The Case For “Health” Separatism. Let’s Talk About Overmedicalization.

I wrote earlier about the apparent recent rewriting of the definition of “healthy” here. A good paper examining the rewrite and new definition is here, from the Pan African Medical Journal. Reading this article for the third time, I was struck at the hopelessness of the situation of reformism in general, and that includes rewriting definitions of previously existing words and the problem of inclusivity, or trying to include marginalized people and their lived experience when and where they just are not welcome. The exclusion, in other words, is deliberate. It is not an accident, the system is not broken but is functioning exactly as intended. We know this.

One problem reformists encounter over and over again is that our words are constantly twisted, misinterpreted and applied in ways that manage to be the exact opposite of the way they were intended by the marginalized people (or allies) who originally crafted them. Arguably perhaps, feminists initially wanted liberation from male supremacy but ended up mired in equality activating that positioned male as the default. Women wanted to survive and thrive like men survive and thrive, we wanted to be not-oppressed because of our sex the way men are not-oppressed because of theirs. If we ever said “equal” and we may not have, but if we did, that is what we meant. At least, that is the feminist meaning of those words whether the ones who used them originally were really feminist or not, or controlled opposition or not.

Feminists then and now notably did not mean that men and women are the same. Now we are in the horrific situation of being unable to enforce same-sex female spaces for example, because men and women are legally and socially the same when men want them to be, and this is said to be a feminist outcome because it is an equality outcome. Grown men can “compete” against teenaged girls in women’s sports and must be granted access to women’s changing and locker rooms because feminism. This is the easiest example I can think of but there are many.

This is what happens when we try to change the system from the inside. This is why, as law professor and inventor of the concept of workplace sexual harassment ffs Catharine MacKinnon has said, despite all her efforts on behalf of women’s legal rights, the “perfect plaintiff” in a workplace sexual harassment case has turned out to be a male victim and notably not a female one. Male victims of sexual harassment will never be problematic victims the way women often are. Men are the perfect everything, compared to women, because male supremacy. Get it?

All the “feminist” and other work that went into the law recognizing workplace sexual harassment and the material consequences of that offense to women’s financial, physical and mental wellbeing ended up being largely for the benefit of men. We created yet another metric by which females just cannot measure up when compared to men. And we are always being unfavorably compared to men in a more or less global patriarchy. That’s pretty much the definition of it.

And as I have concluded many years ago by now, the only solution to the problem of patriarchal mission-creep, where male supremacy slides into every nook and cranny despite anyone’s actual intent, is female separatism as opposed to reformism. And by female separatism I mean prioritizing female identification, female perspective, female lived experience etc. where males and maleness are deliberately not the default ever. Not ever, in feminism, can maleness be the default, so participating in patriarchal power structures like legal reform — where male supremacy is a feature and not a bug of the law and always has been — is right out. The reality of political mission-creep in reformist activating and separatism as the only solution is where I would like to begin discussing this article on the “new” definition of health.

Again, here is the article we will be looking at. The authors first look at the 1948 WHO definition of health, which is

a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

and proceed to tear it apart. The authors’ criticisms incorporate the language of social justice including feminist language like “intersectionality” but their aims are not feminist aims. Here, they use the language of social justice to propose unburdening the fucking government and for-profit corporations, in this case, the sector of Public Health.

The first criticism is with the use of the word “complete”

Although comprehensive, the WHO definition of health has received criticism. Most criticisms center on the word “complete”, which many believe to be absolute, and difficult to measure. Furthermore, questions arise over whether it is even possible for a person to be without any physical, mental or social challenges. [T]his prerequisite for completeness would mean many would be unhealthy most of the time. In addition, the increase in the prevalence of chronic disease would mean that many with even minor long-term ailments would be persistently classified as being ill. Indeed, this need for “complete” wellbeing brings the risk of over-medicalization; redefining and treating conditions not previously identified as health problems, leading to individuals receiving unnecessary interventions.

Overmedicalization is a problem, oh yes it is. We have talked about this before and I will continue to talk about it in the context of a more or less global patriarchy othering and problematizing women and women’s biology/psychology. It’s that important. But that’s not the context in which these authors are talking about it. To them, the problem with overmedicalization is this: because pretty much everyone would be considered “unhealthy” under the WHO definition, the problem lies with the definition and not with the demonstrable fact that everyone is sick, or getting sick, or can be expected to become sick unreasonably early in their lives or at all, and that this is especially happening to women. The problem of actual/factual widespread especially female chronic illness is the more interesting issue to me, but apparently not to them. Them being the authoritarians in charge of writing/rewriting issues of Public Health.

