women’s health update
Reshaping women; beauty, fashion and advertising
Looking good these days may involve more than a trip to the hairdresser’s, a long soak in the bath and a visit to the beauty parlour for a facial. For increasing numbers of women it means undergoing a great deal of pain as the result of the cutting and/or piercing of various body parts, the partial or complete removal of hair from their genitals, followed by the display of increasing amount of flesh including the breasts, stomach and buttocks. Sheila Jeffreys, author and lecturer in
the Department of Political Science at Melbourne University, was the guest speaker at the Women’s Suffrage Breakfast. In a preview of some of the ideas in her new book Beauty and Misogyny: Harmful Cultural Practices in the West which is due out later this year, Sheila described how the beauty, fashion and advertising industries have come together to reshape and ‘beautify’ women in ways that involve increasingly extreme and brutal cultural practices. She spoke of how the fashion and advertising industries have crossed the line between fashion and pornography - evidenced by a browse through the magazines and daily newspapers in any bookshop, supermarket or corner Sheila Jeffries speaking at the Annual Women’s Health Action diary. Smokefree Suffrage breakfast
vol 9 no 1 • May 2005
I n s i d e ●
National Cervical Screening Programme changes
●
World Breastfeeding Week 2005
●
What’s on
Back in the 1970s when women got involved in what is now referred to as second wave feminism the issues discussed in consciousness-raising groups throughout much of the western world included how pressure is put on women to conform to men’s expectations and cultural requirements about how the female body should look. Beauty practices such as the shaving of legs and armpits, the wearing of makeup, bleaching, dyeing and perming of hair, and wearing high heeled shoes and platform shoes, were put under the spotlight. All of these seem ridiculously tame when compared with what women are being encouraged to undergo today.
Breast implants Women are now subjecting their bodies to an ever increasing variety of surgical practices on a regular basis. Despite the ongoing controversy over their safety, breast implants remain more popular than ever. Women still opt for implants despite being informed that they do not last a lifetime and that having breast implants will continued on page 2
Women’s Health Update features women’s health news, policy and scientific findings, to enable health care professionals and community-based workers to be at the forefront in women’s health. Women’s Health Update is published by the Women’s Health Action Trust
2 • Women’s Health Update • vol 9 no 1 • May 2005 Reshaping Women continued from page 1 mean repeat surgeries in order to have them replaced and/or to treat the range of complications that often occur.
Cosmetic surgery Breast implants are just one of the long list of cosmetic surgery techniques on offer. There is no part of the body that cannot be reduced, radically altered, augmented, amputated, trimmed or nipped and tucked. Sheila Jeffreys referred to cosmetic surgery as ‘severe self-mutilation’ by proxy in which 80% of the patients are women and the vast majority of surgeons are men. In Australia, Rhian Parker interviewed 32 women who had had cosmetic surgery and nineteen doctors who practiced it about their views on cosmetic surgery. She found most doctors misunderstood women’s reasons for wanting it, they underplayed the risks and complications and that communication by them to their patients was brief, fragmented and often delegated to nurses and other staff. Of the nine women Parker interviewed who had breast implants, eight said the implants were bigger than they wanted. The real question here is: are women able to get what they want or are they getting what doctors think they should have? Increasing numbers of women turn to the scalpel as a means of conforming to men’s expectations of beauty and as a response to the ageing process. Women have largely given up trying to change the beauty ideals of a sexist and racist society which are reinforced by the powerful manipulations of the fashion and advertising industries.
The influence of pornography The infiltration of the pornography industry into mainstream society via advertising, fashion and the Internet, results in the acceptance of practices such as the removal of genital hair (bikini and Brazilian waxing), surgical alteration of labia to create a uniform look (labiaplasty), and revealing increasing amounts of flesh especially breasts, stomach, and buttocks. Many women routinely remove most of their genital hair and undergo genital surgery so that their genitals resemble those of porn stars in pornographic magazines and videos. Images which are certainly airbrushed or surgically created.
