Overused and Underinformed: The Secrets of the Hysterectomy in the U.S.

Amie Newman

Are hundreds of thousands of women in the U.S. undergoing unnecessary hysterectomies without proper informed consent? Women's health advocate, Rep. Carolyn Maloney says possibly.

Updated 5/20/2010, 2:15pm EST: A point of clarification, for the record, from Mrs. Maloney’s legislative office: Congresswoman Maloney is not contemplating introducing a bill and, in fact, in response to a question from an audience member during the forum, made clear that she is considering looking into if GAO can do a study, not legislation. Indeed, she doesn’t like the idea of Congress mandating that a particular video should be shown prior to any medical procedure. Nonetheless, in 1978 and 1993, Congressional hearings highlighted the issue of unnecessary hysterectomies, and Congress does have a role to play in investigating the reasons why so many women are being encouraged to undergo hysterectomies when less invasive alternatives are often available, particularly since they can have a negative impact on women’s health.

Rep. Carolyn Maloney is wondering why people aren’t more outraged. Hundreds of thousands of women undergo hysterectomies in this country every year, but many don’t fully understand the extent to which this surgery will impact their health and lives. As a consequence, the Manhattan Democrat, according to an article in Womens eNews today, “Maloney Mulls GAO Study on Hysterectomy,” is on a mission to figure out whether or not mandating informed consent, by watching a video about the adverse effects prior to having a hysterectomy, is feasible.

It started when Maloney considered undergoing a hysterectomy herself but then was, according to the article, persuaded not to by friends who were women’s health advocates.

Why?

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According to the HERS Foundation, a nonprofit organization which provides information about the alternatives to – and consequences of – hysterectomies and which held the event where Maloney spoke about this issue recently, the effects of a hysterectomy’s damage are “lifelong” and 98 percent of women who have the surgery do not, in fact, need the surgery.

In addition, according to an ongoing study led by HERS,  

“99.7% percent of women…were given little or no prior information about the acknowledged adverse effects of hysterectomy — information that is a legal requisite of consent.”

Because of this, the HERS Foundation has created a video that they want women to view prior to the surgery taking place. Writes Cerra Whittelsey in Womens eNews:

About 600,000 American women undergo hysterectomies every year. Rarely do they hear anything from their doctors about adverse effects other than the inability to have more children, said Nora Coffey, founder of HERS, during an interview.

Many people are not aware that there are different types of hysterectomies which can involve the removal of not just the uterus, but may also involve the removal of the cervix, ovaries and/or upper part of the vagina. HERS says some types of hysterectomies are considered “castration” and clearly some women who have been through the various procedures agree.

This is drastic surgery and from all available evidence women do not seem to be fully informed of the drastic consequences. From urinary incontinence to loss of sexual desire to an increase in the risk of heart disease and osteoporosis, the list of after effects of a hysterectomy is a long one.

Indiana’s House of Representatives held a hearing on the issue after one of their representatives, Rep. Borders, spoke up about his own wife’s hysterectomy, the unexpectedly debilitating impacts and the subsequent decision that they were lied to about her need for the surgery. Borders has been a vocal advocate for informed consent prior to hysterectomies in his own state.

The full Womens eNews article is here and worth a read.

In case you’re not convinced that this should be a priority for women’s health advocates, the performance of a hysterectomy, according to the Department of Health and Human Services, is the second most common surgery for women in the U.S. And, by the way – the first? Cesarean sections. So, not only are hysterectomies and c-sections the most common surgeries for women in this country, but there is now growing evidence that they are two of the most overused.

I’d say it’s time for a reality check amongst womens’ health advocates. Understanding that the medical establishment is being allowed to persuade women that we “need” these invasive – incredibly invasive – surgeries related to our reproductive and sexual health should lead us to swift and concrete action.

Culture & Conversation Media

Bitch Magazine Co-Founder Probes ‘the Buying and Selling’ of Feminism in New Book

Amy Littlefield

In We Were Feminists Once, Andi Zeisler argues that a 2014 Beyoncé performance signaled feminism's "arrival" as a mainstream movement. But, the gender equality promised by feminist imagery in pop culture and the market​ has not trickled down.

Beyoncé, Taylor Swift, and Emma Watson are feminists. So is Miss Piggy from the Muppets. Chanel’s 2014 runway show flaunted feminist imagery, and even Katy Perry’s signature perfume is feminist.

Something has happened to feminism.

“It was hot,” Andi Zeisler writes in the introduction to her new book, We Were Feminists Once: From Riot Grrrl to CoverGirl®, the Buying and Selling of a Political Movement. “And, perhaps most important, it was sellable.”

