Can We Please Stop Blaming Women for Being Sick?
By Kristine Kaoverii Weber | July 15, 2022
A Chronic Illness Story
The first time I went to a doctor to talk about feeling exhausted he told me I had to slow down, that I was overworking myself, that I needed more rest.
Sure, he was right. I was young, busy, trying to make ends meet, working a lot. I was tired. But so were lots of other women I knew. And while he had a good point (because just about everyone in our rat race culture needs more rest), I also knew there was something else going on.
After a few more years of trying to figure out why I was so tired (and many different practitioners), an integrative doc finally decided it would be a good idea to check my thyroid. The tests showed that I had abnormally high levels of TSH (thyroid stimulating hormone) which meant that I had Hashimoto’s disease.
At that point the doctor told me I could either start taking thyroid medicine daily (which I’d have to be on for the rest of my life) or try some supplements that might help.
I went the supplement route.
I also doubled down on my relaxation practices – Yoga Nidra, restorative yoga, legs up the wall, long savasanas. I added more poses like Shoulder stand, Hare, and Bridge which were supposedly helpful for the thyroid, and did more meditation. Subtle Yoga emerged from this time in my life – because I started to understand that there were ways to practice that supported my health rather than contribute further to my exhaustion. For a while my meditation practice was like an anti-depressant. I’d wake up exhausted, do a bunch of asanas and a long meditation, and then I’d feel okay enough to get through my day.
(BTW I’m not prescribing this solution for hypothyroidism, everyone’s gotta find their own path, this is just what worked for me, and only for about 15 years.)
As I began to slide into menopause my symptoms got worse. My doctor strongly suggested I start medication and I capitulated. I started feeling much better right away and I have made peace with having a chronic condition and being on medication. I still do tons of yoga and lots of other integrative stuff to support my health.
Still, I have felt a lot of shame about my autoimmune diseases (I also have Raynaud’s which was diagnosed when I was 4). Practitioners have told me that it has to do with my “Type A personality,” my go go go attitude, my striving, my perfectionism, etc. I’ve heard it all – often from folks who don’t know me very well and are simply guessing that’s what I’m like based on autoimmune profiles.
Autoimmune issues are rampant in western culture. There are at least 100 of them including things like Type 1 Diabetes, Rheumatoid Arthritis, MS, Lupus, Irritable Bowel Syndrome, and of course Hashimoto’s. Three out of four people who have autoimmune diseases are women.
And while there are lots of theories about this gender imbalance being related to everything from chromosomes to hormones to sex specific inflammatory processes, there is no definitive biomedical answer – probably because it’s not entirely physiologic.
The Problem of “Type A” Women
There are strong correlations in the research literature between stress and autoimmune disorders. But toxicity in the environment and mental health challenges are also highly correlated with autoimmune dysfunction, so we cannot place the blame entirely on psychological stress, or having a “Type A Personality” (and, BTW, the whole theory of the “Type A” has been robustly refuted).
Several doctors blamed my Hashimoto’s on my tendency to be too busy. And even if that was 100% accurate, it also smacks of victim blaming – quite common from medical providers towards white women, even more so toward BIPOC women (There’s plenty of data about implicit bias of medical professionals towards people of color).
Also, I think it’s useful to remember that American culture tends to eat you up if you don’t hustle.
The fact is that women have been labeled “hysterical” and “psychosomatic” and have been accused of making a fuss over nothing for centuries. And while I believe these prejudices are starting to unravel, we still have a long way to go.
For me, the idea that your personality is a primary cause of your illness is deeply problematic for many reasons. Sure, stress is a factor in autoimmune issues – but stress comes in many forms – physical, psychological, environmental, and social. Yoga is wonderful for coping with some of the effects of stress. It has been my go-to for most of my life.
But human beings don’t live in isolation. We interact. We are affected by each others’ behavior, thoughts and ideas. We are affected by discrimination and stereotypes leveled against us, by disciminatory messages we’ve internalized, often unknowingly. We are also affected by environmental stressors like toxins from agriculture, in the water, and in the air. These are things that we, as individuals, don’t have a lot of control over.
The problem, as I see it, is when you blame autoimmune issues (or any chronic disease for that matter) on the individual, their personality, their behavior, or even on their trauma – you are missing a much larger phenomenon – the phenomenon of having a body and living with other humans on this planet.
