Spectacular Specula: an activist dyke discusses self-care, queer reproductive rights, and her os (2002?)

Not long ago, a queer med-student friend of mine was interning with a gynecologist.  Since I had always respected her opinions on women’s health issues, I asked her, only half teasing, “Do you give all the women who come in their own specula?” (I am a fan of specula).  “No,” she replied, “That would be too ’70s feminist.  Instead, we tell them their medical options so they’ll be better informed.” 
            Too ’70s feminist.  Wow.
            Calling any action or thought ’70s feminist is a bit like throwing water on a cat–it’s a fast way to stop an idea in its tracks.  (My cat is looking anxious about that analogy.)  But was my friend correct?  Does the right to learn about one’s own body, or the choice to practice self-care belong in the past?
            Although self-care is a practice begun in the past, the reasons some of us practice it today are grounded in the present and future.  Self-care is one way of acquiring tools which will help us take care of ourselves on our own terms. 
            Self care is any act of taking care or control of our own bodies.  It’s only one of the resources we need to help us make and carry out choices.  These choices are the basis of reproductive/body rights. 
            Dyke activists need to have more dialogue on reproductive rights, self-care, and the politics of menstrual health.  Right now, there are certain political issues we focus on.  How do we decide what those are?
            I define activism as any action that is motivated by a goal of social change on an individual, community, or larger level.  Self-care often goes hand-in-hand with learning or teaching on an informal level.  Both care and education can be acts of activism.  Spreading information about the health-related, social, and environmental problems of tampons is activist.  (I used to teach my teenage campers about tampon dangers and alternative products.  Even the boys, worried I was disappointed with them for sneaking out or generally tormenting each other, would insist, “Don’t be mad!  I still remember all the tampon stuff!”).  Activism also happens on a personal level; I once sent a friend of mine a care package with a speculum, a mirror, self-exam instructions, and pecan cookies.  (Her letter back was filled with exclamations about how adorable her os is.)  It is activist to speak up when someone says that tampons have nothing to do with endometriosis (menstrual bleeding from places inside your body other than your uterus) even though there’s a significant connection between endometriosis and dioxin exposure.  (Tampons have been shown to contain dioxin, a substance to which the FDA says there is no safe level of exposure.)  It is activist to challenge inconsistencies that threaten our safety.  Learning something that someone has tried to keep me from learning can be an activist act. 
            Dyke activists are starting to talk about self-care and reproductive politics, or about how we need to address these issues.  Some of us experience the politics of queer parenthood.  A few of us want to learn self-care – or want, at least, to have the option to learn it if we choose – but others can’t imagine why self-care and reproductive politics are queer issues.  In college, when I was co-teaching a course called “Menstrual Health and Politics,” I e-mailed another dyke I know, suggesting she enroll.  She replied that, as a dyke, she felt she had no use for her period, might as well not have it, and might as well not learn about it.  We see this attitude within and beyond the dyke community: that menstruation is only a reproductive function and that dykes have nothing personal at stake when it comes to reproduction, reproductive rights, or self-care.  There are a lot of barriers left to address before these become larger dyke-activist issues.  Addressing those barriers is activist. 
            Self-care is something you can learn on your own or a group of people can learn together.  While self-care can encompass a range of physical and emotional practices, I’m mostly addressing a few examples of physical self-care that are also political.  Here is some basic information about these practices:

Gynecological self-exam – This can be done alone or in a group.  Using a speculum (the duck-bill shaped device you may have encountered at the gynecologist office) you can open up the vagina and examine the walls, fluids, cervix, os (that cute opening near the center of your cervix), and the whole general area. 
With another person, you can do a bi-manual, using two hands to feel the shape of the uterus from inside the vagina and from outside.  This allows you to feel how your uterus is shaped, how it is angled, and how its own regularities and irregularities feel.
Menstrual Extraction –  Menstrual extraction involves suctioning out the contents of the uterus, generally within a group setting.  The basic tools are a thin sterile cannula (a straw-like object with two holes in one end; it’s a narrower version of the type used in a suction abortion), and a Del-Em™ (a jar with one tube running to the cannula and another attached to a suction device that doesn’t push air back in).  One person inserts the cannula into the uterus through the os to suction out the contents of the uterus around the day menstruation is approximated to begin.  It’s a practice drenched with politics, mostly because it can be used as a method of birth control and it’s a way women can take reproductive health into their own hands.
Breast self-exam – Breast self-exam involves getting to know what feels normal for you, while feeling and looking for any unusual lumps or changes.  Ironically, breast self-exam is enthusiastically promoted by medical professionals, although gynecological self-exam is almost never discussed. 

