Medicine needs to respect the subjective
Sep. 14th, 2019 03:15 pmCosmopolitan reports that a procedure for preventing cervical cancer might, possibly, have an unintended side effect of severely reducing sexual sensation:
Cosmo particularly foregrounds the undervaluing of women's capacity to orgasm, and that's definitely part of the issue, here:
I was also struck, though, by the way in which this presents such a clear example of misusing rationality to dismiss women's subjective experiences. Scientifically, sure, it makes sense to say "we don't yet have enough evidence to say." Medically, however, a standard of "we won't take seriously the possibility of a side effect until you can prove it happens" is downright irresponsible.
I don't doubt that, to many of the doctors dismissing these potential side effects, the dismissal seems "rational" to them. Feelings are just feelings; the sensible rational person is skeptical of such things. Especially (alas) if the feelings in question are women's feelings. But in medicine, of course, there are all manner of effects that you can't learn about except by asking the patient about their subjective experience. In this situation, a lack of respect for subjectivity in our rational discourse has deep and profound costs.
[T]he research just isn’t there: Studies on LEEPs mostly focus on cancer prevention or pregnancy complications. A 2010 one out of Thailand did find a small but statistically significant decrease in overall sexual satisfaction after a LEEP, and an Italian study that same year showed a loss of sexual desire. But both concluded that the cause is likely psychological versus the result of damage to the cervix. In 2015, a review in the American Journal of Obstetrics & Gynecology suggested that LEEPs can affect sexual function...but that more research is needed.
Without strong evidence to back them up, several women Cosmo spoke to say they face an endless procession of doctors who don’t believe that their sexual dysfunction could be caused by the procedure. And the trauma of being disbelieved only compounds, for them, the trauma of feeling that an essential part of them has been irreparably damaged. No one gave them another option. Instead, to stay alive, Sasha, Emily, and the others had to give up one of the things that makes life worth living.
Without strong evidence to back them up, several women Cosmo spoke to say they face an endless procession of doctors who don’t believe that their sexual dysfunction could be caused by the procedure. And the trauma of being disbelieved only compounds, for them, the trauma of feeling that an essential part of them has been irreparably damaged. No one gave them another option. Instead, to stay alive, Sasha, Emily, and the others had to give up one of the things that makes life worth living.
Cosmo particularly foregrounds the undervaluing of women's capacity to orgasm, and that's definitely part of the issue, here:
In the field of urology, doctors regularly discuss the possible sexual side effects of surgery on the male reproductive organs—and Dr. Irwin Goldstein says this should happen in gynecology too: “An era has to come when we accept that there are risks to operating on the cervix."
I was also struck, though, by the way in which this presents such a clear example of misusing rationality to dismiss women's subjective experiences. Scientifically, sure, it makes sense to say "we don't yet have enough evidence to say." Medically, however, a standard of "we won't take seriously the possibility of a side effect until you can prove it happens" is downright irresponsible.
I don't doubt that, to many of the doctors dismissing these potential side effects, the dismissal seems "rational" to them. Feelings are just feelings; the sensible rational person is skeptical of such things. Especially (alas) if the feelings in question are women's feelings. But in medicine, of course, there are all manner of effects that you can't learn about except by asking the patient about their subjective experience. In this situation, a lack of respect for subjectivity in our rational discourse has deep and profound costs.