Women and Aging

Transcending the Myths

Linda R. Gannon

• Publisher: Routledge
• Year: 2005
• Print ISBN: 9780415169097
• eBook ISBN: 9781134701780
• Topic: Psychology
• Subtopic: Developmental Psychology
• Index: Psychology

Aging in women has traditionally been defined by the menopause, however it is often social and economic changes which are more important to women.
In Aging in Women Linda Gannon redresses the balance. From a feminist perspective, she critically reviews current research and provides a more comprehensive analysis of the psychological effects of life-span changes for older women. Some of the topics she explores include second careers, empty-nest, divorce, chronic illness, retirement and sexuality.

1
INTRODUCTION

One is not born, but rather becomes, a woman; …it is civilization as
a whole that produces this creature…which is described as feminine.

(de Beauvoir, 1953, p. 267)

Women’s biological, psychological, and social development across the life span is compromised by cultural, political, and economic factors creating long-long lifestyles, habits, expectations, and roles that place women at risk. The first step in reducing the risk is to understand it. My goal is to promote understanding of the physical and psychological well-being of women as they age. Many of the common concerns in middle-aged and elderly women (e.g., cardiovascular disorders, sexuality) are at the nexus of scholarly tensions between explanatory models emphasizing normal aging versus disease and nature versus nurture. These concerns also continue to be targets of scientific sexism in research and treatment. In a feminist context, the traditional assumptions that aging is necessarily associated with intellectual deterioration, depression, physical disability, and social disengagement are challenged. Social skills and support, control over one’s life, and social and economic roles are emphasized as major determinants of psychological well-being. Physical well-being is discussed in the context of diet, exercise, substance abuse, and obesity. Even the common separation of psychological and physical well-being, while convenient, is restrictive in that the strongest predictor of psychological well-being in aged women is physical health. While many seek solutions and answers within a medical paradigm, feminist scholarship invalidates this route by elaborating the essential synergism of nurture and nature. Appreciating the complexities of women as they age in Western society and facilitating healthy development requires assuming continuity and interdependence, rather than opposition and contradiction, between biological and environmental forces. Indeed, with age, biology becomes relatively less important as the combined influences of pollution, trauma, sexism, ageism, poverty and access to quality health care accumulate over a lifetime.

In the last several decades, science has been inundated with criticisms aimed at questioning the legitimacy of the essential underlying principles of the endeavor. Critics from a wide variety of disciplines and professing an even wider variety of ideologies have challenged priorities, funding sources, assumptions, methodologies, interpretations, goals, applications, and ethics of scientific research. Postmodernists, social constructionists, and deconstructionists have created an atmosphere of intellectual challenge as well as considerable professional insecurity and defensiveness. A dominant force in this search for valid, useful and humane theory and practice has been and continues to be feminism. A crucial contribution of feminism to the revolution in the physical and social sciences has been to provide critique based on an examination of the ideological underpinnings of theory, methodology, and interpretation—to demand acknowledgment of the fact and the meaning of the social, political, financial, and personal context within which research is embedded. In all respects, the ideology and practice of feminism is the basic context and motivation of this book.

In the following chapters, I have attempted to gather together information from a variety of sources and disciplines and to offer interpretation, synthesis and resolution of contradictions from a feminist perspective. There were several themes that repeatedly emerged from the integration of feminism and science in the study of aging women. The first is androcentrism: an ideology in which males are recognized as the “standard” or “norm” of a species and females are acknowledged only as “different” or “other.” The second is biological reductionism. This is the conversion of biology to ideology—the goal being the legitimization of ideology by appealing to biology. And the third is the dualism that has traditionally guided scientific thought and has transformed our conception of nature from one of continuity to one of antagonistic opposites. These themes are basic and salient to the discussions in the following chapters and are elaborated here.

