My sources tell me that today, the immunization committee at the CDC (Centers for Disease Control) is debating whether to recommend the use of Gardasil, a vaccine against HPV, for use with male patients. HPV, or the human papillomavirus, is the most common of sexually-transmitted infections; the CDC estimates that 50% of sexually active adults will acquire HPV at one point over the course of their lives. Some suggest that the percentage is higher still.
HPV has been conclusively linked to cervical cancer. Since 2006, Gardasil has been approved by the FDA for use in inoculating women against HPV. Because the best form of protection is prevention, many health experts recommend vaccinating girls before they become sexually active. Given the grim reality that HPV can be easily transmitted through non-consensual sex, and given the ease with which the virus is spread through oral sex, vaccinating girls before the onset of puberty is encouraged. (This has led, of course, to predictable howls from the religious right, who are less concerned with protecting young women’s health and more concerned that a vaccine against HPV might encourage pre-marital sexual exploration.)
But as an article in the brand-new issue of Ms. Magazine makes clear, HPV poses a greater threat to men and boys than was previously known. The Adina Nack piece is not available online, but here’s a quote from what’s available on your newsstand:
While it is fears of cervical cancer that
have motivated young women to get HPV vaccines,
that’s not the only cancer caused by this virus: It can lead
to oral, anal and penile cancers as well. In fact, the combined
U.S. death rates for these cancers are at least twice
that of cervical cancers… Some researchers, in fact, believe that
HPV may soon cause more oral cancers in the U.S. than
alcohol or tobacco combined.
As a result of this research, the CDC may well soon recommend that boys and young men also be inoculated with Gardasil, as the connection between HPV and oral/anal cancer becomes as apparent as it already is with cervical cancer.
Nack emphasizes that men’s health is a feminist issue:
Women’s health—especially reproductive health—is usually
the focus of sexual-health discussions but men’s health
also deserves women’s attention—and not just because
women care about their sons, male partners and male
friends. It almost goes without saying that women can also
be infected by their intimate partners, and since the great
majority of women primarily have heterosexual relations,
that usually means by men.In fact, men’s health is an even larger feminist issue.
“Feminists have a vested interest in advocating for policies
and circumstances around the world that shape men’s ability
to develop healthy sex lives, which, by definition, has
to include respect for the rights of those with whom they
partner, regardless of gender,” says Patricia Rieker, Ph.D.,
a sociologist at Boston University and Harvard Medical
School and coauthor of Gender and Health (Cambridge
University Press, 2008).The truth is, if women don’t prioritize men’s health,
we’re not just losing a chance to foster the overall health
of our communities, we’re actually putting ourselves and
future generations at risk
It is axiomatic that women of all ages are more willing to seek medical treatment than are men. The “sturdy oak” myth of robust masculinity makes it difficult for boys and men to acknowledge vulnerability. Our cultural narrative about heterosexuality tends to suggest that women are emotionally and physiologically more fragile — and more likely to “suffer” from sex. That “expectation of female suffering” (associated with everything from first penetration to pregnancy to increased vulnerability to STIs to the guarantee of heartbreak after a break-up or abortion) is matched with a narrative of male imperviousness to harm. We like to pretend that boys are dense, violent, and comparatively shallow. But boys do cry, and boys do get hurt, and as the latest research shows, boys do get HPV-related cancers too.
Feminists have done much to dispatch the myth of female frailty. They have also been on the frontlines of fighting against this myth of the invulnerable male. It is no surprise then that we find this important clarion call for male sexual health in the pages of Ms. Magazine.
This isn’t an axiom, but an empirical result. Women see doctors about 20% more frequently than men (which isn’t really a huge divide). Of course, herd immunity and possibly ultimately extermination of the species (yeah, I know virii aren’t alive, don’t have species, et al. Nonetheless.) are a communal good. That mothers, girlfriends, wives are the ones to advertise to if you want men to see doctors, rather than men themselves, is probably something that ought to be a source of feminist outrage. (Of course, if women can just be immunised, then maybe the feminist choice is just to let men make their own choice, even if it is along the lines of “Well, if I get herpes, it’ll just be a personal failure on my part.”)
Still, applauding Ms. in this context from a feminist perspective doesn’t jive with the situation.
This does not annoy you?
Feminists have a vested interest in helping men develop healthy sex lives?
