Social 

Self Representation and responce to environment

The sex to which one identifies

socially contructed beliefs, attitudes and roles associated with sex

Both the beliefs and the performance of the gender roles

Kane Low article 

Rooted in biology shaped by environment and experience.

Biological (chromosomes) / anatomical (sex organs) 

Kane Low article

"A state of complete physical, mental, and social wel being"

- basic needs

-Freedom from war

- Public support

- Equal opportunity

- Secure work

- Useful role in society

- Political will 

All encompassing 

-traditionally reproductive 

-media version -> sex, beauty 

differences in health outcomes explained possibly by social and political forces 

- beast, cervical and heart disease are examples 

social construction of gender and its effect on health outcomes

we know the world as we percieve it 

perceptions based on social learning

"reality" and "truth" = siuational

eductation

media

- What is defined as health or disease is rooted in social contect (ex. ADD v. domestic violence)

- What is recognized as an issue for WH is irectly related to our assumptions of gender (breat cancer v. heart disease) 

Perspetive that acknowledges the oppression (not having a choice) of women w/in a patriarchal society, & struggles toward the elimination of sexist oppression & domination for all human beings

• critical analysis
• heterogeneity (not women as one homogeneous group)
• equal worth 
• Personal is Political
• Personal experiences are linked to social patterns
• rejects androcentric model

a movement to end sexism, sexist exploitation, and oppression. 

Does not imply that men are the enemy

females can be sexist as well 

Says Feminist movement has lost clear definitions

Belief in social, politicalm and economical equality of sexes

The movement organized are this "belief"

Not man hating and not ugly girls

studies only included men

-1st study to investigate estrogen use for heart disease was exclusively male, same with asparin. 

Heart Attack

Beyond reproductive

Enhanced funding for research

Marketing of WH programs

↑ in women physicians

Movement towards WH medical specialty

1. Look for who has been left out
2. Analyze your own role or relations to the issue or topic
3. Identify women;s agency in the midst of social constraint & biomedical paradigm
4. Consider the social construction of gender & how its assumptions may limit options
5. Gender defines or affects power
6. Look at others social positios & implication of individual
7. Risks and beneficts of generalizations & speaking in terms as groups or individual

What do we know, how do we know, who knows?

Why dont we know? What dont we know and why?

Who determines what is left out and who has access?

very important in looking into medical research 

Is it personal? Political?

Objective and removed or subjective and engaged?

Invested in outcome?

Why do you care?

women really victim or acting with agency?

individuals making choices despite positions of powerlessness?

Choices allowing control to be kept?

or do they allow for some sort of power in context of the situation?

-What is defined as a health problem?

- assumptions about the value of anatomy

-Would his health issue be definited or explored in the same manner if it promarily affected men or women?

Doctor/ nurse

Doctor/ patient

Parent/ child

Husband/ wife

Father/ daughter

Married woman/ single woman

Lesbian/ heterosexual

Race

Age (young looking for reproductive health care)

sexuality (fertility)

Class 

Gender

Socioeconomic status

- Who has access to what forms of health care services and rosources and who does not?

Who are "we" or "all women"? Are "all" the same?

When is coherence or consistency the goal compared to diversity in health care consideration? Which reflects realtiy?

Who is missing/ not reflected in the group?

Human Rights Framework for Safe Motherhood 

Lisa Kane Low

Rights relating to..

Life, liberty and security of person

Foundation of families and family life

Highest attainable standard of health and benefits of scientific progress, including health info and education

Equality and nondiscrimination (sex, marital status, age, and class)

Breast Anatomy

Purpose  = provide nutrients 

[image]

Transaxillary (near armpit)

Periareolar (around areolar)

Inframmammary (underneath) 

Breasts are social/ media influences not anatomical

have to move nipple

complications..

- breast feeding ability

- sensitivity 

- appropriate look and feel

- lession in the insert

- Does NOT decrease breast cancer mortality 

Individual experiences of women finding lumps early

- medicalization of getting to know our bodies

- Debate start at 40 or 50? 

- US preventative service task force - start 50 every other yr till 74

 - Radiation can cause cancer so evry yr and early not good

- harder to read after breast surgery

Vulva Anatomy

Lapiaplasties

different from genital mutilation? - consented, informed

Hymenoplasty/ hymen restoration

Lower portion of the uterus

3 potitions of uterus (forward, back [retroverted], middle)

Folds of skin for expansion

(in vagina, but also linings pf other ogans, stomach etc.) 

