Sex, the charmed circle and disability

Note: This is almost 4000 words long… just thought you should have a heads up!  I was going to split it but it didn’t feel right…

What is the charmed circle?

In 1984, Gayle Rubin argued that we should view sex as a vector of oppression – we shun what we don’t understand and human sexuality is so varied that we inevitably don’t understand all of it so we do consider some acts as lesser or as abnormal. As such, we then end up oppressing people who carry out those acts and society creates a hierarchy of sex.

“Like gender, sexuality is political. It is organized into systems of power, which reward and encourage some individuals and activities, while punishing and suppressing others.”
– Rubin

A significant consequence of a hierarchy of sex is the creation of moral panic.  Historically we have seen panic and moral outrage in response to different sexual behaviour, eg sex outside of marriage, same sex sex, prostitution and obscene material.  The theme they share is always that they are outside the privileged, or charmed, circle of behaviour.  One reason these panics create such out roar is because the behaviour and activity is seen, ultimately, as a threat to civilisation.  If ‘bad’ types of sex are allowed to become mainstream then even ‘worse’ behaviours will follow. We see this when fear of children being molested is brought up in arguments about allowing same sex marriage.

Time and place are important when looking at what is and isn’t acceptable.  Sexual behaviours have changed rapidly in the last century and this speed has created confusion about what is ‘normal’ when it comes to sex.

“Regarding sexual normalcy from a social perspective, the individual accepts societal norms for choice of sexual object and activities.  Within a given society, sexual norms may differ according to a subgroup’s religion, education, political beliefs, or socioeconomic status.”
– Leslie R Schover and Soren Buus Jensen

To try and illustrate the concept that certain sexual behaviours are considered privileged over others, Rubin developed the charmed circle.  Sexual activities which are judged by society as being good or natural are set up within a binary where the flip side is then unnatural and bad.  The inner circle is where good sex takes place and the outer therefore is where deviant sex is place.  This diagram shows how different values are used to judge the acceptability of different types of sexual behaviours and demarcates the line between normal and abnormal.

In setting up a binary of good and bad behaviour the charmed circle, by extension, creates good and bad people.  In reality of course, we are all complex layers of differing, and sometimes competing, identities and this matrix of interaction can balance out certain sexual behaviours or come together to emphasis the prejudice that is cast on a person’s sexual identity.  It is important to note that making the ‘right’ decisions about sexual behaviour can result in our belonging to, or not, a particular group, to having citizen ship of a particular society.

As a disabled person who is interested in disability and sexuality, I shall be viewing the charmed circle through a disability lens.  Having said that, I don’t feel I can truly step away from my other identities and hence this will not be an unbiased look at the charmed circle.  In addition to being disabled, I feel it is important to note here that I am also bisexual, feminist, single and cannot have penetrative sex. These are all parts of my identity and as such they will affect how I view the charmed circle.

What is sex?

As I mentioned above, I cannot have penetrative sex.  This obviously skews my concept of what is and isn’t sex, but despite this, for so long I had internalised the dominant discourse that penis in vagina sex is the only legitimate type of sex, or certainly that it is top of the hierarchy.  It works well in our culture of black and white thinking as it is a clear cut act.  We set people up as virgins or sexual and whilst we don’t value these labels as strongly as Victorian society did, we do still feel the need to have a specific, defining moment where you move from one to the other.  This is why penis in vagina sex is so useful in defining sex – it is a very precise moment when you transition from virgin to not and I think we still find ourselves with internalised ideas about what this means as part of maturing.

However, penis in vagina sex is not available to us all.  Not everyone is attracted to someone with different genitalia, not everyone has a functioning penis or vagina and even if you do, it doesn’t mean that penis in vagina sex is what you enjoy.  This also sets up a goal orientated vision of sex instead of one that focuses on pleasure throughout.  How many times do we see male orgasm portrayed in the media as the aim of sex?  What about female orgasm?  And what about non penetrative acts that are not purely for foreplay?  I have problems with that word – foreplay – because it implicitly sets up the idea of a destination and privileges the goal over the journey.  I haven’t read magazines which talk about sex for a while now because they frustrate me but they did, and I assume still do, portray foreplay as incidental.  As a detour to get to the (male) orgasm.

