OPEN LETTER TO DR JEN GUNTER
Dear Jennifer Gunter,
I’m a GYN, and when I can remember to do my jade egg practice for more than a few nights in a row, I begin orgasming in my sleep.
There is nothing the patriarchy likes to see more than a good cat-fight. I read your open letter to Ms Paltrow when it was published in 2017, and at the time found it very unfortunate. I, too, struggled with whether it was worth my time or mental energy making a public response as urgent social, environmental and political events piled up around us. I decided to classify your letter as yet one more public beat-down of a female voice offering an alternative narrative to the monopoly-on-truth claimed by the western medical model. I ignored it. However, the publication of your new book and in particular the Guardian Interview article I read this morning have goaded me into a response.
First, I’ll say that I have no interest in participating in a take-down of any woman, least of all a single mom with medically-challenged kids who (I truly believe) is trying to help. This f***ed up patriarchal world does enough of that every single day. I celebrate strong female voices, professional success, and especially doctors who have found ways to bring in alternative revenue streams as insurance company reimbursements decline by double-digits annually. That being said, the condescending tone and overall arrogance of the stance you take on these issues is, in my opinion, the precise reason why so many women are moving away from allopathic medicine and seeking alternative or complementary care and sources of information.
I find in your words a callous blanket dismissal of the lived and felt experience of women, justified by the claim that you are an “expert.” What I do not encounter in anything you have written or been quoted as saying in an interview, is a genuine humility regarding our understanding of the complexities of the human body, nor an acknowledgment that the dominant medical advice of the moment has often been subsequently proven erroneous. I do not hear or see any responsibility-taking for the well-documented and very serious harms that have resulted from women unquestioningly following the advice of experts like ourselves prescribing pharmaceuticals and surgical interventions.
A brief historical tour through some of the highlights of our particular profession would reveal such peer-reviewed published wisdom as applying manure, honey or astringent-soaked sponges to the prolapsed uterus, hanging women upside down by their ankles and bouncing them up and down, or “scaring” the uterus back up into a woman’s body by attacking it with a red-hot branding iron.
Moving into the 20th century, I certainly don’t need to remind you of the widespread prescription of diethylstilbestrol (DES) to prevent miscarriage and preterm deliveries leading to thousands of DES-daughters with cervical and vaginal cancers. Or how about obstetricians of the past routinely treating preterm labor with IV ethanol (alcohol)? And let’s not forget the decades of prevailing wisdom that all women in labor needed to be knocked unconscious with ether, have their pubic hair shaved and perineum surgically prepped before routine episiotomy and forceps-extraction of the baby. For decades, numerous medical experts and professional bodies advocated that women should routinely be put on synthetic hormone-replacement at menopause to prevent osteoporosis, and cardiovascular disease until… oops! That may not even work and it also causes stroke and breast cancer.
Nineteen years into the 21st century and we’ve already had our fair share of “mea culpa.” Robotic and minimally invasive surgery for early stage cervical cancer was the standard of care during my own gynecologic oncology fellowship training. Until… we find that it doubles a woman’s risk of dying from her disease. How many women had the Essure device placed into their fallopian tubes before Bayer was finally forced to pull it off the market? How many women continue to endure chronic pain or the side-effects of multiple surgeries to remove eroded vaginal mesh that has subsequently been withdrawn from use and (by the way) never passed safety testing on humans for this indication to begin with?
You accuse the wellness industry of peddling a “load of garbage” or “profiting from snake oil” without considering that most pharmaceuticals on the market have never been adequately tested on female populations, and when they are they frequently are found to behave in highly unique and unpredictable ways. We have the highest maternal mortality rate of any industrialized country, and a cesarean section rate that far exceeds what we generally understand to be safe or necessary for either the mother or the baby’s health. You and I have a certain set of training and expertise, but we are NOT the keepers of all truth. And we have a LOT to learn from listening to women, as well as from healers of different traditions and training backgrounds.
I don’t know what kind of person you are. Perhaps we might even be friends. I generally love badass women who swear saltily and aren’t afraid to talk loudly about vulvas, vaginas, rectal prolapse and the like. But when I read your words they call to mind the arrogant eye-rolling I witnessed for years by physicians who take the stance that they know best and these poor, misguided women they are treating had better shut up and listen up if they want to stay healthy. It’s a philosophical approach that I reject. It IS the patriarchy, though in the disguise of a female messenger who has been knighted by one of its acceptable postgraduate degrees.
You are a strong and articulate warrior. Instead of concerning yourself so much over whether my jade egg might possibly one day give me bacterial vaginosis (it hasn’t after years of use), or the woman who sought care for second-degree burns after vaginal steaming (if this is your standard for unacceptable, please look to the epidemic of spilled coffee)- I invite you to turn your wrath on the 200 billion dollar a year medical device industry that only tests 2% of its products for human safety. Or the 400 billion+ dollar US pharmaceutical industry that laughs all the way to the bank as one blockbuster drug after another comes onto the scene until the inevitable class-action lawsuit reveals that company executives knew all along it caused teen suicide, or cardiac arrest, or fetal malformation etc. etc. etc.
Finally, please acknowledge the irony that you titled your book referencing a biblical text, while simultaneously ridiculing the belief systems of millions of women who feel there might indeed be something sacred involving our sexual and reproductive anatomy. After suffering millennia at the violent hands of a system that treats our bodies with outright disdain and our voices with utter disrespect, is this truly the message you feel compelled to impart? I’m sorry to say that you, my friend, are no prophet for me.
Also, here are a few responses I read on Facebook from some other sexual/women’s health professionals:
“Thank you Dr. Jennifer Lang for articulating so clearly and completely what I and so many of my colleagues have been thinking. I shared your Open Letter on my Facebook page with this introduction: “Hey friends, it’s been awhile since I posted anything on Facebook, but this is important. This open letter from a gynecologist named Jen, clearly articulates my many concerns with how the other gynecologist named Jen is presenting her message. As a veteran sexual and reproductive health advocate, with decades of experience reading, writing, and talking about women’s reproductive health, I do not consider the new “bible” of the vagina to be the best or last word on women’s health. Here’s an alternative narrative to the hype, for your consideration:”
“I’m so troubled by the platform currently being given to Jen Gunter’s minimally informed (especially around cultural practices) and highly biased views. I’m also troubled by my cursory Google that revealed a number of poor reviews of her work as an MD online (dating from before her fame, so I’m assuming it’s not people reacting to her message). I’m not sharing what I found to attack her, but it seems highly relevant to her constant insistence on her “expertise”.”
“This is fantastic! Thank you. I unfollowed her years ago when she made claims to me that Pitocin doesn’t increase pain in labor over spontaneous physiologic labor and other surprising revelations.”