#MeToo & the Medical Field

Posted on October 19, 2018 by hannahmccandless

Written by Kendal Flowerdew
Kendal is a Senior at Sarah Lawrence College and will graduate in May, 2019

The Me Too Movement was founded in 2006 by Tarana Burke in an effort to support young women of color who were survivors of sexual violence. As the movement gained momentum, they expanded their mission to support adults and people across the gender spectrum. In 2017, the Me Too Movement went viral with the hashtag #MeToo being used in support of survivors of sexual violence. Because of this sudden explosion of support, the #MeToo Movement was able to expand their platform and continue national conversations around sexual violence, in both the United States and abroad. While the Me Too Movement is often associated with “taking down powerful men or targeting individuals,” this is not the purpose of the organization. They want to support survivors of sexual violence and give them access to a “healing journey.” By the exchanging of the words “me too,” people are telling survivors that “I hear you, I see you, and I believe you.” In addition, they began a movement for radical community healing, where communities come together to make them safer for everyone and to protect the vulnerable members from sexual violence. They want to work against all the ways that have allowed sexual violence to flourish in our communities.

As part of community healing, I believe that work needs to be done to improve the medical care and treatment of survivors of sexual assault. A recent study by Priyanka Amin, Raquel Buranosky, and Judy C. Chang revealed what physicians see as their role in sexual assault care and the barriers they face in providing care. They stated two main categories of roles: clinical tasks and interpersonal role. Clinical tasks was further divided into “(1) screening patients for sexual assault, (2) completing and documenting a history and physician exam, (3) conducting a forensic exam by completing a ‘rape kit’…(4) providing appropriate treatment for injuries and sexually transmitted infections as well as emergency contraception, (5) providing referrals to sexual assault experts, sexual assault crisis lines, women’s shelters, and/or mental health professions” (Pg 5). Interpersonal roles including educating and providing guidance to survivors, giving survivors support after a disclosure is made, and advocating for patients, both at work and in the community.

The barriers to sexual assault care had three broad categories: internal barriers, physician-patient communication, and system obstacles. Internal barriers included fear of getting a disclosure of sexual assault, emotional burdens of sexual assault management, and personal opinions regarding sexual assault and sexual assault survivors. The physicians in this study described the current approach to the topic of sexual assault survivors is “Don’t Ask, Don’t Tell” because they felt unprepared or uncomfortable. With managing sexual assault comes feelings of powerlessness and frustration when patients don’t follow up with referrals or plans or when they choose to remain in the abusive relationships. There is also fear of triggering more distress in patients by bringing up the conversation of sexual violence. The preconceived opinions about sexual assault and survivors mostly surrounds difficulty believing report because they suspect ulterior motives for disclosing the information. The physician-patient communication barriers can include language barriers, difficulty helping patients feel comfortable disclosing or discussing sexual assault, and challenges that arise when patients choose not to disclose history of sexual violence. The two system obstacles are time limitations and competing demands. The healthcare system is set to prioritize certain patients over others and for seeing more patients with less time, which puts pressure on physicians to get through patients quickly.

While improving the medical care and treatment of sexual assault survivors will not solve the root of the problem, it can help with physician, mental, and emotional healing. The American College of Obstetrics and Gynecology recommends that a universal screening process be established for survivors of sexual assault. The American College of Emergency Physicians gives the policy recommendation that hospitals should “address the medical, psychological, safety, and legal needs of the sexually assaulted patient.” The plan set by the hospital for care should include counseling services and specifically address concerns about pregnancy and the treatment of sexually transmitted disease. In addition, systemic changes need to be made to address the problems of lack of time and competing priorities. With changes to the medical care and facilities, training for physicians should be required to address sexual violence. This will improve physician comfortability and competence regarding the topic. The training should specifically address communication skills, dealing with emotion, and understanding trauma.

Overall, the medical care of sexual assaults survivors by physicians is a point of concern that needs to be addressed in order to help survivors on their “healing journey.” The #MeToo Movement began in support of young survivors of sexual violence and has grown into a much larger organization providing support for many others. The medical community can help with the mission of the #MeToo Movement by providing exceptional, compassionate care to the survivors of sexual assault.

Bibliography

Me Too Movement . “You Are Not Alone.” Me Too, metoomvmt.org/home.

Amin, Priyanka, Raquel Buranosky, and Judy C. Chang. “Physician’s Perceived Roles, as Well as Barriers, towards Caring for Women Sex Assault Survivors.” Women’s health issues : official publication of the Jacobs Institute of Women’s Health 27.1 (2017): 43–49. PMC. Web. 12 Oct. 2018.

Welcome to the Feminism and Mental Health Issue!

Posted on January 13, 2014 by emilieegger

Dear Readers,

Feminism is an essential aspect to many realms of women’s mental health–validating the taxing experiences of all women (and all others who are oppressed by patriarchy), pushing back against the the assumptions that women are ruled by their emotions, encouraging the pursuit of fulfilling lives, and in countless other ways.