Wait a second. What happened to keep your laws off my body? What business does a woman (and, granted, not all feminists are women) have telling a man what to do with his body.
What happened to “what about teh menz?”
Sorry for the mini-rant. This just seems to conflict with so many of the other feminist doctrines when it comes to issues of medical care and bodily autonomy.
And, I find it a bit ironic that Dr. Rieker says a healthy sex life, “by definition, has to include respect for the rights of those with whom they partner, regardless of gender.” This also means that the partner has to respect the man’s right to say, “I am not taking Gardasil; I am willing to take the risk of HPV.”
How is this not a double-standard?
Sorry, I feel another rant coming on. Better cool down.
-Jut
I have to express skepticism here about the concern regarding men’s health for its own sake. Without numbers as to the actual risks and prevalence of HPV-induced anal, oral, or penile cancer in men, this still seems like a “concern” about men’s health primarily arising out of its impact on women rather than for its own sake (and ignoring, among other things, potential risks associated with subjecting everyone to yet another vaccine). Let me know when Ms. has anything to say about prostate health or heart disease.
Two interesting comments. Maybe I can add to the discussion by offering another perspective. To address the issue of a possible double standard- I’m not sure I see one. I don’t think that it was suggested anywhere that women ought to tell men what to do when it comes to choosing which vaccines to get. In fact, the whole point of this article is to expose the fact that Merck, despite knowing of Gardasil’s potential to prevent cancers in men, failed to seek FDA approval for male vaccination. Instead it sought approval for use in girls, then women, and it marketed the vaccine exclusively to females. This was a calculated business move in an effort to manage the Gardasil “brand.” Merck thought that “consumers” would be more comfortable with a vaccine that prevented cervical cancer than a vaccine that prevented HPV and genital warts. Not to mention anal, penile, and oral cancers. And as a result, most people are unaware of the existence of a vaccine that could prevent HPV and deadly cancers in men. Furthermore, even if the public knew about its efficacy, gardasil isn’t recommended for men by the CDC, therefore insurance won’t cover it, therefore it is inaccessible, therefore men remain at risk UNNECESSARILY. Because they could be vaccinated. But they aren’t. Because Merck thought men would be squeamish about seeking out prevention for genital warts, and that could make Gardasil less profitable. That is the real issue here, not the politics of who should nag who about going to the doctor.
This issue has a lot to do with gender and social norms, and the stigma that surrounds STIs. And it has a lot to do with how these things impact corporate behavior and public policy making. And it’s a big deal. So while the opposition to the notion that “feminists have a vested interest in helping men develop healthy sex lives” makes sense if one wants to argue semantics, it also doesn’t make sense if one wants to see the forest for the trees. Here’s my interpretation of that notion:
Feminists, like all people, have a vested interest in the sexual health of their potential sexual partners. And when the majority of those potential sexual partners are denied access to a vaccine that could prevent HPV, then feminists, and all women, are at higher risk for contracting HPV. And whenever women’s health is threatened, that’s a feminist issue. (Not to mention the obvious concern for men’s health, and dismay at the fact that men have been denied access to a potentially life-saving vaccine all for the sake of marketing, but I don’t want to step on any toes.) Additionally, this vaccine is currently given to young girls, and may prove to be safe and effective in young boys. The sexual health of sons and daughters is an issue that mothers and fathers should be concerned about too.
I understand the temptation to call feminists out when they tread into certain non-traditional territories, and maybe sometimes it’s appropriate to do so. However, as bell hooks said, “feminism is for everybody,” and it’s precisely because Ms. understands those words that they printed this vitally important story.
Okay, I will try again.
Yes, I understand that feminism says it is for everybody. That is a good thing. I am just skeptical and do not identify as one (some feminists say I should not, given some of my beliefs). Having said that, I find some of its theories and critiques interesting, including many of Hugo’s perspectives, although I frequently disagree with them.
However, many feminists respond to male concerns in a few choice ways. Male problems interest them if they affect women (not, as Tom says, for their own sake); or they will disparage them (e.g. you cannot bring up the amount of money spent on breast cancer versus prostate cancer (a more common form of cancer), without them saying something to the effect of “well, start your own prostate cancer foundation”); or there is the “what about teh menz” trope. That is why I am skeptical.
