A Sociological Autobiography: 16 – Studying Menstruation

We had moved to a rented flat – 45 Sandown Lodge – in Epsom in 1972. In fact we could have moved anywhere south of the Thames, it just happened that an opportunity arose in Epsom. We were to spend nearly 20 years there as our family multiplied. Three of our four daughters were born during this time, two of them actually in the flat. The predatory landlord was Freshwater, and had we not had legal access to a ‘rent officer’ to arbitrate in the event of a dispute we would have been kicked out much earlier: several times we successfully resisted Freshwater’s attempts to double, even triple, our annual rent.

My three-year half-time stint at Charing Cross threatened to our household income at a difficult time, notwithstanding Annette’s income and my ad hoc teaching contracts. I applied for a few part-time posts but to no avail. One was as a VD contact tracer. I recall being interviewed by Mike Adler in James Pringle House adjacent to the Middlesex Hospital. He sensibly (I guess) concluded that I was over-qualified and would likely leave sooner rather than later. It seemed harsh at the time, as it always does when you need the money and are told you satisfy the criteria and some and are yet passed over.

A change in fortune came in 1976 when I was appointed to a half-time research post in the Department of General Practice at Guy’s Hospital Medical School. If the general area of investigation was fine – illness behaviour – the specific focus was not one I would have chosen: disorders of the menstruum. But this was the focus required by Head of Department, Peter Higgins. Peter impressed from the outset me as a wise man, the kind of doctor who might, to cite Zola, unfussily assume the social control functions associated in previous times with the clergy. Margot Jefferys was later to demur, apparently finding him fussily difficult and dogmatic during their shared committee work. Who knows? One person; many aspects. He was if I remember rightly a Catholic, and this might perhaps have inclined him to obdurate and set-piece thinking and behaviour. I have over the years encountered many Catholics and have come to see their – often guilty, even fearful – subservience to taught doctrine as a largely untreatable disorder of the blood. People who should be atheists live on in the long shadows cast by their childhood priests and the Vatican. They know better but cannot admit it. On the other hand Margaret Archer, one of sociology’s deepest and most subtle thinkers, seems to do okay!

Peter Higgins initiated one interesting exploratory study. Together with his colleagues he made surgery  consultations open-ended, allowing patients to take their time and talk: it was a Balint-like gesture. The result: the experiment had to he abandoned as the surgery was rapidly flooded with help-seekers of one stripe or another. Two other GPs practiced in Thamesmead where the study was to be based, Drs Craig and Turner. The former was a voluble extrovert with a touch of narcissism, the latter remains for me a role-model for GPs (his mantra was a duty to keep patients out of hospital, which struck me then and strikes me now as eminently sensible).

The trek from Epsom to Thamesmead was awkward by train or by car, but I managed not only to set up a decent study but to contribute a handful of pilot interviews before, in 1978, I made my apologies and left for yet another medical school. I diligently read-up about women’s periods, acquainted myself with a limited social scientific literature and devised and tested both a six-week health diary and a list of topics to be covered via what Richardson and his mates at the time called a non-schedule standardized interview. I was reasonably pleased with the diary and my interviewing skills and their return: the women seemed willing to talk to this – by then quite experienced – male interrogator in his late 20s. Maybe I did okay, but a lesson was learned when Annette took over and conducted the main study on my departure. When I listened to Annette’s taped interviews It was clear beyond dispute that her data trumped mine with something to spare. In retrospect it seems obvious: of course women were more relaxed and open talking to Annette about menstruation than they had been to me! This remains an under-researched issue I suspect, even among feminists. When many years later I interviewed women sex workers I remembered only too well my research excursion into Thamesmead and asked clinician . and epidemiologist Helen Ward from the Praed Street Project at St Mary’s Hospital, Paddington, if she thought they would talk freely to me. She replied that they might well . talk more freely to a man than to a woman since they were more used to verbal as well as other kinds of intercourse with males!

Annette and I thoroughly enjoyed analyzing the data together, in those days with reams of computer print-outs unraveling around us amidst my pipe-smoke in our kitchen at . As with the epilepsy study, our, or more accurately her, examination of health, illness and help-seeking behaviour in relation to menstruation led to a number of publications, including a book. It also precipitated a dissertation I was to supervise by a medical student from St Mary’s who was intercalating a B.Sc in ‘sociology applied to medicine’ (I will return to the B.Sc and to her in a later stop-off point on this meandering narrative). Her point of departure was the Moos Menstrual Distress Questionnaire (MMDQ), an American effort to measure the extent of the distress experienced during the menstruum. She got half of one of my intakes of pre-clinical students to fill in this questionnaire. She presented the other half not with Moos’ list of negative ‘symptoms’ or attributes but with their positive opposites. And, intriguingly, the students with only positive options scored more decisively than those with only negative options. The methodological lesson resonates and I still incorporate it in lectures on gender and health. Menstruation has traditionally been viewed and researched – almost exclusively by men – as a disruptive and abnormal event. If the ‘scientific, validated’ MMDQ is used, this is inevitable; if on the other hand only positive attributes and connotations are on offer, menstruation emerges as a normal aspect of womanhood to be celebrated rather than dreaded. It is a finding that holds independently of rates of very real distress. I have three points to make here. First, and axiomatically, we are very likely to find what it is we decide to look for. Second, talented undergraduates can surprise and educate their teachers. And third, patriarchy endures: Gloria Steinem was spot-on: ‘if only men could menstruate …’.

 

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