Rachel Ruminations—It’s Not Hysteria: Everything You Need to Know About Your Reproductive Health (But Were Never Told) by Karen Tang, MD, MPH

Did you know:

·        90% of women experience menstrual abnormalities or pelvic issues? 

·        Gynecologic health issues are under-researched, underfunded, and undertreated?

·        It takes most endometriosis patients 7 years and visits to 3 or more doctors to receive a diagnosis?

·        More than 50% of transgender male teens attempt suicide?

·        5% of adults under 30 identified with a gender that differed from the sex assigned at birth?

·        One in four women in the US will have an abortion in their lifetime?

Dr. Karen Tang is a gynecologist who recently published a book that addresses these concerns. Her laudable mission is to transform how we engage with our bodies and our healthcare.  On page 4 she calls this book a, “greatest-hits collection of gynecologic topics,” with the over-arching goal to reverse the gross lack of information about women’s health.

The book is divided into 3 parts:  background (history, anatomy, sex ed), situation (menopause, incontinence, cancer, etc), and treatments (birth control, hysterectomy, abortion, etc).  I would classify it as an encyclopedia on women’s health written largely for the lay person.  Individuals will likely pick and choose which chapters are pertinent.  I will highlight what stood out to me:

·        In the first chapter she takes a deep dive into the history of the word hysteria as it has been applied to women’s health.  On page 10 she provides a historical definition of hysteria as a combination of physical, emotional, and psychological distress associated with the uterus and womanhood.  This idea dates back to ancient Greece and was considered an actual medical affliction for hundreds of years!  Anyone who has an interest in history or medicine will find this chapter fascinating.

·        Chapter 17 is all about gender diversity.   She does a good job explaining the difference between gender and sex.  Gender has to do with identity and social meaning (norms, behaviors, roles) of being male, female, or other.  Sex refers to biology which includes genes, chromosomes, reproductive organs, genitals, and hormones.  She also addresses the topic of gender diversity and states that there are at least 1.6 million transgender people ages 13+ in the US and this is likely an underestimate due to the ongoing stigma.  She emphasizes the necessity of gender-affirming care which allows a transgender person to more closely align their physical body with their gender identity; gender care is one of the most politicized types of medical treatment.  She further elaborates about gender identity, gender fluidity, sexuality, and gender dysphoria and explains that this language and these categories continue to shift and change over time.   If you are interested in this topic, I encourage you to read the National Geographic Special Issue Gender Revolution issued January 2017.

·        Dr. Tang addresses “intersex” in Chapter 18.  Intersex is another term for disorders of sex development (DSD).  What was formerly referred to as hermaphrodite; this phrase is now considered antiquated.  I learned a significant amount of new information in this section, definitely a worthwhile read!

·        Abortion is the focus in chapter 23.  Dr. Tang gives a very unbiased and objective overview about this currently incendiary and politicized medical procedure.

I think Dr. Tang has successfully achieved her goals to break the cycle of misinformation and suffering and to spark a movement to change these injustices.  This book is strictly conventional/allopathic so for those of you looking for alternative treatment approaches to many of the conditions which she addresses, I recommend Dr. Tori Hudson’s Women’s Encyclopedia of Natural Medicine (edition 2).  Additionally, Tang’s book has no overlap with Dr. Jolene Brighten’s Is This Normal which I reviewed in a past column.

Rachel Oppitz, ND