WHAT IS A HEALTHY WOMAN? THE SOCIAL
CONSTRUCTION OF WOMEN'S HEALTH
Observers of the literature on women's health have pointed out that health itself, and women's health in particular, are socially constructed phenomena (e.g., Corea, 1985; Ehrenreich and English, 1978; Travis, 1988). These writers argue that conceptualizations of women's health reflect prevailing sociocultural standards concerning women's proper place in the world. Lawrence and Bendixen (1992) illustrated this point through their analysis of depictions of male and female anatomy in medical texts. They first outlined two historical approaches to conceptualizing female and male anatomy: hierarchy and difference. Dominant from the time of the classical Greeks through the mid-17th century, the hierarchical approach framed women and men as sharing similar basic biological structures, albeit in imperfect form in women. They quoted Aristotle—“For the female is, as it were, a mutilated male” (p. 926)—to exemplify this understanding of female anatomy.
By contrast, post-17th-century writers began to present women's anatomy as quite distinct from that of men's. To illustrate the concept of difference, Lawrence and Bendixen (1992) quoted Sachs, a German physician, writing in 1830: “The male body expresses positive strength, sharpening male understanding and independence, and equipping men for life in the State, in the arts and sciences. The female body expresses womanly softness and feeling. The roomy pelvis determines women for motherhood. The weak, soft members and delicate skin are witness of woman's narrower sphere of activity, of home-bodiness, and peaceful family life” (p. 926). Other writers have pointed out that the scientists and physicians of the late 1800s used accepted scientific theories to promote the primacy of the maternal role for women (Travis, 1988). For example, Helmholtz's principle of energy conservation was used to support the proposition that because women's most important function was reproduction, it followed logically that other biological structures, especially those involved in intellectual pursuits and physical activities, could not and should not function at maximum capacities in women (Travis, 1988). Further, the purported primacy of cyclic biology and hormonal function in women is illustrated by one physician's (Virchow,
Returning to the present day, Lawrence and Bendixen (1992) found in their analysis of medical texts between 1890 and 1989 that although 63% of anatomy illustrations in medical texts they reviewed were not gender specific and that text space devoted specifically to males had declined over the century, medical texts in 1989 still evidenced a disproportionate use of male-specific figures and descriptions. Further, male structures often were presented as the norm with female as the variation, and female-specific content was at times vague or inaccurate.
These findings illustrate two primary contentions of social constructionists—that scientific and professional treatments of women's health have served (1) to perpetuate the view of male as normative and female as deviation from the norm and (2) to promote a focus on women's reproductive function to the exclusion of other aspects of health. Recent evidence also suggests that the social construction of women's health is apparent in researchers' selection of topics for study and in their interpretation of data (e.g., Meyerowitz and Hart, 1995; Stanton and Dan-off-Burg, 1995). Fortunately, today many researchers are investigating women's health concerns in their own right, are broadening their focus to encompass a host of areas in addition to reproductive health, and are framing answers to the question “What is a healthy woman?” in terms of women's own experience.