In Our Control (24 page)

This push to send periods “into the closet” happened, not coincidentally, at the same time that menstrual product makers such as Kimberly-Clark (makers of Kotex) were creating and growing their industry and claiming authority to dictate cultural standards on menstrual etiquette. Marketing products that had been originally developed to bandage
war wounds, pad makers successfully appropriated both the feminist language of freedom and the sexist anxieties about self-control and dirtiness of early century activists.

From the turn of the century through the 1940s, parents were a young girl’s main source of education about menstruation. Journalist Karen Houppert explains that while periods weren’t positively perceived—they were shrouded in a pink cloud of secrecy—there was a general cultural consensus that if maturing girls were to be protected from the dangers of their burgeoning sexuality, it would be by providing them with a good amount of information about their bodies. She writes, “Warnings … were used to persuade middle-class parents that they desperately needed to teach their daughters the facts of life if they were to prevent them from sexual experimentation. Today, of course, similar diatribes imply that young girls know
too
much.”
¹⁹
An important point here is that conversations about menstruation were placed in opposition to discussions of sexuality. You had theoretical conversations about bleeding so that you wouldn’t seek firsthand knowledge about sexual intercourse.

A 1915 manual called
Almost a Woman
describes respectable middle-class parents debating how to tell their prepubescent daughter the facts of life. The father of the family, Mr. Wayne, urges his wife to have the conversation sooner rather than later: “I beg of you not to postpone your instruction too long. I am more and more convinced that right knowledge not only safeguards purity, but really produces true modesty.”
²⁰

If parents were responsible for transmitting information about periods, the source of this knowledge was already an “expert class.” Houppert writes, “The popular interpretation of germ theory, the social hygiene movement, and the Progressive movement led to dozens of didactic pamphlets and self-help books sermonizing about why mothers should tell their daughters about menstruation and why they should tell them about it
this
way.”
²¹

The center of menstrual authority shifted seismically midcentury as the growing feminine product industry began to insist that they—not parents—should be the source of youth education. Tampon and pad manufacturers, who were gaining power in the early decades of the twentieth century, had decided by the 1950s to get into the sexual maturation information business in a big way. Establishing “education departments” that
produced pamphlets and films, the major product makers positioned themselves to shape and dictate the narrative that young girls would receive about their bodies. There were multiple benefits for product makers in taking on this project. First, it allowed them to build brand loyalty to their products before a drop of blood had flowed onto panties. Second, in crafting a story about menstruation that insisted it was a process that called for secrecy, cleanliness, and a certain amount of shame, companies were able to generate the very concerns that would motivate women to consume and adhere to their brands. Girls, for example, were taught that menstrual management involved extreme discretion, and then pitched products that promised easy concealment.

A deep contradiction developed between the optimistic take-home message of initial menstrual education—“periods are normal and there’s nothing wrong with you”—and the lived monthly experience of bleeding—“don’t talk about it and don’t let anyone know that it’s happening.” As Karen Houppert puts it, “To a young girl, if nobody talks about something like menstruation or sex in the real world, and yet she thinks about it, then she’s convinced she’s weird.”
²²
She adds that women “may be excited about getting their period before it happens, but when the reality sets in, with the one two punch of genuine inconvenience and manufactured embarrassment, they view things differently.”
²³

As new ideas and industries emerged in the twentieth century, old beliefs about menstruation found new articulation in the language of science. In 1920, Bela Schick suggested that special bacterium, or “menotoxins,” might lurk in otherwise seemingly innocuous discharge. If this were true, it would explain a host of controls on menstrual behavior; perhaps the blood
could
actually kill plants or poison food. While some scientists still hold a candle for this theory, as Buckley and Gottlieb point out, it was and remains “controversial at best.”
²⁴
Still, a small group of doctors and gynecologists continue to fear that menstrual blood is chemically dangerous. Dr. Nelson Soucasaux, a Brazilian gynecologist, hypothesizes that what were once referred to as “menotoxins” are, in fact, real biological compounds including prostaglandins (lipid compounds associated with muscle contraction and inflammation response) that are responsible for, among other things, PMS and menstrual discomfort.
²⁵

The persistence of beliefs that menstrual blood is somehow dirty or
even toxic offers more ways of understanding its cultural significance. In the 1960s, anthropologist Mary Douglas published a highly influential work called
Purity and Danger
. In it she famously defined pollution as “matter out of place.” In a very literal way, menstrual blood has often been perceived this way. We think of blood as something that stays inside the body unless we are injured. Instead, it leaves the containment of the body without trauma, a phenomenon with no equivalent in males.

For Sophie Laws, concerns about the dirtiness of periods are a more basic expression of a fear of difference: “The idea that people with certain characteristics are dirty is very often found as part of the attitudes of a dominant group towards a less powerful one. It is a persistent feature of racism and anti-Semitism as well as of misogyny.”
²⁶
She explains that dirt is equated with a lack of self-control, which always has the potential to threaten existing social relationships. By staying clean, women demonstrate cultural “compliance.”

A powerful image of resistance to the performance of cleanliness is found in the writing of Inga Muscio. In
Cunt: A Declaration of Independence
, the author’s funny, angry love letter to the female body, she paints vivid pictures of her efforts
not
to contain and manage her menstrual flow. She writes, “In the morning I walk around the house with my Blood towel wrapped around my waist. It catches the flow when I sit down. I use it to wipe the insides of my legs. Otherwise the blood splatters on my feet, floor. I step in it and get it everywhere. Sometimes I don’t clean it up right away. Messy, messy. Fingerpaints in Kindergarten messy. I like to do this for a very good reason: Because I can!”
²⁷

Muscio’s intention is, in part, to disrupt the systems of female control that are based in menstruation. One method of noncompliance is very literally to let the blood flow. Her book is eloquent in its reconfiguration of menstrual meanings and provides a concise queer response to the heteronormitivity inherent in the dominant culture surrounding periods. While most of us wouldn’t be comfortable walking around in bloody clothes, it is worth taking the larger point and thinking about the ways in which even the most independent, confident women among us try to keep bleeding a secret, and how this concealment corrodes our power and self worth.

