Excerpt: You want health care but not marriage or commitment? Tough titties. Get married or die.
Making It Through
I am at the first checkpoint. I can’t help feeling that I really shouldn’t be here. At any moment the smoothly coiffed blonde woman with the discreet earrings and the beautifully manicured hands will look at me with a frown and say, “You’re not supposed to be here. How did they let you in?”
I hold my breath, waiting. I quietly exhale with relief when she she looks back up at me, ticks something off on the sheet in front of her, smiles and tells me to go through the door on my right.
Now, the second checkpoint. This is much more exposed. I am now in front of everyone else, everyone else who looks like they actually belong. We are all waiting for stage two, as personnel step up and call out our names one by one, directing us each to any one of the kiosks staffed by people in blue uniforms. I scan their faces, wondering which ones seem more or less sympathetic to me, which one is more likely to scrutinise my credentials with more or less care. I keep waiting for the ball to drop: “Ah, yes, I see, yes, well, I’m afraid you really shouldn’t be here after all.”
But it all goes well. I’m home free, and I can have my breasts examined.
I’m here for a mammogram. I am practically a charity case at my local health care provider, a private organisation with some kind of a grant to guarantee all their female patients free yearly mammograms. It’s a nice gesture, especially in a climate where unmarried, non-child-bearing women are considered expendable and useless and even procreative women are deemed useful only as bearers of children. In Arizona, lawmakers have declared that the rights of the “unborn” extend far beyond any limits of, well science, claiming that life begins even before conception. The phrase, “before you were a twinkle in your parents’ eyes” has never seemed so strange before.
The Near North Health Service Corporation is staffed by lovely people and even some decent doctors, but it habitually messes up its paperwork. This has meant that, on the one hand, it allowed me a free appointment for a lingering ear infection with an ENT specialist at Northwestern University Medical Hospital. On the other hand, it failed to file my “charity” papers on time – testifying that I would not have to pay because of my income bracket. As a result, the hospital sent my bill, for a service that was to be paid by Near North, to a collection agency.
So, understandably, even though I had called Near North ahead of time to confirm that my appointment was indeed free, I arrived that morning at the gleaming doors of The Lynn Sage Comprehensive Breast Center at Northwestern’s Prentice Women’s Hospital in Chicago (I call it, “The Breast Place”) with some trepidation, anxious about being turned away, marked with a scarlet P for too fucking Poor to qualify.
Being a charity patient also meant that my appointment was scheduled for a year after I had asked for one. Apparently, charity cases need to be extra careful in watching their health. My appointment sheet came with strict instructions: I was to wear no perfume, make-up, or deodorant. Somewhere, written in invisible ink, was an additional injunction: You must guarantee that you will not actually develop any mammary irregularities for an entire year from this date.
I make it past the second checkpoint – my non-existent papers are in order. I imagine that, as they enter my name into the system, it springs up with a large pink-for-breast-cancer flag: Let this poor shit pass. I am led through another door, and a nurse hands me a hospital gown with instructions to disrobe in one of the changing cubicles and to “cinch it nice and tight.” She is a slender white woman, and I wonder if she’s terrified of large brown breasts, in the familiar racism of Chicago, or is simply echoing the American hospital industry’s fear of naked bodies in general. Perhaps both. I’m reminded of how, every single time I’ve had my vagina examined, the doctor in question has always done so decorously, with a large cloth between the two of us, screening us both from the horrific possibility that we might see my pussy at the same time and, who knows, be overtaken by a lusty yearning for it and each other.
So here I am, waiting for a mammogram among people who are terrified of seeing my breasts out of context.
My mind wanders on Whitmanesque lines: In my breasts, I hold multitudes.
