SEPTEMBER 22, 2022
IN SEPTEMBER 2005, I entered a competitive graduate program in anthropology with only one pre-tenure woman on the faculty. She had a young child. At Friday beer hour, which she did not attend, a student brought up the size and shape of her breasts. Nursing breasts, he commented. Their too-muchness, another implied, must repel her husband. Goaded on, the first suggested with a sly smile that the husband’s back injury was feigned so that he could avoid going to bed with her. Laughter rippled through the group. In the time-honored tradition of folks making their way in fucked-up systems, I said nothing. Rather, I did what many people in marginalized positions do: I turned my gaze on myself. I was in no danger of pregnancy at the time. My body’s latent fertility, though — what researchers in my branch of anthropology call “fecundability” — put me on notice. Monthly evidence that I might join the discard pile, subject to mockery and disdain, felt like permeability — worse, like unbearable vulnerability. People who warranted respect did not cramp, bulge, or leak. They had their bodies under control.
The idea that the uterus is a seat of danger and instability has a venerable history. In settings as diverse as Amenemhet I’s Egypt and Franklin Delano Roosevelt’s United States, this history has relied on its dual nature as a physical and metaphysical organ. At the material level, it’s a scant 0.13-pound pear-shaped aggregation of muscles and glands anchored by ligaments to the pelvis. It is nonetheless unusually talkative: even nonpregnant and in perfect health, the unaltered uterus pipes up at semi-regular intervals for the decades between puberty and menopause. And it punches far above its weight class in determining what is possible and to whom its bearer is beholden. This creates remarkable vulnerability, which is then further exacerbated by the fact that every culture politicizes the uterus.
Consider the story of the wandering uterus: the internal organ most identified with femininity can’t be counted on to stay put. When it moves, it wreaks psychological havoc, preventing women from fulfilling their reproductive functions. (Note here: not all people with uteruses are women, and not all women have or were born with a uterus, but I refer to women when discussing historical periods in which people understood women and people with uteruses to mean the same thing.) Historian Mark S. Micale traces the origins of the wandering uterus narrative to Egypt, where the Kahun medical papyrus, dated to around 1900 BCE, explained that a woman might be “ill from her womb wandering” upward, putting pressure on the diaphragm, and causing her to “smell roasting.” Doctors enticed it downward by fumigating the uterus with whatever delicacy the woman reported smelling. If the uterus couldn’t be lured, Micale claims, they scared it back into place by having women sniff or taste foul substances. The uterus, in this account, shares traits with feral creatures: it is irrational and disobedient, responsive to tempting and aversive stimuli.
Women and their wombs were in no better hands with Plato, who made the beast connection explicit. In Timaeus (ca. 360 BCE), he called the womb the “animal within” women. While the penis channeled lust, the uterus longed to bear children. An empty womb, Plato informed his readers, “gets discontented and angry, and wandering in every direction through the body, closes up the passages of the breath […] causing all varieties of disease.” Roman thinkers who came after Plato amassed enough anatomical knowledge to determine that the uterus doesn’t literally wander. But this didn’t mean women were any less vulnerable to male hypothesizing or indeed to male certitude about the uterus’s needs and expressive range. The Romans retained the belief that uterine mishaps, like pregnancy loss or absent menstrual periods, caused health problems in women that needed to be remedied by a combination of fumigations, injections, purgations, and penetrative sex with men. Roman encyclopedist Cornelius Celsus, for instance, opined that “[f]rom the womb in women proceeds a violent distemper; and next to the stomach, this part both suffers most sensibly itself, and most affects the rest of the body. Sometimes it destroys the senses, so as to occasion their falling as in an epilepsy.” Galen prescribed “coitus, pendente menstruatione” to cure a uterus of “piteous” menses, but he warned that “too frequent coitus” could result in an overly relaxed uterus that menstruated often and copiously.
