Tag Archives: infertility

PCOS, Gender Identity, and Medical Oppression


Debbie says:

Ariana Smit’s terrific article at Women’s Media Center, “Healing my PCOS does not mean confirming to your ideal feminine body” is decorated with the author’s own artwork (example above). WMC doesn’t provide a bio, so I don’t know what pronouns Smit uses; since they are completely clear about being gender non-binary, I’m going to go with “they.”

Here’s their quandary:

Five to 10 percent of women have PCOS — a statistic that doesn’t include me and my queer, nonbinary body. Beyond not feeling represented or seen by my doctors, the persistence of a binary understanding of sex and gender in the medical field has failed to account for the way I, and patients like me, deserve and need to be treated.

For those who don’t know about PCOS (polycystic ovarian syndrome), Smit gives us a little background, describing it as:

a condition caused by a reproductive hormonal imbalance. The condition can manifest in different ways from person to person, but my symptoms include weight gain, acne, facial hair, and hyperpigmentation.

They also experience intense pain, which they describe in the opening of the article, but  don’t mention in the symptom list, perhaps because the pain is the symptom the medical profession seems to be least concerned with:

Gynecologists and general practitioners have told me time and time again that my hirsutism (a subjective diagnosis of “excess” hair growth), weight gain, hair loss, acne, and hyperpigmentation are all “issues” that need to be “dealt with” in order to make me “normal” again. In other words, the only way for my body to be acceptable to society is for it to conform to society’s idea of the perfect woman: hairless, thin, and with clear skin. While it is true that these symptoms are important indicators of a hormonal imbalance in my body that have had a debilitating effect on my mental health, the symptoms these doctors focus on treating do not actually threaten my physical health — treating them is cosmetic, not medically necessary. The number of stubborn hairs on my chin in and of themselves affect neither my health nor my identity.

In other words, the issues of how Smit looks take precedence over how they feel. Waking up every morning in an almost unbearable amount of pain — well, that’s just part of having PCOS. But “excess hair” (a phrase rather like “overweight”), now that’s an issue worth reckoning with. After all, “she” might not get married and have children, if “she” has “excess hair.”

As one of the best-known symptoms of PCOS is infertility, Smit takes on that concern of the medical profession:

For example, gynecologists constantly identify the only definitive reason to heal my PCOS as enabling me to have children with my husband one day. I have not corrected doctors who make this false assumption, but rather have hidden my identity because I do not want to have to teach them about how they should treat me. I do not want to have to explain that I do not identify as cisgender and that my partner does not either. I am also afraid that telling my doctors would lead to enduring erasure of the very identity I would explain to them — that they might not believe me or take my identity seriously because I am still (mostly) female-presenting.

Again, buried in the “only definitive reason” language is an assumption that everyday pain is not a definitive reason to treat Smit.

The medical profession both reflects and transmits simple binary gender thinking, getting this oversimplification from the larger community and sending it back.

PCOS Diva, one of the most popular PCOS dedicated websites, states on their homepage that they “[offer] women the tools they need to gain control of their PCOS so that they can regain their fertility, femininity, health, and happiness.” This focus on femininity is alienating for queer people with PCOS, as their goals are not based on restoring some kind of essentialized femininity based on fertility, hairlessness, and thinness. Although I am confident in my identity as a queer, nonbinary person with little intention of having children, this kind of rhetoric is still isolating, and I sometimes feel trapped into having to prescribe to these ideas in order to feel like I am taking adequate care of myself.

And that’s the core of the problem. Confidence and sureness of our own self-worth is almost always somewhat vulnerable to the assumptions of people in power, and perhaps even more so to the assumptions of our peers. Smit sounds like they have good support in their nonbinary identity, and good tools to defend themselves; still, the essay screams with not only the physical pain of PCOS but the emotional pain of not being seen for who they are, not being able to walk into a doctor’s office or open a website and see acknowledgment of people like themselves. In this context, I especially appreciated their mention of a related but different group, mentioning “cisgender women who do not conform to stereotypical notions of femininity” — another cohort that might not want a doctor to focus on hair or weight gain when treating PCOS.

What does Smit want? What we all want!

Ultimately, I want to love myself while looking after myself. I don’t want trips to the gym to be shrouded in the idea that in order to feel “normal” again I need to mold my body into the perfect image of femininity. I want to go to the gym acknowledging that yes, I have issues that require me to maintain a healthy, balanced lifestyle, and regular exercise forms an important part of fulfilling that need. I do not believe that framing this within femininity is productive for anyone looking to heal themselves.

I also want to be able to acknowledge that yes, I do have acne and residual scarring, but that does not mean that I am “ugly” or in need of a quick fix so that people will be more accepting of me. Instead I want to enjoy looking after my skin by indulging in homemade bentonite clay face masks but still be happy going out without any makeup on, or with the fear that someone will judge me for it.

I came away from this essay with a very high regard for Smit, with an increased awareness of what gender nonbinary people face from the medical profession, especially when they have diseases associated with a given binary gender, and with a renewed determination to move my language away from the gender binary.

In the U.S., we’re so steeped in electoral and other national politics that I also appreciate the perspective  of someone half a world away (Smit lives in South Africa) and their commitment to linking their personal experiences to a political lived reality around the world.

Follow me on Twitter @spicejardebbie.

Linksday Friday

Links got delayed twice this week, but here they are!

Kathleen Turner is 60, and has something to say about aging.

“I don’t look like I did 30 years ago. Get over it!”