Margrit Shildrick discusses these ideas and how historical and religious ideas still shape our understanding and definition of sex today.

But for my purposes here, I’m going with the idea of self definition.  Sex is what the person or people engaging in it consider it to be.

How do disability and sex interact?

Note, different people experience disability very differently and will also experience being disabled and sexual in vary different ways.  This makes it very hard to discuss this area comprehensively and yet concisely, as such, please note that some ideas will not apply to some disabled people and there will be other aspects that I haven’t been able to cover.

Earlier I mentioned that sexual activity can be related to someone’s ability to be a citizen of a society and Cashelle Dunn argues that disabled women are denied full citizenship simply by virtue of being a disabled woman.

When it comes to disability, people are reduced to things, objects to be pitied, to be looked after.  There is a prevailing view that the disabled person is childlike, especially if they are perceived as being dependant, and this is a barrier to seeing disabled people as sexual.  Society wants to prevent disabled people from having sex in the same way they do children.

Two thirds (67%) of the British public feel uncomfortable talking to disabled people.

Over three quarters (76%) think of disabled people as needing to be cared for, and 13% think of disabled people as getting in the way some or most of the time

Just a third (33%) of British people said that they would feel comfortable talking to disabled people, with many worried that they will seem patronising or say the wrong thing

– 2014 report from Scope

44% of people in a Guardian poll said they had never had sex with someone with a physical disability and probably wouldn’t.

These are not sexy ways to view people.  And thus, these attitudes taint society’s view of disabled people having sex.  If 67% of people are uncomfortable talking to me, how are they going to feel about having sex with me or even thinking of me as a sexual being?

Disability, sex and the charmed circle

“I am aware that, for many, sex and disability at times seem not so much intersectional as incongruous: “What exactly do you do?” is about as frequent a question for disabled people, in relation to sex, as it historically has been for many queers. The motivation behind the question, however, has usually been different. Although stereotypes of the oversexed disabled person engaged in unspeakable acts do exist, disabled people are more commonly positioned as asexual— incapable of or uninterested in sex.”
– Robert McRuer

Whilst disability is not one of the segments in Rubin’s charmed circle, I would argue that it is implicit in many people’s view of acceptable and unacceptable sexual behaviour.  However, because the majority of the population assume disabled people to be asexual, it has possibly not crossed many minds to even include it in the circle.  I am positing that for many people, disabled people are outside the circle entirely.

“There is an unspoken taboo about relationships and disabled people.  Disabled people’s sexual and emotional needs are rarely included in any discussion or representation in everyday life.  This reinforces the public’s attitudes and expectations towards disabled people as seeing them as ‘sick and sexless’ rather than participating in full sexual and family relationships.  It is perhaps one of the most pernicious ways in which society has blanked out disabled people from a fundamental area of social life.”
– Lamb and Layzell, 1994

Echoing Rubin’s discussion, Shildrick notes that there is a “cultural imaginary that fears nonnormative sexuality as being a potential point of societal breakdown.”

 “Where disabled people are seen as sexual, this is in terms of deviant sexuality, for example, inappropriate sexual display or masturbation.  Derogatory stereotypes, concerning for example blindness, are typical of this tendency.”
– Tom Shakespeare

I, obviously, advocate for the inclusion of disability within the circle and whilst I do not believe in a hierarchy of disability or that certain types of disability are acceptable when it comes to sex, I do know that some people, consciously or unconsciously, feel this way.  What I mean by this is that, for example, people with invisible disabilities are considered to be potential sexual partners and that it is acceptable in the minds of others for that person to be engaging in sex, with the confines of the other aspects of the charmed circle.  On the other hand, a person with no bodily control is seen by the majority as not just not acceptable sexual participants, but as not even in the game.  Some of these distinctions become clearer when we consider the other binaries that are featured in Rubin’s charmed circle.