If the Egyptians, Greeks, and Romans understood the uterus as a source of organic disorders, stemming from the essential nature of women as bearers of children, early Jews and Christians conceptualized its function and dysfunction as dependent on God or the devil, the former resulting from women’s morality and the latter from her sinfulness. Torah held that a God who was pleased with you could open your womb and give you children, though you might be beyond the age of childbearing. (This is why the matriarch, Sarah, named her son “Isaac,” which means “he laughs” — it struck Sarah as a divine joke that she could conceive, as God had promised, at her advanced age.) Early Christian tradition, by contrast, attributed disorders of female reproduction to possession by the devil. For instance, St. Augustine cites approvingly the claim that “the devil can so darken [a wife’s] understanding that she considers her husband so loathsome that not for all the world would she allow him to lie with her.”
Even with the advent of Enlightenment thinking, ideas about women’s fundamental nature continued to infuse scientific and medical theories of the uterus. In the 17th and 18th century, European physicians no longer attributed the emotional and psychological symptoms characterized as hysteria to a problem with the womb — autopsies revealed that hysteria patients seldom had uterine pathologies. But their insistence that the female reproductive system produced disease susceptibility set up 19th-century gynecology for a return to the hypothesis that the uterus caused mental illness. This time, the irritant wasn’t celibacy and childlessness but a too-potent libido. Hysteria libidinosa, wrote late-18th-century physician William Cullen — coiner of the term “neurosis” — was a particular form of hysteria. It occurred in “those females who are liable to the nymphomania,” which he defined as “an unrestraint desire for venereal enjoyment” to assuage an irritable uterus. As his late Victorian counterpart Thomas More Madden asserted in his 1893 gynecology textbook:
[Such hysteria was] one result of that hopeless contest with nature, in which [women] are engaged who seek to unsex themselves by assuming all those masculine privileges and modes of life which are too dearly purchased at the expense of that increased tendency to cerebro-nervous disorder by which, in such cases, outraged nature frequently avenges her violated laws.
Physicians were not content to let nature mete out the punishment. They assisted, treating complaints as diverse as depression and backache with interventions like application of leeches to the vulva and clitoridectomy.
Now, in 2022, we’re still not free from the metonymic use of the uterus: stories about the uterus continue to be stories about the nature of people who have one. Though scientists no longer claim, as they did in 1930, that some uteruses are “receptive” and some “rejective” when it comes to semen (paralleling the psychoanalytic frame in which some women are frigid and others are not), contemporary obstetric rhetoric channels the cultural zeitgeist. A cervix, the mouth of the womb, may be diagnosed as “insufficient” or “incompetent” if it dilates too easily. A pregnant uterus that contracts rhythmically before full term is “irritable.” (Imagine clinical language around erectile dysfunction calling out a clumsy vas deferens or an indolent prostate!) And while we’ve stopped disqualifying people with uteruses from activities because we’re afraid they’ll faint when they menstruate, as the military did with Women Airforce Service Pilots in World War II (mysteriously, none of them reported a period), the notion lingers that a uterus equates to unreliable performance. This narrative, floating around in the cultural ether, enacts a kind of pervasive gaslighting. It’s hard to resist believing in it, at least a little bit — and, if you have a uterus, it can seep into your beliefs about yourself.
As for my own uterine conundrum, I would have been hard-pressed, as a young white cis woman, to find a surgeon who would give me a tubal ligation or a hysterectomy, but there were many reversible options on the table. This was the era of pills, the occasional diaphragm, NuvaRing, Norplant, Depo-Provera, and a new generation of intrauterine devices (IUDs) which, unlike the infamous Dalkon Shield, came with low risk of septic infection. However, I did not want medical professionals to surveil my body or to put plastic, metal, or synthetic hormones into it. That is, I did not want anyone else controlling my ability to control myself. Furthermore, I did not — and do not — want others, be they medical professionals, friends, partners, or apps, to track my cycle, which I find creepy and intrusive. (As far as apps go, research by Mozilla bears out the fear that most are not secure. Neither, for that matter, is discussing your reproductive business in direct messages on Facebook.) In my case, the idea of someone other than myself making meaning of my behavior based on cycle phase feels coercive, reductive, even uncanny. Like Paul B. Preciado, whose 2008 memoir Testo yonqui (Testo Junkie), details the pleasures of self-directed microdosing with black-market testosterone, I gravitated to the nexus of privacy, knowledge, and agency. This seemed as close as I could get to control and as far as I could get from vulnerability. It felt, in a word, like power.