Members of the medical profession have become complicit in the practice of ‘carving the genitals of pornography on women’s bodies.’ Western surgeons, who call themselves ‘appearance medicine’ specialists these days, have been quick to cash in on and promote the demand for such procedures. It’s known as the Penthouse effect and an American ‘designer vagina’ specialist has a whole page on his website dedicated to publicity about his expertise. You could be excused for thinking that you had strayed into a pornographic magazine website rather than a medical one. Today Playboy, Playgirl Nerve and Madam sit alongside mainstream publications such as New Woman, Cosmopolitan, Bazaar and Marie Claire on this website. In New Zealand, doctors and surgeons are dabbling. Some have a history of working with these bits of women’s bodies. One who is beyond dabbling and in boots and all is ‘appearance gynaecologist’ Dr Andrew Mackintosh. He regularly advertises his services in the NZ Herald and a visit to his website shows that women can choose from a range of procedures which includes: • labial rejuvenation including surgical reduction by ‘sculpturing the elongated or unequal labia minora according to your specification’ or surgical augmentation to ‘create aesthetically enhanced and youthful labia majora’) • pubic liposculpting to ‘alleviate the unsightly fatty bulges of this area and produce an aesthetically pleasing contour’ • hymen reconstruction which repairs ‘the hymen as if nothing ever happened’ • perineum rejuvenation to ‘rejuvenate’ the relaxed or aging perineum and enhance the sagging labia majora and labia minora to provide a youthful and aesthetically appealing vagina. The question this raises is aesthetically appealing to whom? And who is benefiting from this rejuvenation? Is it the women who suffer the pain of the operation? Women’s Health Action has begun receiving complaints from women whose genitals have been seriously carved, far beyond their expectations. We are
interested to talk with other women who find themselves in this situation.
Pornography or fashion statement? The distinction between the fashion industry and the sex industry is extremely blurred. Young women eagerly adopt the minimal clothing, boots, piercings, body jewelry and tattoos once considered the domain of those involved in the sex industry. T-shirts proudly proclaiming ‘slut’ are marketed to pre teens. Pornographic images of women abound in fashion magazines. For example, the front cover of the summer 2004 issue of Style featured a naked black woman, pointy breasts exposed, with the word ‘SURRENDER’ emblazoned in large letters across the bottom of the page. Inside are images of scantily clad women in various poses – sitting with legs wide open, lying on arched backs, crouching and kneeling in provocative poses. Some are completely naked in a magazine which purports to sell clothes! The men are either fully clothed or - very occasionally - bare chested. The summer 2004/2005 issue of Pavement contains numerous images of extremely thin vulnerable young women in erotically innocent child-like poses, some exposing their breasts, midriff, back or naked buttocks, hanging out their washing in their underwear, or holding a bottle of beer between their naked breasts. Some of these women are also completely naked. Once again the men are usually fully clothed. As Sheila pointed out we now have the fashion industry selling prostitution and pornography and the sex industry selling clothes.
Brave new world Sheila concluded her talk by envisioning a world without harmful beauty practices where women took care of their bodies in ways that were not focused on serving the sexual interests and dictates of men and a male-dominated society. She envisages a world in which the clothing women wore, including the shoes on their feet, would be comfortable, practical and to their liking. It is a world we seem to be moving away from, the challenge for us all is how to move towards it.■ See also article in Shoe box on page 3
Women’s Health Update
• vol 9 no 1 • May 2005 •3
Changes at the National Cervical Screening Programme Changes to the National Cervical Screening Programme (NCSP) came into effect in early March. The changes are aimed at improving the quality, safety and effectiveness of the programmes and are a result of the Health (NCSP) Amendment Act passed in March 2004. Amongst other things, the new Act allows evaluations and audits of the programme to be carried out without the consent of women whose records will be used in the evaluations. The records available to be used include access by auditors to women’s files held by GPs and hospitals.
At the end of February, the NSCP sent a letter outlining the changes to all the women enrolled on the NCSP Register. This letter has become known as the million women letter as there are now over one million women enrolled in the NSCP.
