We only went from bed to work and from work to bed again . . . and sometimes if we sat up a little while at home we were so tired we could not speak to the rest and we hardly knew what we were talking about. And still, there was nothing for us but bed and machine, we could not earn enough to take care of ourselves through the slack season.

Sickness, exhaustion, and injury were routine in the life of the working-class woman. Contagious diseases always hit the homes of the poor first and hardest.

Doctors became obsessed with this “most, confusing, mysterious and rebellious of diseases.” In some ways, it was the ideal disease for the doctors: it was never fatal, and it required an almost endless amount of medical attention. But it was not an ideal disease from the point of view of the husband and family of the afflicted woman. Gentle invalidism had been one thing; violent fits were quite another. So hysteria put the doctors on the spot. It was essential to their professional self-esteem either to find an organic basis for the disease and cure it, or to expose it as a clever charade.