Sunday, 5 October 2008

I love the new pink ribbon campaign ad!

My partner asked me yesterday what I thought of the new ad for pink ribbon week, and said tentatively that he quite liked it. He was tentative, bless his pro-feminist cotton socks, because he knows that I hate it when blokes jump onto women's causes for dubious reasons - and the new pink ribbon ad exclusively features men.

Let me explain that 'jump onto women's causes' comment. This can take the form of subverting feminist values for non-feminist ends, like Steve Crow defending a woman's right to bare her breasts in public (thanks Steve). It can take the form of Chris Trotter calling THM writers faux feminists, and explaining to us how we should be running our own movement.

Or - and this annoys me most - jumping on women's causes can mean playing that sorry trump card: men have it at least as bad as women. This can involve countering women's concerns about domestic violence, for example, by saying, 'What about men who are abused by their wives?'. It implies - absolutely wrongly - that women don't care about violence towards men. It also implies that domestic violence has nothing to do with gender - that we highly-strung women are just imagining some connection.

One of the nuttiest examples of this kind of thinking was in a letter to the editor I once read. The male author was complaining that breast cancer got so much attention when hardly any men know how to self-examine for testicular cancer. There was actually no connection between breast and testicular cancer whatsoever, except that they both affect people's rude bits. The author of this sorry letter simply had a bee in his bonnet with anyone pointing out that health is a resource which is distributed unevenly in our society, and that this distribution is in part to do with gender. He thought he was seeing women get the upper hand in some sort of competition, and he didn't like it.

So you can see that I get irked when men put in their two cents' worth in a dumb way that undermines women's autonomy. But the pink ribbon ad doesn't do that. If you haven't seen it, it features four men of various ages and ethnicities, wearing pink ribbons and talking about how men can support women to care for our health. If you love the women in your lives, the ad suggests to men, you'll take an active interest in their wellbeing.

Now, I'm not a huge fan of the pink ribbon phenomenon. I didn't agree with the Breast Cancer Foundation's stance on Herceptin, and I don't like the pink Tim Tams and pink deoderant and general junky consumerist fanfare that surrounds the pink ribbon campaign, turning the ethically serious business of health needs into a competition for funding between different groups of ill people.

I feel that the current ad somehow has a bit more maturity about it, though. It suggests that breast cancer isn't just some sort of marginal icky women's business type of thing that should be left to the ladies to sort out. Rather, it treats breast cancer as exactly what it is: a public health issue which should be of concern to us all. Acknowledging this isn't some sort of defeat for males, any more than feminists pointing out the gendered distribution of good health means we don't care about the wellbeing of men.

The approach to breast cancer in the new ad is, surely, a step forward for feminists. It erodes that destructive idea that women's achievements (in health, education, wherever) come at the expense of men, and replaces it with the idea that women's health and wellbeing are important because women, like men, are valuable members of society.


Julie said...

Great post Anna! I think the ad you mentioned might actually be a re-tread - I'm pretty sure they showed it briefly a few years back, although I haven't seen it since. I remember that at the time it prompted my dad to initiate an awkward conversation with me about whether I got scans and stuff. I was really impressed and very touched.

Alison said...

Anna, I haven't seen the new pink ribbon campaign ad, but I'm actually relieved to see a feminist note some of the problems with The Breast Cancer Foundation, the pink ribbon campaign, and their take on herceptin. I've been sent the email petition on herceptin so many times, each time with more women I know having signed their name to it, and yet I've quietly refused to do so for several reasons. I'd be really interested in reading more about why you disagree with the BCF's take on it, as I've been starting to second-guess my stance, purely out of peer pressure.

Anna said...

Hey Alison

Ex-expat wrote on this very topic a few weeks ago - have a look at:

I actually don't know that much about the scientific merits of Herceptin, but my problem basically is that every bit of health spending has an opportunity cost. Even in an ideal world where the health system had a tonne of resourcing, people would still want better health and longer lives. So decisions will always have to be made about whose needs are most pressing.

This situation means we have to look at 'bang for buck' in terms of health expenditure, which in turn means we have to look at how many people benefit and how much they benefit. Which is the job of Pharmac, I guess. Herceptin hasn't met this test for me yet - I don't know enough about it to say that this drug is the best way of meeting women's health objectives, or other public health objectives. Added to that is the role of the drug companies in aggressively promoting their products...

Most of all, I dislike feeling pressured to support Herceptin without knowing much about its scientific or ethical merits, simply because it's a drug for women. I feel the aim of feminism shouldn't be advancing women while ignoring all other considerations, including other people who might have greater needs for medical resources! Hope that makes sense!

And my unease about the whole pink ribbon thing is pretty similar. All these gimmicks seem to be different ways of competing with other groups who need resources. Medical resources should be allocated on the basis of need, not according to who's got the trendiest campaign, I feel!

Alison said...

Thanks for your reply Anna. Somehow I totally missed ex-expat's take on it, so I'll head off to read that now. My concerns about herceptin are much the same. I also can't help wondering whether the immense cost of the drug actually reflects the cost of development and manufacture in any way, or whether it's an arbitrary figure based on the assumption that breast cancer awareness groups worldwide will drum up demand for the drug.

For my part I've been doing everything possible to avoid drumming up further support for the drug, since I trust that Pharmac have much better knowledge than me on the subject, but I'm a little sick of being attacked as an anti-feminist by some women when I'm asked to explain my position.

Anna said...

Well put Alison - I completely agree!

The ex-expat said...