These authors seem to want to undermedicalize and unproblematize (read: normalize) incurable, progressive disease. If they proposed un-medicalizing it, since there’s not a fucking thing doctors can actually do to treat most chronic illness I would support that, but that’s not what they are saying, is it. Here, as I discussed in my previous post, they are alluding to health as performance and minimizing the material realities of sick people because addressing the scope of the problem honestly would be overwhelming. Indeed. This is the language of PublicHealthTM for anyone who doesn’t recognize it. And as we saw during the COVID panicpanic, PublicHealthTM has its own agenda and its own strategies for fulfilling its own ends which ends is always to unburden themselves, the Public Health System. Normal people’s — and feminists’ — interests lie elsewhere. Let’s continue.

We [submit] that true health is the intersection of one’s physical, mental, emotional, social, economic, and spiritual state of being at any one time. The aforementioned shortcomings of the WHO’s definition of health, coupled with ever-more encompassing and complex descriptions of health, necessitate the need for a new, single, universal definition of health to replace the outdated one created over 60 years ago.

Before that was a discussion of resilience and anyone’s ability to “adapt” as being the better marker of health. This is health-as-performance speak. It sounds good with the acknowledgement of society and money and whatnot and their impacts on health, particularly women’s health. Feminists have been raising (ineffective) Cain about this for decades by now. But an intersectionality framework never turns out well for women, does it. These authors don’t say anything interesting about society or money here, paying mere lip-service to the social determinants of health, instead proposing that we as a society prioritize unburdening PublicHealthTM by discarding the WHO’s previous allegedly unruly, not universal-enough definition of health. The one that talked about people actually being healthy in the sense of being free from disease and the social determinants of disease including male supremacy and poverty. Let’s get rid of that definition imminently and use a feminist framework to do it. Fucking insidious.

These selfish pricks are talking about themselves, and unburdening themselves. Again. And supporting/unburdening PublicHealthTM was not feminists’ intent when they began speaking about overmedicalization of women’s biology/psychology and intersectionality, was it. We had other ideas when we brought up the axes of women’s oppression including their affects on women’s health but intersectionality ended up biting us in the ass and here it bites us in the ass again. That was supposed to be helpful to us, not to PublicHealthTM so they could normalize female suffering ffs. The problems that arose from intersectionality discourse have been discussed elsewhere and are beyond the scope of this post. See generally trans.

Anyway. What I am getting at here is this: radical feminists, the separatist kind, have long recognized that we cannot, in fact, change patriarchy “from within” patriarchy and that changing patriarchy at all at this point is probably impossible. I have written at length about that here and elsewhere and I do not wish to reinvent the wheel. What I would like to do is to propose another flavor of separatism, which we could refer to as health separatism, where women-identified-women (as opposed to the dick-licking male-identified women, in other words, normal/ized patriarchal women) do not even attempt to speak with normies including doctors in most cases about anything health related because we know we will not be heard when we do.

What they will “hear” when we address overmedicalization is what they have already written about above: that widespread (largely female) chronic illness should be normalized and markers of mental and physical health should be performance-based. Because that’s what will benefit patriarchy and PublicHealthTM. These researchers care not at all that our actual concerns with overmedicalization lie with institutional misogyny, medicalized abuse including medical rape, medical tyranny/authoritarianism, and the past, current and future states of women’s ACTUAL FUCKING HEALTH which appears to be collapsing globally as we speak. And how sick (and “sick”) women become even more vulnerable to patriarchal abuse than we were before.

We can attempt to address those things until we are blue in the face, and make ourselves even sicker/predisposed to illness than we were before but our actual meaning will never, and I mean never be heard, acknowledged or addressed. Similarly, what they will hear when we or anyone talks about “intersectionality” has nothing to do with qualifying or quantifying women’s oppression and somehow has everything to do with how various males are more oppressed than various females, eg. how a Black “trans woman” is more oppressed than a Black actual woman. And how every male is somehow more oppressed than White women are.

Somehow, PublicHealthTM has managed to use the language of intersectionality to call attention to their own agenda which is to make EVERYONE seem healthy in order to unburden PublicHealthTM themselves, and if you aren’t healthy it’s your own fucking fault for not somehow addressing and remedying your own “physical, mental, emotional, social, economic, and spiritual state of being at any one time.” Get right on that, they seem to be saying, and everything will be fine. What this medical separatism would actually look like, and how, then, separatist women will have our concerns and medical needs addressed in another fashion — and whether that’s even possible — will have to be a discussion for another day.

On a meta note, this was a very difficult post for me to write for some reason, and I usually find that the mental molasses-type thinking/writing experience is indicative of pervasive mind-bindings and massive cultural relevance that we aren’t supposed to see or know about or be physically or mentally able to discuss. But this is the best I can do for now and I think it’s good enough. Please feel free to flesh out the conversation — because it surely needs it — in the comments below.

Comments open.