Note: just as I was posting this, I stumbled across a paper which has used the charmed circle model to illustrate a hierarchy of ability.  I haven’t read it yet but about 2/3rds the way you can find an image of this.  It doesn’t fully illustrate the point I make in the previous paragraph but it does show that the more disabilities you have, the more unacceptable you are seen as being.

Additionally, if we accept, as we should, that disabled people are sexual beings, we must then decide where they fit in terms of the charmed circle.  In Rubin’s model, it seems we would tend towards the outer limits simply because of how sex plays out given our particular disability.

Marriage

According to a variety of different reports from the last 50 odd years, disabled women are less likely to be married than non-disabled women.  Interestingly this divide is smaller when it comes to men.  From the point of view of having charmed sex, this means disabled women would have to wait longer, or forever, to have sex.  There is also evidence that in heterosexual relationships, disabled men are more likely to maintain their relationships whereas disabled women tend to find their partner leaves them.

Returning again to the 44% of people who haven’t had sex with someone with a physical disability and probably wouldn’t, we are left with just over half the population to consider relationships with, and if you are heterosexual that figure roughly halves, if you are of a sexual minority then you’re really limited, especially given some of those people will already be in relationships.  And if you manage to find that needle in a haystack, not only do you have to date them, you have to both want to marry each other as well before the sex is considered acceptable.

Couples only

For Rubin, this excludes masturbation.  As we saw with marriage, this could leave disabled women in particular unable to have any form of acceptable sexual experience.  There is also the consideration of facilitated sex:

“Where sociocultural mores and the law broadly support a normative image of sexuality as heterosexual, private, ideally reproductive, and above all autonomous, facilitated sex—which by definition cannot be wholly private or self-directed—all too clearly draws attention to the difference of anomalous bodies. If the public discussion of sex and, more particularly, sexual variation is still a strong taboo in many Western societies, then the very notion of such hands-on involvement is even more disturbing.”
– Shildrick

This also brings up some legal aspects which Shildrick expands on:

“Although consensual acts of homosexuality are no longer always a crime in many Western jurisdictions, a homosexual act remains illegal under the Sexual Offences (Amendment). Act 2000 in the United Kingdom, for example, if it takes place in a situation deemed to be not private. Given that the presence of any third person or persons is understood to break that privacy condition, then clearly gay disabled sex is, strictly speaking, illegal if it is facilitated by a personal assistant whose physical presence is required.”

Procreative

This assumes that all people are fertile, would make good parents and want children.  I want to be clear here that disabled people can be parents and can make amazing parents, that is a stigma which would be an entire discussion on its own.  But not everyone can be.  I can’t dress myself, let alone a baby and I certainly couldn’t life one or safely hold it.  I also don’t want to pass on my genetic condition.  These are choices I have made due to living with my particular disability.

I would also argue that many people assume that disabled people are not having procreative sex but I have lost the research I read about perceptions around disability and parenting…

To privilege procreative sex also turns sex into a goal orientated activity.  One which is phallocentric and by necessity requires male orgasm and penis in vagina sex.  Extending this idea of goal orientated sex, one which is prevalent in our society where the goals is penetration or (normally male) orgasm, the idea of sex as a destination is one that troubles me and seems to take away pleasure.  Penetration as goal rules out anyone who can’t penetrate or be penetrated and there are so many reasons why disabled and non disabled people could find themselves in that situation, whether as a one off or ongoing.  It also dismisses other pleasurable parts of sex and also, a lot of penis in vagina positions are physically demanding in a way that other activities might not be.