You might also want to check out this from no right turn.

Ayesha Verrall said...

Thanks for your thoughtful post Anna.

I want to respond on the issue of the new campaign ad, the problems of comparing testicular cancer to breast cancer prevention and finally, the herceptin issue.

The new campaign ad is mature. It draws gentle attention to the fact that men have an interest in breast cancer prevention too, because women are members of their families & communities. This attempt to broaden the campaigns' support base appeals to me as I think too often health focuses on the albeit important right of individuals to treatment while neglecting that ill people have relationships with many others. It is true that part of the tragedy of breast cancer is that it is one of the most common cancers affecting women in midlife when they make important contributions to families and communities. We shouldn't take this argument too far though - the majority of breast cancers occur late in life. The campaign doesn't go as far as some local activists who have confronted policy makers with choirs of "breast cancer orphans" to bring home this point. I think that's a little distasteful and unfair.

Regarding testicular cancer, or prostate cancer, or whatever other important male cancer we're talking about I think two points need to be made. Firstly the biology of these diseases are very different, as are screening and treatment. So it is incorrect to assume that screening for these cancers is scientifically, economically and ethically justifiable. For the record teaching men about testicular self examination probably is a good idea, screening for prostate cancer is a very bad idea because you identify disease of unknown significance where treatment of unknown benefit and does carry risks of impotence and incontinence. So called men's health advocates often assume screening programmes are unquestionably good and the implementation of breast screening reflects a pro-woman bias rather than a lack of evidence supporting prostate cancer screening. Notwithstanding this there are questions to be asked about whether either sex should be the subject of screening programmes. Women through the cervical and breast screening programmes, pregnancy and their care of children (who need to go to the doctor more often than adults) are in much more frequent contact with the health system. Some authors argue this has the benefit of promoting other healthy behaviours - e.g. getting smoking cessation advice when you present for a cervical smear, or having a talk about a mother's blood pressure control, or HIV or diabetes risk when discussed during pregnancy. You could argue that men's relatively poor performance in many health indices are in part due to their lack of contact with the health system (as well as driving fast, going to war and having dangerous jobs). Alternatively you could argue that the health system is too involved in the lives of women; that women are effectively under surveillance by a health system that readily pathologises them and coerces compliance in a way that men won't tolerate. In summary, there are many problems with the assumption that feminists should support initiatives to screen for breast and cervical cancer, or that men's health activists should support screening for prostate cancer.

Finally - herceptin. There is a lot you can read about the politics of this drug. It is one of a new generation of cancer therapies, where molecules resembling immunoglobulin (the chemical your immune system makes to attack foreign cells) are made in the lab to attack cancer cells. They're expensive because this new technology is expensive, and also because pharmaceutical companies need to make squillions. It is only useful for some breast cancers (those with a certain molecule called HER2 on the surface). It has been trialled as an adjuvant to surgery i.e. once the surgeon has cut out all visible disease and a wide margin of normal breast. So in practice, its given to women who have had all the cancer cut out to reduce the likelihood of it coming back. So many people will have the drug, not have recurrence of cancer even without herceptin. I think if a hundred women in this situation received herceptin then only seven more would not have recurrence of there cancer than a hundred who go without herceptin. The of those receiving herceptin over eighty had it without it making any difference to their disease, which was cured by the surgeon cutting it out. However I understand the desire to do everything you can in this situation. Add to this the other problem which is that it can be cardiotoxic, and the benefits are not clear cut by any stretch. The issue of opportunity cost is very pertinent - it would consume a lot of our cancer and other drug buying budget. I think PHARMAC has made a very good decision on this issue and I'm disappointed to see that the National Party has chosen to undermine this important body on this issue.

Oh, and be very suspicious. Read Sarah Boseley's award winning article for the Guardian on Herceptin and how pharmaceutical companies manipulate patients and advocacy groups into selling their drugs:

Hope that lengthy reply clarified some things. If it matters to readers I'm a physician trainee and bioethicist.
Ayesha Verrall

Anna said...

That's fantastic, Ayesha. I'd love you to write up your comments on women's and men's relationships with the health system as a guest post, and I will continue to pester you to that effect.

On a slightly related note, Grey Power came out recently and complained that the Govt is funding flavoured condoms but not Herceptin. Irk.

Andrew said...

Hi everyone. I'm the partner in question in Anna's post. I actually share completely Anna's concerns regarding men effectively running roughshod over women who are at the vanguard of women's issues. This really annoys me, and is something that I am always on the lookout for in myself. It's such a 'male' thing to do. Anna's precis of Chris Trotter's recent antics is very much the sort of thing I'm referring to here.

However, on the flip-side, what I do really like is when men get involved alongside women - recognising when issues are relevant to all of us. For essentially the same reasons I like the "Are you o.k.?" campaign. But this is a slight off-shoot. What's particularly important here is it's a situation in which men are taking ownership of abuse caused by men, and that's ultimately the way that family and domestic violence as well as rape and all other forms of sexual crime will be eradicated - when the sectoral group that benefits stands up and says "no more"!

The other aspect I like about the two ads I've mentioned is that they both feature men talking about things that are very personal; things that men traditionally are not meant to think about: you know what I mean - unmanly concepts like emotions, feelings, depressive thoughts, love for one's family, etc. This is really synonymous with my first point in the sense that the more empathetic men can become the more they'll realise what a shitty world we've got here, and the more they'll want to try and sort it out for themselves.

Azlemed said...

thank ayesha, that made so much more sense for me than listening to what the media say.