Sexism Makes Me Sick: Gender and Mental Ill Health.

For Blog Against Sexism Day.

Since the birth of psychiatric medicine, gender has played a vital role in how we get sick, who is determined to be sick and how sickness is treated. The presence of any mental illness is, after all, determined by experiences and behaviours that are markedly different from what is considered normal or healthy. Perceptions of mental ill health are therefore far more prone to cultural influence than perceptions of physical ill health, because normal varies between cultures and those experiences and behaviours that are considered normal or healthy for a man differ from those experiences and behaviours considered normal or healthy for a woman.

As psychiatry has matured, there is a growing recognition that individual differences only need labelling and dealing with where someone’s experiences or behaviour are effecting or endangering their own wellbeing. You don’t need to have surgery on an extra large left ear lobe unless it causes you significant distress and you don’t need to take drugs to suppress the desire to wear a top hat in the bath. You can be different without being unwell. And I like my top hat; it keeps the soap fairies out of my hair.

However, our culture and the medicine it influences still maintains biased ideas about normality and gender. Earlier on, the situation was disastrous for women. Following the agricultural revolution, it became viable and therefore fashionable for an entire class of British women to be more idle than they had ever been before. At the same time, you have the beginnings of the boarding school system, which took boys out of the family home, and meant that girls and boys were brought up and educated seperately and in an entirely different manner. Upper-class men and women became more different than they had been in recent centuries and as often happens with gender, these culturally-constructed differences were very quickly seen as innate.

In many ways, femininity itself was (and still is) considered to be a state of illness; the much-envied life-giving womb being condemned as a very dangerous organ indeed. Women in the late eighteenth and nineteenth centuries were not felt to be mentally competent, they were considered physically and mentally fragile and as such, those who could afford to lived in conditions which positively promoted physical and mental fragility; physical exercise was discouraged, education and even reading was considered potentially dangerous to their tiny minds and there was very little to do. The first sign of deviation from this very passive gender role could be assumed to be hysteria or even nymphomania and responded to with medical intervention

However, women are still seen as innately emotionally fragile and our behaviours are still pathologised. We are brought up to pathologise our own behaviour; to question the reasonableness of our own reactions and to anticipate mental ill health. Not the more complex conditions like Bipolar Disorder or Schizophrenia, but Depression, Stress and Anxiety.

Fed up with your job? Unhappy in your relationship? Feel like you’re going mad? You probably are. Go to the doctor. Get some pills. The problem is you, not the life you happen to live.

Women remain in a position where we are more vulnerable to the triggers of mental ill health than men. Women are far more likely to live in poverty, to have to work two jobs or have unstable incomes. Women are far more likely to be bringing up children on our own. Women are more likely to experience sexual assault or systematic violence at the hands of a loved-one. Many of those women who do get an excellent education and enter good careers continue to come up against limited opportunities.

Idealistic presentation of love, marriage and/ or motherhood as providing total uncomplicated fulfilment for women sets us up for a fall. Men have long been taught – and have had far more power - to make their own happiness. Women are still taught to expect to have happiness arrive on their doorstep. When it doesn’t, instead of being encouraged to go looking for it, out in the world or within ourselves, we assume ourselves to be unwell and we are treated accordingly.

Just recently I was talking to a friend about a couple we both know whose marriage is on the rocks. The husband has a mental illness. This label followed a lengthy diagnostic process to eliminate every possible physical cause for his largely non-physical symptoms. I have never heard of a woman who needed more than present with insomnia, fatigue and low spirits before being told she was depressed, and almost every woman I know with a chronic physical illness of any kind has had it suggested that her physical symptoms are psychological in origin at some point.

The husband’s condition doesn’t look easy to live with. He can be extraordinarily absent-minded, bad-tempered and is often rather disconnected from events going on around him. The wife finds this all extremely frustrating and is not behaving with sympathy.

My friend suggested that she is most of the problem and should herself go on anti-depressants to help her cope and behave in a more reasonable manner.

“I don’t think she’s depressed,” I said. “I don’t see anything which suggests she is depressed.”

“She keeps snapping at him. She keeps having a go.”

I shrugged. “So she’s angry. She’s not ill.”

“But he is under a lot of stress. It isn’t fair.”

“She might be behaving unreasonably, but that doesn’t mean she has an illness.”

Certainly, there are unreasonable behaviours which are sanctioned and condemned for either gender. There are certain behavioural reactions which remain unacceptible in men, such as crying in public or spending a lot of money on high-heeled shoes. In all seriousness, gender does make men ill too; it exerts very particular and unreasonable pressures on them, attaches far greater stigma to certain experiences (like being the victim of sexual or domestic violence) and makes it far more difficult for them to seek help and to get help when it is sought. Mental ill health is probably underdiagnosed in men, and it carries a much greater stigma where it is recognised.