Bodies only

Sex toys and things like sex swings and positioning aids are all ways in which disabled, and non disabled, people can have a satisfying sex life and the stigma around them has lessened since Rubin’s writing in 1984.  But there is still some stigma and reluctance to discuss sex toys which impacts on those of us more reliant on them.  If you have hands which don’t function well or you can’t get an erection or need help positioning yourself then sex toys can come to your rescue.  Whilst non disabled people use sex toys, for some disabled people they can be the difference between sex and no sex but again place the disabled person in the realm of unacceptable sex, at least in the 80s.

In private

This requires that you do not live in a group home or sheltered housing or anywhere were you have limited privacy.  Deinstitutionalisation has made it more likely that a disabled person has a home space but having carers and other types of support can limit your privacy, even within your own home.  It also pulls in ideas we saw when we looked at couples only.

Disabled people often feel an additional pressure to play out all intimacy within a private sphere. I have heard time after time stories of disabled people being out in public with their partner and being assumed that they are actually a paid for carer.  Further, if the couple hold hands or kiss, the common narrative either feels pity for the non disabled partner, congratulates them for being an amazing person or pressurises the disabled partner to feel grateful that they are loved.

“Whilst law may allow women with disability to participate in sexual activity, society tolerates it only if it remains in the private sphere.”
– Dunn

Free

This is a more controversial area and not one I want to go into right now but some people who have disabilities have argued for the right to use sex workers to meet their needs.  When society is set up in such a way that disabled people are not seen as sexual it can be difficult to find someone who wants to have sex for free.

Disability Now conducted a survey in 2005 which revealed that 22 per cent of disabled male respondents (compared to an estimated 10 per cent if you look at the whole male population) reported having paid for sexual services compared to just 1 per cent of disabled women. Similarly, just 16 per cent of disabled women had considered paying for sex compared to nearly 38 per cent of disabled men.

Alternative charmed circles

If we accept the idea that some types of sex are privileged over others then the charmed circle could be considered as a model for this, although I do find the use of binaries objectionable.  One could consider instead an array of spectrums, for example marriage being highly privileged by our society, couples who live together coming next followed by long term relationships followed by short term relationships and sex with strangers featured at the other end of the spectrum.

If society is set up so that one of the binaries in the charmed circle is able bodied and disabled, then I would argue that in reality there is again a spectrum.  Someone who has an invisible disability is privileged over someone who has a visible disability.  And someone who can still partake in ‘traditional’ sex would be privileged over someone who, for example, has very limited bodily control.

NB, I am not advocating for a spectrum here, I am noting that in my experience and hearing from others, that this spectrum exists and to ignore it would be to great too large a generalisation about what it means to be disabled and sexually active.

An interesting alternative I found was from Meg-John Barker who flipped the circle so that narrower ideas about acceptable sex where on the outer circle.  This is reached by reasoning that people who have less mainstream sexual identities and behaviours often have more fluid and more diverse ideas around sex.

From an anecdotal and common sense perspective I would argue that the same is true for many people with disabilities.  The nature of having sex with a disability often means increased communication is necessary.  There are also, by virtues of different bodies, a greater number of ideas about what sex is and what sex can be and similarly the use of sex toys and accessories may play a bigger role in sexual activity.

“Some women feel liberated from social expectation as a result of impairment, some men feel doubly inferior.”
– Tom Shakespeare

Having a disability can take you outside of certain societal pressures.  If you are treated as though you are invisible and cannot be beautiful because of your disability, it makes it easier to shun society’s expectations when it comes to appearance.  Being seen through a genderless role, reduces the pressure to perform to your gender.  Of course, these ideas aren’t going to be true for every disabled person and some people may feel even greater pressure to conform to society’s expectations.  If you do defy convention then this may extend to your sex life.  Personally, not being able to have penetrative sex has created space for pleasure-centric not goal-centric sex.

Non acceptable approaches to sex and disability

Flowing through all of the above is the idea that sex and disability should be viewed as acceptable, as good and not stigmatised.  Having set that up, I do want to highlight areas where behaviours are unacceptable as I think this is one of the flaws of Rubin’s model.  She has set up a value based model around how we view sexual behaviours and yet has failed to include consent, rape and objectification which are surely crucial elements of any acceptable/non acceptable model.

