Britney Spears and the Advent of Female Distrust in Reproductive and Gynecological Health
By: Viktoria Wulff-Andersen
“I want to be able to get married and have a baby,” Britney Spears expressed before a Los Angeles probate judge on July 23rd. “I have an IUD inside of myself right now...but this so-called team won’t let me go to the doctor to take it out because they don’t want me to have children.” (1) With those harrowing statements, the world-famous musician did more than call for an end to her 13-year conservatorship - she reignited a conversation regarding the abusive policing of women’s reproductive health.
Spears’ courage to come forth and expose how her team disallowed her from drawing her line when it came to her body encouraged others to reveal their own similar limitations, begging numerous questions regarding the future of reproductive healthcare. If one of the most famous people in the world can be stripped away of their own rights regarding their reproductive and gynecological health, what are women with less power enduring? How many more women need to be policed before actions will be taken? When will women be able to make their own health choices without interference?
Whereas Spears’ concerns about her reproductive health were largely ignored by her conservatorship, most women find their similar concerns ignored by the very doctors sworn to help them. Despite the fact that conditions like vulvodynia and Polycystic Ovary Syndrome are described as “common” by organizations like the American Journal of Obstetrics and Gynecology and the CDC, the majority of women with such conditions are “undiagnosed and inadequately treated.”(2) 16 percent of respondents in Bernard Harlow and Elizabeth Stewart’s study analyzing the prevalence of vulvodynia reported histories of chronic vulvar pain for at least three months or longer, but of those who chose to seek treatment, 60 percent saw three or more doctors that could often not provide the correct diagnosis.(3) 50 percent of women with PCOS go undiagnosed. (4)
Such neglect from medical professionals can lead to pregnancy and somatic complications, a narrative only recently represented in the media. Serena Williams dedicated an entire Vogue cover story to recounting how it took her persistently asserting that she had a pulmonary embolism after her C-section to get her treatment that ensured her survival. “The nurse thought her pain medicine might be making her confused,” the 2017 cover story read. (5) Linda Villarosa published a 2018 report in the New York Times of Simone Landrum’s experience being told to calm down and take a Tylenol after complaining of headaches during her pregnancy. She was later found to have pre-eclampsia, resulting in a stillbirth.(6) Diane Hoffman and Anita Tarzian’s 2001 study revealed that because females who said they were in pain were thought to be anxious, “physicians prescribed less pain medication for women...than for men in the same age group.”(7)
There’s plenty of evidence that points to a pattern of medical professionals distrusting females, particularly in being able to determine their reproductive fate. Just as far back as the early 1970s, numerous states required spousal consent for tubal ligation procedures (it’s worth noting that vasectomies never required spousal consent). Today, despite the federal courts ruling state spousal consent laws unconstitutional by the end of the 1970s, many private hospitals and providers still have spousal consent policies. The American College of Obstetricians and Gynecologists claims that religiously-affiliated hospitals, employer-based insurers, and individual physicians may prohibit sterilization or request spousal consent based upon religious or moral tenets.(8) Such tenets caused women like Monica Trombley, Lori Witt, and Erin Thompson to have to fight for their own right to have a hysterectomy - being told they’ll change their mind, they’re too young, or that they needed to get cleared by a psychologist.(9) For context, men have never encountered those obstacles when requesting vasectomies.
Women of lower privilege are disproportionately distrusted by physicians. While women on public insurance cannot be denied a hysterectomy like women on certain types of private insurance can, they do not benefit from the lack of a wait period and lesser restrictions that come from private insurance. On the other side of the spectrum, incarcerated and disabled women that do not want a hysterectomy can often be forcibly sterilized because of such little regard for their opinion. The 140 cases of women undergoing sterilization in California prisons between 2006 and 2010 were revealed to often be undesired and coerced. (10) Buck v. Bell - a Supreme Court case which ruled that a woman named Carrie Buck could be forcibly sterilized because she was “feebleminded” - has never been overturned.(11)
Evidently, something needs to be changed. The bias against women needs to be fought against as early as medical school. Doctors know less about every aspect of female biology as compared to male biology and are often unaware of the fact that most of their understanding of female bodily processes comes from studies with majority male participants.(12) If states mandated that public medical schools host mandatory classes on the gender bias in health - teaching how the formerly mentioned knowledge gap causes dismissal when it comes to addressing female issues - perhaps doctors would be better equipped to treat women seriously. Perhaps women wouldn’t have their symptoms relegated to mere anxiety.
Furthermore, inequalities across reproductive health have to be rectified. Medicaid needs to remove their 30-day hysterectomy waiting period and complex consent forms so that women on public insurance are spared the same burdens as women on private insurance. The Supreme Court needs to issue a judgment on spousal consent laws (which has been brought up in numerous federal court cases) so that no woman has her fate dependent on someone else. It also should overturn Buck v. Bell to set a precedent that no disabled female shall be forcibly sterilized. Federal prisons need to offer more LARCs and employ oversight (such as perusing prior requests for sterilization) to ensure no individual is coerced into a hysterectomy.
With these changes, women will be able to draw their own much-needed line when it comes to their health. As Spears herself said, “[We] don’t need permission [to] make [our] own decisions.” (13)
Aswad, Jem. “Read Britney Spears’ Full Statement Against Conservatorship: ‘I Am Traumatized,’” Variety, Jun. 23, 2021.
Reed, Barbara Diane et al. “Prevalence and demographic characteristics of vulvodynia in a population-based sample.” American journal of obstetrics and gynecology, vol. 206, no. 2, 2012.
Harlow, Bernard L, and Elizabeth Gunther Stewart. “A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?.” Journal of the American Medical Women's Association (1972), vol. 58, no. 2, 2003, pp. 82-8.
Brugal, Sommer. “Too many women with PCOS go undiagnosed,” The Lily, Nov. 14, 2017.
Haskell, Rob. “Serena Williams on Motherhood, Marriage, and Making Her Comeback,” Vogue, Jan. 10, 2018.
Villarosa, Linda. “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis,” The New York Times, Apr. 11, 2018.
Hoffmann, Diane E. and Tarzian, Anita J. "The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain.” University of Maryland Francis King Carey School of Law, 2001, pp. 17.
Committee Opinion. “Sterilization of Women: Ethical Issues and Considerations,” ACOG, American College of Obstetricians and Gynecologists, no. 695, Jul. 2017.
Feder, Shira. “A woman was told she needed her husband’s permission to get her tubes tied. Her story went viral, but it’s not uncommon,” Insider, Feb. 25, 2020.
Roth, R. and Ainsworth, SL. “‘If they hand you a paper, you sign it’: a call to end the sterilization of women in prison,” Hastings Women Law Journal, 2015, pp. 7-50.
Brennan-Krohn, Zoe and McCray, Rebecca. “Britney Spears’ Reproductive Freedom is a Disability Rights Issue,” ACLU, American Civil Liberties Union, Jun. 25, 2021.
Jackson, Gabrielle. “Why don’t doctors trust women? Because they don’t know much about us,” The Guardian, Sep. 2019.
Spears, Britney. “My Prerogative,” Greatest Hits: My Prerogative, Jive Records, 2004. CD.