The Social Stress of Being a Woman
A few things that I think have contributed to my stress which has prompted my Hashimotos include factors like being exposed to pesticides and other environmental toxins, including radioactive iodine released from the Three Mile Island disaster (I was a teenager living about 100 miles from the plant when it melted down and all of my 3 sisters have thyroid or other endocrine issues as well).
Other stress factors include the excessive amount of cortisol that pumps through women’s bodies when we feel dismissed, mistreated, or minimized in countless situations, over the course of a lifetime. Things like being repeatedly sexually harassed or abused by strangers, neighbors, and family members. Or being dismissed, brushed off, or belittled when we voice an opinion. Or being told that we can’t do things because of our gender, and all the other blatant and micro-aggressions women are subjected to.
I always thought I was safe and free as a white American woman. I never thought I had a lot of stress around my personal safety. But then when I was 25, I moved to Tokyo, Japan. I lived there for two years. I would take the train around the city. Sometimes I’d be out with friends and come home by myself at 11 pm or midnight.
But walking home in the dark alone as a white woman in a Japanese city, when I felt rather safe, was an entirely different experience than walking home alone in an American city, where I felt very unsafe. When I stopped and thought about this, I realized the tremendous stress incurred by being female in American culture – which I had never previously understood so intimately.
So stress is a factor in autoimmune diseases but the amount of stress could be better managed not only by the individual, but also by the culture.
Still, why is it that more women get autoimmune diseases?
Is it because we are naturally more predisposed to them?
Or because we don’t handle stress well?
Better stress management and a healthier lifestyle including more yoga practice are essential IMHO. I am a yoga teacher, trainer, and a passionate advocate for the use of yoga in health care – particularly in the management of chronic illnesses like autoimmune disease.
However, this is only the tip of the iceberg. If you don’t widen the lens and bring in a larger, social perspective on human existence, you can easily end up victim blaming/shaming.
The Social and Environmental Determinants of Health
Up to 70% of the health locus of control (that means who and what controls your health) is external to the individual. That’s right – external. Meaning that we do not have control of up to 70% of the things that cause us to get sick.
I remember when I first saw this data, it blew my socks off because it’s so opposite of what pop culture and the medical world tells us about who is to blame for poor health.
This research from the Robert Wood Johnson Foundation suggests that our health, up to 70% of it, lies in factors that are external to ourselves including the social and environmental determinants of health (SDOH and EDOH). The SDOH and the EDOH are factors including whether or not you have strong support system, good friends, a happy family, meaningful work, a healthy place to live, enough money to live well, access to good, affordable health care, a safe neighborhood, good educational opportunities, and access to clean air, water, parks, nature, etc.
Before I read this study, I had always understood that it was MY behavior, MY personality, MY unrelenting drive to succeed, MY inability to relax blah, blah, blah that caused my auto-immune issues. It was ME. I was the problem, I needed to change.
But maybe that’s not entirely true.
Telling people that their personalities have caused their illnesses is not only victim-blaming and hurtful, it’s also bad science. Because the cause of our illnesses is even more embedded in the culture, the environment, and in social factors than it is in the individual’s behavior, personality, or mind.
Now yoga, at its core, is about looking deeply at ourselves and making necessary changes (and just to be clear, when I use the term “yoga” I include ethical engagement, pranayama and meditation in the definition). I get that. I totally believe in it. And I love that part of yoga, as hard and unpleasant as it is to hold that mirror up to yourself and make the changes that you need to make.
But to really heal ourselves, we have to transform not only our own ways of being, but we also have to transform and heal our cultures. As much as anything, yoga is about understanding and perceiving the interconnectedness and interdependency of all things. Basically, we individual human begins are each cells in the body of humanity. We influence each other all the time.
Yes, yoga can help us become more conscious and more aware of our own issues and what we can do about them, and I love that. But, for me, what’s even more compelling about yoga is that it can help us apply that awareness to making important social and cultural changes. It inspires us to change ourselves – and also to recognize the problems in the world and help to change them.
We have to stop blaming women for their illnesses. What we need is more empathy, understanding, nurturing, and support – attitudes and activities that are often considered very feminine. The world needs this feminine energy to counter the insanely hypermasculine energy that has overrun this planet. It’s through this shift that we will achieve real social as well as environmental transformation.
And that’s what the world is waiting for. It’s what will bring healing – individually and collectively.
That’s the kind of world I want to live in.