The clitoris, pain and pap smears: how Our Bodies, Ourselves redefined women’s health
In 1969, Wendy Sanford was still in the early days of her marriage, living in Cambridge, Massachusetts, with her husband and their newborn son. A couple of years earlier, she had graduated with high honours from the prestigious Radcliffe College, and yet the path before her was clear: domesticity, home decor, dinner parties. She struggled with this new life. “My husband was so disappointed that I wasn’t happy,” Sanford remembers. “I cried a lot. I was in the middle of postpartum depression, and had no words for it at all.”
Sanford spoke to her doctor, who suggested she find solace in raising the next generation and supporting her husband. He also prescribed a diaphragm. She asked when she ought to put it in, and the doctor gave her the same mantra he gave all of his female patients: dinner, dishes, diaphragm. “So that was the era,” Sanford says. “And he was a very kind man, but he embodied sexist medical care. He had no idea that he was just pushing me into the arms of feminism.”
When her son was nine months old, and Sanford felt at her lowest, a friend invited her to a women’s health meeting at Massachusetts Institute of Technology (MIT). “You have to come to this group,” the friend told her, “because we’re learning about our bodies.” Reluctantly, Sanford agreed.
The meeting was not what she expected: “I walked into this lounge full of women,” she remembers, “and someone up in the front of the room was talking about the clitoris, orgasm and masturbation, and I was just so embarrassed. I just sank down to the floor and listened really hard. This was stuff that I had never heard said out loud before.”
At one point, Sanford remembers, the speaker held up a lifesize picture of a woman, with legs apart, to show the location of the clitoris, and to explain how, contrary to Freudian thinking, it is the major organ of female sexual pleasure. “Who knew this before?” she asked the group, who sat largely blankfaced. “That’s my point,” she told them. “We should know these things. These are our bodies.”
For Sanford, the opportunity to discuss such issues proved radical. “That evening really turned something around in my life,” she says. “I was so grateful, I gave the next 40 years of my life to the women’s health movement.”
Sanford would become one of the founding authors of Our Bodies, Ourselves, a book about women’s health and sexuality that would prove revolutionary. It sold more than 4m copies globally and became available in 33 languages, and is considered one of the most influential books of the 20th century. Across its nine editions, it addressed sexual health, sexual orientation, menstruation, motherhood, menopause, postnatal depression, abortion (still illegal in much of the US in the book’s early editions), violence and abuse, gender identity, birth control and desire.
The origins of the book began some months before Sanford’s first meeting at MIT. In the spring of that same year, as the women’s movement gained momentum, a Female Liberation conference had been held at nearby Emmanuel College. There were taekwondo demonstrations, talks called Women and the Church, How Women Oppress Themselves and, on the Sunday morning, a workshop called Women and Their Bodies, held by Nancy Miriam Hawley.
At the end of the workshop, the attenders were reluctant to leave, and the discussions spilled on outside. Over the months that followed, they formed a group that would be named the Boston Women’s Health Book Collective, to discuss their bodies, their lives, sexuality and relationships. The next year, they published a book named after the original workshop title.
In 1971, they changed the book’s title to Our Bodies, Ourselves, to reflect women taking ownership of their own bodies. Priced at 30 cents, it sold 225,000 copies without any formal advertising, and its success attracted the attention of Simon & Schuster, which would publish the first commercial edition in 1973.
Alongside Sanford were 11 other women: Ruth Bell Alexander, Pamela Berger, Joan Ditzion, Vilunya Diskin, Paula Doress-Worters, Hawley (who did the workshop), Elizabeth MacMahonHerrera, Judy Norsigian, Jane Pincus, Esther Rome, Norma Swenson and Sally Whelan. Each took a chapter topic to research and write. None of the authors were medically trained, though trusted medical authorities were consulted. Alongside factual information, it featured strikingly graphic illustrations and first-person stories from women. Its tone was informal and warm – the voice of a trusted but authoritative friend. It quickly earned a reputation as a book to be passed from mother to daughter.
What was radical about Our Bodies, Ourselves was not just the subjects it broached but the fact that it was written by women for women. In so doing, it challenged the power and role of the largely male medical profession. “We as women are redefining competence,” the 1970s edition stated. “A doctor who behaves in a male chauvinist way is not competent, even if he has medical skills. We have decided that health can no longer be defined by an elite group of white, upper-middle-class men. It must be defined by us.”
