The definitive women’s health sourcebook, Our Bodies, Ourselves written by the Boston Women’s Health Book Collective is undergoing revisions for its 40th anniversary (and 9th) edition. Lots of folks in the women’s health community are involved in the revision and that’s a good thing—multiple voices, multiple perspectives.
I am among those reviewing the chapter on Sexual Anatomy, Reproduction, and the Menstrual Cycle in collaboration with others, such as health educator and activist, Esther Morris Leidolf, founder of the MRKH organization (MRKH=Mayer Rokitansky Kuster Hauser Syndrome, a.k.a. congential absence of the vagina) For years, Esther has been nudging me to be more inclusive in my research, writing and teaching of people with variant sexual anatomy. And she did it again.
While reviewing the content on MENOPAUSE in this chapter, she questioned the definition of this biosocial transtion used (that is, the cessation of menstruation, specifically, 12 months after the last menstrual period (LMP)).
She asked: What about women who don’t menstruate?
What about women who may not have vaginas or others with variant sexual anatomy that prevents menstuation. Many of these women still experience other menopausal symptoms, such as hot flashes and mood swings.
Our current definition of menopause excludes such women and that’s a problem; it leaves women who do not menstruate OUT.
The assumption of menstruation for ALL women is a pervasive problem and it runs deep.
Culturally-speaking it is common to collapse womanhood with menstruation. But there women who don’t menstruate (there’s some athletes, anorexics, women on continuous contraception, and post-menopausal women as well as those with variant sexual anatomy, as referenced above) and the list goes on). And they are still women, of course. And there’s gender queer folks, intersex folks and transgender women who do not menstruate, too.
In other words, not ALL women menstruate and not ONLY women menstruate.
This overlooked fact leads us to sloppy definitions that exclude. I want to be more mindful of this. Defintions are helpful, even imperative–they help us make sense of our world. But they also draw boundaries that quickly become fences that keep people out. That’s another, even bigger problem and one that cannot be easily resolved. Still, as Esther wisely points out, its important to be ever mindful of how we define ourselves and others.