ANDROCENTRISM: WOMEN AS OTHER

Charlotte Perkins Gilman may have been the first feminist to write of androcentrism. In her book, The Man Made World or Our Androcentric Culture (1911 [1970]), Gilman provides various descriptions of androcentrism:

The man was accepted as the race type without one dissentient voice: and the woman—a strange, diverse creature, quite disharmonious in the accepted scheme of things—was excused and explained only as a female. (p. 18)

She has held always the place of a preposition in relation to man. She has been considered above him or below him, before him, behind him, beside him, a wholly relative existence. (p. 20)

That one sex should have monopolized all human activities, called them “man’s work,” and managed them as such, is what is meant by the phrase “Androcentric Culture.” (p. 25)

While Gilman provides a definition of androcentrism, MacKinnon (1987) describes the everyday implications of an androcentric culture:

Men’s physiology defines most sports, their needs define auto and health insurance coverage, their socially designed biographies define workplace expectations and successful career patterns, their perspectives and concerns define quality in scholarship, their experiences and obsessions define merit, their objectification of their life defines art, their military service defines citizenship, their presence defines family, their inability to get along with each other—their wars and rulerships—defines history, their image defines god, and their genitals define sex.

(MacKinnon, 1987, p. 36)

And Bem (1993) describes the political implications:

although males and females differ from one another in many biological and historical characteristics, what is ultimately responsible for every aspect of female inequality, from the wage gap to the rape rate, is not male-female difference but a social world so organized from a male perspective that men’s special needs are automatically taken care of while women’s special needs are either treated as special cases or left unmet. (p. 183)

Thus, the ideology of androcentrism is the basis for a culture in which men’s bodies, feelings, activities, behaviors, interests, desires, and occupations are taken as “the point of reference”; women are ignored or characterized as deviant. In some cultures, the “standard” human is further limited to those men who are White, heterosexual, and middle-or upper-class.

Not surprisingly, those who are the “standard” human are those with the power and authority to define what is normal for others, and those who are powerless are “normal” when they comply with their second-class citizenship. Women, ethnic and racial minorities, and gays and lesbians are normal only if they behave in a manner that reinforces the primacy of those in power. Thus, subservient roles and biologically defined roles are deemed “normal” for women and minorities; striving to become heterosexual or acknowledging their “illness” is judged “normal” for gays and lesbians. Essentially, those who lack power are “normal” when their physical, psychological, biological, and sociological natures are such that they support and reinforce the supremacy of the physical, psychological, biological, and sociological natures of those in power. Ideologies, practices, and laws are constructed to maintain this structure by defining as “normal,” standard, or healthy that which either defines or serves androcentric culture. An obvious consequence is inequality, and this inequality provides the basic ingredient for patriarchy.

Androcentric ideology has provided the basic, underlying structure for medical and social science research. Historically and to some extent currently, across academic disciplines, “normality” is defined as that which men are, do, and desire: medical schools teach anatomy and physiology of men with women as a variant; men’s professional career paths are standard while women tag along with “mommy tracks” and “biological clocks”; personality characteristics more common in men are normal while those more common in women are pathologized (Kaplan, 1983); men have rational responses to a stressful environment, women have irrational responses during the premenstrual period; aging men are wise, charming, and sexy, whereas aging women have a hormone deficiency.

“BIOLOGY AS IDEOLOGY”

This title is borrowed from the title of an incisive and brilliant book by R.C. Lewontin (1992). Biological determinism is a philosophical, scientific, and political theory within which the social and economic differences between women and men (or among racial and ethnic minorities or among persons of various sexual orientations) are attributed to natural, biological differences—the goal being to legitimize inequality, to make inequality a natural and inevitable consequence of human culture. The outcome is that the politically disenfranchised are told, “that their position is the inevitable outcome of their own innate deficiencies and that, therefore, nothing can be done about it” (Lewontin, 1992, p. 20).

