Reviews with content warning for Physical abuse - Unwell Women: A Journey Through Medicine and Myth in a Man-Made World

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Unwell Women: A Journey Through Medicine and Myth in a Man-Made World by Elinor Cleghorn

7 reviews

ceallaighsbooks's review against another edition

challenging dark emotional informative reflective sad medium-paced

5.0

“Keeping women silent and diminishing their voices are conditions of the man-made world. Medicine, a construct of the man-made world, is androcentric. This means it assumes male bodies to be the standard and holds male-dominated knowledge in the highest esteem. But it also means that traits of maleness and masculinity are privileged. Throughout its history, medicine has claimed that the defective, deficient, excessive and unruly nature of female biology means women are suited only to the subjugated sphere of ‘femininity’… When androcentric medicine, today, maligns, ignores, belittles and undermines unwell women it is consciously or unconsciously reigniting historical ideas about women's bodies and minds that were invented to maintain the patriarchal status quo…”

“When women refuse to be silenced, androcentric culture loses some of its power.”

TITLE—Unwell Women

AUTHOR—Elinor Cleghorn

PUBLISHED—2021

PUBLISHER—Weidenfeld & Nicolson

GENRE—nonfiction: western medical herstory

SETTING—UK & US

MAIN THEMES/SUBJECTS—herstory, history of western medicine, systemic misogyny, patriarchal oppression & paternalism, capitalism, intersectional feminism, midwifery & matriarchal knowledge, women in ancient Greece & Rome, women in medieval Europe, witchhunts, “age of enlightenment”, Victorian women & culture, hysteria nervosa, the uterus, birth control, eugenics, Our Bodies Ourselves, the fight for bodily autonomy, legal developments of the 20th c in the field of medicine & health care, conservative political oppression, neoliberalism

WRITING STYLE—⭐️⭐️⭐️⭐️⭐️

FLOW OF INFORMATION—⭐️⭐️⭐️⭐️⭐️

PHILOSOPHY—⭐️⭐️⭐️⭐️⭐️

Bonus Element/s—Cleghorn clearly states that “of course, not all women have uteruses, and not all people who have uteruses, or who menstruate, are women”—she takes an intersectional perspective on the history of women’s experience in Western medicine.

“Women who dared express their mental and emotional pain, pain that doctors couldn't explain, made ideal lobotomy candidates… Like the ovariotomy and the clitoridectomy, lobotomies were endorsed as ways of keeping unwell women out of asylums, which were woefully overcrowded. …the lobotomy was medically sanctioned silencing, to stop women voicing how, and where, and why it hurt.”

Summary:

“UNWELL WOMEN is one of the most important books of our generation. I read it in a rage, and recognised myself in its pages.” — Fern Riddell, author of ‘SEX: LESSONS FROM HISTORY

“If doctors have ever misdiagnosed you, disbelieved your symptoms, or discriminated against you, then UNWELL WOMEN is the holy grail of answers you have been waiting for. A decisive, comprehensive, well-researched, and fascinating book about the ways in which medicine has failed women and what that neglect has cost us—including our lives.”

—Evette Dionne, author of LIFTING AS WE CLIMB

My thoughts:

Incredibly well-researched, well-cited, thorough, intersectional, clear, and concise. Goes hard, calling out systemic racism, transphobia, neoliberalism, and Western religious institutions and ideologies. The focus is on UK and US history of medicine so this book works as a good response to all the imperialist, nationalist, and colonialist propaganda those two countries develop in particular to obfuscate the reality of their anti-indigenous & misogynistic sociocultural institutions and healthcare systems.

I would recommend this book to all readers. It’s one of those nonfiction works almost everyone could benefit from to not just supplement, but correct an education heavily misguided by systemic misogyny.

This book is best read deliberately with highlighters and page-tabs. For this read I used a system of annotation adapted from the one developed by @_britt_lit for a readalong of Professor Kendi’s STAMPED from a few years ago that I have pretty much continued to use for all of my nonfiction reads which allows me to keep track of:

notable quotes & new information (💙blue💙)
elements of personal significance &/or resonance (💜purple💜)
statistics (🧡orange🧡)
new word/term/phrase, & important figures, publications, events, etc. (💚green💚)
positive emotions (💛yellow💛)
negative emotions (🩷pink🩷)

…I used my pink highlighter *a lot* during this read… 😵‍💫

“A gulf opens up between a woman's lived experience of her illness and medicine’s comprehension of her disease, between her intimate knowledge of her own body and medicine’s requirement of objective proof. But we can't do that work ourselves; believing and responding to individual testimony is the only way to start. If medicine is to solve our medical mysteries it needs, urgently, to deliver policies, support research and increase funding on local, national and global scales.”

