In 1998 my wife discovered a mass in her abdomen. It was about the size of a softball. We scheduled an appointment with an ob-gyn, who told us that it was probably not a cancerous ovarian cyst. It was more likely a uterine fibroid. An ultrasound confirmed that two very large cysts were growing, distorting the shape of her uterus so that their placement was unclear. Were they inside or outside? On her ovaries or not?
We scheduled laparoscopic surgery and a biopsy, and learned that they were, in fact, uterine fibroids. “Very unusual for a white woman to have such large fibroids,” said the doctor, a statement we’d hear more than once in the following years. “I can’t believe you’re not having more pain.” We’d hear that one, too. We scheduled a follow-up appointment and spent a couple of weeks in a haze of mild anxiety.
This was just as Google was becoming a household word, but internet searches didn’t turn up much about uterine fibroids. I was a seminary student at Vanderbilt University, and there was a fabulous medical library on campus. We spent several hours looking through journals and learned that although fibroids are very common, they are not typically dangerous. There were a variety of possible treatments, from embolization (killing the fibroids’ blood supply) to myomectomy (cutting them out), but cutting out such large cysts increased the risk that scar tissue would complicate pregnancy—if we could even get pregnant. We learned that a majority of women have fibroids, and they are the main reason women have hysterectomies.
I was surprised that neither of us had ever learned about this common problem, and frustrated that every article we read said that nobody really knows why fibroids happen. In addition to creating fertility problems, we learned that fibroids might sometimes be responsible for dangerous ectopic pregnancies. Everything we learned about them only increased our uncertainty. My wife had been taking birth control pills for years to control painful periods. Did that contribute to the growth of fibroids? There was no consensus. Some said yes, others said no.
When we went in for our follow-up appointment, we brought all of our questions. Would we be able to get pregnant? Would it be safe to do so? Would insurance cover some kind of surgery or treatment? The doctor listened to our questions and was impressed with our research, but he couldn’t really tell us much more. He referred us to a specialist.
The specialist wasn’t much help, either. Our biggest concern was a dangerous pregnancy. He basically shrugged and said, “Whatever your plans for having children, you should probably do it sooner rather than later. These things tend to grow. It may grow a little, or it may grow a lot. If it grows a lot, you could have a complicated pregnancy.”
As a student, I was required to buy health insurance. We seldom used or needed it. Every August as the semester began, I had to scrape together enough money to buy our coverage. Most of our doctor visits happened at the university, and we never had trouble with insurance.
The following month we got a statement from our insurance company saying that we owed $260 for an uncovered doctor’s appointment. We were school-poor. We budgeted each month down to pennies. Our entertainment was whatever was free on campus. We had $100 in a savings account. The bill might as well have been for $1000—there was no way we could pay it.
I called the number on the back of my insurance card. The customer service representative on the other end of the line was a young guy—probably my age. I asked him why our insurance was refusing to pay. He looked up something on his computer.
“Ummmmm… oh, here it is. Yeah, we don’t cover contraceptive charges.”
“What? No, this isn’t a contraceptive charge. This was a consultation about tumors on my wife’s uterus.”
“This doesn’t say anything about tumors,” he said.
“They are fibroids. A kind of cyst. We were just thankful it wasn’t cancerous, but we were worried about complications. So that’s why we had the consultation.”
“So, were you asking about getting pregnant?”
I didn’t like where this was going. “Yes—I mean, no, not really. Getting pregnant is part of it, we just want to make sure there wasn’t any danger. This is about her health.”
“Well, if you were talking about getting pregnant, then it’s a contraceptive charge. Or a fertility charge, and we don’t cover fertility consultations, either.”
“No, listen, you’re not hearing me.” I had tangled the cord around my fingers. “I want to make sure my wife is safe. This is about her health. I wanted to know if she gets pregnant, would it put her life in danger.”
“If you were talking about preventing pregnancy, then it’s a contraceptive charge.”
“What the hell? Look, if I had a tumor the size of a softball on my testicle, would that be covered?”
The cubicle jockey on the other end laughed, “Sir, men can’t get pregnant.”
I’d always heard of sentences being felt “like a punch in the gut,” but had dismissed them as cliche. But that’s where I felt his words: a physical pain, a cold, hollow place in my abdomen. Then I felt the rage. I started cussing.
I asked to speak to a manager, and I was referred to another man with whom I had the same conversation. They informed me of an appeal process, but said they doubted it would change anything. If I couldn’t pay the $260 at once, I could probably work out an arrangement with the doctor’s office to pay in installments.