The role of privacy in power, to address the elephant in the womb, took center stage on June 24, 2022, when the Supreme Court of the United States overturned Roe v. Wade, arguing that the 1973 ruling protecting abortion, which hinged on the right to privacy, had been wrongly decided. In addition to the well-documented horrors to which people with uteruses are now subject, Dobbs v. Jackson Women’s Health Organization places us in complicated relation to institutional and interpersonal surveillance. We’re in the spot I resisted as a student, though I couldn’t have anticipated the particulars. When the Supreme Court decided Citizens United v. Federal Election Commission in 2010, corporations became entities with protected political speech, like individuals. In the 1990 precedent that Citizens overturned, Austin v. Michigan State Chamber of Commerce, justices noted that corporations had access to far more wealth than individuals. The political agendas that corporations could promote with that money, they pointed out, might have nothing to do with public support for the corporation’s position. Now, with the right to end a pregnancy varying by state, people seeking abortions may be forced to rely on the benevolence of those very corporations for paid time off and travel funds to access care. Companies from Dick’s Sporting Goods to Disney have promised this kind of assistance. The blow to privacy hits deep: you might need to tell your employer — the same employer entitled to use profits from your labor for political speech in which you have no say — about what’s happening in your uterus. (This is already a problem for people who bear children. Corporations, you may note, are not jumping into the breach to offer ample paid leave and childcare for employees who want to become parents.) Add to that the empowerment of civilians to persecute abortion providers and facilitators for bounty, per Texas’s heartbeat bill, and you have a situation in which corporations are people, anti-choice people are law enforcement, and federal law, many of whose representatives are beholden to corporations, is powerless to help.
The landscape of uterine knowledge — who is allowed to know what — is also changing rapidly. The Texas heartbeat bill and its ilk are increasing scrutiny of abortion-trained providers. They are criminalizing medical and civilian knowledge of abortions past and future. Healthcare providers’ uncertainty about whether care violates their state’s laws have left people who miscarry continuing to carry dead fetuses for weeks, risking infection, infertility, and sepsis. If the Idaho GOP platform becomes law, there will be no exemption for a pregnant person’s health. Diagnosing a life-threatening condition and acting on that knowledge to protect the pregnant person will become criminal.
What I had going for me in my own efforts to avoid institutional, interpersonal, and legal entanglements in managing uterine vulnerability was a specialized form of knowledge about how the womb works. I also had the kind of zeal that comes from an acute sense of what I stood to lose if I failed to maintain control: professional status and income, yes, but also the fundamentals of personhood, autonomy, and the ability to chart the course of my future.
If you’ve hung around evolutionary scientists, you’ll know that we focus on how an organism’s features help it to survive or reproduce. In that light, the uterus is obviously essential. For all its centrality in childbearing, though, it doesn’t call the shots when it comes to conception. Humans — and our close primate relatives, like chimpanzees — can get pregnant at any time of year. We’re not seasonal breeders, like the birds you see performing fluffy courtship dances in spring. This flexibility, as anthropologist Peter T. Ellison explains in On Fertile Ground: A Natural History of Human Reproduction (2001), comes with a catch. The bodies of childbearing people put enormous time and energy into gestating a fetus and nursing an infant. To ensure that a pregnancy has a good chance of resulting in a full-term, healthy baby, the body monitors its energy economy. How much energy does it have stored? How much, on average, is arriving by way of food, and how much is leaving to support activity, fight infection, or heal from injury? The hypothalamus, a part of the brain that monitors systems all over the body, compiles information about energy coming in and going out, in addition to other data about well-being and stress. It sends a signal to the pituitary gland, which amplifies that signal and broadcasts it to the ovaries. Together, these three body parts — the hypothalamus, pituitary, and ovaries — negotiate how likely it is that a person will ovulate in any given month.
