Not long ago, a male therapist friend told me with great delight about a recent victory — how he’d found a way to get free health care for a mental health clinic patient of his – a woman with a chronic illness who had no health coverage of any kind. People like this patient who have no insurance and no money are in serious trouble if they need health care; he knew his patient needed some health care services and he set out to find who could provide her with coverage. He discovered that a local Catholic hospital has a free outpatient clinic so this woman’s immigration status and lack of financial resources would not be a barrier to her care. And he was excited to share the news with me, because he knew of my special interest in access to health care.
Except as he told me the details, I realized he hadn’t focused on a larger issue for his patient, a 20-something woman with a chronic illness.
I said, “You may have a problem. This place is sponsored by a Catholic institution. Will this woman be able to get reproductive health services there?”
He didn’t know and didn’t see that as a major problem. “She has serious health problems – and now she’ll get care!” he said. He didn’t like me bursting his bubble; he had gone to great lengths to find a health care provider for his patient and didn’t understand why I couldn’t see that being able to get some access was better than no access. My friend is a good man, but he didn’t see the possible related health problems for a woman with a chronic illness if she doesn’t also have access to reproductive care. He didn’t see that a pregnancy for such a woman could create even more serious problems for her down the road.
I tried pointing out that health care doesn’t mean “everything but the parts below your waist and above your thighs.” I asked him, “What if this woman’s chronic illness means that pregnancy is a life-threatening condition?” (For this particular patient, it does). “Will this clinic help her get contraceptives to help avoid that? What will their associated hospital do if she appears in the emergency room in serious condition because she’s pregnant and the pregnancy is endangering her life?”
He hadn’t thought about those issues, but is was clear that he was very angry that I was criticizing the place he’d found when he had expended so much in finding for this patient.
In the weeks after our conversation, I read two articles that specifically addressed the problems with Catholic health systems and their refusal to give complete health care to women, which, of course, includes reproductive care. One reported on taxpayer money paying a Catholic organization to provide health services to immigrants that was refusing to provide reproductive services, and another, very recently, about the difficulty of getting contraceptives when your doctor works for a Catholic health system since eight of the largest health care systems in America are Catholic-owned.
I shared these articles with my friend and, being a good man, he read them and reluctantly agreed with me about the potential problem I saw for his patient. But when I asked him a few days later about whether he’d done anything to make sure this patient could have access to that additional care, he still hadn’t called the outpatient clinic to ask if they would prescribe contraceptives or if they have a plan for patients with risky pregnancies that could endanger their lives.
He hadn’t asked if they would tell this woman that her illness means it may not be safe for her to get pregnant.
He hasn’t called because he doesn’t want to know, because he might learn that his plan for this woman is only half a plan because it covers only half of her, and if he admits that, he has to admit that what he’s suggesting for her is insufficient. It might be the best he can find, but it’s still insufficient.
The problem is that most men – even good men – can’t see that women’s health care should include more than what their own health care includes. Men can’t get pregnant (with the exception of a few transgender males) so reproductive care is viewed by them as apart from health care in general, kind of like the audio system in a car is not considered part of general auto maintenance and repair. But unlike a car’s audio system, a woman’s reproductive system is not an unnecessary but pleasant addition – it’s part of the whole, integrated with the rest of a woman’s body.
With rare exceptions, women don’t have testicles, prostates or penises. Yet, I don’t know of any women who have trouble with the notion that men may need special medical care when it comes to their special parts. I don’t know of any women who think that male health care shouldn’t include prostate exams and blood tests to see if they are at risk of developing prostate cancer. And most women don’t complain about their taxes being used to help men when their penises fail to work properly for sex even though that failure is not life-threatening.
But apparently the generosity of women and the automatic respect women give men in determining what health care they need is rarely reciprocated. Male legislators, judges, religious leaders, company executives and radio talk show hosts feel perfectly comfortable telling women what their health care should and should not include. They feel perfectly comfortable blaming woman’s need for contraceptives on female sluttiness and sin. They feel just fine telling a woman that her own body is under men’s auspices and must continue to grow a fetus that is unwanted or even life-threatening.
It’s infuriating that some men think they have the right to make these decisions for women. But what’s almost as infuriating is that good men, men like my therapist friend, men who think that a woman’s reproductive choices are her own to make and would never accuse a woman seeking contraceptives of being a slut, those fine and decent men still don’t get it that for women reproductive health care is not an extra set of services but is essential to our health and well-being.
There is no reason why women’s health care should stop at “insufficient” and be considered enough. There is no excuse for the fact that in some areas of the country, the only hospital within a reasonable distance will let a woman suffer greatly or even die rather than perform a necessary abortion because of their religious “values.”
Sadly, until we get our “good men” friends on board with the fact that women’s reproductive health services are about more than just the freedom to choose when to have sex, patients like those of my friend’s, will continue to face bigger, and more serious, health issues than just being able to choose the timing of a baby.
For almost 20 years, Marti Teitelbaum used her doctorate in public health working for the Children’s Defense Fund, producing most of their numbers on children’s health, disability, health insurance, Medicaid, and immunization. Marti is the mother of two high-energy young women (a twenty-something dedicated social worker, and a 15-year-old emerging band photographer), and is married to a psychiatrist who devotes half his work life to a child mental health clinic.