I think there are many important issues surrounding men’s health. And, I think Hugo is half-right: men are TAUGHT NOT to go to doctors. Added to that, they are NOT TAUGHT to go to doctors. Girls are run into doctor’s offices in their early teens and are taught to go there annually for the rest of their lives. This makes sense; they have issues that need regular routine attention. Boys do not have such issues and, hence, are not taught to go. Often, they do not learn to go until it is too late.
Part of me is okay with that. Feminists will often complain that women are “medicalized” too much (or “pathologized”). Frankly, that is the downside of having so many medical treatments for your ailments; they have to medicalize you to treat you Men are medicalized far less, because men do not want to be. The downside of that is, of course, less attention to their medical issues.
-Jut
Jut,
I get that you are skeptical of something, and if it’s just feminism in general, please know that I’m not trying to convert you. I am trying to point out that if you can look past an aversion to what you perceive feminism to be, then I think you will be able to see the point of the article. However, as a feminist, let me say this: male health problems concern me both because of the potential for transmittal to others (women and men), and because of the negative impact illness has on individuals (women and men). I also think that the polio vaccine was a good thing, because I wouldn’t want anyone to have to suffer from the disease, nor would I want a disease spreading to others (myself included). This is the whole idea behind “public health,” and it’s not exactly radical. I’m sure there have been many feminists who have responded to men’s concerns in the few choice ways you described. But if we were to just look at the article in question, we would see that no one is disparaging men, and as I pointed out, the article doesn’t suggest that the only reason to care about this is because it could somehow impact women. Many women are mothers, and many have sons, and many of them are feminists, and to suggest that their concern about getting this vaccine added to the schedule of vaccines for their young boys to protect their health is something to be skeptical about borders on paranoia. The thing is, you can’t just pick a few things that a few feminists have said at some point about something and then insert them into arguments where they don’t belong. Like medicalization. Where in this article did a feminist, did anyone, complain about being medicalized? I didn’t bring that up either. Although I do see how it might seem like medicalization of women led to Gardasil being marketed to them before men, that’s not an excuse for Merck and the CDC to deny men access to the vaccine. On the subject of medicalization, to say that men are medicalized far less because they don’t want to be implies that women DO want to be, a pretty bold charge to say the least. But that’s beside the point. As for being taught to, or not to go to the doctor, that’s a valid concern and something that should be debated. But, if a vaccine isn’t available or if insurance won’t cover it then it doesn’t matter if a man chooses to go to the doctor or not. That’s the issue, that’s the point of the article.
Annie,
Don’t worry. I do not think you are trying to convert; heck, you may not even want me. ;)
Having said that, I think I understand the point of the article. Taking aside any preconceptions about feminism, I share Tom’s concern that, when feminists speak of male health issues, it is usually in the context of the way they affect women. That is directly in response to the way the Dr. framed the issue.
And, I do not think my concern is based upon any paranoia. There are many other health-related examples I could use to illustrate my point, but they are not really directly relevant here.
As for medicalization, that is more a response to Hugo’s broader view of the picture. The specific point of the article is that, maybe, Gardasil should be given to boys to help their health. Hugo stepped back from that to talk about “robust masculinity” and “female frailty.” I thought he missed part of the point about masculinity; I do not totally agree with his view of traditional masculinity. But, having raised that contrast, I was merely trying to point out that the issue is very much a double-edged sword. Medicalization is just a sample of that. Without addressing women, this article could be boiled down to the statement, “boys are not medicalized enough.” Granted, that is an oversimplification; that often happens when you distill thing. But, it does show the downside of the article; the upside, of course, is better health. But, as feminists seem very hesitant to over-medicalize women, they should see that they are balancing a potential benefit in sexual health with a potential detriment in medicalization.
So, no, medicalization did not come up directly, but it is an issue that lurks under the surface and should be addressed if you are trying to discuss notions of masculinity.
But, to address your challenge, I do not know if I would say women WANT to be medicalized. However, a big issue in feminism is women’s health and studies on female-related health issues (as opposed to studies on men’s health), whether it be breast cancer, cervical cancer, heart disease, ovarian cancer, menopause, etc. However, there is the idea that “to desire the ends is to desire the means to it.” Well, the means to the ends of better female health is medicalization. That is the other side of the sword. That is what I was getting at.