Conversely, women need to do far less to have their mental health speculated upon. A wife infuriated with her infuriating husband, for example. Women are not allowed to be angry, really angry. It’s unseemly. Women are supposed to look after themselves for the sake of other people; to look nice for the sake of lovers, to keep healthy for the sake of family and so on. Women therefore meet far more disapproval when we drink in excess, take recreational drugs, drive fast or vent our frustrations through casual sex or aggressive behaviour. This is why we are far more likely to stop eating, self-harm or attempt suicide (in italics because there are varying levels of earnest); we are more likely to turn our violent frustrations on ourselves. And self-harm with blades, burns and bruises is considered very much more serious than the more commonly masculine self-harm through large quantities of drink and drugs or general self-neglect.

Once again, I have got a long way down a rambling post before completely losing my bearings and struggling to wind up in a succinct manner. I didn't even get as far as saying anything about women within the psychiatric system. Suffice to say that sexism stinks. So there.

Blogging Against Sexism Day

Blog Against Sexism Day 2007 will be held on March 8th, which is International Women's Day. Read all about it here, and to join in go here and leave a comment. The day last year was a fantastic event which inspired our somewhat more modest Blogging Against Disablism Day.

On which subject, a couple of people have already asked me about the next BADD. I would like to see it happen again this year, not sure how best to go about it. However, seems sensible to go for 1st May again, in which case we have a good while to go at.

In other news, our car has come back to life so hope to be off out and about tomorrow. Looking at... carpets! Oh the excitement! I expect I'll be floored for a few days after that...

Ism Through a Prism

For Vegankid's Blog Against Sexism Day.

Both sexism and disablism are based on the same faulty mechanism; the confusion between biological fact and social construct. Sex is a fact. Impairment is a fact. But gender and disability are both garments that society has sewn for us. Both constitute a vast set of assumptions and expectations based on a relatively superficial matter, whether it is your particular combination of X and Y chromosomes, or your capacity to walk, see, hear etc as judged against a fictional norm.

The victims of sexism and disablism have also suffered far less from any kind of violent oppression as from the assumption that other people know what is best for us. Other people know what is best for our bodies, even what is best for our souls, about to how and to what extent we should be educated. Other people know how best we might best spend our time on Earth. We are rarely hated or feared until we step out of line, but such lines, subtle and unspoken as they are (now more than ever), are our subjugation.

Impairment often poses a direct challenge to gender identity and thus sexism increases the burden of disablism for both men and women. I recall a discussion among a group of people with my particular condition where the question arose as to whether men or women suffered most severely, in social terms, from having this illness. The men argued that the stigma of financial dependence and unemployment was far greater for them. That fatigue and enforced inactivity was emasculating; they were expected to be strong and active, not weak and passive.

Chronic pain and loss were also very difficult to deal with as a man. Men were allowed to show their feelings, but the sanctioned releases were exhausting; you go to a football match, stand and shout for ninety minutes, you participate in sport to get it out of your system or you flood your system with alcohol or recreational drugs. None of which does a great deal of harm if you are in otherwise good health and you just need a single discharge of emotion.

When your life has undergone significant change and you are suffering on a daily basis, you need to talk about it. The men felt that not only did they have difficulty with this, but their male friends tended to drop off very quickly when confronted with the new situation. It wasn't that the disabled men felt that didn't have the words or that their friends didn't have the capacity to listen, but the culture had made both parties feel entirely compromised by the prospect of any discussion. That is was going soft; giving up a bit of their masculinity.

The women argued that whilst they suffered from lack of sympathy from others over their unemployment – as if it just didn’t matter – there was so much other work that they were expected to do no matter what. This was especially the case when they had children; friends, relatives and others would be vocal in their disapproval if it wasn’t Mummy picking the child up from school, if it wasn’t Mummy cooking the dinner or if poor useless Daddy had to flail about ironing his own shirts. As if motherly and marital love consisted of a set of practical tasks and to decline from these tasks meant a failure as a woman.

Women also felt that their emotional response to illness was far more likely to receive a medical label and indeed, that the very physical nature of their condition was likely to be questioned if they ever came across as even slightly hysterical. This certainly seemed to be the case; out of the men who had gone through lengthy diagnostic processes, there were far more physical tests and scans than with their female counterparts, who seemed to need to demonstrate perfect mental health before any physical investigation would take place.

I could go on and this was just one group of people who had a particular condition. However, there is a theme running through these experiences which I think must apply to most conditions and impairments; being disabled means that you are regarded as a little less of a man or a little less of a woman.

Egalitarianism would seek to reduce the impact of rigid gender constructs on people’s lives, so this might not seem such a bad thing. Unfortunately, the effects of being a little less of a man or a woman in a sexist society is not to free you from the constraints of gender, but to reduce your value as an individual. Gender remains so important in our lives that if you do not fulfil your assigned gender role, you are a little less of a person.

Of course, disabled people are thought of as being a little less in many and various ways, but our compromised gender identity is a major contributing factor.

It is therefore imperative that disabled people are active in the fight against sexism, not just because we are right-on liberals who believe in fair play, but because sexism is part of our problem.

As long as we have assumptions and expectations about our roles, desires, strengths and weaknesses placed on us because of a physical and biological status that we all have (i.e maleness or femaleness), an altered physical or biological status (i.e impairment) is going to impact on those assumptions and expectations. And thus people with impairments will continue to be treated differently because of them.

Does that make any sense to anyone?