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A: The first edition of my second book, The Gynecological Sourcebook, was published back in 1994 and was praised at that time for tackling all the below-the-belt health topics women needed to know in language they could understand.
It was like "our bodies ourselves" without the politics. That edition served women well for many years. But as women began straddling health systems, and it became clear that so many of the standard ob-gyn procedures were questionably misogynistic, women began to seek out information about different ways to heal themselves and stay healthy.
The Gynecological Sourcebook sold more than 200,000 copies in various editions over the years, but it became outdated. I wanted to do a book that covered east-west gynecology and that could also uniquely address Canadian women. Gynecological Health does that, I hope — it's a book I wanted to write and that my readers have told me they want to read.
Q: How does gynecological health affect us?
A: Women are squeezing their bodies into a male-constructed world. That has an effect on our physical and emotional lives. Often what manifests as a gynecological problem has emotional roots. Likewise, what can manifest as an emotional problem, such as depression, has a gynecological basis. Women's bodies and minds are complex and intertwined. They are also political; they are studied and the contents of our uterus are often legislated. So, gynecology isn't just about gynecology. Integrated medicine is really the pathway to gynecological health, which is what this book reflects.
Q: What are the top three most important gynecological health concerns facing women today?
A: I guess that depends on the women you ask and how old they are. The short answer is that there are no top three issues. Women need different information at different stages of their lives. For Sex In the City women, top priorities are safer sex and birth control; for women approaching 50, top priorities are hormone replacement questions and safer sex.
When it comes to gynecological issues, it's largely the same old story. But we could use a new approach! In between are the "wham bams" no one asks for: aids and HIV, fibroids, cancer, or endometriosis. Priorities can shift dramatically from one doctor's visit to the next, from one blood test to the next. My job is to make sure no one gets left out.
Q: What special philosophy or outlook do you bring to your writing and the world of medicine as a feminist sociologist and bioethicist?
A: My books embody informed consent through self-education. That is the legacy of the women's health movement, which in many ways proved that the "personal is political." In other words, within one woman's story about her body lie many women's stories. I believe that what separates women who are informed from women who are not is education and the ability to think critically. Medical jargon remains a barrier to informed consent — it indimidates women into decisions they might not make if they understood their options in plain, non-technical language. Hopefully my book supports a woman's right to make her own choices about her body based on her cultural preferences, lifestyle and quality of life.
Q: Are there many women who are afraid to address important gynecological issues, such as taking an annual pap smear? How can doctors help their patients overcome their fears?
A: Canada doesn't have enough doctors trained to manage the range of gynecological issues that affect Canadian women, or enough doctors trained to the sensitivities that arise within a cultural mosaic as diverse as Canada's. Do you think the average family doctor understands how to give a woman who has undergone female circumcision a pelvic exam, for instance?
Women have to seek out their own information, gather it together, and use their doctor's time the same way they would a lawyer's time: maximize it to get as many answers as possible.
Doctors are not required to be trained in bioethics, so ethical issues regarding informed consent are frequently not on their radar screen. That's just the way it is when you have limited resources.
Q: Male or female gynecologist?
A: Some of the most insensitive gynecologist's are women; some of the most sensitive are men. It really depends on the skill set of the doctor and his/her personality. Ther are equally talented male and female gynecologists to choose from. Gender is only an issue if it is an issue for the patient.
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