Monthly Archives: December 2017

Sexism on the left

There isn’t much difference between the current transgender ideology that bullies women and ejects us from our own home ground, and ordinary sexism that has always existed in the left, in all the movements ranging from anti-war to the one I’m most familiar with, the survivors of psychiatric oppression movement.  The only difference is that anti-feminist men and women have found a way to obliterate the political existence of women as a dogma of leftist politics.  In order to be a bona fide, acceptable speaker, organizer, thinker in these movements, now, one has to agree that there is no such thing as sexism defined as systemic, institutionalized male supremacy over females.  Sex is said to have no political meaning, to assert such a meaning is considered tantamount to the bigotry that feminists lead the fight against – the biological essentialism of patriarchal society, particularly fundamentalist Christians, who believe that females must serve males and that both must stay in pre-defined roles.

Transgender ideology takes up part of the feminist agenda, which I welcome – the part that says we can all be ourselves, look how we want, dress and speak how we want, we don’t have to fit the roles that patriarchy assigned to our sex, we can cross over or do our own thing outside the box.  Marlo Thomas sang it in ‘Free to Be You and Me’ and it’s still what feminists believe.

But feminism has always been a movement that 1) fights against institutionalized male supremacy over females, and 2) pays attention to the body and particularly to women’s subjectivity as embodied female human beings.  So much of male supremacy happens by men asserting not just control over or imposed access to women’s bodies, but the negation of women’s subjectivity.  If she says no to sex, she can’t mean it, she really means yes.  If she doesn’t respond to you, she’s a whore.  Men impose their meaning on women and their meaning is a servile body.  It’s not entirely an object, not the same as a plastic doll, they want the subordination of women’s reason and conscience to their own, enacted in many ways but focused on sexual, emotional, reproductive, and caregiving service.  (Carole Pateman, The Sexual Contract, points out that women were not excluded entirely from the realm of contract, they were required to make one contract, that of marriage, which secured their inferior status.)

Women taking back our subjectivity meant our embodied subjectivity.  Not just in personal life and in heterosexual relationships, but as a matter of cultural archetype and policy claiming that our form was as much ‘in the image of God’ as that of males – or more, since it is females who birth males and females both, not the other way around – and that the world should be run from the standpoint of women, including our bodily experiences of menstruation, fertility, childbearing, menopause, our kinds of physical strength and endurance, our physical configuration and energy, our physical vulnerabilities and protections – as distinct from the socially imposed ones or the reaction to predatory male violence.  We got some changes made for some of the most obvious aspects of policy, like providing for pregnancy leave and prohibiting workplace discrimination including sexual harassment – though we know these measures are insufficient and don’t change the actual power relations much; as I write this the #metoo campaign is for the first time in memory succeeding in toppling the careers of sexual predators, not because of law but because of women rising up.

Lesbians are outside much of the focal points for male supremacy, we aren’t in a position of fighting for sexual equality in our intimate relationships or generally of dealing with unwanted pregnancy.  Having relations with other females, we are doubly negated in the patriarchy and our subjectivity is simply of no importance to anyone but ourselves.

Until it comes time for a male-bodied person who is heterosexual to declare himself a lesbian – then our subjectivity is derided and reviled if we cast him out, call him a man and deny him a place in our sisterhood.

The same way, all women’s subjectivity as women to define our own boundaries collectively, as well as individually, is derided and reviled and silenced when we assert that our movement is a movement of females to end male supremacy, and that males who want an identity other than that of men as it has been assigned to them need to create their own movement, with a separate identity, and not parasitize ours – not attack and feed off our political labor as men have done in every other sphere of life.

If our movements cannot fight sexism – cannot embrace as a core political principle the abolition of male supremacy over females, and the primacy of female people as the political agents of this struggle, then they are more than bullshit, they are another face of oppression.

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Health, women, and autonomy

The feminist women’s health movement wasn’t just about abortion and self-examination with speculums.  It was about taking the knowledge and power of health into our own hands, in all aspects of our health.  Herbal knowledge from parts of the world our ancestors came from and where we are now, other kinds of healing traditions both energetic and manipulative.  Some of us learned deeply and trained and became practitioners to treat others, some of us learned enough to apply it to ourselves, more or less well.  Not so different from the knowledge any of our mothers and grandmothers had, to be able to take care of a sick child or elder or anyone the best they knew how.  We also asserted ourselves with doctors who were mostly male and rejected the idea that they knew best because their white coat and stethoscope and degree conferred knowledge stamped with patriarchal institutional authority.  We created, or tried to create, relationships with doctors based on equality, tried to be on first-name basis or otherwise to be on formal basis equally, to be Mary and Jane/Bob, or Ms/Dr/Rev/etc. X and Dr Y, not Mary and Dr Y.  We learned about diagnostic procedures and treatments, pros and cons, and decided for ourselves, sometimes rejected western medicine for holistic medicine of some kind, other times did a combination.