Cultural institutions and structures have been created for this purpose. According to Lewontin (1992):

For an institution to explain the world so as to make the world legitimate, it must possess several features. First, the institution as a whole must appear to derive from sources outside of ordinary human social struggle. It must not seem to be the creation of political, economic, or social forces, but to descend into society from a supra-human source. Second, the ideas, pronouncement, rules, and results of the institution’s activities must have a validity and a transcendent truth that goes beyond any possibility of human compromise or human error. Its explanations and pronouncements must seem to be true in an absolute sense and to derive somehow from an absolute source. They must be true for all time and all place. And finally, the institution must have a certain mystical and veiled quality so that its innermost operation is not completely transparent to everyone. It must have an esoteric language, which needs to be explained to the ordinary person by those who are especially knowledgeable and who can intervene between everyday life and mysterious sources of understanding and knowledge. (p. 7)

In the past, these institutions have been religious; today, they are scientific ones.

As the reader might anticipate, biology is assumed to determine destiny only when this assumption reinforces the prevailing ideology. Albee (1982) comments:

people, and especially social scientists, select theories that are consistent with their personal values, attitudes, and prejudices and then go out into the world, or into the laboratory, to seek facts that validate their beliefs about the world and about human nature, neglecting or denying observations that contradict their personal prejudices. (p. 5)

Thus, the discourse surrounding biological determinism focuses on information that supports the theory and ignores that which contradicts it. To illustrate, a recent scholarly focus is the relatively high rate of osteoporosis among aging women in Western society. This has been incorporated into scientific dogma as evidence for women’s innate biological inferiority. That osteoporosis is uncommon among mid-and old-age African American women is conveniently ignored. Why has no one suggested that African American women are biologically superior to European American women? Why has no one suggested that we study the lifestyle of African American women in order to determine the cause of their superior bones? This racial difference has not been emphasized because it is not consistent with Western beliefs in the superiority of the Caucasian race. Similarly, until recently, insurance companies claimed that women’s longer life spans justified the practice of awarding women monthly retirement dividends that were lower than those given to men; a logical extension of this policy—one that is not mentioned or followed—would be to award high dividends to ethnic and racial minorities—persons whose life span is considerably shorter than that of Caucasians (Lorber, 1994). Contradictions such as these are the consequence of a science done in order to be consistent with a specific ideology rather than one driven by common logic or common benefit. The dilemma is not that all scholarship is shaped by the beliefs and values of its creators; the dilemma is that this influence is unacknowledged and denied—the consequence being that the beliefs and values of those in power are sold as universal truths. Scholarly rhetoric claims that the “facts” emerging from Western scientific tradition will enhance freedom and equality; yet, it seems to be the status quo that is enhanced.

Historically and currently, the theory of biological determinism has been utilized, not only to support gender inequality, but also to pathologize women. The medical paradigm of development and aging in women has redefined women’s normal developmental transitions and experiences as medical problems that require medical interventions. Not only does the medical community benefit by increased profits and status, but defining an experience that is common or universal to all women as a disease supports women’s inferior status. In this way, biological gender differences may be invoked to justify inequality: economic, political, and social differences between women and men are dismissed as the natural consequences of biological differences. But attributing difference to biology is highly selective—the selection being consistent with ideology and self-interest. In order to maintain the inferior status of women in Western society and to limit the options, power, and control of women, certain biological states are labeled as healthy and normal, whereas others are branded as abnormal and indicative of illness: although the hormonal profile of childhood and that of postmenopause are similar, the former is normal, the latter is abnormal; although pregnancy is associated with far greater hormonal fluctuations than is the menstrual cycle, the former is normal, the latter is abnormal; while both the reproductive years and the postmenopause are characterized by some health benefits and some health risks, the former is normal, the latter is abnormal; while puberty and perimenopause are both characterized by hormonal, physical, and psychological changes, the former is normal, the latter is abnormal. Those biological states associated with or preparing for fertility and reproduction are good, healthy, and, above all, feminine, whereas menstruation—prima facie evidence that a woman is not pregnant—and menopause—the absence of potential pregnancy—are pathological. In other words, those biological phases in which women are free from reproductive concerns are designated illnesses.