That women are treated differently by the medical profession is a long-established truth: scientists, researchers and doctors are predominantly male, and most clinical trials have been carried out on men or male cells. Early medical textbooks suggested that women’s bodies were inferior to those of men – Aristotle even referring to the female body as a mutilated male body. This has had huge implications for disease, diagnosis and treatment.
Even today, discussions around female health are often couched in moral terms, implications of hysteria and suggestions that women’s bodies are principally reproductive machines – ideas explored richly in Gabrielle Jackson’s Pain and Prejudice, Laura Bates’ Everyday Sexism, and Caroline CriadoPerez’s Invisible Women: Exposing Data Bias in a World Designed for Men.
More than 50 years after Our Bodies, Ourselves’ call to redefine health, a recent Guardian investigation into women and pain found that women are more than twice as likely to be prescribed opiate painkillers rather than having their pain properly investigated. This followed a 2020 UKgovernment-ordered inquiry that concluded that the arrogance of medical culture had resulted in serious complications, from vaginal mesh to hormonal pregnancy tests, being dismissed as “women’s problems”.
This spring, the UK government launched a review to better understand women’s experience of the healthcare system, with the plan to create the first ever women’s health strategy. It will begin, they say, by “placing women’s voices at the centre of their health and care”.
Over the past five decades, Our Bodies, Ourselves has not been without controversy. In the early 1980s, it incurred the wrath of the conservative attorney Phyllis Schlafly and the televangelist Jerry Falwell of the conservative Christian movement Moral Majority, who declared the book “obscene trash”. This in itself perhaps only raised awareness of the publication, and for a time it was the moststolen library book in the US.
Other criticism was more valid, pointing out that the members of the collective’s core group were all white, able-bodied and well educated. Subsequent editions, along with expansions in the editorial team, board of directors, nonprofit founders and staff members, sought to be more inclusive.
Speak to the founders today, and what marks their conversation is an expansiveness and a capacity for change. Swenson, for instance, who talks of how, as the group’s oldest member in 1969, she was forced to confront many of the beliefs she had held as outmoded, educating herself in contemporary feminism. Or Judy Norsigian, who discusses pioneering work in perimenopause education. Or Sanford, who talks of the joy of her second marriage, to a woman.
As Our Bodies, Ourselves spread around the world, it took the crucial step of being adapted, rather than translated – so embracing the nuances and specificities of different cultures. Among those adaptations is the Ugandan edition of 2017, edited by Diana Namumbejja Abwoye, 35, a family nurse practitioner and a member of the board of directors of Our Bodies, Ourselves.
Namumbejja Abwoye moved to the US as a student in 2007, and became involved with the group after a distressing pap smear experience. In Uganda, where the focus is on curative rather than preventive medicine, pap smears are uncommon, and Namumbejja Abwoye had no understanding of what was being done to her. “I felt violated,” she remembers.
She discussed her experience with a colleague, Ruth Hubbard (an adviser to Our Bodies, Ourselves) , who encouraged her to attend the Our Bodies, Ourselves 40th anniversary symposium. Like Sanford more than 40 years earlier, Namumbejja Abwoye was floored by what she heard. “All these accomplished women talking about these things,” she remembers. “Things that were a taboo to talk about from where I came from.”
Given a copy of the 2011 edition, Namumbejja Abwoye went through the book with a highlighter. “I knew it was something I wanted to share,” she says. “The gift of knowledge that you want to pass on to girls and women who you think really need it.” She set about finding ways to fund a translation into Luganda, the main language in central Uganda.
It was not without challenges: abortion and same-sex relationships are still illegal in Uganda, and so Namumbejja Abwoye had to find a way to write about such issues covertly: “In my generation, we had some code words that we had come up with to talk about things that were a taboo, ensuring that the opposite sex or our elders would not know what we were talking about,” she says. “So I depended on such language to talk about certain aspects in the book.”
