Doctors Are Not Gods

Doctors Are Not Gods

Gwyneth Paltrow’s Goop brand is annoying, unattainable and overpriced, for sure. But Goop does more than just annoy. It incites an interesting rage among medical in particular, most prominently Jen Gunter. An ob-gyn and the author of The Vagina Bible (also a New York Times contributor, prolific Twitterer, TV show host and soon-to-be podcaster), Gunter wrote an open letter to Paltrow in 2017 and hasn’t stopped harping on her since. Gunter points to Paltrow as emblematic of the “wellness industrial complex” that is not only exploiting gullible women with snake oil but threatening their health. At a recent event in Toronto, Gunter went so far as to call Paltrow “a predator.”

The internet loves a celebrity takedown. Gunter has 250,000 Twitter followers and counting, and Paltrow is a salad of low-hanging fruit (last month her dining and family room shelving were featured in a lifestyle piece about a high-end bookshelf curator).

Gunter, who has personal experience performing abortions and losing her own very premature baby, also spends a lot of Twitter time nimbly smacking down fetal rights trolls. She’s sending a copy of her book to every member of Congress, hoping they might learn something, anything, about female biology. She’s sex-positive and rightly defends the vagina as “a self-cleaning oven.” So, she has considerable feminist cred.

But as Gunter tours the continent promoting her book and other media ventures, she’s also been calling out Our Bodies, Ourselves for spreading “misinformation,” because it was originally written in the 1970s and not by doctors. In a letter to Gunter, the board of directors (it is now a nonprofit) defended its more current editions, which have been continually updated and vetted by “dozens of physicians and researchers.”

Gunter was a child in the 1970s, but surely she has read some history. A book written for women by women—and not by doctors—was the whole radical point. The feminist health movement challenged what was then an extremely male-dominated, misogynist, paternalistic and not very evidence-based establishment. It disrupted the whole notion of expertise, or what scholars call “authoritative knowledge”: women sat in circles and talked about their experiences with their own bodies; they took off their pants and looked at their own and each other’s cervices, they shared long-standing home remedies that had rarely been codified or perhaps ever written down, and they compared all this gathered wisdom to what men in white coats had been telling them and doing to them. They wrote books like Our Bodies, Ourselves as a corrective: Sorry, no, you are not the experts of us. We’ll consider your opinions, but henceforth you will not have a monopoly on our health, thanks.

Today these concepts live on in the ideals of informed consent and participatory medicine. This was also the movement that, ahem, sent droves of women to medical school.

In attacking the feminist health bible, Gunter tips her hand. What irks her isn’t actually the manipulative capitalism of Goop, but really anything that undermines her authority as a physician: Jade eggs and vaginal steaming and home remedies like yogurt or garlic to balance vaginal flora cannot possibly be beneficial because the medical establishment, the authorities, have not researched or endorsed them as such. She often begins a tweet: “I am a board certified OB/GYN and …”

This is exactly the kind of doctor-as-god attitude the feminist health movement fought to reform.

Because if we dismiss everything that isn’t patented or presciption-only, we dismiss people’s lived experiences. When writer Sarah Barmak tweeted that clinicians had actually recommended yogurt to her in the past, and that she had found it helpful, Gunter tweeted back: “They are wrong and I am correct. Any provider who recommends vaginal yogurt for yeast does not understand the vaginal ecosystem.”

Gunter goes so far out of her way to debunk yogurt, in fact, that she misses credible research suggesting that it might be beneficial. No, it hasn’t been rigorously studied in large randomized clinical trials. But in every edition since the 1972 original, Our Bodies, Ourselves has cautiously reported some version of “some of us have had success.” There’s nothing scandalous or unscientific or pseudoscientific about that statement.

On her CBC show (unironically titled Jensplaining), Gunter channels Wonder Woman to wield her lasso of truth to separate “myth from medicine.” But the distinctions aren’t always so clear. The occasional glass of wine in pregnancy? Data-cruncher Emily Oster settled that one, but Gunter says no, not even a drop. In her book, she calls tea tree oil an endocrine disruptor, which seems to be based on one unpublished case report presented at a meeting with industry sponsors.