Twentieth-Century Legacies

For centuries, the absence of a doctor’s presence signaled health. Today, it is very much the opposite, and we understand medical intervention in bodily processes as proactive insurance of enhanced wellness. We take statins to lower cholesterol and bisphosphonates to strengthen bones. There are antidepressants for mood and vitamins and supplements to ward off nutritional deficiencies. Since the twentieth century, all aspects of women’s sexual and reproductive health have been subject to medical management, from periods to childbirth and, of course, menopause. That trend has ebbed and flowed under the criticism of social forces like the women’s health movement, which critiqued gynecological practices and pharmaceutical interventions such as hormone replacement therapy and the Pill itself. Today, however, the forces urging medical and pharmaceutical intervention are as strong as ever. Women must decide if they believe, as some doctors have argued, that it is evolutionarily more “natural”
not
to menstruate, or if HT and ET with their proven risks are still better than enduring the menopause transition without drugs.

One reason that women have been ready to pop the pills or take the tests or undergo the procedures, both historically and currently, is that both the medical and pharmaceutical communities have tended to gloss bodily processes that are distinctly female as equivalent with illness. As I have shown, this is a tradition with a history as old as medical writing itself. In the nineteenth and for much of the twentieth century, women’s complaints of pain and distress were often associated with mental illness; they were often counseled that it was mostly (if not entirely) in their heads. Their ovaries or hormones might be behind the mental illness, but it was mental nonetheless. The end of the twentieth and beginning of the twenty-first century have brought a near complete reversal of this approach, with doctors claiming that, in fact, every discomfort is real, indicative of sickness, and possibly ripe for drugs or surgeries. Both of these approaches betray a conspicuous lack of room for middle ground.

In the 1970s, the women’s health movement worked to raise awareness of the ways in which healthy women’s bodies were “medicalized,” pointing out that female difference was interpreted by the still largely male medical establishment as signs of abnormality and illness. This groundbreaking
perspective saved countless women from the dangers of badly tested drugs and unnecessary surgeries. The problem with it, of course, was that it didn’t leave too much recourse or sympathy for women who were genuinely suffering and dealing with physical pain. To these women it seemed as if the feminist message was “buck up, pull up your socks, and get over it.” Unfortunately for all women, there were drugmakers and doctors who were all too willing to provide a caring shoulder for those who felt ignored or disrespected by the antimedicalization camp. These industry forces were right to acknowledge women’s discomfort and distress, but they were wrong to capitalize on it and answer it with dubious drugs and useless medical interventions.

The crux of the problem seems to be an insistence that female symptomatology is necessarily one way or another, entirely physical or purely sociological. The body and the mind are seen as separate entities. The mind is the terrain of culture, best studied by psychology and anthropology. The body is the domain of science and medicine. The problem with this way of seeing things is that it doesn’t allow for the ways that culture (including medical and pharmaceutical culture) can create sickness, and indeed the ways that aspects of the body can generate attitudes and identities. It creates a world in which science and medicine can claim the authority of absolute truth.

As Margaret Lock, a Canadian anthropologist who has worked extensively on female life transitions, explains, “Until recently the individual body has been conceptualized as a universal biological base upon which culture plays its infinite variety.”
²⁸
In other words, bodies are all the same, and any difference can be understood as purely cultural. In this adversarial world, women’s health activists were on one side of the debate, and the medical community on the other. The problem with this matchup, from a feminist perspective, is that if medical language insists that it is infallible and completely objective, it suggests by extension that activist arguments are based in subjective, unscientific, and emotional rationales.

Increasingly in the 1980s and 1990s, this hard and fast division was challenged. Anthropologists—often feminist—sought to highlight the fluidity between different fields of knowledge about human beings and bodies. Rejecting a traditional binary way of seeing the body, these new scholars argued for “biocultural” approaches, meaning a way of understanding
physical phenomena (such as menstruation) that took into account both social and biological factors.

Lock, both a scholar and a feminist, took a leading role in this redefinition process. Deconstructing and rebuilding earlier arguments about medicalization, Lock points out that certain dichotomies—such as mind/body and nature/culture—that were previously thought to be antithetical are, in fact, integrated. She writes, “Social categories are literally inscribed on and into the body.”
²⁹
Imagined this way, illness and pain are real, but they are also heterogeneous experiences, the children of a complex conversation between physical sensations and the tools our cultures and societies provide us with to evaluate them. Pain is not determined by power relationships, but the way that we interpret pain is. The same thing is true of wellness: you may be healthy and overweight, but if you live in a culture that perceives excess pounds as signifiers of disease, you may not feel well. Given this, one of the great successes of medicalization is that it has successfully masked the role of social forces in defining illness and deciding who is sick.

Seeing Red: Cultures of Menstruation

Understanding the ways that menstruation has been represented, imagined, manipulated, and culturally deployed to maintain gender difference has been a major feminist project of the last three decades. This cross-disciplinary effort has worked to give women new ways of understanding their bodies and well-being. In the early days of second-wave feminism, this was a simpler task: people argued that periods had been negatively construed and harshly censored, mostly by men at the expense of women. Alternately, others insisted that our own “bad attitude” about periods was a cultural aberration, that women who were removed from these negative influences would naturally use bleeding as a locus of spirituality and empowerment.