To be a Woman Is Not a Disease. It just seems that way since most standards are base on men. Gender-related differences in health and disease panoramas can be defined as consequences of modern society's binary thinking; i.e. masculine versus feminine, healthy versus sick etc., and this binary logic implies different criteria if you are a man or a woman.
DURING THE PAST FEW DECADES THERE HAS BEEN A relative change in the disease panorama to the detriment of women. Taking the rate of sick leave, occupational injuries, early retirement, drug-consumption and hospital care as indicators, women's health has deteriorated in most countries with well-developed welfare systems. But is this a true picture? Are women really sicker then men or is this picture deceptive, a validity problem? What do our statistical sources actually measure? By what criteria are women evaluated as sick or as having diseases? And why do women live longer than men if unhealthy?
These essential questions are difficult to answer. Firstly, we ought to have comparable scientific knowledge about men and women, but we haven't. We know so much less about women's biology and health-risks than we know about men's. Secondly, we need to study much longer time-spans in our analysis to be able to separate secular trends from direct societal influences. Thirdly, we need to conduct systematic comparative studies in different parts of the world with the very specific aim of analyzing the following problems:
Society is based on male standards with women seen as anomalies deviating from the male norm. In regard to health issues, to treat women as though they are men may often prove wrong and also creates an unhealthy notion of women's health. Women face health risks because of biological factors that men do not experience. Therefore a gender perspective requires using women as the norm for women's health standards. Many issues are similar but must be based on a much better understanding and knowledge of both sexes, in order to avoid gender blindness. What do women's longer life expectancies really reflect, regarding women's health status?
Life-expectancy for women is increasing around the world. France, Canada, Sweden and Austria are rated highest, with women's average age being 80-82 years old, while men's life expectancy is about six years less. This pattern has occurred since originating in the agrarian societies of the mid 18th century in the Nordic countries, and it can be seen world-wide today. If we exclude maternal and infant mortality, women's life expectancy is longer even in cultures where women suffer severe discrimination. Thus, women seem to be biologically more healthy than men.
THE QUESTION OF WOMEN'S LONGER LIFE EXPECTANCY can possibly be answered by the new research around mitochondria, which is however still at a hypothetical level. Mitochondria are not part of the cell nucleus, but are organs found within the cell body. They provide the main source cell energy, acting as a kind of power station, and control cell life and breathing. They have their own genetic material and divide independently of the cell's normal division via the nucleus. This dividing mechanism is a scientific sensation because sperm cells generally lack mitochondria - which are passed on via the female's ova from woman to woman, generation after generation without intervention from men. The mitochondrial substance changes only through mutations. And ageing has been described as a mitochondrial disease. The normal ageing process depends on a gradually decreasing effectiveness in the mitochondria's energy metabolism. This theory fits well with the theory about the significance of free radicals for ageing through gradual cell destruction with ageing as a result. The question about women's longer life expectancy is crucial from an evolutionary perspective but does it matter when discussing women's health?
Maybe we mix causes with effects when we compare morbidity with life-expectancy. There is no obvious correlation between being healthy and living a long life on the individual or aggregate level. Besides: is it really possible to define what constitutes a healthy person? It certainly differs between men and women and women are often measured by the standards of men. Without discussing at great length the basic definitions of health, I will try to analyze the consequences of our failing to apply gender-specific knowledge. It is my firm belief that without this knowledge we cannot discuss what a healthy person or a healthy society is.
Are these dichotomies meaningful? As I see it, they cause a lot of misunderstanding since they lead our way of thinking into a black-and-white coloured world when reality is ever increasingly nuances of grey. Still, it is vital to take these dichotomies into consideration, since they affect our way of thinking; they are a part of our traditions and mentalities in most cultures and societies around the world.
Even if we consider differences between men and women as important, it does not lead to an acceptance of binary thinking. Today we are on the eve of a breakthrough, a completely new way of seeing which rejects false dichotomies - whether female/male, social/biological, hierarchic/ democratic or any other opposites. This new approach is characterized by complexity, exchange, profoundness, connections and interrelations. Technological developments do not oppose but can facilitate our understanding of deeper human processes. It is easy to get trapped in traditional thinking, to put male glasses on. To avoid this we need a strategy which allows us to shift flexibly between many different levels of analysis. That is to be able to look simultaneously upon our existence in all its complexity, respond to the prevailing social trends and identify focal points of change.
My starting point is to challenge the masculine concept of a healthy and balanced individual; an idea that is nurtured and preferred in most cultures and which is based on men's biological reality and created by the powers that in all known cultures are controlled by men. Thus to be female is not an unhealthy condition by objective means. It is an outcome, an effect of our biased way of thinking where females are measured by a male standard and where specific female behaviours are considered a deviation from the norm, as a disease. Let me try to analyze how this male/female dichotomous thinking effects womanhood and our lives by stating the following hypothesis:
Firstly, that the notion of "the regular good" counteracts with the variability of the dynamic human, and that this affects women differently to men.
Secondly, that an adequate sense of coherence (SOC), becomes increasingly difficult to maintain in a transitional society, with continuously changing values and belief systems, and that this affects women differently to men.
Thirdly, that people's lives need validation and confirmation of their value. In today's transitional society, such needs are insufficiently met and this affects women differently to men.
These hypotheses do not necessarily imply that women's health will always be more at risk than men's. The ability to think and act with a long-term perspective decides the outcome. It is certainly a question of complex interactions. And what it means to be male or female is not a question of simple definitions. It means different things in different cultures and societies and there are patterns working on a deeper level, like an undercurrent, a melody, a theme, that are common for each sex. If we can manage to identify these patterns and bring them to light, then we will have a powerful tool to change the world, to make it a better world for women to live in.
©2003 Bi Puranen