And don’t even think about trying a jade egg, commands The Vagina Bible—the stone is porous and might harbor bad bacteria. That sounds logical, though, here it doesn’t seem to matter that there’s no evidence of polished gemstones causing harm. If you’re at all hesitant about glyphosate in tampons, however, Gunter says don’t be. No need for precaution, because there’s not enough research.

This is exactly how industry weaponizes science to shirk accountability.

In an open letter to Gunter last month, physician Jennifer Lang wrote that the “condescending tone and overall arrogance of the stance you take on these issues is, in my opinion, the precise reason why so many women are moving away from allopathic medicine and seeking alternative or complementary care and sources of information.” Lang also shares a personal testimonial about jade eggs giving her orgasms in her sleep.

“Who really knows how the mind-body connection works,” says Lang, “I don’t have a problem with women taking some control with what goes on, in, and around their bodies, and doing what feels comfortable to them. That doesn’t intimidate me.” Furthermore, “the risks of those things pale in comparison with the risks of things that are offered every day in doctors’ offices around the country.”

Goop’s grandiose claims about the ancient Chinese origin of jade eggs and their magical powers so incensed Gunter that she teamed up with prominent archeologist Sarah Parcak, winner of the TED prize, and surveyed databases of 5,000 Chinese artifacts for evidence of the concept’s provenance. They found none.

I called up Parcak because I was curious why she, an internationally renowned Egyptologist who created satellite analysis that finds lost civilizations, would care enough about something so relatively insignificant as a Goop trinket. Parcak focuses on “harmful mythologies” writ large—for instance, the racist idea that aliens built ancient monuments. And when she and Gunter crossed paths on Twitter, she was equally perturbed by Goop’s profiteering off what looked like another harmful, racist myth.

“I’m just so sick of the way that people’s money and time and belief are being warped,” she says. She did the research because to her, Goop is part of the crisis in facts. “It’s all connected to this bigger theme of what role do experts have in our world today. Who should you be listening to?”

Gunter, who has tweeted “I’m the fucking expert,” takes the same hard-NO stance on vaginal steaming, which she warns could cause a burn (as if women can’t handle boiling a pot of water). Out of curiosity, I tried this at home over the weekend. It was warm, gentle, contemplative—all qualities I also happen to value in a health care provider.

“Anyone who promotes vaginal steaming is the patriarchy,” Gunter tweeted recently. But proponents say this is a complete misunderstanding; it’s not about hygiene, it’s about bringing comfort and blood flow to areas that have suffered trauma, disconnect and abuse. There are, anecdotally, many women healing from sexual violence and cancer treatments, who find that steaming helped them regain sensation. Are you really going to argue with them? Isn’t that called gaslighting?

In September, several ob-gyns took issue with the premise of an article in Cosmo. The piece reported that the standard surgical procedure to remove abnormal cervical cells (called LEEP) may damage nerves involved with orgasm. Thousands of women have joined Facebook groups claiming a loss of sexual sensation, sometimes even their orgasmic abilities entirely, following LEEP. The reports are anecdotal, yes, but such reports are what the FDA calls a signal.

This information seems important, especially to patients, who might opt for a less invasive technique.

Physician Kimi Chernoby accused Cosmopolitan of ‘spreading vagina myths’. Youtube myth debunker @mamadoctorjones called it “so dangerous.” Gunter tweeted: “It is not well researched. I will be writing something soon.”

So far, Gunter has not written about LEEPs, or any other urgent gynecologic controversies besides labiaplasty. And this is what’s most troubling: instead of taking shots at what’s in your fridge or nightstand, she could be using her to talk about, say, obstetric violence, the rising maternal death rate, the pelvic mesh disaster or the overuse of hysterectomies, to name a few trends more threatening to women’s health and lives than yogurt.

If this were Gunter’s “vagenda,” she’d be part of a much larger conversation, led by people with humility about the body, healing, and the not infallible profession of medicine. They are concerned with medical reversals, devices that have been permanently inserted into humans without any study at all, predatory pharmaceutical practices, conflict of interest in research, and the “perverse incentives” of our health system. And they see the fear-mongering about “Big Wellness” for what it is: a distraction from the most egregious harms.