Oh, My Firm Young Melons of Yesteryear
I find myself in a waiting room with eight other women, similarly attired in ill-fitting smocks. I try to make sure that my nipples are not erect, affirming whatever suspicions the nurse may have had about them. I pick up a copy of Architectural Digest, hoping that the sight of a modern glass chandelier or a mahogany credenza, circa 1950, will not be too arousing. I wonder if I should reveal that I am sexually attracted to women, if I should perhaps turn to the others and simply state it as a matter of fact. Would that make them all less or more comfortable? Was that what the nurse really saw after all, my queer desire threatening to erupt and engulf every single one of us?
I’m finally escorted into the exam room and the female technician who runs the machine is incredibly friendly and profusely apologetic about the fact that we are running fifteen minutes late. I can tell she’s used to dealing with wealthier, paying clients. At Near North, I always bring my knitting to an appointment, expecting to finish my entire scarf, knowing that I might be there for more than an hour beyond my scheduled time.
The actual mammogram is painful and surprising. At one point, she has to struggle to squish my breasts under the part that presses down upon them. It surprises me how pliant my breasts are, and that she is actually able to mould, prod and stretch them the way she can. My breasts, I muse, are floopy, a combination of floppy and loopy, pulled like linguine through a pasta machine. Where, I wonder, are the firm young melons of yesteryear?
I wonder what the rules are. Am I required to disclose the sad truth of my breasts to all my lovers past and future? To those who might return, I regret to inform you that my firm melons are no longer as sumptuous. They are, alas, much floopier than you might remember them.
I come home exhausted. I write to R. that I have just had my breasts poked, but not in a fun way.
The Absurdity of It All
At the second checkpoint, I was asked if I wanted to make an appointment for next year. I said, “Yes,” feeling a kind of we-are-women-we-must-be-responsible-for-our-breasts kind of peer pressure. But the truth is that I had woken up that morning struck by the absurdity of it all and had even considered cancelling my appointment.
I knew that there was one of three diagnoses I could receive after the mammogram: nothing, benign, or malignant. None of them would make a difference to me.
I mulled over the words “benign” and “malignant,” such affective renderings of what might happen to my body, the kind of pesonalisation that has resulted in narratives about breast cancer that render it in terms of a human drama, a battle between good and evil. The word “benign” seems so, well, benign, evoking a picture of a slightly self-satisfied tumour, sitting smugly and benignly behind a desk, neither angry nor happy, just absurdly benign. “Malignant,” on the other hand, marks an evil force I will be compelled to combat, battle with. I will be admonished that I can “lick this thing,” and not let it “conquer me.” In the elevator up to The Breast Place, I shared my ride with a man and a woman. As they stepped off and began to head in the direction opposite to mine, he gave her a hug and rubbed her back; she heaved a great sigh and steadied herself. I could sense immediately what they were heading towards, I could tell the contours of their narrative.
I don’t know what I dread the most: The diagnosis or the narrative into which a diagnosis would push me. For nearly all my life, it seems, I’ve put up with the relentless pink war against breast cancer. Barbara Ehrenreich and others have written about the pinkifying and commodification of breast cancer, and the relentless corporatisation of the condition. All of this burst into flames when the Susan Komen Breast Cancer Foundation considered defunding Planned Parenthood, the abortion provider and advocacy organisation. I wondered, as I got my appointment slip: If I am ever diagnosed with any form of breast cancer, will I be compelled to turn into one of those smiling and brave women, her bald head swathed in a pink scarf, beaming from the sides of buses shuttling through the city? Will I be compelled to mark myself as a survivor and to fight the good fight and all the rest?
All of this strikes me as exquisitely absurd for a number of reasons.
The first is that, lacking healthcare, a diagnosis of breast cancer would mean little to me other than my impending death. Without the proper resources – such as a health corporation that would even bother to file my poverty papers on time, or money to pay for medications – I would be at the mercy of the state. I know too much about what unpaid/free health care looks like in the United States and at Chicago’s notorious Cook County hospital, where the poorest and most indigent get their “health care.” I know that I would die of bureaucratic ineptitude before I died of the cancer.