Shoes
• Making it clear who is responsible for running the programme, how it works and what the responsibilities are for the health professionals involved in it, including smear takers, laboratories and gynaecologists • Making sure women get the information they need about the cervical screening programme, including their option to withdraw from it • Changing the NCSP-Register withdrawal option from opting out of individual smears to withdrawing from the Programme as a whole • Recording and monitoring of all cervical smear results except for those women who withdraw from the Programme • Allowing access to personal health records by trained evaluators (without the consent or knowledge of the woman) so that Programme can be fully evaluated. • Providing for regular external independent review of the NCSP
High heels and platform shoes, once again fashionable, reshape women’s bodies - changing their posture and forcing them to walk or mince with short steps and feet close together. High heels not only make standing and walking precarious and tiring, it causes pain and damage, and can result in permanently deformed feet.– bunions, hammer toes, the shortening of the calf muscle and lengthening of the Achilles tendon. The resulting damage can make it impossible for women to walk without high heeled shoes. High heeled shoes are also a safety hazard. An interview with Naomi Campbell, one of the world’s most famous models, recently screened on TV One featured a clip of a young Naomi in platform shoes falling off the catwalk. This is not an uncommon hazard for models as they teeter along the catwalk in ridiculous high heeled shoes that most women would find unwearable. Despite the well-publicised damage that this practice causes to women’s health, shoe manufacturers ( predominantly male) and the fashion industry show no sign of making foot health a priority in the foreseeable future. The latest foot craze is surgery to make women’s feet fit the fashionable shoes. To streamline the foot the little toe and the side of the foot are ‘sculpted.’ (That is, surgically removed). The parallels to the ancient cultural practice – Chinese footbinding – are obvious. Today, there is little doubt about who benefited and who was harmed by such extreme ‘historical’ practices. Too few are able to apply these lessons from the past to women
The changes include:
Changes for women wishing to ‘opt-off’ or withdraw Women are either in or out of the NSCP now. If you are in, all your results must be recorded on the NSCP-Register. If you ‘opt-off’ or withdraw, none of your results are included and any results already on the register are destroyed. It is no longer possible to ‘opt-off’ individual smears. Women who choose to withdraw from the NCSP do so by filling in the ‘Withdraw from the Programme’ form (available on the NCSP website: www. healthywomen.org.nz) or by writing to the NCSP asking to withdraw. Women are able to choose whether they want the paper records already on the NCSP-
Register returned to them or destroyed. Prior to 7 March 2005 women were provided with a printout of the information held electronically about them on the NCSP-Register when they opted off. However, it is unclear whether this option is still available. The Federation of Women’s Health Councils is consulting with its membership prior to approaching the DirectorGeneral of Health, Dr Karen Poutasi, asking that the new process be amended. They want women who choose to withdraw from the programme given a printout of their NCSP-Register information prior to it being deleted. The Federation points out that while this is not a requirement of the new legislation, the law does not prevent the NCSP from doing this.
Information available for women and where to get it • Pamphlets and booklets – including Cervical Screening: A Guide for women. Cervical smear tests – What women need to know. Cervical screening – Understanding cervical smear test results. Colposcopy – Information for women who have abnormal cervical smear results. Atawhaitia Te Wharetanga • Posters – My body, my health, my future. Atawhaitia Te Wharetanga. Pacific peoples cervical screening poster • Questions and Answers on the new Act:www.healthywomen.org.nz. Click on the news button • Fact sheets: 1.About the NCSP, 2. Purposes of the new Act, 3.Enrolment in the programme, 4. Benefits of the programme 5.Evaluation to ensure quality for Women, 6.The NCSP-Register • Screening Matters newsletter – a regular newsletter from the National Screening Unit ■ For further information on any of these resources: phone the NCSP freephone 0800 729 729 or visit: www.healthywomen.org.nz.
