The Forgotten, Part 2
It was very disconcerting to hear Dr. Mary Claire Haver explain on the Huberman Lab podcast that when she started to experience perimenopause she was shocked by the void of information. I thought if Dr. Haver, a highly experienced Obstetrics and Gynecology specialist knew very little about perimenopause, imagine a lay person like me. Since myself and some friends have been experiencing perimenopause and menopause we too have been bewildered by the low level of knowledge and services available from the medical profession. I had no idea what was going on with my body. I didn’t initially experience hot-flashes, the only symptom I had heard women suffer from during this period. Instead I had extremely painful dry skin and insomnia which was really strange because I’ve always been diligent about moisturising my skin, and one of my best talents is being able to sleep anywhere, at any time and on demand. I’ve been wondering how such a significant period of a woman’s life could be forgotten by the medical profession. Is not like it lasts just a couple of years. Perimenopause alone will last anywhere from 7-10 years. And menopause can “go on forever” as a friend in her seventies once commented that she experienced “hot-flashes” until she was 70. Typically menopause symptoms last up to 10 years but could last for the rest of women’s life.
It occurred to me that perhaps it could be because medicine was largely created and run by men. But these men were born by, raised by and lived with women so how could they have forgotten an important part of their health? The other thought I had was that when modern medicine was created in the 19th century, the average life expectancy was much lower, less the age 40, so there was no need to worry about a physical change that started to happen to women in their 40s. But the practice of modern medicine is more than 200 years old and the average life expectancy for women has been above age 40 for over a century, as of 2021 it was 73.8 years.
Forgotten, intentionally
I recall a comment a female geneticist made recently when we were comparing our health care experiences as 40-something year old women: “Doctors know nothing about women after age 40.” Her comment is only a slight exaggeration if you consider some stats Dr. Mary Haver shared from PubMed, a global source for research in biomedical and life sciences with over 37 million citations. Prior to when the podcast aired in June 2024, on PubMed researching, Dr. Haver found that for pregnancy there were 1.1 million articles, for perimenopause 6,400 and for menopause 97,000. When I checked recently on PubMed the articles on pregnancy have increased to 1.5 million while the figures for menopause and perimenopause were the same. I wondered if the above results could be due to a shortage of female doctors? I believe there are sufficient numbers of doctors. To be sure, I checked the data. In the US female doctors are 37.7% with OBGYN doctors 60.5% female, in the European Union and OECD 50% of doctors are female. Dr. Haver explained why despite a sufficient number of doctors there is little attention given to this stage in women’s lives. For example, the American board of OB GYN every year requires doctors to take board certification exams, based on a set of cutting edge articles divided into specialty oncology etc…but there is no menopause category. She went back 10 years on her green journals (aka.The American Journal of Medicine), only <1% was on anything to do with menopause. When asked by Andrew Huberman if there were any exceptions and if the more forward thinking research in this area was coming out of Europe and Scandinavia. she replied:
“Some of the most forward thinking, shockingly, is coming out of Asia. A lot out of China. I asked my husband why, as he has worked there before. He said that there are as many researchers in China that are female as male. It’s not like they have a big stay at home culture… Women are expected to work and they are getting PhDs, doing the research.”
I find Dr. Haver’s surprise about China to be both ignorant and arrogant. As someone who has lived and worked in both the West and China I found China to be more of an egalitarian society for women. What impressed me the most about China was the fact that they were women working in roles and industries where in the West there were barely any women. Prior to moving to China I worked as a technologist in the US and Europe and I was always one of the handful of women, while in China I saw plenty of women working in construction, engineering, computing, etc.
The Creation Of Patriarchy
“I’m proud of what I learnt. I learnt amazing things. I’m a boss at delivering babies, taking care of pregnant patients. I’m great at paediatric oncology… Where I failed and let the system let me fail, was in the care of women after reproduction, outside of her surgical needs”.