Abuse

Disabled people are significantly more vulnerable to abuse, including sexual abuse.  For some people there is something inherent in their disability which makes them vulnerable – a lack of understanding about what’s happening, a physical inability to defend oneself – and having carers and other professionals in your home does create increased possibility for abuse.  In fact a 2014 study found that more than 40% of women with disabilities had been victims of violent sexual encounters.

The 1995 British Crime Survey found that disabled women were twice as likely to experience domestic violence as non-disabled women.  In 2008, Women’s Aid confirmed this was still the case and additionally:

  • “Women with learning difficulties are even more likely to be at risk and the level of violence that they experience is also likely to be higher.  The more dependent they are and the more complex their needs, the more likely it is that they will be at risk, as are women with mental health problems.”
  • “More than 70% of women with learning difficulties are sexually assaulted, a rate that is twice as high as for those in the general population.”

(quotes from Scapegoat by Katharine Quarmby)

Devotees

I’ve written before about disability devotees, that is people who are attracted to the disability or related equipment but just to touch on the subject, Tom Shakespeare sums up the issue quite well:

“Some non-disabled people are seeking disabled partners for reasons we can only be described as exploitative… Disabled people very commonly find themselves the focus of sexual interest from people who find their particular impairment titillating… the person is being treated as an object, and this implies that the relationship is unequal and potentially oppressive: they become a means to the sexual gratification of others, rather than an equal partner and someone whose own pleasure is valued.”
– Tom Shakespeare

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Can you be a feminist and…? | Choice feminism

Choice feminism states that any choice is feminist purely by virtue of having been made by a woman: that she is in a position to, and has, made a choice is thereby feminist.

This is something I’ve heard a lot of in the last few years within feminist spaces. It is, as far as I can tell, a core part of sex positive feminism and links closely with “corporate feminism”.

Choice feminism turns a collective movement into individual struggles. Every choice is made within a context, a society and a culture which impacts on that decision.

“a woman who quits her job after bearing a child, for example, may be “making her own choice,” but a society where there is no guarantee of parental leave, where workplaces remain hostile to pregnant women and new mothers, and where our conception of the ideal worker is still inherited from a 1950’s male breadwinner model all make that choice considerably easier for her to make.” (Feministing).

Choice feminism focuses on individual choices and thus erases the idea of women as a group of oppressed people. It ignores the patriarchal influences which affect the constraints around that choice. It reduces our power. One woman making a choice does not have the same power as a group of women making a stand.

Choice feminism empowers those who are already in a more privileged position. It is much easier to make choices when you are white, middle class upwards, non disabled, heterosexual and traditionally attractive. You are likely to have a lot more doors open to you and thus more choices.

Choice feminism allows for choices which hinder the feminist movement and hurt other women.  In my view, this isn’t feminism.

Choice feminism reduces the conversation to individual choices to wear heels or lipstick rather than the structural oppression of women the world over.  A lifestyle rather than a political movement.

Choice feminism suggests that if you aren’t an MP or CEO it is because you didn’t choose it, you didn’t work at it, you didn’t try hard enough. It removes the barriers of sexism in the workplace, of childcare issues, of educational inequality that stand in our way.

Choice feminism removes the impact of our actions on other women. If you choose to become a sex worker, you are perpetuating the industry and by holding onto your choice, you can deny other people’s lack of choice. I watched a film about sex work recently and three white, well educated women were discussing how it had been their choice and how they hadn’t received any abuse or coercion. And the implication from their language was that they hadn’t been hurt by the sex industry so abuse didn’t happen.

Choice feminism is about choices made within a patriarchal structure. And how can that compliance with the oppressor possibly further the rights of women? Choice feminism does not challenge the system. It cooperates with it and can be used to further oppress.