DUALISM

Dualism is a philosophical doctrine that organizes constructs into two radically different and opposing elements. Classic dualistic notions include Descartes’ mind-body dichotomy and Darwin’s separation of nurture and nature. Many philosophers and scientists have criticized this manner of thinking as being motivated by a desire to dominate and control nature by imposing ill-fitting order, hierarchy, and dichotomy rather than being inspired by a longing to understand and comprehend. Feminist scientist, Ruth Blier (1984) proposes that the majority of our cultural dualisms reflect the basic female-male dichotomy: thus, we have private-public, body-mind, subject-object, subordination-domination, feeling-thought, and passive-active—all are gendered. According to Blier (1984):

The problems with a dualistic mode of thought are several. It structures our approach to knowledge of the world, it structures the world itself in an a priori fashion and imposes, as premises, dualisms and dichotomies onto the organization of the natural world that do not exist. Most basically, it obscures a fundamental characteristic of life and matter, perhaps first enunciated by Heraclitus over 2000 years ago: everything is in a constant state of flux, change, interaction. With such a view of reality, we cannot separate genes from environment, culture from nature, subject from object. We cannot view science as an act of domination and objectivity, but rather as one of mutuality and interaction with nature. (p. 201)

In spite of brilliant, creative, and varied criticism, dualistic thinking continues to dominate discourse in health, medicine, and psychology and to obscure continuity and interdependence because doing so serves the interests of those in power.

A basic dualism of Western medicine is “sick” versus “well.” The underlying medical assumption is that the ill are not quantitatively different, but qualitatively different, from the well—an assumption requiring the imposition of the discrete categories of “sick” and “well” on essentially continuous functions. To illustrate, in a study in the UK (Cohen et al., 1993), research participants were intentionally exposed to a virus; 6 days later, the researchers measured the degree of viral replication in the blood and the extent of clinical symptoms. On both measures, participants showed a wide range of responses; and clinical symptoms were not necessarily related to the degree of viral replication. At what point on either dimension do we label an individual “sick”? One could specify a particular criterion for “sick” but, without cause, the criterion would be necessarily arbitrary. A better question is why do we need to make the distinction? By forcing both risk factors and disease processes into poorly fitting dualistic paradigms, both diagnosis and treatment are compromised.

The essential dualism underlying traditional medicine and health creates a context in which it is believed to be both possible and desirable to distinguish normal aging from disease. This creates an artificial dichotomy since the deterioration associated with normal aging is unrecognizable from illness. Charcot, in the nineteenth century, stated the problem as “the textural changes which old age induces in the organism sometimes attain such a point that the physiological and pathological states seem to mingle by an imperceptible transition, and to be no longer sharply distinguishable” (cited in Katz, 1996, p. 81). The criterion is, thus, both arbitrary and temporary and depends, to some extent, on medical advances. As soon as a medical procedure is devised to modify a particular age progression, the previously “normal aging deterioration” is labeled a disease: menopause was first labeled an illness when estrogen therapy became available and inexpensive. Katz (1996) proposes, “The object of treatment in senescence should be to restore the diseased organ or tissue to the state normal to senescence and not a restoration to the condition normal in maturity” (p. 88, emphasis added). Yet, the goal of hormone therapy is to achieve a hormonal profile typical of a woman 20 years younger.

A dread and fear of aging is, perhaps, “natural” since aging culminates in death. None the less, an even greater source of fear is the illness, pain, disability, loss of independence, and loss of control that often precede death, particularly death in old age and particularly in Western societies where many survive to old age. As more and more individuals live to an old age, our understanding of the aging process has increased. Age-related changes are, by definition, universal and inevitable, illness is not. At what point does the deterioration associated with normal aging end and illness begin? What purpose is served by distinguishing the two? The traditional scientific discourse favors dualistic concepts and, as such, has assumed the reality of discrete categories—chronic and acute diseases, normal and abnormal aging. But the contents of these categories are often determined by ideology, self-interest and historical precedent rather than scholarship. Defining normal aging (or acknowledging the impossibility of definin...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Dedication
• Contents
• Preface
• 1 Introduction
• 2 Psychological well-being
• 3 Physical well-being
• 4 Menopause
• 5 Sexuality
• 6 Cardiovascular health
• 7 Osteoporosis
• 8 Concluding remarks
• References
• Author index
• Subject index