Wikipedia wars: are there really novelists and 'women novelists'?

How many brilliant writers will be sorted away entirely, never making the cut as novelists because they're weighed down with the tag "woman"?

Bad news if you're an American, a novelist and a woman: Wikipedia has decided that you don't count as an American Novelist and have to go in your own sex specific sub-section called Women American Novelists. Well, not Wikipedia itself – Wikipedia is a platform, not a unified entity, and it makes no more sense to talk about it as the possessor of a single corporate mind than it does to imagine that your Facebook feed is the carefully curated output of one editor. Better to say instead that certain Wikipedians decided the best way to organise fiction was with women on the outside.

Since Amanda Filipacchi drew attention to this in the New York Times, there has been a lot of serious discussion on the the American Novelists talk page, as editors work out how to resolve such a highly scrutinised issue. A few have defended it as a neutral decision designed to reduce an untenably huge category, but to most involved, the sexism seems obvious: such a system of ordering makes men the default type of human, and women a subset. One contributor suggests creating the category American Men Novelists as a solution, only to be hit with the objection that this would leave the parent category populated solely by those who identify as neither male nor female — a curiously narrow group to represent the literature of a nation.

It's not just America which is to be sifted by sex. I took a look at Victorian Novelists, and there you can find a single subcategory: Victorian Women Novelists. While some women get to sit in the main section, many don't — including George Eliot. George Eliot, arguably both the finest novelist and the most Victorian of all Victorian novelists, tucked away in a feminine dependency of literary history. No such fears of perverse classification for Hardy or Dickens, of course: Victorian Male Novelists doesn't even exist as a category, because to be a man is to be neutral of gender in this system. It doesn't feel like we've shaken off all that much of the sexism which caused Mary Anne Evans to publish Middlemarch under a male pseudonym, does it?

The problem is, it's not just Wikipedia doing the classifying and it's not just novelists getting classified. We live in a world where everything is furiously sorted along gender lines. As a parent with feminist pretensions, I've been discretely appalled to see both my children (one boy, one girl) start sorting things by gender. For example: jumpers turned out to be a boy thing, cardigans a girl thing, and no amount of cajoling could persuade either child that they weren't committing gender treachery through knitwear. Of course, I felt somewhat shocked and then betrayed that my children had turned against my principles — until I'd had a moment to think about the example they had to work with.

I might not always love my place in the gender binary system, but I certainly don't want to be outside it. Through my clothes, through my make-up, through my manner, every day I do a hundred small things that announce my fealty to femininity. I sort myself — almost all of us do. And such sorting is not particularly malevolent in itself, except that it tends to spread and then become a kind of destiny. There's a hierarchy to it, too: I've heard my daughter describe a classmate derisively as a "girly girl, one who just likes girl-girl-girl-girl-girl stuff." Not putting on your gender properly is traumatic, but too much femininity is something to be scorned.

It's this same way of thinking — male as the mainstream, female as a diminished subset — that led to faint murmurings against Hilary Mantel's inclusion on the shortlist for the 2013 Women's prize for fiction. Having already won two Bookers, the murmuring goes, why should she get a run with the ladies as well? She's already proven herself as a novelist, no gender qualifier required. In success, she sheds her sex. Of course, if I object to Wikipedia categorising women novelists apart, perhaps I should object to prizes that do the same – and I do, or rather I object to the necessity for them.

The Booker has been won twice as often by men as by women, and I refuse to believe that's because men are twice as talented. Until there's parity there, the Women's prize does a sadly needful job of celebrating female authors. Its existence perhaps perpetuates the need for it to exist, and yet I can't think of a better answer to pervasive sexism than just pointing out that women are, and the culture we make matters. That culture should not matter only within gender bounds though, and if we sort and sort until we have sorted ourselves into separate spheres entirely, God knows how many brilliant writers will be sorted away entirely, never making the cut as novelists because they're weighed down with the tag "woman".

Hilary Mantel, after winning her first Booker prize. Photograph: Getty Images

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.

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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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