Swab cervix for HPV 

Ages 21-65 - sexual activity doesnt matter

Every 3 yrs

HPVco-tests (bimaunals also start)

- Area of outer to internal os of cervix

Where cancer occurs b/c area of differentiation

light to look @ cervix if abnormal pap smear

may biopsy

28 days lasting 3-6

avg blood loss - 20-60 cc

FSH increases at beginning of cycle (during period) stimulating maturity of an egg to be released. 

Estrogen levels rise at beginning and peak at ovulation (14 days) 

At ovulation LH and estrogen are high, body temp increases (for remainder of cycle) 

Progesterone increases during second half to prepare lining

Phases: 

• Ovarian (FSH & LH) 
• Uterine ( Estrogen increases then decreases and progesterone increases)

increases at beginning peaking at day 7 of menstrual cycle

stimulates the maturation of an egg

Sharp peak at ovulation

Causes ovulation

~ day 14 

in responce to LH the egg leaves the ovary

lack of a period

people who don't have period by 16, or previously did and now don't

Pregnancy, hormone problems, weight loss, breast feeding

painful periods 

caused by hormone prostagliandin

Central aspect of being human, sex, gender identities and roles, sexual orientation, erotisism, pleasure, intimacy, and reproduction. 

How one defines oneself 

Behaviors, beliefs, and desires

physiologucal response - orgasm, lubrication

frequency of sex

body image

relationships

sexual satisfaction

desires

aging 

illness

How vagina looks, feels, smells, changes

Public Policies - Sexual education 

Gender norms and inequalities

Media environment 

Yound women;s experiences

Abstinence only v. Comprehensive

Federal Funding Requirements (CBAE) for abstinence  - stopped by Obama

US pregnancy rates 72% are high

Condom use is low

Sexual subjectivity

Sexual desires 

Sexual satisfaction

Likert Scale (high dissatisfied to highly satisfied)

Acidic pH 5.4-4.4

discharge clear to white, mucousy or thin

varries person to person 

"abnormal" discharge is found through microscopy not always look

Curdle white discharge

Vaginal & vulvar burning

When taking antibiotics

discharge is thin and grey

Fishy smelling

Yellow frothy discharge

sexually transmitted between partners

treated with antibiotics

most frequent currable infection

routine testing of sexually active < 25

can hurt the os of cervix 

treated with antibiotic

2nd most common

tested with chlamydia (come together0 

treated with antibiotics

causes pelvic inflamatory disease

small tags on labia, vagina, anus

treated but not cured

very common

skin to skin contact transmission

can cause cervical changes and cancer or abnormal pap

not always obvious

vaccine 

Initial and subsequent infections

200,000-1 cases/yr

1/5 adolescents

treatable not curable (valtrex)

you can get HST1 from cold sore

genital lessions → oral = not common

Oral lessions → genitals = common

both cause gential herpes (GH)

>25% womens have HSV-2 antibodies

HIV

Hep B & C

transmitted through blood, semen, and fluids

20-50% of women

lack interest, orgasm, pleasure, lubrication

"plumbing" or "feelings"

$$ can buy better food

$$ can buy better care services

$$ can buy more time and less stress

The choices we make are constrained by the choices we have " Lesley Welch

Social Justice

Business

Moral 

behaviors

resources

chronic stress

politics determines choices we can make

social policies are health policies

Visible difference: race, gender, style, disability

Invisible difference: education, sexual orientation, family history, economic status.

complex social phenomenon that changes slightly over time

media - skinny models and sctresses

boob jobs

rhinoplasty - nose 

liposuction

Body mass index 

classifies more people obese than actually are

underestimates fat in eldery 

overetimated fat in athletic people

high BP

high LDL 

low HDL 

high triglycerides - diabetes

media enforced skinny as the norm

food economy based on producing cheap but high cal low nutrition food

Fredickson 1997

women viewed as obkects

body monitoring as a result of objectification

serves aas a distraction - care how we look to others

can become pathology - eating disorder

use desire to be thin

impact - motivations to work out not to be healthy

Large quantities of food at one time

Feeling ashamed by behavior

Eating when not hungry and eating in secret

High BP, Cholesterol, Diabetes, Heart disease, Gallblader disease

Resistance to maintain body weight above a low value 

Constant fear of "being fat" though not

Denial of low weight

Self-evaluation based on size

Loss of mentrual cycle (whats that called?)

