Leslee Udwin, the documentary-maker whose film, India's Daughter, has been censored on the sub-continent. (Photo:Getty)
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The attitudes expressed towards women in India's Daughter are chilling. But they're also universal

India's Daughter has exposed that country's rape culture. But don't imagine that these attitudes aren't found around the world. 

This week’s screening of the film India’s Daughter has brought long overdue attention to India’s national rape crisis, and the causes behind it. It examines the story of a young woman – Jyoti Singh - who was gang raped by six men and murdered on a bus in Delhi in 2012. Jyoti was raped repeatedly before the men forced an iron rod inside her, removing part of her intestine. She died later that night in hospital. Her rapists and their lawyers’ attempted justifications behind the attack – including “in our culture, there is no place for a woman” - are among one of the most shocking aspects of the film.

Yet, many of the repugnant views voiced by the rapists and their defenders interviewed in the film are alive on our own doorsteps, and the doorsteps of women around the world. Many societies, for example, have adopted a culture of acceptability, where sexual harassment and rape are seen as inevitable. A lawyer defending the Delhi attackers compared women at various points in the interview to a precious flower and a diamond, saying that “if you put the diamond on the street, certainly the dog will take it out, you can’t stop it”. This implication, that the urge to act upon sexual desires in a violent manner is natural and therefore socially acceptable, is prevalent elsewhere. For example, according to Egyptian academic Dr Hania Sholkamy, Egyptian politicians have compared women to raw meat who, if left uncovered, will inevitably be devoured by animals.

Viewing sexual violence as an inevitability, particularly when a woman steps outside of her traditional gender role, directs the blame away from the perpetrator and towards the victim. One of the rapists in the film looks blankly into the camera and says “A girl is far more responsible for rape than a boy”. This view, though extremely prominent in India, is held by millions of men – and, in some cases, women – around the world. In early 2013 Egypt, after months of brutal attacks on female protesters, I asked the Freedom and Justice Party’s Shura Council human rights representative, Reda el-Hefnawy, about the causes behind sexual violence. He insisted that there are “so many reasons” why harassment remains the woman’s fault, including her whereabouts and clothing at the time of the attack.

Blaming the victim rather than their attacker is also still embedded in Western countries, particularly within college campuses. A 2007 study found that three of the five factors behind “rape-supportive attitudes and beliefs” among male college students were: a “belief that women should hold more responsibility for sexual assault”, “justifications for sexual aggressions based on women’s behavior”, as well as an acceptance of traditional gender roles.

Not only are women around the world seen as unequal to men and therefore deserving of lesser human rights – many victims of sexual violence are perceived as subhuman by their attackers. Women are often placed within a hierarchy of value, depending on their social status, sexuality, caste, religion or behaviour, used to justify how certain ‘types’ of women ‘deserve’ to be treated. Let’s look at the behaviour of women. In an almost unwatchable clip, one of Jyoti’s attackers says unblinkingly: “you can’t clap with one hand, it takes two hands to clap. A decent girl won’t roam around at 9 o’clock at night”.

This attitude often extends right to the upper echelons of power. In Egypt, a senior general attempted to justify forced virginity tests on detained women by saying that they “were not like your daughter or mine. These were girls who had camped out in tents with male protesters”. Those who inflict extreme sexual cruelty against women often completely dehumanise their victims, conceiving to be subhuman creatures rather than women with human rights and feelings. Yazidi women enslaved by ISIS are considered apostates and devil worshippers by their captives. They are bought and sold like cattle, before being repeatedly raped, abused and tortured.  American soldier Steven Green, who in 2006 gang raped a 14-year-old Iraqi girl before shooting her in the back of the head, was quoted as saying “I wasn’t thinking [Iraqis] were humans”. Salafi preacher Ahmed Abdullah (known as Sheikh Abu Islam), who accused women of speaking out about rape and sexual harassment of being “like ogres” and “like a demon”, also said that rape is “halal”, or ‘permissible’.

Sexual violence is often accompanied by a lack of fear of being held accountable. In Green’s case, he attempted to justify his actions in Iraq by saying “I didn’t think I was going to live. . . I wasn’t thinking about more than 10 minutes into the future at any given time”. In fact, many legal and policing systems around the world are designed to work against the victims rather than the perpetrator. In Egypt, a woman can only report an incident of harassment if she first catches her attacker and brings him and two other witnesses to the police. In the unlikely event of her doing so safely, she then has to deal with the police, many of whom share the same beliefs as those who commit the attacks on the streets. In fact, many police around the world pose a great risk to women. Just last year, an Indian woman was reportedly gang raped by four officers inside the police station.

Sexual violence against women is a subject that, time and time again, gets completely ignored by governments, whose job it is to protect its citizens. Following the 2012 attack in India, thousands of women pounded the streets shouting “We want justice!” Three years later, and their government has banned the screening of a film which highlights the problem. Yet, public officials in the UK are also guilty of staying silent on the subject, particularly in the name of protecting cultural sensitivities. In Rotherham, for example, public officials were accused by an independent inquiry of deliberately covering up thousands of cases of appalling sexual violence and abuse against vulnerable young girls. Just this week, a council whistle blower told of how he was silenced by senior staff after speaking up about child sexual abuse in Oxford, where an estimated 307 girls were failed by authorities.

Women around the world risk their lives in demanding an end to sexual violence. They bring subjects that are considered unspeakable onto the streets and shout about them, despite the risks. This International Women’s Day, it is time we recognise that patriarchy – the fight to keep women off the streets; to kill their independence; and, to control every aspect of their sexuality and movements – breeds sexual violence, and is a problem that must be fought on a global scale. So often British girls and women – from victims of female genital mutilation to ‘honour’ killings - are let down by our fear of facing uncomfortable truths. Let this be the year of airing them, and acting on them.

Emily Dyer is a research fellow at the Henry Jackson Society. She tweets as @erdyer1.

Flickr/Michael Coghlan
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Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 


Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

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