⭐️⭐️⭐️⭐️⭐️

Season: Fall

CW // graphic discussions of: misogyny & misogynistic violence, racism & racist violence, medical abuse & malpractice, eugenics, classism (Please feel free to DM me for more specifics!)

Further Reading—

THE CANCER JOURNALS by Audre Lorde
LETTETS TO MY WEIRD SISTERS by Joanne Limburg
HOOD FEMINISM by Mikki Kendall
BEFORE WE WERE TRANS: A NEW HISTORY OF GENDER by Kit Heyam
Angela Davis
bell hooks
WITCHES by Stacy Hall—which I have always thought did *not* go hard enough into the deeply systemic misogyny at the root of European & American witchhunts, and to which I would compare Cleghorn’s book as one that is laudably very critical of and honest about the history being discussed

Favorite Quotes—

“Of course, not all women have uteruses, and not all people who have uteruses, or who menstruate, are women. But medicine, historically, has insisted on conflating biological sex with gender identity… We understand, today, that our biology does not determine our gender identity... But medicine has inherited a gender problem. Medical myths about gender roles and behaviours, constructed as facts before medicine became an evidence-based science, have resonated perniciously. And these myths about female bodies and illnesses have enormous cultural sticking power. Today, gender myths are ingrained as biases that negatively impact the care, treatment and diagnosis of all people who identify as women.”

“…the man-made world privileges specialist, sanctioned knowledge over our own thoughts and feelings.”

“Western medicine is also a system of power—one that has, over its long history, always privileged male knowledge and professional expertise and enforced and upheld sex and gender binaries.”

“Medical ideas reflected and legitimised society's control over the female body and its precious procreative power. Right at the very beginnings of Western medical history, in writings that would become the foundations of scientific medical discourse and practice, unwell women emerged as a mass of pathological wombs.”

“Medical knowledge in the Middle Ages, as it had been for centuries, was a way of confining women to marriage and endless child-rearing.”

“But far more serious, and chilling, was [Heinrich] Kramer [notorious misogynist & author of ‘Malleus Maleficarum’]'s assault against midwives. Female healers were already pushed to the margins of medicine. And since most women could often not afford to see professional physicians, midwives and wise women provided essential support to women while pregnant and in labour. Since these women were already going against the law and having to operate clandestinely, Kramer crafted a narrative of secrecy and deviance around their practices. Childbirth, at the time, was perilous and fraught with dangers. Women, and their babies, frequently died during labour. Kramer attested that infant death and miscarriage wasn't a natural occurrence, but the devil working through possessed midwives to slaughter innocents. Amongst his more egregious tales—of witches stealing newborns, drinking their blood, devouring them and offering them to the devil as sacrifice—he strongly implied that any instance of failed pregnancy in a woman attended by a midwife should be suspected as witchcraft. Procuring an abortion, after all, was one of the seven methods of witchcraft Kramer defined. ‘No-one does more harm to the Catholic faith than midwives,’ he wrote.”

“Over centuries, religious doctrine and medical discourse had claimed that women's bodies and minds were defective and dangerous. The ancient physicians had decreed that women were at the mercy of their uncontrollable, unruly reproductive organs. Christian theology had woven these foundational ideas into a new dogma of female inferiority, in which women's physical and mental weakness was proof of their susceptibility to channelling demonic forces and committing evil deeds.”

“Busting the myths behind clitoral secrecy and shame means understanding that we're still grappling with a centuries-old legacy of women's sexuality being marginalised, trivialised and demonised. As O'Connell writes, 'The tale of the clitoris is a parable of culture, of how the body is forged into a shape valuable to civilization despite and not because of itself’… The clitoris also proved women could enjoy physical sexuality without having to get a man involved.”

“…the subordination of women in the age of sensibility was cultivating the 'weak and wretched’ conditions of womanhood. Having worked as a governess and teacher, Wollstonecraft saw how the private, domestic education of middle-class girls stunted their intelligence and encouraged the infantile, frivolous qualities valued as marriageable. 'Exquisite sensibility' was prized in women because it made them dependent on men.”

“But women were 'under the dominion' of feelings, so they were incapable of mustering the rational control needed to stave off diseases of the body and mind. And if you added 'sexual desire' to the ‘forces bearing upon the female' then she would succumb to hysteria, because social mores dictated that women conceal such feelings. Men had the option of seeking 'gratification' to take the lid off the proverbial pressure cooker. One might hope that [Robert Brudenell] Carter thought women, for the good of their health, should be allowed similar indulgences. But he was a zipped-up conservative who believed women's ardour must be dampened by any means necessary. His treatments for taming a woman's nervous system included making her wind a heavy wheel for hours, forcing her to confess her secrets, chess, sending her to bed early with a short candle, suggesting others believe she is pregnant, a bit of light astronomy, and absolutely no reading.”