Our January issue features discussions of diverse intersections of mental health and feminism, including interviews with health-care providers in various fields, portraits of what mental health looked like in other historical eras, and art inspired by a feminist search for inner peace.

Our first submission is a discussion of mental health care with a feminist-identified social worker in California, who uses her feminism to assist families through challenging times in their lives.

We then move on to discuss mental-health maintenance when common resources aren’t available. Maria Vallejo-Nguyen provides a portrait of historic patriot Manuela Saenz and how she maintained her sanity during years of exile and being considered outside of what it meant to be a woman. Vallejo’s portrait shows the strategies her subject used to survive such a trying time.

Editor Tiffany Williams submitted a personal journal entry. She also evokes raw emotion in a poem that reflects on her past in a effort to move towards self-acceptance and growth.

Carly Fox addresses what spirituality can bring to both feminism and mental health through her discussion of Pema Chodron’s work on working through self-hatred and jealousy both personally and inter-personally.

Taylor Russell discusses the treatment of eating disorders.

Guest contributor Jessica Williams writes a piece about why medicine is important and how it has the power to heal.

Finally, Carly Fox provides a list of national mental-health resources as well as a list of book recommendations.

Please enjoy the stories, art, and resources included in this issue. We hope they inspire you to find the ways in which feminism contributes to your own emotional well-being and that of everyone in your lives.

As always, we welcome your thoughts, comments, and submissions.

Sincerely,

Tiffany, Emilie, and Carly

The Evolving Identity of Manuela Saenz

Posted on January 13, 2014 by emilieegger

by Maria L. Vallejo-Nguyen

Doña Manuela Sáenz (December 27, 1797 (or possibly 1795) – November 23, 1856) was born in Quito, Viceroyalty of New Granada (Present-dayEcuador), and died in Paita, Peru. She was a revolutionary hero of South America, who also became the mistress of the South American revolutionary leader, Simón Bolívar.

Manuela Saenz (1797-1856) wrote in her journal that “history was supposed to be made, not told.” She wrote this to express the general frustration she experienced while in exile, as well as her inability to exert political influence. It also expressed how she wanted to live her life – in the public sphere. It was her participation in the male political sphere that brought her fame during the Andean wars of independence and later led to her exile after independence was won.

Manuela Saenz is remembered today as La Libertadora del Libertador (the Liberator of the Liberator) because she saved Simon Bolivar’s life twice.[1] It was Bolivar[2] that first called her La Libertadora when her quick thinking and intervention saved him after the first attempt on his life in 1828.[3] It was not the first time nor would it be the last that Saenz’s quick thinking and intervention helped Bolivar, his army, the Andean countries fighting for independence from Spanish rule and later Ecuadorian President Juan Jose Flores.

Although she was illegitimately born, she was raised in a white criollo world by her Spaniard father who was the head of La Audencia – the Spanish ruling body in Quito, Ecuador. Therefore she had wealth and status. Because of her father’s position, she was able to build a network of contacts that enabled her to exert significant political influence throughout the Ecuador-Peru-Colombia region during the Andean wars of independence. Her network of contacts also made her invaluable to Bolivar such that he makes her a general in his army.

Studying Saenz’s life sheds light on the changes imposed on women during the transition from colonial state to independent state

Studying Saenz’s life sheds light on the changes imposed on women during the transition from colonial state to independent state. Saenz’s life provides insight on who was or was not considered part of the newly independent nations. Furthermore, her life explains how women’s role in the new nations evolved before and after independence.

Saenz joined the criollo’s fight to rid their countries of Spanish rule and to establish criollos as the ruling party. Saenz conformed to her class and race ideals: she didn’t seek to change the socio-economic status of indios, mestizos and blacks, she just wanted criollos to rule. It is ironic that Saenz worked hard to remove Spanish rule because her father was a Spaniard (peninsular) and both her wealth and her political power stemmed from her father’s position in the Audencia. It is also ironic that Saenz was a general in Bolivar’s army fighting for the criollos to take control of the new republics since it was later the criollo elite that kept her out of Ecuador.

Although she conformed with her class and race political views, it was her gender non-conformity that eventually left her nationless.

Although she conformed with her class and race political views, it was her gender non-conformity that eventually left her nationless. The woman who had embodied patriotism (she won a medal for her contributions to the Peruvian war) was now at odds with the criollo ruling party of the new nations.

Women had been invited to participate in the wars for independence. They provided financial resources, served as spies, recruited soldiers, worked as nurses and sewed uniforms. After the wars however women were expected to return to their homes. White criollo women especially were expected to return to the private sphere (home) and re-build the nation – literally (child-bearing) and figuratively (embodying the virtuous family ideal).

Saenz was not “virtuous” by conventional standards; she had left her husband to become Bolivar’s mistress and chose not to return to her husband.[18] She did not have children and therefore no family or household to care for. Most importantly, she had grown accustomed to exercising political power and living as a financially independent woman.

To ensure women’s return to the home, laws were implemented that stripped women of any economic power by requiring them to turn over any assets to their husbands or sons, they were no longer able to inherit wealth and dowries were eliminated. [14] Additionally laws were implemented that allowed fathers to stop or disown daughters who married outside of their class and race. Wealth and political influence were interdependent and the lack of both relegated women to second-class citizens or in Saenz’s case as non-citizens.