One punch line is that, if a person with a uterus isn’t getting enough to eat, or if they’re extremely active even without weight loss — think Olympic athlete — the body does the math and forgoes ovulating. This could last for a month or longer. With significant weight loss or a high volume of calories out the door, a period might not show up at all. In either case, with enough energetic stress, a person won’t get pregnant. And that, Dear Reader, is where I mobilized to take control of my own uterus.
I pounded miles of Boston pavement and shredded laps at the university pool. The best days, the ones that furthered the project most effectively, included both a long run and a long swim, followed by just enough food to keep me from thinking nonstop about food. When cycle day 30 came around with no period, I registered a grim triumph. Every day that my cycle was extended landed as a win. I felt sleek and powerful in my neutered state, as if the part of femininity that made me vulnerable in a competitive professional world were gone. (It wasn’t, but that’s a subject for another essay.)
The power was an illusion in more ways than one. While there may be nothing inherently health-giving about menstruation, the hormones the ovaries make when the body is adequately nourished promote mental health, strong bones, and supple skin. A well-fed, rested body has more tools to ward off illness, metabolize nutrients, and respond with resilience to the wear and tear of living.
When I described the uterine control chapter in my life, a friend pointed out that there’s no way to exercise agency around the uterus that doesn’t come with cost or risk, whether it’s from contraception or the hazards of pregnancy. (Opting out of sex that could get you pregnant is no guarantee; in a culture of sexual violence, not all pregnancies that start with sex result from sex we choose.) And pregnancy is far from the only way a uterus can impact a person’s life. How we experience periods and the days leading up to them are tremendously complex intersections of biology and culture, as my colleague, Kate Clancy, details in her podcast, Period. As I have written elsewhere, the widespread perception that menstruating people suffer impairments can have a negative impact on performance, even when the science shows no differences in function. To be sure, extreme menstrual suffering can cause problems — it’s hard to perform at your best when you’re, say, doubled over with abdominal pain. But even so, a period does not hijack cognitive and emotional function. This is all to say: vulnerability is a feature of having a uterus, whether we’re talking about its physical realities or the way the womb gets politicized. Control of either the organ or the narrative, at this historical inflection point, is not something we can take for granted.
As for me, I no longer starve my uterus into submission. Professional security — I’m a tenured professor now — doubtless has something to do with my willingness to go with that particular flow. The will to power remains. But I’ve discovered, with the passage of time, a murky mix of ambivalence and longing. On some days, tentatively, with many caveats and hesitations, I find that I would like to make a human. I do not know if I will. Ambivalence like this makes sense: as a friend thinking through the implications of this essay for trans women pointed out, the only people who don’t have a complicated relationship with the uterus on the regular, whether they have one or not, are cis men.
One perk of being a feminist who studies reproduction is that people tell me what their uteruses have to say, and what they have to say about them. People telling their own stories is important — it’s the product of a certain kind of autonomy. I think of these raw, frank communications as uterus bulletins. The bulletins are seldom about pleasure, though there are joyous moments for those who want to become pregnant and do. Most, however, feature embarrassment, inconvenience, suffering, and exhaustion. Desperation and rage make appearances: the pain of IUD insertion, the grief of an abortion when a wanted pregnancy goes awry, the agony of fibroids, the dysphoria of a uterine condition when you don’t identify as a woman. Physically and legally, a uterus changes what’s possible — and now, once again, what’s possible is being curtailed.
I wish that weren’t true. Whether, like one friend of mine, you see so little use for your uterus that you would gladly donate it, or whether, like another, you respond to babies with the urge to shove them in your uterus and pull them out again as your own, I wish we could inhabit a world in which an organ of generation is not also an albatross around our necks. And I wish we all had the freedom to navigate the many meanings of the uterus from a position of autonomy and privacy. Stories about people getting shamed at work, and stories featuring unhealthy if inventive battles for uterine control, should be things of the past. At bare minimum, I wish for a legal structure that grants all people the right to make their own choices about their bodies, so that what we have is not uterine double jeopardy, physical and cultural, but power tout court.