            The way self-care is treated is political.  When was the last time you saw a plastic sign hanging in the shower suggesting that you peek in your vagina and, even wilder, to stick something in there to help you figure out what’s going on?  Someone doing a gynecological self-exam can monitor her cervix for irregularities just as someone examining her breasts can.  She can tell her gynecologist, if she has one, “I usually have this much mucus when I ovulate” or “Those bumps on my cervix show up when I’m stressed” or “My uterus tilts a little to the left.”  Self-care isn’t a full substitute for a gynecologist (it’s pretty impossible resource-wise to do your own Pap smear) but it’s a basic way to monitor your own health.  It can be useful to someone without insurance, to some survivors of violence who may not feel comfortable being examined, or to anyone who’s had a bad experience in a doctor’s office with homophobia, transphobia, sexism, racism, classism or for any other reason.  Besides, dykes defy mainstream convictions about what we should and should not do with our bodies all the time.  Demanding the right to self-care resources as a supplement to medical care is just another way we need to push for control of our own bodies. 
            Sometimes, however, we’re the ones giving out misinformation that puts us in danger.  At the 1998 Lesbian Avengers conference in Portland, I sat in a workshop called “Your Fucking Health” (about sexual health, you see).  The facilitators were talking about dental dams and other protection from STDs and HIV/AIDS when one participant interrupted,  “Why are we talking about this?  Dykes don’t get AIDS from other dykes.”  Dykes aren’t the only ones spreading these rumors; a straight nurse once told me that dykes can’t transmit HIV to one another sexually, but that fisting is a high-risk behavior.  We put ourselves at risk when we don’t critique flawed information or when we think that we don’t need to learn about our health.  I’m surprised by how many people I know who had never heard the words “os” or “endometriosis” before I mentioned them.  (Side note: neither had spell-check!)  We hurt ourselves if we don’t make room for political health in our activism.
            In a way, my friend working at the gynecologist was right.  Not when she suggested that self-exam was a thing of the past, but when she said we need to know our options.  The problem was, she apparently no longer felt that learning about self-care was one of those options.  We need medical information but we also need critiques of medical practices. 
            The right to perform self-care and have access to information is a choice issue dyke activists have not recognized extensively enough in the reproductive rights movement or beyond.  We say “pro-choice,” meaning one specific reproductive/body issue, but we need to expand what “choice” means.  Choice must include any decisions we make about our own bodies on our own terms, like how, if, or when we each want to be sexually active or whether to perform sex work. 
            For instance, for some people pregnancy is an unrealistic burden while for others it is an unrealistic hope.  Reproductive/body rights are not only about bearing or not bearing children; they are expanding to include other personal needs having to do with our bodies or reproduction.  In the dyke/queer/trans activist movement, we fight for the right to be parents and retain custody of our children.  We fight to adjust our bodies to fit our gender identities.  We fight to get accurate information about dyke sexual health.  Are these issues prioritized in the reproductive rights movement?  We don’t usually call those issues “reproductive rights,” and neither does the reproductive rights movement.  The term “reproductive rights” itself is limiting, but we have to see how all choice issues interconnect and overlap, no matter what we call them.
            “Reproductive rights” often implies a negative wording, as in the crucial right not to keep a pregnancy.  But what about the “positive” rights, such as the right to adopt or to receive low-cost queer-positive gynecological care, or to have access to abortion and general health care?  Even publicity information for some mainstream reproductive rights/abortion rights organizations is usually heterosexual-focused.  When we are represented, it’s in a limited and careless manner.  The rights that are perceived to be relevant only to heterosexuals are being prioritized over primarily queer and trans rights.  We need to speak up about that.
            Basic queer rights and reproductive rights have so much at stake in each other’s futures.  The Supreme Court has argued cases for queer rights using the same terms as cases for reproductive rights; they’re both considered issues of privacy and personhood.  When we gain or lose one right, a precedent is set for other rights. 
            Dykes need to do our part in un-silencing queer reproductive rights.  Many of us in our communities retain a tough image which keeps us silent about some health problems.  Our community’s bi-phobia means we silence discussion of sex between men and women.  People assume we’re heterosexual (or that we’re women) if we need abortions.  We should to be able to go into abortion clinics and doctor’s offices without the providers assuming we’re straight women and without having to be out enough to correct them.
            I’m not devaluing the activism we’ve already done.  I’m writing this because for activism to stay alive, we constantly have to critique and revise what we are and are not doing.  You don’t need to go out tomorrow and learn self-care, single-handedly end heterosexism, learn everything there is to know, and critique everything you learn.  Just spend a while listening, watching, and speaking up.  Where do you see the problems we need to address?  How do we perpetuate the same ideas that keep us from learning?  How can we better connect our own activism with reproductive/body/choice issues? 
            And in the meantime, if you want to and are biologically equipped, try out a speculum.  Get a mirror and a flashlight and some health information.  Learn about the politics of the body and the basics of your own.  And if you haven’t seen it before, well, your os is probably pretty damned cute. 
“Debs Gardner is a bona fide cat-loving children’s literature-reading, creative activist dyke with a special penchant for doing anti-oppression work with youth.  She eschews eggplant.” -Devon Greyson.
Deb is currently living in Seattle where by day she temps in an office and by night she tries to balance out activism, taking care of herself and her cat, seeking more meaningful employment, cooking, listening to NPR, and reading, while still getting enough sleep.