Choice feminism opens up the space to ask “Can you be a feminist and…?”, turning the focus inwards, dividing feminists and distracting us from unequal pay and sexual harassment.

Choice feminism closes down important conversations about patriarchy, about sexism, about women’s rights and women’s opportunities.  It stops discussion about glass ceilings and sexual harrasment.  The cry of “anti-choice” is used to shut down people wanting to talk about pornography and the sex industry.

Finn MacKay, more eloquently than I, says in the Guardian:

Choice feminism can be found particularly in media representations of what feminism is and what women’s empowerment might look like. There is an attempt, unfortunately fairly successful, to reduce feminism to simply being the right for women to make choices. Not choices about whether to stand for parliament, or instigate pay transparency in the office or lead an unemployed worker’s union, or form a women-only consciousness-raising group in their town; far from it.

Instead, there are choices about what amount of makeup to wear, whether to go “natural” or try mascara that makes your eyelashes look like false eyelashes, or what diet drink to buy, or whether or not to make the first move with a man.

We all make choices within a context.  I will choose to watch an unfeminist box set within the context of very limited feminist options.  We have to exist in our society and that involves making the least worst choice or compromising on ones ethics and values sometimes.

Choice feminism is much easier to approach that feminism about breaking down structures and patriarchy.  It is alluring and makes life easier to live in an unequal society.  I can very much see the appeal.

However, I do not believe that choice feminism is the way to go.  It individualises the debates, it turns women on each other, it detracts from the major structural inequalities that we face.

And we are not going to get anywhere if we do not unite…

‘… women’s advances in terms of rights and social and political standing have never been the result of isolated actions of individual women making personal choices. And although feminism has frequently been about giving women the right to make any choice they want, it also recognises that choices are not made in a vacuum any more than movements grow in one.

I’m a writer, not an activist, but this book is, nevertheless, a call to arms. I wrote it because I’ve noticed that some lovely, hip, intelligent progressives, people who can recognise racial, religious and class-based oppression without difficulty, are uncomfortable with the idea that women in first-world countries face discrimination. I wrote it because I’m sick of hearing people say that women aren’t oppressed because their husband does lots of housework or because their company pays women the same as men or because they’ve never personally been raped/groped/called a slut/been denied a human right.’ – Emily Maguire, Princesses and Pornstars

For further reading about choice feminism, try:

Does gender matter when it comes to mental health diagnoses?

The housekeeping…

Firstly a bit of housekeeping. I’m referring to gender here, not sex; gender includes the societal influences and roles we play rather than just pure biology.  i think this is vital in this discussion because whilst some mental illness is biological, down to genes etc, the environment around a person and their socialisation plays a huge part in causing mental ill health.

I’m focusing mostly on male and female here but am aware that not everyone fits into those gender boxes however, as these are what society predominately uses, it is a helpful way to think about it. Even if you are not male or female, the chances are you are perceived as one or the other which means you’re likely to be affected by the biases and stereotypes
related to that gender. I recognise that not fitting into the male/female boxes is likely to bring it’s own difficulties especially when it comes to engrained social biases and stereotypes. I think how gender affects mental health diagnoses when you’re not cisgendered (your gender matches the sex you were at birth) is probably a blog post on its own and is probably better written by someone with more experience. Similarly, your sexual orientation and how that plays with mental health diagnosis is also not something I’m going to cover right now but sounds interesting to look into (and I feel, as a bi woman, a bit more qualified to speak about that).

Within this discussion we need to remember the historical context in which gender and mental health sits. it would be a travesty to ignore or forget about the way women have been oppressed through the use of mental health diagnoses. a prominent example is the Victorian ‘mad woman in the attic’, a much critiqued view of mental illness.  There are many writers who unpick the use of diagnoses to oppress women who weren’t submissive and obedient. Its an interesting area to read about and there’s lots of blog posts, articles, books etc about it. Here however, I’m looking more at the point of diagnosis in the contemporary world, mostly focussed on the developed world or the global north.