Upon receiving a diagnosis, I would simply roll over and choose to die a long lingering death without treatment of any sort. I would first call my friends R. and K., who would need to be told so that they could sort through my utterly disorganised effects and my burgeoning Hello Kitty collection, and take care of my cat. I would then proceed to fundraise for six months of rent so that I could finish my book. I would find a way to painlessly kill myself before the stench of my putrefying breasts became unbearable.
Lesbian? Breast Cancer? Marry or Die!
If the Centers for Disease Control were to include “sexual orientation” in its breast cancer surveys, I would have to be counted as a lesbian. “Queer” is still a word that causes discomfort among well-meaning straight people who don’t want to be accused of being homophobic. At home, I google “lesbian breast cancer” and find that the entire movement for lesbian women’s health care has already been co-opted by the gay marriage movement.
On the website of the National LGBT Cancer Network, I find a piece on breast cancer by Liz Margolies. Her words pretend to offer comfort to women suffering from the adverse effects of being lesbian in a homophobic society and seeking culturally competent health care; yet she also echoes the pervasive medicalised logic that the blame either rests with lesbians who get sick or with the sad, unfortunate fact that the poor dears cannot be married:
So far, the information we have on breast cancer in lesbians has been both limited and contradictory. The large national cancer registries and surveys do not collect data about sexual orientation, leaving lesbians embedded and invisible among this vast wealth of information. Other ethnic, geographic and racial groups have been able to use the data gleaned from these statistics to develop programs to erode the health disparities they face. They know precisely how prevalent cancer is in their communities. …
Some research has been conducted that specifically addresses lesbian cancer risks and experiences, but the results have been inconsistent. In almost every case, the sample sizes have been too small for us to draw reliable conclusions.
In other words, most of the conclusions aren’t worth a damn.
But then Margolies goes on to propound precisely the most problematic of these unsound statements and hypotheses, placing the onus upon mysterious third-party research.
While we still await definitive state-of-the-art research, some people currently believe that lesbians have an increased risk of developing breast cancer, based on a “cluster of risk factors” theory (italics mine). The increased risks are a result of behaviors that are a result of the stress and stigma of living with homophobia and discrimination. Each of these behaviors carries with it an increased risk of cancer. Taken together, as a cluster, they could more than double a lesbian’s chance of getting cancer. Again, the data on these behaviors is mixed in its results and it’s important to remember that many people with known risk factors never develop cancer.
She goes on to cite the risk factors, like cigarette smoking, alcohol abuse, and obesity. While these individually or together might in fact have an effect on an individual’s health, the links between, say, obesity and actual breast cancer are tenuous at best.
It’s the pregnancy link that jumps out at me. Writing about, “The four most-cited cancer risk factors in the research on lesbians and breast cancer risk,” she states that “lesbians are less likely to have biological children before age 30, which would offer some protection against cancer.”
Pregnancy. Of course. I knew I had missed something. And, alas, my cat, no matter how hard I try, will never substitute for a child.
When this “fact” was first disclosed to straight women, the result was instant outrage in feminist circles, and while it still pops up in conservative arenas, it has mostly been debunked in legitimate medical circles and rightly dismissed as yet another way to regulate women’s bodies and confine them to their child-bearing roles. And, yet, here it is, boldly offered on a site that lesbian women might peruse to find comfort and affirmation about their bodies. Here, directed at precisely the women who are least likely to conform to society’s gendered demands upon them, is the nasty, biting and utterly unprovable supposition and accusation flung in their faces: If you didn’t want breast cancer, you should have had children, you fucking freak.
Margolies gets worse, as she develops a rationale for why lesbians are more likely to develop breast cancer:
To begin with, lesbians are less likely to have adequate health insurance coverage than heterosexual women, as most employers do not offer coverage for unmarried domestic partners …
Some research has been conducted that specifically addresses lesbian cancer risks and experiences, but the results have been inconsistent. In almost every case, the sample sizes have been too small for us to draw reliable conclusions.
So there you have it. GAY MARRIAGE WOULD SAVE MY BREASTS. Having children would make breast cancer less possible. Silly, silly, me.
Get A Pair!