The discussion with Dr. Haver resurfaced a nagging question I have had most of my life: When and how did we create and sustain for so long a world where women, the majority in numbers, are treated like the minority in all aspects of society? Over the years I’ve heard many explanations starting with the earliest one I heard as a kid at church from the Bible–that God created man in his own image and from the man’s rib cage, a companion and helper, wo-man. Therefore a woman is subservient to man. But this explanation has never sat well with me. As I grew older, I realised that the Bible consists of stories, written by a bunch of men to reflect and suit them. As I was mulling over this question again I remembered a book that I had been waiting for the right time to read, titled The Creation Of Patriarchy. I thought it might offer some answers. I was pleased to see that the author Prof. Gerda Lerner’s research started in ancient Mesopotamia, as this period predates when the Bible was written. I hoped it would explain why the content of the Bible was steeped in patriarchy.
What is patriarchy? It is “the manifestation and institutionalisation of male dominance over women and children in the family and the extension of male dominance over women in society in general. It implies that men hold power in all the important institutions of society and that women are deprived of access to such power. It does not imply that women are either totally powerless or totally deprived of rights, influence, and resources” (G. Lerner, The Creation of Patriarchy, pg.239). When exactly did it start? Based on archaeological evidence and written records difficult to assign to a specific time, rather it was a process that took place over a period of 2500 years from approximately 3100 to 600 B.C. and at different pace and in different societies (G. Lerner, The Creation of Patriarchy, pg.8).
How it was established
According to Lerner there is no evidence of a known society where women are not subordinate to men (G.Lerner, The Creation of Patriarchy, pg.30). Though hunter/gatherer societies were more egalitarian. Women gathered subsistence food and men hunted meat which they exchanged. Meat was considered more valuable but women supplied the majority of food consumed so there was strong economic cooperation. The general consensus amongst scholars is that in these societies women could be classified as “separate but equal” (G. Lerner, The Creation of Patriarchy, pg.29). How did women become unequal? The shift to a more sedentary and agricultural society necessitated a constant supply of labour. As women were required to give birth to and nurture labourers, men had to ensure they had rights to them. They acquired women through marriage, or as gifts to avoid incessant warfare or conquered them as slaves. “Women became a resource, acquired by men much as the land was acquired by men” (G.Lerner, The Creation of Patriarchy, pg.212). Lerner stressed that women should not be seen as mere victims in this situation but as participants in the creation of societies that subordinated them. They, like men, wanted to ensure the survival of their groups so they dedicated themselves to pregnancy, child-bearing and nursing. And they accepted the protection of their men from wars. Since then the commodification of women’s sexuality and reproductive capacity has continued. It was only in the last two hundred years or so that the rise in feminist consciousness has emerged to challenge this status quo. Why did it take so long?
Lerner put it down to the lack of women’s presence in history. By history she means the recording and interpretation of historical events. The history of civilization we have was written by and for men and interpreted by men. There is very little record of women’ contributions, achievements and struggles because women were restricted to the home as procreators and nurturers with little time and space to do anything else. The record of men’s contribution to civilization dates back to the third millennium B.C. while records for women started in the nineteenth century. This, Lerner believed, has had a big psychological impact on women and in keeping them subordinated, for history is critical for human consciousness and psychic well-being. “History gives meaning to human life and connects each life to immorality, but yet history has another function. In preserving the collective past and reinterpreting it to the present, human beings define their potential and explore the limits of their possibilities” (G. Lerner, The Creation of Patriarchy, pg. 221). Hence why Lerner dedicated her life to advance the development of women’s history. This is a worthy pursuit for the history of human civilization as we know it is incomplete without the other (slightly more than) half part of it–women’s.
After I finished reading the book, I felt disheartened by the knowledge that women have been subordinated to men for thousands of years. I know it is hard to break the habits of a lifetime, never mind that of multiple generations. I wonder if women will ever become emancipated. Then I realised that women’s subordination was a long historical process, so the emancipation of women from the clutches of patriarchy will also be a long journey. However, I believe it will happen sooner because women are having fewer kids, are better educated, and are freer to pursue their interests and realise their potential. China is a good example of what can happen when women are emancipated. I remember a conversation I once had with a male senior executive of a global Chinese company. I told him that a Western friend had told me that the best thing Mao did for China was get rid of religion. He disagreed, he said: “the best thing he did for China was free women. China wouldn’t have developed as fast and as well without women.”