Er, get to the point…

So, men and women can experience a vast array of mental health issues for which they may receive a diagnosis and treatment related to that diagnosis. Having had the issue of equality and mental health diagnosis come up a couple of times in conversation with friends, I wanted to look into it a bit more.

Is there a difference?

Overall, the rates of diagnosed mental illness in men and women is much the same (and is under diagnosed across the board), but disparity does arise when it comes to the rates of diagnosis.

Diagnoses of common mental disorders including depression and anxiety are made up of mostly women eg depression is twice as likely to be diagnosed for a woman than a man.  However when it comes to alcohol addiction in developed countries, 1 in 5 men and 1 in 12 women will receive this diagnosis at some point. Take another example; men are more than three times more likely to be diagnosed with antisocial personality disorder than women.

Interestingly, according to the WHO, there is little gender difference for diagnosis rates of severe and rarer mental disorders such as schizophrenia.  I wonder if this is because they are rarer so have a less engrained stereotype?

So do men and women just have different mental health susceptibilities?

To answer this question, I think we need to start by mentioning that mental illness can be caused by a vast number of things including genetics, life experience, poverty etc.

The WHO states that gender specific risk factors include the nature of the stereotypical gender role, stressors and negative life events. We then have to consider that women are disproportionately affected by gender based violence, low status, economic disadvantage, responsibilities for the care of others etc.

Looking specifically at PTSD for example, because they are more likely to experience sexual violence, women are obviously more likely to have PTSD as a result of that violence. 1 in 3 women who have been raped develop PTSD instead of 1 in 20 when looking at non victims. And at least one in five women suffer rape or attempted rape in their lifetime.

When it comes to the impact of other types of abuse, we know that women who experienced childhood sexual abuse or partner violence as an adult, rates of depression are 3 to 4 times higher than the rest of the population. I’m obviously not saying that men do not suffer abuse, of course they do, but the figures are much higher for women. Lifetime prevalence rate of violence against women ranges from 16% to 50%.

In terms of life events impacting on women and their mental health, an estimated 80% of 50 million people affected by violent conflicts, civil wars, disasters, and displacement are women and children.

Similarly, low status, low income and the burden of taking care of others can place a lot of stress on a woman and in turn result in associated mental illness; women make up around 70% of the world’s poor and are paid significantly less than men. This lack of resources results in higher stress and being less able to seek help, or seek the same quality of help, as men who are earning more, which in turn makes things worse. People with higher income or good health insurance are more likely to seek support and therefore . This lack of resources means that women can get trapped in difficult situations such as domestic abuse as they have limited means to get out and this will obviously have some impact on mental health.

OK, so men and women have different types of mental illness, fine.

No. Sorry, it’s not that simple.  Men and women may in general experience different types of mental illness.  But we don’t know that.  This is because of gender bias occurs in the treatment of mental illness. Even when presenting with the same score on a standardised test, women are more likely to be diagnosed with depression than men. Remember above, we noted that women are more likely to have this type of diagnosis than men…

There is also a difference in presenting for help. Women are more likely to approach their primary carer, such as a GP whereas men are more likely to turn to a specialist and are the main users of inpatient care, again, potentially affecting diagnosis. If you turn up to a substance misuse centre you’re likely to end to with a related diagnosis. Turn up to your gp who hasn’t got much experience about these things and doesn’t ask you the right question, maybe you’ll get a different diagnosis.

Returning to alcohol, men are more likely to admit to having a problem with it than women, again providing a possible reason for the large gap in diagnosis rates between genders. It could also be related to men feeling unable, because of gender stereotypes, to get help for depression, anxiety etc and are self medicating with alcohol which in turn gets picked up as a diagnosis of alcoholism.

Gender stereotypes themselves can get in the way of a diagnosis as they reinforce emotional problems in women and alcohol problems in men. This can be a barrier to a correct diagnosis.

So, why does it matter?