“In the autumn of 1887 [Charlotte Perkins Gilman] separated from her 'devoted' and 'loving' husband. 'It was not a choice between going and staying, but between going, sane, and staying, insane.' Over the next years she continued to write and lecture, but she was exhausted by her 'wilted nerves.’ 'To do anything... is incredible effort, as if trying to rise and walk under a prostrate circus tent, or wade in glue.’ Her friends didn't believe she was unwell because she seemed so capable; but how could they understand what she might have achieved if she hadn't been so broken?”

“As the end of the nineteenth century beckoned, hysteria would begin, at long last, to be dismantled as a diagnosis for any and all 'female' pathologies that physicians failed to understand. Gradually, new medical knowledge, diagnostic techniques, medications and therapies would reveal what was lurking beneath those ingrained layers of misconception, misapprehension and misunderstanding. But as evidence-based medical knowledge was layered upon misbeliefs, women would become subiect to a whole new spectrum of mystifications.”

“For centuries, many medical 'cures' for women's apparent deviancy and defiance had been punishments masquerading as therapies.”

“Throughout the suffrage movement, women rose up against medicine's complicity in the social control and limitation of women's lives and rights. Force-feeding, like so many punishments meted out to women 'for their own good', represented just one of the ways in which male-dominated medicine continued to establish dominance over women's bodies and minds.”

“The 'torture of bearing children' was a punishment forced upon women in a society that held the female sex responsible for all the world's sin. Medicine then claimed that obeying the ‘natural law' of childbearing was the only way for. women to obtain 'health and happiness.’”

“Pervasive myths still circulate around the benefits of so-called 'natural' and 'normal’ births, leading many women who receive pain relief to internalise the false idea that they, in some way, have failed—as women and as mothers.”

“Menopause, today, is under-researched, misunderstood and still shrouded in myths and misconceptions. …medicine still doesn't have enough knowledge about the diverse experiences of menopause to support women through it properly… Menopause marks the beginning of a liberatory, transformative and empowering stage of life. Myths about the depletion of women's worth that have shrouded menopause for too long should now be consigned to history. Breaking down stigma, shifting perceptions and allaying anxieties at a medical level need to go hand in hand with a cultural celebration of what it means to be unbound by reproductive biology.”

“Where female nature had, in the past, been blanketed as hysterical' and 'neurotic', now it was 'hormonal'.”

“The Nazi eugenics programme was the logical conclusion of regarding women as nothing more than reproductive material.

These unthinkable atrocities were only a part of the suffering meted out to women for the purposes of biological research.”

“As the influential American activist and philosopher Angela Davis wrote, ‘What was demanded as a "right" for the privileged came to be interpreted as a "duty" for the poor.’”

“But just because objective science was about to transform and expand medical knowledge, it was no lightning rod for change—especially where social and cultural attitudes towards women were concerned… Social and welfare reform didn't mean that traditional medical beliefs underwent a progressive overhaul.”

“While the reform of maternity care contributed to massive improvements in maternal and infant health, it also shifted the culture of childbirth from home to hospital. …[where] the specialist care and intimate knowledge of midwives was subsumed by new regulations. And women—still very much the vessels of the future—were more subject to medical scrutiny, supervision and surveillance than ever before.”

“In the absence of a clinical sign that could be observed and interpreted by a doctor, a woman's pain was presumed to exist only in her head.”

“…until medicine creates a culture in which the impact of sex on women's minds, bodies, health and lives is properly researched and respected, people with vaginismus risk being dismissed out of hand before their condition can be properly diagnosed and effectively treated.”

“So much knowledge about their own bodies was withheld behind that veneer of paternalistic professionalism.”

“Understandably, the risks of trialling new drugs on 'vulnerable' subjects—like pregnant women—should be mitigated. But barring all women from participating just because they could 'potentially' give birth was not only downright sexist, but shamefully myopic. It reinforced the paternalistic belief that medicine's duty was to protect women, even if that meant suppressing information from them. The ban also highlighted how female biology was regarded as reproductive first, human second.”

“‘Medicine's focus on obiective factors and its cultural stereotypes of women combine insidiously, leaving women at greater risk for inadequate pain relief and continued suffering,’ wrote Diane Hoffmann and Anita Tarzian, in their path-breaking 2001 study ‘The Girl Who Cried Pain’.”

“…if you are a woman, especially one with a disease that medicine doesn't fully understand and that requires you to go to the GP often, you will encounter the kinds of gender biases that have been ingrained in medical culture and practice for centuries.”