The legal changes left Saenz poor and hence without the resources to remain as part Ecuador’s criollo ruling class. Even after Ecuador lifts the exile, Saenz chooses to remain exiled in Paita, Peru becauses there she is able to work, continue to exert some political influence, however small, and maintain her independence.

Saenz did not change. She identified and remained, until her death, a white criollo woman that refused to conform to the new nation’s gender norms.

Saenz did not change. She identified and remained, until her death, a white criollo woman that refused to conform to the new nation’s gender norms. She became a political threat because of her desire to remain involved in politics, in effect, diminishing the masculinity of those in power..The patriarchal government of the new nations prevail and Saenz’s contributions to the wars of independence were forgotten. She died from diptheria in 1856, her home with all her belongings was burned and she was buried in a mass grave.

Notes:

[1] Pamela S. Murray, For Glory and Bolivar: The Remarkable Life of Manuela Saenz (Austin: University of Texas Press, 2008), 27-50. See also Victor Von Hagen, The Four Seasons of Manuela: A Biography (The Love Story of Manuela Saenz and Simon Bolivar) (Boston: Little, Brown, 1952). Simon Bolivar (1783-1830) is considered the Great Liberator of Latin America. He was Venezuelan born and both a military and political leader. He is credited with liberating Venezuela, Colombia, Panama, Ecuador, Peru and Bolivia from Spanish rule. He was responsible for laying the groundwork for democratic governments in these young republics.

[2] Ann Marie Arana, Bolivar: American Liberator (New York: Simon & Schuster, 2013), 13

[3] Murray, 25. See also Von Hagen, 65.

[4] The event was covered by various newswires. It took place on July 2nd, 2010. Chavez buried symbolic remains of Manuela Saenz along with Simon Bolivar. President Hugo Chavez wrote the article for the Latin American Herald Tribune about the event. Hugo Chavez, “Manuela Saenz Returns,” Latin American Herald, July 10, 2010.

[5] Von Hagen, 281; see also Alfonso Rumazo Gonzalez, Manuela Saenz Aispuru: La Libertadora del Libertador (Buenos Aires: Almendros y Nieto, 1945), 189. Santander had become an enemy of Bolivar and many believed, including Saenz that he had been behind the assassination attempts against Bolivar. After Bolivar’s death, the Colombian people recalled Santander from the exile Bolivar imposed on him. Shortly after his return, Santander passed an edict exiling Saenz from Colombia; effectively declaring her an enemy of the Colombian state.

[6] See Arana’s Bolivar: American Liberator and Martin Minchom, The People of Quito, 1690-1810: Change and Unrest in the Underclass (Boulder: Westview Press) 1994.

[7] Benedict Anderson, Imagined Communities: Reflections on the Origin and Spread of Nationalism (London: Verso, 2006), 6.

[8] Anderson, 6.

[9] Peninsulares were Spaniards that immigrated to the colonies and by the power of the King of Spain held the top government positions. They would collect taxes, set laws; enforce laws and held most of the wealth. Criollos were Spaniard descendants born in the Americas. Because they were born in the Americas, rather than Spain, criollos were relegated to second-class citizenship and as long as the Spanish were in power criollos would not hold the top political positions or own the majority of the wealth. Arana, 15.

[10] Murray, 9 and Von Hagen, 5.

[11] Murray, 10. The Ecuadorian Audencia passed the laws of the country and also determined their enforcement.

[12] Murray, 25 and Von Hagen, 30.

[13] Dore, 8.

[14] Dore, 20.

[15] Murray, 36.

[16] Elzabeth Dore, “One Step Forward, Two Steps Back” in Hidden Histories of Gender and State in Latin America edited by Elizabeth Dore and Maxine Molyneux. Durham: Duke University Press, 2000.

[17] Dore, 20.

[18] Murray, 140.

[19] Simon Bolivar to Manuela Saenz, August 1830.

[20] Suad Joseph, “The Public/Private: The Imagined Boundary in the Imagined Nation/State/Community: The Lebanese Case,” in Feminist Review, No. 57 (Autumn 1997): 75.

[21] Murray, 135.

[22] Laurel Thatcher Ulrich, A Midwifie’s Tale: The Life of Martha Ballard based on her diary, 1785-1812 (New York; Vintage Books) 1991.

[23] Camilla Townsend, Malintzin’s Choice: An Indian Woman in the Conquest of Mexico (Dialogos) (Albuquerque: University of New Mexico Press) 2006.

[24] Manuela Saenz’s letters were in poor condition when the archive of Ecuador received them. There are concerns that historians may have dated some of the letters incorrectly or in the wrong order as they attempted to recreate the timeline. Furthermore, there are questions on the authenticity of the journal belonging to Saenz that Carlos Alvarez Saa published in 1995. A recent edition suggests that he has submitted the journal to evaluation and the introduction is presented by the historian that vouches for its authenticity.