4 • Women’s Health Update • vol 9 no 1 • May 2005
Breastfeeding and Family Foods: Loving and Healthy World Breastfeeding Week 1-7 August 2005
The theme for this year’s World Breastfeeding Week from the World Alliance for Breastfeeding Action (WABA) is Breastfeeding and Family Foods: Loving and Healthy with the key message being “Feeding other foods while breastfeeding is continued.” Last year the emphasis was on exclusive breastfeeding for the first six months to reduce risks of illness, disease and allergies to babies. This year the focus is on continuing to breastfeed after solids have started. An informal survey by Women’s Health Action reveals that, like the rest of the world, the introduction of solids generally starts before six months of age in New Zealand. WABA suggests that if babies world wide were • exclusively breastfed for six months • then introduced to appropriate solids while breastfeeding continued up until two years then almost 2.5 million babies per year would be prevented from dying. This single health initiative has the potential to save more lives than antimalarial measures, vaccination and vitamin A supplementation put together!
The Golden Bow lapel pins are a visible symbol of breastfeeding support anytime of the year. Available at cost price from WHA
Breast milk provides more calories and nutrients per ml than most other foods, such as baby cereals and pureed vegetables. If babies’ small tummies are filled with other foods they will drink less breast milk and their overall diet and health will be inferior. The challenge is assist New Zealand families to wait until 6 months before introducing other foods and to see breast milk as a main component of diet for at least the first 12 months of life. The three key messages around the introduction of solids are: 1. TIMING: Wait until the baby is 6 months old before starting solids and continue to breastfeed frequently on-demand. Understand that from 6-8 months solids are very experimental for babies, so the
majority of nutrients come from the breast milk. 2. RESPONSIVE: Solids are best introduced with sensitivity; slowly and patiently. In the same way that baby regulates breastfeeds, so too will they regulate solids. They will stop eating a solid feed when they are ready and should never be forced. 3. NUTRITIONAL: First foods should be small in quantity and high in nutrient value. The recommendation is to keep the cereal, carbohydrate and bread component low and the protein, fruits and vegetables high. Women’s Health Action is organising a campaign and activities for World Breastfeeding Week which will promote these messages and promote breastfeeding alongside the introduction of solids. We are also interested in what other organisations are doing for the week.■ For information on WHA activity or to report initiatives of your own, please feel free to contact Breastfeeding advocate, Louise James at (09) 5205295 or louise@womens-health.org.nz
Noticeboard ●
INTRODUCTION TO STRENGTHENING FAMILIES
21 June 2005 Awataha Marae, Northcote Organised by Strengthening Families, Ministry of Education For information contract Aggie Cherrington (09) 487 1161 or email: agnes.cherrington@minedu.govt.nz
● MAKING THE LINKS FOR PUBLIC HEALTH PUBLIC HEALTH ASSOCIATION CONFERENCE 6 - 8 July 2005 Wellington For further information http://www.pha.org.nz
TIDAL MODEL - MAKING WAVES:
●
●GETTING THE BALANCE RIGHT: THE CANCER SOCIETY, ITS FUTURE ROLES IN CANCER CONTROL
CELEBRATING DIVERSITY AND CONNECTION 29 June - 1 July 2005 Matamata, Totara Springs, Matamata For further information contact Jacquie Kidd, Tidal 2005, 14 Balmerino Crescent, Pukete, Hamilton or email: Tidal2005@clear.net.nz
●
CHILDREN AND YOUNG PEOPLE AS CITIZENS
7 - 9 July 05 Dunedin Children’s Issues Centre Conference. information: www.otago.ac.nz/CIC/CIC.html
12 - 14 September 05 Palmerston North The 2nd National Cancer Conference For information: mlefevre@xtra.co.nz
●
COURAGEOUS PRACTICE IN FAMILY VIOLENCE - A CALL TO ACTION
20-22 October 2005 Waipuna Conference Centre, Auckland Abstracts for papers or workshops to be submitted by 30 June to: jillp@preventingviolence.org.nz. fax: 09 303 0067
Women’s Health Update is produced by Women’s Health Action Trust • Edited by Jo Fitzpatrick To receive copies of Women’s Health Update, make suggestions about future contents or send items for publication please contact: Women’s Health Action Trust • PO Box 9947, Newmarket, Auckland, New Zealand • 2nd Floor, 27 Gillies Avenue • Ph (09) 520 5295 • Fax (09) 520 5731 • email: info@womens-health.org.nz Internet address: http://www.womens-health.org.nz • Women’s Health Update is published with the assistance of the Ministry of Health