Affirming the Autonomy of Indigenous Women

November is National American Indian Heritage Month. As we celebrate the positive sides of Indigenous Nations’ histories, we must acknowledge that the U.S. government has both robbed Native Americans of their land and, through the policies of the Indian Health Service division of the U.S. Department of Health and Human Services, made it difficult for Indigenous people to access quality health care.

Indian Health Service (IHS) was established in 1955 with the stated goal of improving the health care of Native Americans living on reservations. However, Indigenous women who came into IHS clinics for something as common as vaccinations were often sterilized without their consent. During the 1960s and 1970s, 25 to 50 percent of women who visited IHS clinics (approximately 3,406 women) were sterilized without their knowledge. Methods of sterilization included partial or full hysterectomies, and tubal ligations.


Bodily autonomy is about having the power to decide for oneself whether and when to bear children.


The IHS had a clear objective: population control (aka “genocide”). Census data collected during the 1970s showed that Native Americans had birthrates that were much higher than white communities. According to census data, the average American Indian woman had 3.79 children, while white women had 1.79 children. The 1980 census revealed that the average birthrate for white women was 2.14, while the birthrate for Indigenous women was 1.99. You don’t have to be a math whiz to see that this is a drastic contrast.

Myla Vicenti Carpio, a professor of American Indian studies at Arizona State University, explains: Continue reading

Are There Any Survivors in the Room? A Story for Gynecological Cancer Awareness Month

female-dr-comforting-patient“Are there any survivors in the room?”

I don’t remember why I was there, but it was a discussion of cancer. I looked around at the people who had raised their hands. It wasn’t until the speaker moved on that I realized I was a cancer survivor, too.

Does that seem strange? But my first cancer in 2004 was so ambiguous. I had had a routine Pap test, and was referred to a gynecologist. I had had problematic Pap tests before, and it had usually meant I had a uterine polyp or a vaginal infection. This time it was not simple dysplasia. It seems I had precancerous cells, and the recommended treatment was a hysterectomy. I thought about it, and my sister discussed it with a friend who was also a gynecologist, and reported back that surgery was indeed the treatment of choice.


How was I supposed to relate to a cancer diagnosis that was made only after the cancer was out of my body?


I was over 50, and had pretty much gone through menopause, though once or twice a year I would have some bleeding. Everything about my reproductive system was ambiguous. I had started menstruating at age 9, along with the body changes of puberty, but seldom had my periods. When I was 18 and starting to move beyond my circumscribed Jewish Bronx upbringing, I was diagnosed with Stein-Leventhal syndrome. Great, I thought, I finally get a diagnosis, and it’s Jewish! Since that time, the condition has been renamed polycystic ovary syndrome, or PCOS. PCOS is a risk factor for many other diseases, including endometrial cancer.

But let’s get back to the hysterectomy. I had already decided that I would have the surgery when my sister got back to me. What had my uterus done for me lately, anyway? I had the doctors make the arrangements, met with the surgeon, and went through all the pre-surgery rigmarole. I made plans to stay with a friend for about a week after surgery, and checked into the hospital. When I woke up afterward, I was told that the biopsy that was done during surgery had been negative. Continue reading

STD Awareness: “Can STDs Lead to Infertility?”

Being diagnosed with a sexually transmitted disease (STD) can be upsetting. Some take it as evidence that they’ve been cheated on; others wonder if they can ever have sex again. Some people who have long dreamed of having children might worry about what impact, if any, their STD could have on future fertility. The bad news is that certain STDs can make it difficult or impossible to have children. But the good news is that STDs are avoidable — and regular STD screening can ensure that infections are caught and treated before they have time to do damage.


It’s common for STDs not to have symptoms, and infections can cause tissue damage — unbeknownst to you!


Fertility can be impacted in several ways. The ability to become pregnant and bear children can be affected by a condition called pelvic inflammatory disease, which is usually caused by untreated gonorrhea or chlamydia infections. If you have a cervix, an infection with a high-risk strain of HPV can require invasive treatment, which in some cases might affect the ability to carry a pregnancy. If you have a penis, an untreated STD might lead to epididymitis, which in extreme cases can cause infertility.

Pelvic Inflammatory Disease (PID)

Many sexually transmitted infections are localized; for example, the bacteria that cause gonorrhea usually just hang out on the cervix. But untreated infections can spread on their own, and bacteria can also hitch a ride on sperm or the upward flow of a douche, which can take them into the cervix, through the uterus, down the fallopian tubes, and to the ovaries. At any of these locations, microbes can stake claim on your reproductive real estate, establishing colonies deep in your reproductive system. As these colonies grow, the bacterial infections become more widespread, and can cause scarring and other tissue damage. To keep these interlopers from getting through the front door, sexually active people can use barrier methods, such as latex condoms — especially with spermicides. There’s no need to host an open house for sexually transmitted bacteria in your uterus. Continue reading

Endometriosis Treatment

endo medsIt’s still March, so it’s still Endometriosis Awareness Month! Today we’ll be looking at endometriosis treatment questions and answers. If you missed the first two posts in this series, you can click to read more about an overview of endometriosis as well as info about diagnosing endometriosis.


Why are there so many treatment options? Which one is best?

There are so many options because there is no “magic bullet” option — that is, no single treatment that works best for everyone. The two main categories of treatment include medication and surgery, but each option has its own benefits and drawbacks. When deciding on the best option for a given individual, some helpful questions to consider might be:

  • Do I have any current health concerns that would render some treatments unsafe? What types of health risks are acceptable to me?
  • Am I currently trying to conceive, or will I be in the next six to 12 months? Will I ever want to be pregnant in the future?
  • Aside from significant health risks, what types of factors — side effects, treatment frequency or duration, cost — would make a treatment difficult for me? How long do I need this treatment to last before I can reevaluate?

For specific questions, your best bet is to check with your health care provider. Continue reading