Sometimes we come across women’s health issues that are simply crying out for a response, be they from the world of research, from popular media, or from the experiences of individual women. At the CWHN we decided to create a space for that response here on our website, and to invite guest commentaries from people with health knowledge and expertise who are willing to speak out and get "To the point" about some of these issues. Watch this space for informed guest columns with a new topic every month. And let us know what you think by writing to us at cwhn@cwhn.ca.
To the Point - Guest column
By Abby Lippman
Nora Ephron felt bad about her neck; Shari Graydon edited a collection about women who "feel great about [their] hands." (Read the review). Connecting their reflections about body parts is how both explore the experience of aging for women.
Now, while it's still not at all clear to me why my neck or hands should matter in who I am or how others see me—despite all social pressures to the contrary—the commercial opportunities to keep anatomy from being women's destiny are quite apparent. And increasingly problematic.
Among the latest—and in sharp contrast with the upbeat title of Graydon's book—are what are billed as "tips to prevent premature aging of the hands" aimed at "busy moms." Age spots and loss of volume are the targets for change by a growing list of interventions. Some are just common sense for ALL hands (wear gloves when washing dishes; use hand cream), but others, more intensive, propose to do for hands what is already done for faces and breasts (e.g., inject fillers to add volume), perhaps using fat removed during a liposuction treatment to "rebuild the lost shape" of the hand. This isn't quite the kind of recycling environmentalists encourage, but who knows? Perhaps a human handfill is ecologically wiser than dumping more into already worrisome landfills, polluting the environment.
Anyway, it's both a this new approach and the rather cavalier way in which it's being promoted that raised particular alarms for me. First bell rang when I read an endorsement of “fractionated laser treatment” by a physicians' society, and another rang when I saw a full page story about it in the Globe and Mail a day or two later. This new tool for rejuvenating older women uses laser beams to target "small sections of the deep layers of the skin," with treatment needing to be repeated from two to six times to be effective. For reasons that are not explained, the American Academy of Dermatology seems to give a strong thumbs up to this "aesthetic technology."
This laser technology isn't just for hands, though, and likely this is behind the huge increase in its use reported by another professional society of physicians, this one the American Society of Plastic Surgeons (Globe & Mail, 25 August 2012). In fact, this group is using the approach to "resurface" faces by aiming the laser light deep into the skin to stimulate collagen while, at the same time, removing surface skin tissue. Goodbye (maybe) wrinkles and crow's feet without the puffed look Botox gives—if one can pay at least $400 per treatment (and a series is needed each time) with "maintenance visits" every six to 12 months. But hello swelling and redness afterwards, with possible burning and serious damage if the lasering is too intense.
This is called a "non-invasive" treatment, but this does seem to be a rather loose and problematic expansion of the term. It certainly seems “invasive” to me even if nothing is cut open. But worse: do hands or faces really need to be resurfaced like streets and highways? Cracks and crevices in the latter are really dangerous for pedestrians, bike riders, and drivers and demand immediate repair; the cracks and spots on my skin don't quite seem to have this need for attention, urgent or otherwise. So why are physicians so eager to apply this new toy to women? And do we need still to make aging seem such a horrible fate for women?
Some of this need-creation stems from greed. The technology may be expensive for physicians to buy, but it's more than likely to be a short-term outlay with great profit potential when sold to women told they need the latest tuck, fix, or fill to keep them looking younger than their birth certificates would indicate. Alice Dreger, who usually writes things I wish I’d written myself, took on the issue of physicians as cosmeticians three years ago and called for medicine to have a "declaration of independence from cosmetic procedures." (Hastings Center Bioethics Forum, 6 July 2009). Her call for doctors to stick to dealing with a woman's health and not her looks, with a special concern for when physicians become entrepreneurial merchants selling us cosmetic interventions in the name of medical treatments, doesn't seem to have been heeded. And aging women just continue to be vilified.
Does it really matter that I have wrinkles, a saggy bottom, or patchy pigmented spots on my hands? Or that I see a drooping chin and eyelids when I look in the mirror? Why isn't the statement, "you don't look your age," problematic and condemned as ageist? Would we be as accepting to be told—or even hear someone say about another, “you really don't look Black” (or disabled, or queer, or poor)? Wouldn't we immediately recognize this as the racist (ableist, homophobic, classist) statement it is?
In their book on old women and aging, Look Me in the Eye, a book that should be on everyone's shelves, Barbara Macdonald and Cynthia Rich refer to old women who do all they can to make others not think about their age as trying to "pass." And they wisely note that "passing—except as a consciously political tactic for carefully limited purposes—is one of the most serious threats to selfhood." Physicians selling and women buying allegedly anti-aging technologies are usefully seen from this perspective—as threats to our selfhoods.
My hands, like those of many women, have become knobbier with age and stiffer to bend. Rings I used to love wearing on several fingers of both hands all at the same time now sit in boxes waiting to be recycled as dangles on a chain around my wrinkly neck or as brooches to be worn on a jacket draped on my curving shoulders—or just given to others with straighter fingers to enjoy. I'd like to think of the intricately patterned veins on the back of my hands as some ever-changing abstract body art, a kind of natural tattoo, perhaps.
Of course there are aspects of aging, especially for marginalized women and women without privileges and power, that DO demand and warrant interventions: safe housing, financial resources, primary healthcare, universal design of places, spaces, and things, for example. But these aren't pretences to stop aging but, rather, to make it possible and respectful for all women.
If aging really is about hands, it should be about the women in manicure salons using highly toxic products known to be harmful to health to attach fake nails on customers. These women, mostly—if not totally—non-unionized and without proper regulatory systems to ensure the products they use are handled in safe ways, warrant our concern much more than any spots on a hand to which they will glue some glitzy nails. And if aging is at all about necks: then let's admire the older women who stick theirs out and fight for reproductive and social justice.
Abby Lippman is a longtime feminist activist with special interests in women's health and women's health policies. Also an academic based at McGill University and passionate about writing, Abby is past president of the CWHN, and is now on the board of the FQPN where she works closely with them in building an inclusive reproductive justice movement in Québec.