It’s the moment Zeisler, one of the founders of Bitch magazine, has been fighting for for 20 years: the tipping point. Feminism has arrived.

“I always believed that the realm of media and popular culture was where feminism would truly change hearts and minds,” Zeisler writes. “Theoretically, this was exactly the breakthrough my cofounders and I had always hoped to see.”

But as you may have guessed from the subtitle, there’s a catch. Like the wealth promised by President Ronald Reagan, the gender equality promised by feminist imagery in pop culture and the market has not trickled down.

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Here’s how Zeisler sums up the disconnect:

As we celebrate the increasing number of female TV showrunners and writers, Senate Republicans have twice unanimously voted against an act designed to close the gendered wage gap. As our tabloid magazines documented every blessed step of Caitlyn Jenner’s transition, an anti-discrimination ballot measure in Houston, Texas was defeated thanks largely to TV ads that painted transgender women as child predators, warning, “Any man at any time could enter a women’s bathroom simply by claiming to be a woman.” As we excitedly binge-watch a Netflix series about life and love in a women’s prison, dozens of black women have died in police custody in recent years, with no satisfactory explanation as to why.

In this deeply researched account, Zeisler charts the co-optation of feminism and women’s empowerment over the decades, and shows how this process reached a peak in 2014. In 1929, Lucky Strikes cigarettes were cast as “torches of freedom,” a co-optation echoed in perhaps my favorite of Zeisler’s examples: the 1970 billing of the Liberated Wool Sweater as the “embodiment of the new freedom.” In 1998, First USA offered a Mastercard celebrating the 150th anniversary of the Seneca Falls women’s rights convention. But while corporations and popular culture have always tried to sell their ideas of what women want, Zeisler identifies 2014 as The Year It Happened.

It was Beyoncé. On stage at the MTV Video Music Awards, Beyoncé sampled Nigerian author Chimamanda Ngozi Adichie and posed in front of the bright, white, glowing word: “FEMINIST.” In a 2014 Bitch post after Beyoncé’s performance that presaged some of the ideas in her new book, Zeisler wrote that the performance “positioned feminism as Beyoncé’s official brand.” While its impact was undeniable, Zeisler wrote that “the branding of feminism as an attractive product for consumption is very different than the work of feminism as a progressive movement.”

To be clear, Zeisler’s book doesn’t diss Beyoncé; it draws a distinction between what she calls “marketplace feminism”—the “mainstream, celebrity, consumer embrace of feminism,” which is often about selling us something—and the less visible work feminists (including Beyoncé) do every day to advance gender justice. In fact, the best part about Zeisler’s writing on pop culture is that she doesn’t hate it; she’s a connoisseur, which makes her the most entertaining, well-informed of critics.

She applies an almost encyclopedic knowledge of film, television, music, and advertising to reveal the funhouse-mirrorlike results of mainstream culture’s co-optation of radical ideas. Take what pop culture did to the punk movement Riot Grrrl, with its out-of-bounds, anti-capitalist, “girls to the front!” ethos: “The phrase ‘Girl Power’ was harvested from Riot Grrrl zines and re-emerged, a marketplace-feminist Frankenstein’s monster, in the juggernaut of the Spice Girls.” And what happens when even consumer products like underwear can become feminist? An “uncanny valley,” filled with objects that kind of look feminist: “In the uncanny valley, those granny panties are feminist because they say so on the butt.”

In one of the book’s strongest sections, Zeisler unpacks how even feminist ideas like choice and empowerment have been co-opted to sell damaging mythologies, like poverty as an individual, not a societal failing, or the notion that women make choices about work and family in a vacuum. Zeisler writes that Roe v. Wade, the 1973 Supreme Court decision legalizing abortion, “shifted the language of bodily rights from demands to choices.” After that, “the advent of neoliberalism did the rest, normalizing the self-focus and singularity made ever more possible by a booming free market. The parlance of the marketplace became the default way to talk about almost all choices made by women.”

So what happens when neoliberalism—with its ethos of privatization, deregulation, and individualism—co-opts feminism? You end up with figureheads like Facebook COO Sheryl Sandberg, whose “lean-in” feminism masks the failings of capitalism by implying that women who fail to break through systemic barriers simply aren’t leaning hard enough. As Zeisler notes, the neoliberal approach to feminism obscures racism, classism, and other barriers that “make grabbing status-quo balls almost impossible for anyone other than the people who are already in closest proximity to them.”