When I hung up the phone, my wife and I were both shaking and crying, the frustration and helplessness we felt having no other outlet. I do not believe violence is the answer to problems, but in that moment, I wanted to reach through the phone and throttle the idiot on the other end. He was probably just a student, like me, working a call center to pay his way. He spoke out of his ignorance. But my wife and I had scraped together what little money we had to buy this insurance, only to hear them laugh at our physical and financial distress. They laughed at my protest of unfairness. HIs words echoed in my mind: “Sir, men can’t get pregnant. Men can’t get pregnant.” As if it explained everything in the world.
I had never experienced the dehumanizing effects of sexism myself, the devaluation of half of humanity’s fundamental life concerns: health, freedom, and responsibility. For the first time, I felt was on the receiving end of systemic misogyny. At least, I felt it financially. My own health problems were classified as health problems, but my wife’s health problems were contraceptive or fertility problems—convenient labels that allowed our insurance company to refuse to give us the money we had already paid to them for our health care. The fact that I was concerned about her life and well-being was irrelevant. The minute we started talking about her lady-parts, her identity as a human being ceased to matter.
I would never stand for an insurance company or an employer telling me what kind of medical care I could get for my man parts. The only person who can make educated decisions about my body is me. And if part of the compensation of my employment is health insurance, then I’d better get the care that I’ve already paid for.
Of course, I was worried about our family planning, too. But getting any kind of financial help with such things had never crossed my mind. We had been paying for her pills for ages. It never occurred to us that we were actually saving the insurance company money. We were not trying to freeload birth control from a corporation. We just wanted the money we had already paid.
This was also the first time I had seen first-hand the banal dismissiveness of men who fail to see the sexism present in the medical system, or their complicity in it. My attempt to point out that my wife and I were treated differently was laughed off.
I’m a bit ashamed that I had to be hit where it really matters—in the wallet—for me to understand the demeaning way our society treats women every single day. If I had been wealthier, the bill would have been a minor annoyance. Why not just pay it? Instead, I had felt the physical threat to our existence those policies represent because we were riding the edge of poverty. Of course, the worst thing that would have happened is that I would have had to drop out of school and get a job. But I was suddenly much more sympathetic to people in real poverty.
Now, when I hear someone use cowardly rhetoric to talk about birth control, or of “being a slut on someone else’s dime,” I think about all the dimes I collected to pay an insurance company for nothing. I think about the corporate jets their executives fly. I think about the very tall buildings on Wall Street that I helped finance. And I think about the sluts in congress who sell their morals to healthcare industries, and the pimps in corporate boardrooms who control them.
We did manage to have a child, eventually, though we don’t know whether or not to blame the fibroids for her two miscarriages—they still don’t know much about them, you see. And they don’t know why black women get them more often than white. If white men got fibroids on their testicles, and it required castrations, you can be damn sure we’d know what causes fibroids and how to treat them. And you know insurance would pay every cent.
When she delivered by caesarian, the ob-gyn said the largest fibroid was the size of a basketball. It had shrunk by the time she had a hysterectomy. At that point, it weighed only six pounds. By that time in our lives we had decent insurance that treated her like a human being. We only had to pay a few thousand dollars for the surgery—still far out of reach of most of America’s poor.
So, that’s how I became a feminist. That’s when I claimed the label and decided that I would work hard to be a better ally, because being on the losing side of a double standard really sucks. When defenders of that double standard accuse you of being morally deficient, it adds insult to injury. When they laugh at your distress, it makes you fighting mad. Militant, even. I am thankful for the epiphany.
While nobody ever took our medical choices completely away, we were jerked around financially and emotionally by an insurance company, and we paid for the privilege. I wished at the time that we either had no insurance or a public option. Either would have given my wife more autonomy over her own body. If we had not had the financial and moral support of our extended family, I can easily see how this kind of uncaring “care” could cost us the ability to have children… or worse.
Jesus described his problem with the religious leaders of his day in Matthew 23:4: “They tie up heavy burdens, hard to bear, and lay them on the shoulders of others; but they themselves are unwilling to lift a finger to move them.” The concept of universalizability is one of the bedrock fundamentals of ethics: what applies to one, applies to all. Yet we continue to place a heavier burden on one half of humanity than the other in so many ways.
As I said, I’m grateful for the experience. It’s not the only one that has helped me to see my own privilege, and look past it, even when I thought I’d already dealt with it. I hope that our descendants can inherit a world in which the burdens of the world are shared equally between rich and poor, women and men, and where access to healthcare is no longer used as a tool of oppression.