June 5, 2011

Close-up on the Cervix

Drawing by Suzann Gage
While teaching women’s studies at a college in town a few years ago, and discussing genital self-examination with my female students, I remember several saying they would never do that; they would never look at themselves “down there,” – why would they?

As Suzann Gage who runs Progressive Health Services in San Diego, California, explains, there are in fact many important reasons for young women to know their bodies, in particular in a culture where women are bombarded by ideals for how their bodies—including their genitals—should look. Where women beneath the gynecologist’s white sheets can be made to feel bad for the way even their cervix appears.

I was therefore happy to see Gage’s work featured at an exhibit another college in town recently hosted: Every Body! Visual Resistance in Feminist Health Movements, 1969-2009.

A former art student, Gage became a feminist health activist in the seventies, helping women learn about cervical self-examination with a speculum and a mirror, a radical new trend in the women’s health movement at the time.

Interviewed by Bonnie Fortune, the curator of the original exhibit at a gallery in Chicago in 2009, Gage describes the empowerment she felt when she first got to see her own cervix: “It was like I gained a part of my body that was not available to me before and it was just amazing. I became very dedicated to the cause of women having control of their bodies” (8).

After abortion was legalized in 1973, Gage moved from Illinois to California where the Feminist Women’s Health Centers formed the Woman’s Choice Clinic in Los Angeles, becoming the first outpatient clinic that did abortions after the law was changed. Here Gage learned how to provide health services, participating in weekly self-help clinics at night where any woman could come and learn how to look at her cervix with a speculum.

Realizing the need for illustrated material that described cervical self-exams, the women at the clinic set out to make a book (A New View of A Woman’s Body) including photos (by Sylvia Morales) featuring women’s cervices throughout their cycle, and anatomical drawings by Gage:
We were looking at our cervixes every day, and looking at each others’ cervixes and we could see this really wide range of normal. We knew that women’s bodies did change dramatically and that the cervix and the secretions did change dramatically through the menstrual cycle and we wanted the average women to know about that.
Women were incorrectly being told by their doctors that they had health problems that they didn’t have because their doctors just simply weren’t familiar with what was normal in a woman’s body. They had never been trained in medical school to recognize changes in the cervix that occur normally through the menstrual cycle. So, women were sometimes being told that they had vaginal infections when they didn’t just because they had an increase in their secretions which was normal for them … Or, they were being told that they had cervicitis because you could see this reddish skin around the os [the little hole in the cervix where the blood comes out of the uterus during menstruation and where the baby comes out of the uterus during childbirth]. It is normal in younger women to see the red ring around the os, but [the doctors] had never been trained to know that. (12-13)

Drawing by Suzann Gage
The women also found a lack of accurate information on the clitoris, based around "a stereotype of what constituted sexual activity." In our "patriarchal western culture, [sex] was defined as penis-in-vagina sex, missionary position" (15).  -- With this focus on the vagina, the modern medical textbooks referred to the clitoris as “this little, tiny, pea-shaped bump, that happened to be kind of up above at the outer-outside of a woman’s vulva” (16). The women had to go all the way back to old medical textbooks from the 1800s and early 1900s, which included drawings done from cadavers, to find accurate information and illustrations revealing the amazing muscle tissues of the clitoris.
I will never forget at this presentation I did one time where I was showing the drawings about the anatomy of the clitoris and explaining all the parts, and this woman came up to me afterwards. She was a middle aged woman who told me that she never had any information about this and she always thought that she was terribly abnormal or that she was somehow deformed or something, to have experienced the amount of swelling of the clitoris that she did.

In terms of during sexual response, the clitoris is comparable in its overall mass to many men’s penises … It’s a good-sized organ and it swells to several times its size. It really engorges with a tremendous amount of blood and can become very distended. To think of the clitoris as the little, tiny, pea-size shaped portion, just the glands part of it, does not explain this experience. And this woman came up to me and she was in tears, and she said, “I always thought I was horribly deformed or there was something terribly anatomically wrong with me, because I, I thought the clitoris was just this little part, and I would have this tremendous amount of swelling.” (19-20)

Drawing by Suzann Gage
As Gage says, when it comes to our health and well-being, “information is so important in allowing people to make informed decisions” (25).

Gage has been committed to empowering women to take charge of their bodies and their own self-help based care, and not to depend on others, including their physician, to always make the right decision for them.

For her clinic’s website, Gage is in the process of assembling cervix photos and creating new drawings to help women understand their anatomy. Her clinic is run as a self-help based clinic where women are shown how to look at their cervix with a speculum. Gage will still host group cervical examinations, though not to the same extent as in the seventies and early eighties; “what is radical and revolutionary is that women could come together and be empowered. It is not that one woman was the expert or that it was her idea” (30).

I hope exposing college students to the work of Gage and the women with whom she has collaborated will inspire more young women today to stand up against culturally imposed ideals for how their bodies should look; and claim a positive, informed relationship with all parts of their bodies.

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