“You have to get to that place as a woman where you know your worth isn’t dependent on [looks].”


I don’t know about you, but if this trend gets too prevalent, I’m going to have to stop eating in restaurants.

“We find that customers, in the aggregate, made most of the item substitutions that were encouraged by the messages, such as substituting ham for sausage in a breakfast sandwich, or substituting frozen yogurt for ice cream, though effects on overall calories and fat consumed were small,” reads the report, which does recognize two significant limits to receipt-based nutrition information — “it relies on consumer memory and can only affect consumption on future restaurant visits.”

That said, during the two years during which dozens of Burgerville restaurants were successfully convincing customers to substitute side salads for fries, or grilled chicken for fried chicken, these changes ultimately had little effect on the calories or fat consumed.

Maybe people are just eating what they want when they are eating out? For shame!


Oxytocin has been in the news over the last two weeks. First, an idiotic study claimed that it “makes men almost monogamous.”  What made the study idiotic? Give 20 young men (all of whom probably go to the same college)  oxytocin and 20 a placebo. Great sample size. Then show them pictures of their girlfriends (they all described themselves as “passionately in love with their partners”). On oxytocin, the pleasure centers of their brains lit up more when they saw their girlfriends’ pictures. Without oxytocin, pictures of other young women (selected by independent observers to be equally attractive!) were just as exciting. Well, I guess now we know! Or at least now somebody has doctoral research.

But wait! The 8-year-old oxytocin study that everyone uses to show how important the drug is (this one somehow showed that it makes us more trusting) can’t be replicated. (That one had a sample size of 24 young women.) Basically, replication studies are running 3 failures to replicate for every success. I’m betting the monogamy study will do as badly or worse.


Melissa McEwen at Shakesville debunks another piece of junk science (this one anti-fat), so I don’t have to.

So there might be some correlation between weight and semen production which might be statistically significant and which might affect male fertility in an as-yet unquantified way. Do you think this is prematurely being peddled as a FAT MEN ARE INFERTILE!!1! and LOSE WEIGHT TO SAVE YOUR SPERM!1!! by fat hating publications? Is water wet?

Because of course NBC headlined their article with a Scary Headless Fattie and the words “A man this heavy could be harming his sperm.” He’s harming his sperm by being fat, ya’ll! But maybe he’ll read this study and this will be the final straw to cause him to stop being fat for the sake of his sperm and then his sperm won’t be harmed anymore!


ESSAYS WE SHOULD ALL READ ALL OF (a new Linksday feature, by me):

The meaning of disability by Wilfredo Gomez.

The experience of being disabled is perhaps one most appropriately captured by the use of a metaphor: that of the iceberg submerged in a body of water. That said, there is that which is visible and that which is invisible. However, whether our disabilities are visible or invisible, there are always specters of disability looming, the conscious and unconscious choices that situate how we understand our encounters with the disabled, the extent of those encounters, as well as the expectations that accompany them. Central to this discussion is the question of performance: what does it mean to perform disability? What is an accurate representation of said performance and is it ever consistent with the nuances of reality?

With time, access, and increased education, words like “disability” and increasingly disability studies and disability policy have come into consciousness. They have taken on new significance and have effectively changed the landscape of how I understand my intersecting identities as urban, disabled, and Latino. And while disability and disability studies is a pertinent lens that frames discourses and experience, gone is the language of being handicapped.

What does “nobody matters less than black girls” really mean? by the apparently anonymous blogger at Prison Culture:

And so it appears that for us as black people, trauma and domination have always co-existed with pleasure and celebration. It is with this historical context as backdrop that Beyonce released her “visual album” this past weekend to great fanfare and debate. The past bleeds into the present as sense memory reminds us that we were property and that our bodies were violable hypersexualized flesh. We rage and turn our anger towards our reflections sometimes. We can hardly believe that we are still here when we weren’t actually meant to survive. We have few words to convey our mountains of hurt and of pain. We can’t imagine desire or pleasure without penalty. We’ve survived and my young friend is surviving still. We don’t know how to heal our “broken, burned, and bruised places” yet but we are searching for the right path. We know that we have never been in style and that chattel slavery’s script was written on our bodies. But even then, we sought ways to resist and to seize control. We created dances, embraced fashion, depicted ourselves in photographs, created homemade birth control technologies, had illegal abortions. We did this, we’ve continued to do this understanding full well that: “Nobody matters less to our society than young black women.”


In keeping with the Prison Culture post, December 17 was the International Day to End Violence Against Sex Workers, as every day should be. Here’s a useful column on ways to bring awareness to the event, and to the ongoing issue. I’ll be saving it for next year.


This story has lots of possible interpretations, but without knowing the details I generally support parents being able to be naked with their children (of any age) without it being automatically sexualized.

A Missouri mom was arrested after a Snapchat photograph of her and her 14-year-old daughter — topless in a hot tub — were circulated around multiple area high schools.

The 50-year-old mom and her daughter posed for the photo, “covering their nipples,” in an outdoor hot tub in November, according to the probable cause statement. The woman’s other daughter, a 13-year-old, took the photo on her sister’s phone.

“The issue here is the fact the daughter was 14 and the mother was clearly present and involved when the photo was taken,” said St. Charles County Prosecutor Tim Lohmar. “It certainly appeared that the picture was posed and it certainly had some sexual overtones.”

Without knowing more, I don’t necessarily believe the prosecutor’s interpretation, and I don’t think the mom should get a year in jail.


And finally, I would never have guessed what “the Lesbian rule” is. Would you?