“I've been told I look too well to be ill. I've been told my symptoms have nothing to do with lupus and are probably caused by stress. I've been laughed at by harried, time-poor A&E doctors when I reel off my latest inflammation results and immune blood-work markers. I've had flares dismissed as chest infections, and depression provoked by my illness put down to 'not breathing deeply enough'. I've argued with GPs about the necessity of my medications. I've been sent away from doctors' offices in tears and told to 'see how you get on'.”

“Like so many women who live every day with unpredictable, inexplicable symptoms, it's impossible to separate the issue of my gender from the sense that my disease is not perceived as legitimate.”

“Now, more than ever, we need medicine to face up to its history… To be an unwell woman today is to fight against ingrained injustices against women's bodies, minds and lives; but we no longer have to live in silence and shame. Enabling unwell women to advocate for themselves is crucial, but we also need the medical establishment to facilitate urgent change.”

“Medicine has historically pathologised what it means to be a woman, and what it is to live in a female body, to such a degree that being unwell has been normalised in society and culture, while a woman's rights over her own body remain contested even today.”

“We are the most reliable narrators of what is happening in our own bodies. The lives of unwell women depend on medicine learning to listen. To paraphrase the great Maya Angelou: ‘when a woman tells you she is in pain, believe her the first time.’”

Content Warnings

antoniamshmmr's review against another edition

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challenging informative inspiring reflective

4.5

The book shines light on the way women have historically been treated in medicine and how it affects women to this day. A very informative summary of the wide history of western medicine is given throughout the book, while explaining all the systemic problems such as racism, sexism, etc. that women and non-binary people had to face.

One thing I would‘ve liked to see in the book would be a comparison or simply some information about the medicine of non-western society as this book mainly focuses on USA/UK and partly some other western countries. To keep a red lining I understand that this might be difficult to include though.

Overall a very good read – painful sometimes – seeing that so many aspects of inequality retain to this day. I am positive this book helps a lot of (unwell) women to focus on what doctors are telling them and how historical inequalities may be hidden within those words.

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justmehayleyb's review against another edition

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challenging dark informative slow-paced

4.0

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chronically_theo's review

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emotional informative sad

3.75

This book was incredibly hard to read. Reading about how people like you have been violated and dismissed never gets easier. It is interesting though if you are in the right headspace

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radfordmanor's review against another edition

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challenging dark emotional hopeful informative inspiring reflective medium-paced

4.75

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gentle_garbage_baby's review against another edition

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challenging emotional informative reflective medium-paced

4.25

Very interesting history of the trouble that women (in the West) have had regarding illness, medicine, and doctors. There's a consistent theme of women not being listened to when describing their own pain, with doctors deciding it is 'hysteria' or other sexist interpretations. Unfortunately, some of these attitudes still exist today, and I'm sure there are many women who have read this book who can relate to aspects of it, including myself. Some sections can be quite distressing, so I wouldn't recommend this to people who get particularly upset by the subject matter.

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allisonwonderlandreads's review against another edition

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challenging informative reflective slow-paced

4.0

Unwell Women is a sweeping historical look at how women have suffered as patients at the hands of Western medicine, from ancient Greece to present. Peppered with historical case studies and the author's own heart-wrenching journey to a lupus diagnosis, the voices of women rise up through the narrative to be heard where they are so frequently suppressed.

Cleghorn's dry humor was much appreciated throughout this journey to balance the horrific nature of the trends and stories she shares. I found the ancient history amusing, with the Greek concept of "the wandering womb" especially hilarious. But the lived realities of these experiences are far from funny. Seeing medical knowledge peeled back to reveal the insidious tentacles of patriarchy creeping through everything was somehow both liberating and disheartening. Women have survived some horrible shit, sometimes with no help from doctors, and others in spite of the very medical attention meant to cure their ills.

Of the many topics covered, here are just a few that will stay with me:

• hysteria, hormones, and the other excuses to dismiss women's pain altogether or root it in psychology
• abortion, forced sterilization, birth control, eugenics, and all the ways women's reproduction is more valued than her own well-being and decided by the medical apparatus
• the way medical knowledge has been accrued without female input or consent in so many cases -- I was especially horrified by accounts of research done on enslaved Black American women and the more recent trials of The Pill on Puerto Rican women without knowledge of the risks
• the lack of knowledge, empathy, and support for women with chronic pain conditions

This is far from a complete history, but I don't think that's feasible for one book, anyway. It's largely focused on the US and UK, but I was relieved that the author addresses race, class, and gender identity as intersectional factors in women's health. I will carry these thoughts into my own experiences as a patient, and I want to learn even more about this topic and advocacy.

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