Slow HR and low BP, lanugo (hair) covering whole body, fatigue, weakness, dehydration b/c kidney failure

regular intake of large amounts of food then feel out of control over eating

vomiting, laxitive/diaretic use, fasting, obsessive-compulsive exercise

extreme concern with body weight and shape

swelling of cheeks, & jaw

discolored teeth

electrolyte inbalance - irregular heart beat

esophagus problems

chronic irregular bowel movements

Any act of gender based violence (physical, sexual, psychological) harm including threats

- Intimate partner, domestic, dating, family, relationship violence

sterilization and abortion 

- Rooted in unequal power relationships (social, economic, culturalm political)

Physical

conomic

Emotional/ Psychological

Sexual

funds towards investigations

established office of violence against women

reauthorized in 2000, and 2005 

Expired 2011 b/c disagreement b/c specific protection to minority groups and college students

Coercion and threats

Intimidation

Economic abuse

Male privlege

Using childern

Minimizing, denying and blaming

Isolation

Emotional abuse

1) honeymoon

2) tension building

3) acute abuse incident

REPEAT

(cycles decrease in length as time goes on)

homicide, suicide, materal mortality, AIDs-related deaths

Physical health

chronic conditions

mental health

reproductive health

health behaviors 

HIV/AIDS 

PTSD

If men could menstruate it would be something to want

There would be oppression against the non-mentrual

Society - bleeding is embarrassing 

Menarche parties- not common

Period and the moon cycle

Current teaching keeps girls oblivious to their bodies

"hygene" and "sanitary" imply women's vagina is unclean

Sea sponges - keep clean, reusable

The Keeper - rubber cup around cervix with stem that has hole in it. 

Blood towel

Bleeding cycle affects men - men are afraid of our blood

National Coalition for Immigrant Women's Rights (NCIWR) made in 2006

Immigrant women experience hardships at

Work

Bad health care

Violence

Low social and educational status. 

Liguistic isolation

Difficulties in getting VISA then medicare

Welfare reform act and Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA)

Medicaid and the State Children's Health Insurance Program

Undocumented - emergency medicaid only

Made it increasingly difficult for immigrant women to accessing social services such as healthcare.

Must reside in US for 5 yrs before federal funded health programs

Lesbians present later for health care 

term "lesbian" has negative connotations

youth suicide

unprotected sex w/ male or female most have heterosexual activity

high STI risk - pap smear still necessary

unwanted pregnancy

pelvic imflamatory disease - sex toys

Smoke, drink more alcohol

- colon, lung, ovarian (especially if never pregnant), breast cancer, cardiovascular disease and diabetes.

Birth Control should be presented as option.

Tuskegee Syphilis Study - Alabama African Americans denied effective treatment to see course of disease

- symbolize: racism in medicine, misconduct in human research, arrogance of physician, governmental abuse of blacks.

- mistrust: low participation of blacks in studies, low organ donors

Slaves as subjects for dissection and experimentation 

post-civil war - scared of kidnapping by night doctors

Black hospitals: only black doctors can treat effectively

Tuskegee - fear of genocide (also sickle cel and birth control programs)

Lower HC for blacks in based in 3 levels of racism

Institutionalized

Personally mediated

Internalized 

Differential access to resources

-Initial historic insult

- Structural barriers

- Inaction in face of need

- Societal norms

- Biological determinism

- Unearned privilege

- education, housing, employment, medical facilities, safe environment

Prejudice and discrimination, Differential actions based on asumptions about the abilities, motives, and intentions of others due to race.

- intentional 

- unintentional

- Acts of commission and omission

- Maintains structural barriers

- Condoned by societal norms

Acceptance of stigmatized negative messages about abilities and intrinsic worth

-reflects system of priveledge 

- Reflects societal values

- Erodes individual sense of value

- Undermines collective action

- One can say that others are dissadvantaged but deny that they are priveged b/c they want to protect that privlege

- Being white is advantage/ privilege 

unearned entitlement - conferred dominance

Feeling that one belongs should not be seen as privelege for a few

Sex ed in the US lots $$ to abstinence only

ceremonies for virginity

Marrage as the cop out

Teens perform oral sex b/c of this

Feminism teaches responsibility and no shame

Right to enjoy oneself 

Masturbation should be talked about and fun

Societal Praise of Anorexia

Anorexia is control of body

Body hatred - power, but sickness (mental and physical) → isolation

Positivist - large quantitative studies that dominate public health 

Cultural value of thinness → eating disorders

Women more likely to be obese- esp. lesbian, color, poor

Broad-based social and economic change - support eating and active living

Food production

Environments promote increased food intake and decreased activity

demands at home for fast meals

obesity - heart, stroke, breast colon & endometrial cancer, gallbalder disease, polycyctic ovary disease, osteoarthritis, sleep apnea, injury from fall in elderly

Poem about prevalen violence against women

violence can be on anyone by anyone

Horror movies, video games, and musc videos make violence against women positive/ sexy

What can we do? encourage discussion, seek experts, visual and internet tools, reach to boys as activists.