Somewhere along the way things changed.  More women became doctors, and even those who were alternative practitioners – like chiropractors – wanted to be addressed as Dr Y and took on the unequal relationship calling us Mary.  Alternative practitioners created elaborate consent forms that listed everything under the sun that could conceivably go wrong with the treatment so that we absolved them preemptively of any kind of malpractice claims.  Managed care came in and even doctors who wanted to practice the art of medicine were pressured to be assembly-line workers running rote protocols according to the popular evidence-based statistical recommendations of the day.  Population-based medicine is the real meaning of evidence-based; you get what the statistics say is the best overall outcome for a whole population, however large or small that population is defined, and the doctor isn’t expected to really think much about you as a whole person; if she wants to she doesn’t really have the time.  (If she is really extraordinary, wants to serve her patients individually and keeps taking insurance because she isn’t only for rich folks, she has to work serious overtime without pay to keep up.)

The proposal for single payer health care in New York State will not do anything to eliminate these serious structural problems that plague our health care system in addition to the simple lack of access without money.  In fact that proposal if enacted will continue the prioritization of money over people, only as a public system run by the government as cheaply as possible, using the same principles as managed care to treat health as a problem at the level of populations as a whole rather than meeting individual needs.  Paying a ‘capitation rate’ to serve a certain number of patients rather than paying for the services actually used encourages statistical management of the health of the population of patients as a group – achieving a certain statistical outcome for the health center or hospital or geographical region as a whole.  It also encourages manipulative practices to steer patients towards health care decisions that the system deems desirable in prevention or screening or treatment, and the dumbing-down of informed consent practices which are also seriously undermined by their use to avoid malpractice claims which is placed above the patient’s right and need to make well-informed decisions.

The NY single payer proposal brings in an additional requirement that comes directly from managed care, the figure of a care coordinator, who is supposed to ensure that medically necessary services are made available to, and are effectively utilized by, the members.  This is at best a busybody whose calls you can ignore or whom you can direct to leave you alone if you don’t want their attention; at worst, since it would be a requirement to be enrolled with a care coordinator to receive services under the plan, it creates the infrastructure for more aggressive forms of coercion, incentive and disincentive, manipulative opt-out scenarios, being marked down as a troublemaker.

We have already lost our privacy rights thanks to HIPAA, the voluminous federal law on health care privacy that advocates long warned was anti-privacy.  It is hard to get our own records, especially the medical notes that doctors share with each other but prefer to keep hidden from patients lest we dare to read and think about their conclusions for ourselves.  We don’t know what else they keep hidden from us.

The culture of compliance, which some of us know all too well from experience or advocacy in the mental health context, is nauseatingly present and permeating health care today.  I hear of doctors who refuse to treat a patient unless she takes a certain medication that they prescribe (e.g. for high cholesterol), forcing her to lie if she wants to continue receiving treatment that she wants.  The pressure to accept flu shots and other vaccinations is strong.  Screenings and questionnaires sometimes are inordinately interested in personal behavior including such matters as ‘use of illegal drugs,’ alcohol and tobacco use, body mass index, and the ubiquitous depression screening and dementia screening that are designed to capture unsuspecting folks to be initiated into the world of prescribed and enforced psychotropic drugging, and labeled with the kinds of disabilities for which one can have their rights and freedoms taken away.

The NY single payer bill also specifically preserves the existing medicaid managed care plans, including mental health managed care which is required for people covered by medicaid who ‘receive chronic mental health services’ or are labeled as ‘severely and persistently mentally ill’.  I have tried unsuccessfully to get information from reliable sources about how this has worked in practice, but recall that at the time it was enacted there was resistance from the survivor community to this classification and its implications for keeping people tied to a service system that is managerial and essentially institutional even within the community.  (See CRPD Committee’s General Comment 5 on Article 19 and OHCHR study on living independently and being included in the community, both addressing obligations to eliminate institutional forms of care both large and small-scale.)

As I grow older – I will be 59 and eligible to join OLOC on my upcoming birthday – I worry not only about needing health care for the inevitable breakdown of my physical body.  I worry also about the risks to which our society exposes older people of having my legal capacity taken away if someone thinks I am not making good decisions.  I am an ornery and quirky person, I have a great memory for some things and a terrible memory for others, and I don’t want any of the screenings.  Who’s going to stand with me?