Well, cynically, i think that more money would go into treating, preventing and researching the more common mental illness if they were more commonly diagnosed in men. yes, i’m a feminist so i’m going to say that but look at the differing attitudes between erectile dysfunction and pain women experience during sex. one has lots of money thrown at it, the other is barely acceptable to say.

A second reason why it matters is that it could help understand what causes, triggers or perpetuates mental health issues. if particular conditions are more common in women, can we unpick it further, is it biological or societal? can we do anything to prevent this, such as ensuring women have the opportunity to be economical independent or free from abuse? As with most of these things, prevention is vastly superior to cure.

Thirdly, if diagnoses are bias based on gender than there could well be lots of unsupported men and women who are struggling with their mental health because their support and treatment is wrong due to an incorrect diagnosis. Access to services might be formally or informally restricted because of gender – if alcoholism is seen as male illness it could put a woman off seeking treatment and support. There are numerous accounts of men who’ve tried to seek support for eating disorders and the walls they’ve come across and the stigma they’ve faced. Again, correct diagnosis may mean more men are diagnosed with an eating disorder which in turn would hopefully mean that more men feel able to seek support for it and in doing so, perhaps health practitioners would no longer think about gender at the point of diagnosis.

One commonly quoted stat is that men are more likely to die by suicide than women. What it misses out is that women are more likely to attempt suicide than men.  At the moment this means, in the UK, there is a lot of awareness raising going into supporting men who are suicidal. Which is great. However it seems to be at the expense of support for women. Perhaps diagnosis which wasn’t influenced by gender would help us to see the person in distress and help their actual needs rather than their perceived needs.


I’m fully aware I’ve not referenced things… However if you want to do some more reading and find out more for yourself, here’s a few links I found useful:

WHO
Guardian
Judith Trust

And for reading about whether men and women have different brains, check out Cordelia Fine’s Delusions of Gender.  Well worth a read.

Everyday Feminism

We can all take action, however small.  Small actions add up.

Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.

― Margaret Mead

A tiny change today brings a dramatically different tomorrow.

– Richard Bach, One

There are many many excuses for not doing things, but there’s one huge overriding reason why we should.  The world is unfair and unequal and without action it will not change.  It is not in the interest of half the world’s population for things to change.  And when you include the women employed in industries which oppress women, the number who have financial interest in maintaining gender inequality increases.

Think of the people involved in fashion, beauty, magazines who spend so much time telling us and showing us that we are lesser citizens.  That we have to work harder, show up painted and adorned before we can take part in society.  It is a tool of oppressors.  And the more they think we are at risk of fighting back, the louder their message will be. If we start to question, they will amp up the volume.  Send out more and more messages which crush self worth.  Instead of rising together as a movement, we are beaten into our own, individual battles with ourselves.

Think of the power we have that we use to oppress ourselves and others, what if we used that differently?  If instead of repeating my own messages of self hate, what if I turned that out and used that voice to bring down the patriarchy?

Everyday Feminism: A small, everyday act which contributes to the aims of feminism and/or supports women.

I ran a workshop about this at a conference yesterday and some of the ideas we discussed were:

  • Replace gossip magazines in waiting rooms with magazines about something be it science, wildlife, cooking, writing, photography, anything with substance
  • Sticker over sexist graffiti, adverts etc
  • Use twitter and facebook to complain to companies but also to congratulate companies who are carrying out good practice
  • Boycott products with sexist advertising or packaging
  • Turn magazines with offensive covers round in shops
  • Mix up magazines, books and clothes in shops where they are labelled as “mens” and “womens”
  • Compliment someone on something other than their appearance or compliment them about about something different to the norm – great haircut in a fab shade of grey etc
  • Reframe problematic language
  • Tell people you are a feminist
  • Leave leaflets in books, public places, blu-taked on toilet doors
  • Be mindful of our own negative thoughts and behaviours
  • Don’t belittle yourself – “I’m just a…” “Can I just add something small to this debate…” etc
  • Do not apologise for yourself

If you have any other ideas, let me know.