Such narratives about breast cancer abound everywhere, and they are echoed by various “institutes” and foundations which purport to do studies on queer poverty but always manage, through mysteriously frequent studies, to place the blame for all our woes on…you guessed it, the lack of gay marriage. It is much more rare to find centers or foundations willing to place lesbian breast cancer in its proper context: the lousy, non-existent health care in the United States which is killing more people than we care to count.
Such studies place the onus for lesbian health upon individuals and the choices they make: Stop smoking! Have children! Get married! At best, they make weak demands for inclusion: Please be nicer to the lesbians who walk through your clinic’s doors.
I don’t deny that inclusion and expansion of categories to include lesbians/queer women are important (although I suspect that the medical industry will freeze alongside hell before it begins to think that poly/slutty/non-familial queers actually deserve care of any sort). I do think that if we are to consider people’s health care needs in the larger contexts of how they live and fuck, then considering lesbian sex lives and the effects of cancer upon them is as important.
But. If any of these foundations or people like Margolies were to grow a pair of, well, firm melon-like tits and actually speak to the truth of the situation, they would admit that lesbians don’t get breast cancer because they are lesbians who demonstrate characteristic lesbian behavior (i.e they don’t have children or smoke or are larger than straight women) but because they, like transgender people, poor and indigent people, and a lot of non-conforming queers who can’t get jobs, let alone have the capacity to sue their employers for non-discrimination in the first place, are fucked over by a larger cultural rationale that they simply don’t deserve health care – after denying them employment precisely because they are seen as people who will never fit in the workplace.
Perhaps Margolies resides in a universe where every lesbian looks and talks like Rachel Maddow, but the truth is that lesbians, and particularly gender-non-conforming lesbians – you know, the odd, butch ones we try to pretend we don’t see, and I don’t mean Maddow-style butch, but truck-driver butch, without the fancy glasses or the multi-million dollar salary, who can’t help walking “like a dude” even in a skirt kind of butch – are discriminated against from the minute they walk through the door for an interview. Think of the lesbian you know whose hair is cut like a man’s and not in a cute and sassy bob, or a lesbian who won’t suck her boss’s cock – not because she might not want to but because she is incapable of even envisioning the possibility, or a lesbian who doesn’t have the proper accoutrements to prove her lesbianism and acceptable family values, like a wife and child. Now ask yourself: how many of these women do you see in any positions of power, even in the hippy-dippy world of social justice organising or the non-profit industrial complex?
When Margolies imagines that couple in Utah, she is only imagining what she wants them to look like: safe, normal, cute, with perhaps a few quirks, like the couple in The Kids Are All Right. But I wonder what she has to say about the truly invisible, the single lesbians, the lesbians who won’t try to look “normal,” who don’t fit her vision of normalcy, the ones who actually don’t and, horrors, may not even want to have a partner, the lesbians who have spent decades nurturing and growing in networks of friendships and care-giving that Margolies will never recognise as legitimate, or the lesbians who prefer to live distinctly separate lives that others might consider strange and hostile (cat ladies of the world, unite!)? She and her ilk have quietly absorbed the message from the gay marriage movement in the U.S., a message which states, as baldly and boldly as possible, that the primary reason for gay marriage is that it would provide health care for gays and lesbians. This leaves out millions of queers who don’t want to marry or simply don’t, for any number of reasons. In states like Massachusetts where gay marriage is now legal, you will not be allowed to share in your partner’s healthcare if you don’t get married. The logic is simple: Because you can get married, you must. This means that straight and queer couples who might prefer the relative flexibility of civil unions or domestic partnerships are left out in the cold. Even in Illinois, which only grants civil unions at this point and which proclaims how progressive it is for granting healthcare to couples in such arrangements, the state mandates that you must enter one in order to gain healthcare.
You want health care but not marriage or commitment? Tough titties. Get married or die.