-Jut
Girls are run into doctor’s offices in their early teens and are taught to go there annually for the rest of their lives. This makes sense; they have issues that need regular routine attention. Boys do not have such issues and, hence, are not taught to go.
Which issues need regular routine attention? I am a woman and I wasn’t run anywhere, unless I was ill and needed it. Were you talking about menstruation as a medical issue? If everything is fine, why to go? Or about contraceptive pills?
el
Yes, those things are part of it. Menstruation can be handled very easily, but lots of issues can arise from it, from extreme cramping, migraines, or endometriosis. It may not always be the case, but certain side-effects require girls/women to seek medical help. And, most people understand that as a normal thing. I do not know when girls/women start getting pap smears. I do not know the prevalence of yeast infections or urinary tract infections, but women have often told me that “every woman gets a yeast infection at some point.” I understand that annual medical exams are required in order to renew the prescriptions for birth control.
In general, I think it is fair to say (even if it is a generalization for which you may be an exception) that girls/women are taught to go to the doctor regularly. It just becomes a part of their routine. Then, by the time the age comes for routine mammograms, they are more accustomes to going to a doctor.
Boys and men do not get the same message. By the time they should be getting routine prostate exams, they have not learned about getting routine medical exams. Then, of course, it is an exam that people make fun of (but that is another issue), teaching men to avoid doctors. For boys and men, there is no good analogy for a pap smear, or birth control, and yeast infections are much less common in boys and men. So, girls/women are taught much earlier to see going to a doctor as a part of life than boys/men are.
-Jut
Jut, I could be seriously off base, but the reasons I always assumed prostate cancer didn’t get the funding push of breast cancer is because it’s “something you die with, not die of” as expressed to me in some way by a few relatives of those who had it, and the other reason was that the treatments are likely to have an effect on sexual dysfunction, which based on the usual expressions our society expects of masculinity, doesn’t quite sound like something men who are feeling unhappy about ED or the attendant issues would be secure about discussing openly. Like I said, I could be completely off base, but that was always what I figured.
I do not want to derail here, Hugo, but I think this partly addresses some of your points.
Nav- I think part of the reason there is not a funding push for prostate cancer is the sensitive nature of the prostate and notions of masculinity. The tests are not pleasant (and, frankly, they are not terribly unpleasant, but they are just uncomfortable to go through). And, yes, most older men will die with an enlarged prostate, even if it is not cancerous. But, it is deadly; Frank Zappa being an example of someone who died of prostate cancer.
But, one of the reasons that prostate cancer is often analogized with breast cancer is that prostate cancer is more prevalent than breast cancer (1 in 6 versus 1 in 8), but it is also far more treatable. Early detection and treatment is the key for either.
And, yes, the side-effects can be bad. The same is true of breast cancer. I had an ex who got breast cancer and she opted for a double mastectomy “just to be safe.” The psychological effects of that are often enormous for women. Then, she got an ovorectomy “just to be safe.” That pushed her into early menopause. That was not an easy time for her, but she had support of people around her. For better or worse, traditional notions of masculinity and virility do prevent men from getting tested or being open about the impact of these side-effects. That is certainly something worth addressing.
-Jut
Tom, according to the CDC the risks men face are:
- About 1% of sexually active men in the U.S. have genital warts at any one time.
- Penile cancer is rare, especially in circumcised men. In the U.S., it affects about 1 in every 100,000 men. The American Cancer Society (ACS) estimated that about 1,530 men would be diagnosed with penile cancer in the U.S. in 2006.
- Anal cancer is also uncommon—especially in men with healthy immune systems. According to the ACS, about 1,900 men will be diagnosed with anal cancer in the U.S. in 2007.
Statistically males faces very low health risks regarding HPV, and for the most part their immune systems will fight off the virus within two years (although gay and bisexual men and men with HIV are more likely to develop anal cancer).
Well, if you don’t know and didn’t spend ten seconds Googling that information, why do you feel you comfortable making pronouncements about how often women “have to” see the doctor? You seem to have this weird view that women are like British sports cars, poorly built and always rushing off to the doctor for needed maintenance.
It’s certainly true that, at least in the US, pressure on men to “tough it out” discourages them from regular and often from necessary medical care. That has absolutely nothing to do with whether men need to see doctors more often than women.