6 minute read
OPINION In 2023, the Culture War is a Gender War
Every year, as we put out an annual Women’s Issue, we turn our attention toward perennial questions like, what is feminism today? Does it have a place anymore? Have women achieved the equality and parity in this 21st Century that was so sought after throughout the 20th?
To be sure, some of the past issues have been resolved. In 1919, the 19th Amendment guaranteed the right to vote for women. In 1974, women were allowed to have a credit card in their own names. Women today are present in nearly every profession imaginable, including having the right to serve in combat.
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Those were milestones, hard fought, that we can celebrate today – but today is also, for those paying attention – not a time to sit back and rest on our laurels as if all is well.
This past year, for the first time in many women’s lives, the right to an abortion is not guaranteed for women in the United States. States, like Oregon, that have moved individually to protect women’s right to choose are fast becoming havens for those who live in states, like our neighboring Idaho, where those rights are not enshrined.
And that’s just the start of the concerns for women, and for those whom gender or sexual identity makes them vulnerable to the whims of the culture wars. Today, the culture wars are being fought most vehemently around questions of gender. Drag performers are being targeted, even in our own state, for the false notion that they’re “grooming” kids. Numerous states are working through legislation that places limits on the types of care physicians and other providers can offer to patients –including children experiencing gender dysphoria.
Looking at neighboring Idaho is an exercise in contrast. In that same state, in recent pandemic years, leaders and regular citizens proclaimed the supreme power of parents to make their own decisions regarding their children’s health. That was done in the context of vaccinations – but now, as it pertains to parents seeing their children get help for gender dysphoria, it seems that proclamation is moot. The Idaho House just passed a bill that criminalizes gender-affirming care for minors. The bill is likely unconstitutional, and has yet to pass the Idaho Senate – but if it does, it’s one more battle won for those who see gender as the new culture war. This is of course all quite ironic, because amid these battles that win political points for certain politicians are the very real concerns that affect child-bearing people and their kids. Child care across the United States is still in short supply. Schools desperately need updates and more funding to provide an adequate education for our nation’s kids. And the U.S. maternal mortality rate continues to get worse every year, and disproportionally affects low-income and BIPOC women. If certain politicians were seriously concerned about the welfare of children – and by proxy, their parents – they’d put their money where their mouths are.
A focus on the headline-making culture wars, as we know, is really just a diversion from tackling these very real problems that affect so many in our region, state and nation.
GUEST OPINION: HORMONE REPLACEMENT THERAPY: SHOULD I OR SHOULD I NOT?
The topic of menopause and how/ if we treat associated symptoms varies greatly among practitioners. Hormone replacement therapy has gone in and out of favor over the years but remains the most effective treatment for the majority of symptoms experienced. There was a recent article in The New York Times by Susan Dominus that goes through the history of hormone replacement therapy use and how it has come to be such a controversial and misunderstood subject. It is worth a read (or a listen on The Daily). HRT is not risk free and the pros and cons should be weighed carefully. This is a topic of great interest to much of my social circle and one that I have been discussing with women for the last 20 years.
So, to answer some questions posed by patients and friends alike:
What are the symptoms of peri-menopause/menopause? Hot flashes, night sweats, erratic menses, weight gain, mood swings, sleep disturbances, vaginal dryness, lowered libido and memory changes are the most common symptoms. There are some lucky women out there that stop their menses and never have symptoms, but they are the exception. There are also times when these symptoms can occur without being associated with menopause.
What are the risks of HRT? Breast cancer, blood clots and stroke are the main risks of concern, but these risks are proving to be less than originally thought. Some, but not all, of these risks can be reduced with managing how HRT is administered to each individual. Delivery method, age of patient, medical history, family history all need to be looked at closely to maximize benefits while minimizing risk.
When should I take HRT? The average age that a woman stops menstruating is 51. Most women are having menopausal
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symptoms several years before this. HRT is best started before the age of 60 or within 10 years of stopping menses.
If I start HRT, how long am I taking it? However long it is needed to continue providing the benefits you need it for. Generally, it is recommended to be off HRT by age 65. Again, this is decided together with your provider after weighing risks and benefits.
What is a bio-identical hormone? Bio-identical hormones are prescriptions that are chemically identical to what your body makes. Many of the options available to us are bio-identical whether from a conventional or compounding pharmacy. There are some synthetic hormones still used but not very often anymore for women (birth control being the exception).
Not everyone needs to take HRT. HRT should be used to improve quality of life if needed with the minimal amount of risk and maximum benefit.
Both the beauty and confusion concerning treatment of menopausal symptoms lies in variation of treatment options. HRT is not the only treatment out there that can help ease these symptoms. There are both conventional and alternative non-hormonal treatment options available. Be sure to consult with your medical provider or find one that is open to having a detailed conversation about this inevitable transition in your life.
—Dr. Azure Karli is a naturopathic physician and owner of Bend Naturopathic Clinic. www.bendnaturopath.com
GUEST OPINION: THE NEEDS OF WOMEN VETERANS
As a Marine of the Iraq war era, I experienced the unique challenges women veterans face reintegrating into civilian life. Military service during an era of extensive wartime operations carries a weight not well understood by the general public, and this is a major contributing factor to feelings of isolation and disconnection from community. Add demands of professional pursuits, family obligations and often a lack of an established local network of friends and family, and it’s clear that the need for support and resources is substantial.
It’s easy to assume that someone with a high level of emotional resilience and distress tolerance can operate well without a support system. Maybe for a limited duration. However, everyone needs community and connection — everyone — even when we don’t recognize that we do. In 2010, Brené Brown gave a now-famous 20-minute TED Talk, “The Power of Vulnerability,” garnering over 35 million views on YouTube. Trained to eliminate vulnerability, veteran women are wearing an immense amount of armor, built from a culture that normalizes and emphasizes toughness and self-sufficiency. We often lack the acknowledgement that we even have distress, the emotional comfort to engage in social self-advocacy to ask for support or connection, and an attunement to our own body cues of stress and pain. Meanwhile, we are struggling for a sense of purpose, meaningful connection with others and desire for belonging within our new community. This can happen for men too, but the resources are far behind for women veterans who need support.
It is crucial to provide women veterans with opportunities to connect with peers and find true friendships within the community. Isolation and disconnection have significant impacts on our mental health and wellbeing. According to 2022 U.S. Census data, over 7% of our Central Oregon population are veterans, approximately 18,235 individuals, and of those roughly 1,500 are women. In our region, women veterans are two-and-a-half times more likely to commit suicide than civilian women of their same demographic (almost twice the same statistic for male veterans). Connecting with other veterans — especially other women with shared lived experiences, provides a sense of camaraderie and support that is desperately needed among our minority population.
As the Director of Development at the Central Oregon Veterans Ranch, I am proud to be part of an effort to address these needs. We are further extending our agri-therapy programs and peer support networks, providing a safe and supportive environment for women veterans to connect with other veterans. We don’t have to feel invisible in our community. This is especially important for those who may not have family or friends nearby, or who feel isolated due to unique wartime experiences or underlying traumas.
I urge everyone in Central Oregon to come together to build a more inclusive and welcoming atmosphere among us all. We must recognize that expressing vulnerability and seeking help is a sign of strength, not weakness, and support and deep connection are essential for a thriving life outside of the military.
— Lauren Grigsby, Director of Development, Central Oregon Veterans Ranch