Case in point: I refer you, once again, to my breasts. I have no partner and have been against all kinds of marriage, gay or straight, since the age of 8. If I were to die or even begin to do so, most of my friends would not be able to come and take care of me simply because their ultra-progressive workplaces have policies in place for “partner/family leave” but none for friends, no matter how close. I can see R., flying into the U.S from Montreal, confronted by a US customs officer who smirks with one eyebrow raised, “You’re here to take care of… a sick friend?” Or K. going to her department for leave and being told, “But you already live with a partner and S. isn’t sick. Whom do you need to take care of, again?”
R. tells me that his solution to this proposed scenario is that he will designate me as his godmother, making me a relation of sorts. My initial response, and proof that I am climbing out of the depression into which I sometimes find myself plunging when I consider the possibility of my death is, “But wait, that would really age me!”
Gay marriage is supposed to help my breasts. The gay marriage movement, in its relentless search for rationales for what is inherently a conservative movement around “normalcy” and acceptance, often makes the case that healthcare is a primary reason to make it legal. In the process, it has created a climate where the most progressive/lefty people, gay and straight, fail to see that healthcare is an economic matter and something that should go to everyone, regardless of their marital status. At a debate on gay marriage, where I am, yes, the party speaking against it, a woman tries to dismantle my argument with an emotional statement about her best gay friend (she is careful to identify as straight) who lived with his partner in a relationship that was “better and more long-lasting than that of straight couples”, but “who died because he could not get healthcare through marriage, he died because he could not marry!”
I pause briefly and try to address her point as gently as I can.
What I really want to say to her is, “You’re a fucking moron. I need to tell you that you’re a fucking moron if you can’t figure out that your friend didn’t die from a lack of gay marriage but a lack of health care.” I want to scream at her: “If you really watched him die, as you claim, you would see that he died from negligence and the aggravated stress of having to be treated at Cook County, where MY queer friend C. once stood waiting for an appointment for 16 hours straight, on a foot so broken that his bones were sticking through the skin, but too afraid to try to find a seat or to leave for fear of losing his place in line.”
The truth is that she probably understands that the health care system is broken, but that she also cannot see the profound disconnect in her own words. The truth may well be that she accompanied her friend to those endless and humiliating visits to the hospital, but that it never occurred to her that it was not her friend’s gayness and his inability to marry that killed him, but the dank, stinking, hellhole of a “healthcare system” in the world’s most industrialised nation, the only such nation not to provide universal health care.
When even such people cannot make said connections, is it any wonder that lesbians are now told that gay marriage will save their breasts?
Titty Terrorism: My Plans for the Future
My breasts may be more pliant but they are no less political.
In the event of a breast cancer diagnosis, I will let my breasts rot and putrefy into a state that few of these pink narratives, with their tidy, nervous pinkitude, ever care to discuss (what happens to a breast in the late stages of cancer is not pretty). I have already decided to send little bits of my cancer to all the gay marriage proponents. Although I’m not good with pain or even with discomfort, I will hack away at and chop off bits and pieces of my rotting breasts and engage in a form of titty terrorism. Instead of anthrax, I will send bits of my stinking boobs to gay marriage proponents like Evan Wolfson and the heads of the Human Rights Campaign and the National Gay and Lesbian Task Force and to, yes, Liz Margolies and Dr. Susan Love.
In my breasts, I hold multitudes.
This is war, baby. And my tits are the mighty soldiers.
I will take no prisoners. I will squish my floopy breasts against the windows of Lambda Legal’s Freedom to Marry galas. I will use my dripping, pus-laden blood from the open sores to create a poster with the words, Gay Marriage Hurts My Breasts, and march alongside those walking for “gay rights” (read: marriage or else). I will stalk and flash gay marriage activists (Dan Savage, you’ve been warned) on the subway and on the streets, exposing their rot and stench, allowing them to smell the potential success of their campaign. Look, I will say, This is what gay marriage does for me.
My non-diagnosis brought me as close to death as I will ever want to be. I will not go quietly into that good night. I am angry; my breasts are rotting.
In my breasts, I hold multitudes.
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