She also knew that in a country where many families struggle to get by on less than 50 cents a day, she would need to find a way to distribute free copies to communities. But she regarded it as vital work: “Having grown up in a culture where doctors or healthcare providers are like kings, I feel as if knowing your own body, and what to expect at the doctor, equips everyone with a tool so they can advocate for themselves,” she says.
It has also changed Namumbejja Abwoye’s experience of medicine in the US. “My interactions with healthcare providers were totally different after reading this book, because I had the basic knowledge about what to expect,” she says. “It’s empowering. It’s something I’d wish for every woman: to build a collaboration with their healthcare provider.”
It has also altered how she approaches her work as a medical practitioner. “I am very supportive of evidence-based medicine, but certain things can’t beat the experiences talked about in this book,” she says. “I always feel that knowledge is power. Both for me, as a provider, but also for me as a patient.”
And, on a more personal level, she feels the book altered her perception of herself, making her question the upbringing that taught her to be a dutiful wife and mother. “It has changed the way I relate with my own body,” she says. “It has changed the way I perceive myself as a woman, and my role in this world as a woman.”
Since 2011, there have been no new print editions of Our Bodies, Ourselves. But the work lives on online, courtesy of Suffolk University, and continues to be adapted for new audiences – this year, for instance, will bring a new adaptation in Brazil.
The group’s influence also continues to extend elsewhere: 2014 saw the publication of Trans Bodies, Trans Selves, (the second edition is due to be published later this year). Its editor, the doctor Laura Erickson-Schroth, 39, was raised in Brooklyn by a mother who was involved in the women’s movement, and kept a copy of Our Bodies, Ourselves at home. “It was one of many reminders that our home was a place where I could be myself,” says EricksonSchroth, “whatever that turned out to be.”
Trans Bodies, Trans Selves “came out of a confluence of events” she says. “Two of my close friends from college came out as trans, and, at the same time, I was starting to learn about trans health in medical school. There seemed to be a real disconnect between these two areas of my life.” She saw that her friends were having trouble finding the medical information they needed, while the doctors she was meeting didn’t seem to have much knowledge about trans people’s lives. “It felt like a similar moment to when Our Bodies, Ourselves was published,” she says. “There was a community that was the best experts on themselves, but they didn’t have a comprehensive way to share that information with each other.”
Erickson-Schroth contacted Our Bodies, Ourselves and received an invitation to meet Norsigian and Sanford in Boston. “They asked me to come help teach a class with them,” she says. “They ended up writing the afterword for Trans Bodies, Trans Selves, which felt like an amazing way to close the book. For me, it’s a symbol of their
understanding that our lives are intertwined and that we are all fighting the same fight from different angles.”
“Thanks to Trans Bodies, Trans Selves and all the transgender folks who have been writing and teaching over the past many years, we, a group of cisgender women, now know that we can no longer say ‘a woman’s body’ and mean only one thing,” runs Sanford’s afterword. “One person’s body may have a penis and testicles, and be a woman’s body. Another person’s body may have breasts or a clitoris, and be a man’s body. The revolutionary point is that we can name our gender identity for ourselves and rightfully expect respect and recognition. ‘Our bodies, ourselves’ grows in meaning daily.”
Today, though the group now exists as a voluntary organisation, the founders of Our Bodies, Ourselves remain active campaigners for women’s healthcare and social justice. They meet often, talk even more frequently, and have a bond that they describe as more than friendship – they are family, a sisterhood, and together they have helped one another through divorce, death, dementia, celebrated successes, births, marriages and coming out – and encountered disagreements, disputes and divisions.
But what has always united them, what spurs them on today, is what Sanford has described as “expanding this excitement, this learning, and this crucial work for social change”. Though it would be wrong, she says, to suggest they are anything other than a group of ordinary women. “I hope you don’t idealise us,” she adds. “Idealising makes other women feel they can’t live up to us.”
• This article was amended on 22 April 2021 because an earlier version referred to Namumbejja Abwoye’s colleague as Ruth Alexander Bell, founder member of Our Bodies, Ourselves. In fact, the colleague was Ruth Hubbard, an adviser to the organisation.
Laura Barton presents Our Bodies, Ourselves on Radio 4 and BBC Sounds on 24 April at 8pm
It has changed the way I perceive myself as a woman, and my role in this world as a woman