By tackling the false promises of “marketplace feminism,” Zeisler has provided a much-needed counterpoint to Sandberg’s classist vision. Her critique of this exclusive iteration of feminism—and its cozy ties to the corporate powers that be—reaches its peak during her description of the 2014 MAKERS Conference, a corporate-sponsored, invitation-only event attended by Sandberg, Martha Stewart, actress Geena Davis, and more, or what Zeisler sums up as a gathering of “very elite women patting other very elite women on the back for their individual achievements in highly rarefied fields.”

What Zeisler calls “marketplace feminism” could, at times, have simply been called “capitalist feminism” or maybe just capitalism. Its co-optation of social movements is hardly new or unique to feminism. But in an email to Rewire, Zeisler said she coined “marketplace feminism” as a more specific term, “because of the way it invokes picking and choosing, taking on the parts of an ideology or practice that appeal to you and ignoring those that don’t.” In co-opting feminism, pop culture and the market have taken the sellable and left the “thorny, unsexy realities” behind.

Still, Zeisler misses an opportunity to fully articulate an alternative to “marketplace feminism,” perhaps one that encompasses its logical counterpoint: socialism, another idea that’s arguably having its Beyoncé moment right now. For many on the Left, watching Democratic presidential candidate Bernie Sanders criticize capitalism on a national debate stage has been akin—and bear with me here—to what happened at the VMAs in 2014, albeit … well, not nearly as … hot. The number of young women identifying with socialist principles suggests many potential readers would appreciate an explicit discussion of alternatives to capitalist feminism—beyond equal pay, what about basic income?—but Zeisler largely avoids this conversation, instead alluding more broadly to the need for a “post-marketplace-feminism world.”

In the end, the book’s greatest weakness is that it sidelines today’s grassroots feminist and intersectional social movements, many of which oppose capitalism. While she acknowledges organizations like Know Your IX and the National Domestic Workers Alliance, Zeisler’s only explicit mention of Black Lives Matter is to cite the hashtag as a branded entity, lumped in with “Barack Obama’s presidential campaign” and “one-for-one TOMS shoes.” (“By a branded entity, I don’t mean that #BLM is actively selling a product,” Zeisler wrote, when I asked her about this in an email, “but that it has leaders and language and imagery that are associated with it, and the words have become shorthand for something that people feel deeply invested in.”) Yet, it feels like an oversight of one of this generation’s most defining social movements. #BlackLivesMatter caught fire like a brand, but it was created by women of color, not by tobacco or shoe companies. It’s a surprising blind spot for a book that reckons with how “marketplace feminism” can obscure racial and economic injustice.

Zeisler ultimately falls into her own trap, focusing too much on the very things on which, she suggests, we are too focused. In critiquing the fixation on celebrity spokespeople, she writes: “It’s as though feminists are becoming part of a celebrity movement, rather than celebrities joining up with a feminist one.” But the opposite is true: Celebrities like Jennifer Lawrence, Lena Dunham, and Miley Cyrus are responding to a movement that has pushed some feminist ideas into the mainstream. That doesn’t mean feminism has been bought. Beyond the rarefied MAKERS Conference, feminists are protesting on behalf of women killed by police and against anti-transgender legislation. The feminists I know watch Beyoncé’s “Formation” video on repeat, but they don’t think the battle’s over because Beyoncé tipped her hat.

I learned a lot from Zeisler’s witty, well-informed prose, and it was refreshing to read a feminist book so openly critical of capitalism. But in the end, I just can’t buy the idea that feminism has been sold. Maybe it’s because I was there on March 2, as thousands of feminists gathered outside the Supreme Court while it heard the most significant abortion case in a generation. People who had had abortions told their stories, on their own terms, and so did abortion providers. That was feminism—not defined by Sheryl Sandberg or even by Beyoncé.

Roundups Politics

Campaign Week in Review: Cruz Likens His Supreme Court Pick to ‘Lord of the Rings’ Character

Ally Boguhn

This week on the campaign trail, Donald Trump and Ted Cruz spoke about whom they would nominate for the vacant Supreme Court seat, and Trump saw his favorability plummet among women.

This week on the campaign trail, Donald Trump and Ted Cruz spoke about whom they would nominate for the vacant Supreme Court seat, and Trump saw his favorability plummet among women.

Cruz, Trump Discuss Their Supreme Court Nominations

Republican presidential candidates Sen. Ted Cruz (R-TX) and Donald Trump were hard at work dreaming up possibilities for a Supreme Court nominee should the Senate obstruct Obama’s pick for the vacancy.

