A major faux pas

Esteemed medical journal The Lancet has found itself in the headlines recently for all the wrong reasons. In this month’s edition, published September 25, the magazine sought to shine a spotlight on the pressing and stigmatizing twin issues of menstrual shame and period poverty in a review of an exhibition on the history of menstruation at the Vagina Museum in London. Sadly, in its attempt to publicise the article titled, “Periods on Display”, with a front page highlight, it succeeded in perhaps doing more harm than good.

For reasons only known to whomever at Lancet signed off on it, the magazine’s cover was emblazoned with this quote: “Historically, the anatomy and physiology of bodies with vaginas have been neglected,” which was pulled from the article. While the essence of the quotation is not incorrect, the magazine was blasted for its use of the phrase “bodies with vaginas”, the minute it tweeted its cover page. According to a report in the UK Telegraph, a number of academics and doctors immediately announced that they were resigning as reviewers of the journal and cancelling their subscriptions, referring to the phrase used to describe women as dehumanising, abusive and inexcusable.

A women’s group based in Scotland has since lodged a formal complaint and Claire Heuchan, who writes the famed Sister Outrider feminist blog, put the correct cap on it, tweeting: “Medical misogyny... exists - and refusing to acknowledge women perpetuates it...” She was among several commenters who noted that The Lancet has never referred to men as “bodies with penises”.

There is no doubt that the journal’s 21member editorial board, which is headed by a man, but includes some 13 women, committed a major faux pas when it not only accepted an article with that offensive phrase, but chose to use it on its cover. Though at this point it is not, and perhaps never will be known, who among them or how many of the editors were privy to the article prior to publication, one assumed there would have been some collective shame.

Sadly no. Instead, in a response on Twitter, the journal’s Editor-in-Chief Richard Horton, apologised, not for the use of the phrase in general, but to “readers who were offended by the cover quote and the use of those same words in the review”. Then, strangely, he doubled down in his response, noting, “Trans people regularly face stigma, discrimination, exclusion, and poor health, often experiencing difficulties accessing appropriate health care”. And in what can only be described as cringeworthy mansplaining, he claimed that the quote is “a compelling call to empower

women, together with non-binary, trans, and intersex people…” and urged that people read the entire review. Surprisingly, the review does not so much as mention non-binary, trans, and intersex people, who were definitely not the focus of the exhibition.

Mr Horton’s statement is therefore both disingenuous and defensive. Perhaps he meant to highlight The Lancet’s inclusiveness, which really is not in question. However, that particularly revolting terminology proves that it is not infallible. Those words should have been struck from the article. As it stands, this is nothing but a failed attempt to coin a phrase, made one hundred times worse by The Lancet editor’s condescending response.

Notwithstanding this instance of total tactlessness, the journal has long been paying attention to women’s health, publishing hundreds of articles on various issues that affect and afflict women. Further, it has produced series on ‘violence against women and girls’, ‘women and children’s health in conflict’ and just last year announced that it had established a new Commission on Gender and Global Health. It has explored themes such as gender equity, advancing women in science and even has a diversity pledge and a “no all-male panel” policy.

The journal could not have instituted the above changes, including publishing profiles of those it referred to as “remarkable women from around the world whose work helps advance gender equity in science, medicine, and global health”, without being fully aware of medical misogyny and the need for

change. And even if they were unaware, any of the editors need only look at what recently transpired in Texas with regard to women’s rights to medical termination of pregnancy.

Furthermore, it is also common knowledge that lack of access to quality healthcare, and in some cases any healthcare at all, affects poor and minority women the world over. While it is not a healthcare issue per se, period poverty, which refers to the financial burden of acquiring menstrual supplies or the inability to afford them, directly affects lowincome women and girls. If one adds to that the taboos still prevalent in many places around the world that result in menstrual shaming and stigmatizing of women and girls, there is no context in which referring to them as “bodies with vaginas” is empowering.

There is an adage that certainly applies here: ‘it is not what you say, but how you say it’. What is clear is that the London exhibition said one thing, which was echoed by the review, save for three unsavory words. A simple apology would have sufficed. The obvious machismo which stood in the way of that is regrettable.