Appearing at a rally over the weekend for Sen. Mike Lee’s (R-UT) bid for re-election, Cruz commented that Lee “would look good” on the Supreme Court. Cruz compared Lee to Gollum, a character from Lord of the Rings, claiming that “For Mike, the Constitution is ‘my precious,'” according to the Salt Lake Tribune. 

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Lee’s work opposing abortion during his time in Congress earned him a 100 percent rating from the anti-choice National Right to Life Committee. The Republican senator has supported several measures attempting to limit access to or outright ban abortion, including a 2013 bill to investigate all abortion clinics and extend “personhood” rights beginning at the moment of fertilization, which could outlaw many forms of birth control in addition to abortion.

Lee’s 2010 campaign website included a section noting his opposition to legal abortion and Roe v. Wade:

The Constitution says nothing that can plausibly be read to suggest—as the Supreme Court concluded in Roe v. Wade—that States are essentially powerless to protect unborn human life. This power to protect the most vulnerable members of society needs to be returned to the States.

Donald Trump also signaled he was mulling over potential picks for the Court’s vacancy, promising during a Monday press conference in Washington, D.C., to release a list of seven to ten potential picks. If elected, Trump vowed to choose nominees exclusively from the list, which he said will be created by the “Heritage Foundation and others.”

But as ThinkProgress reported, the Heritage Foundation “is an odd place for a presidential candidate to seek advice on any topic” given its history of discriminatory politics:

Heritage is a think tank known for its stridently conservative views and its unorthodox approach to mathematics. They oppose marriage equality, defend discrimination against LGBT Americans, and they have a surprisingly long history of reversing their own stances on health policy when doing so is useful to opponents of Obamacare. Their former chief “economist” is an ex-newspaper columnist and anti-tax activist with no doctorate in economics.

In 2013, Heritage released a widely criticized report claiming that immigration reform would cost an eye-popping $6.3 trillion. One of the co-authors of that report resigned four days later after news broke that “his graduate dissertation on immigration was premised on the idea that Latinos were less intelligent than whites.”

The Heritage Foundation is vehemently anti-choice, a position that could inform its picks for the Court. The organization’s “Solutions 2016” policy recommendations include calls to expand bans on using federal funding for abortion, redirect funding for reproductive health away from Planned Parenthood to community health centers, and codify protections for “medical personnel who decline to provide, pay for, provide coverage of, or refer for abortions.” Its website also details the organization’s opposition to Roe v. Wade, dismissing the decision as “judicial activism.”

Poll: 74 Percent of Women Registered to Vote Hold Unfavorable Views of Trump

A CNN/ORC International poll released Thursday found that Donald Trump is viewed unfavorably by 74 percent of registered women voters and 81 percent of people of color.

The poll, which asked registered voters whether they “have a favorable or unfavorable opinion” of presidential candidates, shows potentially major hurdles for the Republican front-runner moving into the general election. Comparably, 50 percent of women and 36 percent of “non-white” people polled said they had an “unfavorable” view of Hillary Clinton.

Polling from the Washington Post similarly found that Trump’s favorability among women has been steadily decliningjeopardizing the Republican Party’s already tumultuous relationship with women. “Trump’s favorability numbers have decreased 10 points among women nationwide since November, to 23 percent, while his unfavorable number among women has jumped to 75 percent from 64 percent, according to a Washington Post-ABC News poll taken this month,” reported the Post.

What Else We’re Reading

Franklin Foer explained for Slate that “there’s one ideology that [Trump] does hold with sincerity and practices with unwavering fervor: misogyny.”

The Washington Post’s Karen Attiah wrote about the sexism she experienced from Donald Trump after asking him a policy question during his sit-down with the paper’s editorial board.

ThinkProgress’ Aaron Rupar explains how the Republican presidential race has turned into a “sexist competition over whose wife is hotter.”

Voters in Arizona had to wait in line as long as five hours to cast a ballot in their state’s Tuesday primary thanks to a Supreme Court decision that “gutted” the Voting Rights Act (VRA) and “an ill-conceived decision” to cut polling locations in order to save money. As the Nation reported, “Phoenix’s Maricopa County, the largest in the state, reduced the number of polling places by 70 percent from 2012 to 2016, from 200 to just 60—one polling place per every 21,000 voters”a change that “would very likely have been blocked” had the VRA’s protections remained intact.

Bernie Sanders applauded Phoenix Mayor Greg Stanton’s request for a Department of Justice investigation into voting delays in Maricopa County.

Dark money groups in Wisconsin are outspending candidates on ads for the Wisconsin Supreme Court race. When voters head to the polls for the April 5 judicial elections, “they won’t know who funded most of the ad spending around this race,” said the Sunlight Foundation’s Libby Watson.  

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