Illustration by Eglé Plytnikaité
Decades ago, when Seattle scientists and doctors realized medical research was biased towards men, they launched scientific endeavors and creative collaborations by and for women, with the goal of making women’s bodies and health the top priority. Those contributions have shaped medical research and treatment around the world. They’ve also helped create a local culture that affirms women’s medical care and rights.
While it’s easy to despair about the prognosis for American women in 2019—the U.S. ranks worst among developed nations on several counts related to women’s health, including affordability, chronic illness, and mortality during pregnancy and childbirth—Seattle remains a hub of women’s health research, activism, and progressive policies. Here are a few reasons to remain hopeful.
Seattle Is at the Vanguard of Menopause Research
In the 1970s, early in her career as a nurse, Nancy Fugate Woods realized a lot of the research on women’s medical care was “grounded much more in men’s visions of women’s sexuality and women’s bodies,” she remembers. “So I thought, you know, this is something that really needs to change.” In the 1970s and 1980s, out of second-wave feminism emerged a women’s health movement that spurred years of scientific collaboration, much of which is still headquartered in Seattle. Woods secured a post at the University of Washington as a nursing professor in 1978 and launched one of the first-ever studies of menstrual symptoms in the United States. Later she and her colleagues persuaded the National Institutes of Health to fund a decades-long effort to document women’s transition into menopause. They’ve pursued a series of additional major studies on the treatment of menopausal symptoms, and their work has contributed to safer hormone therapies and smarter treatment of infertility, heart disease, osteoporosis, and cancer. Another outcome of their efforts: Seattle has, over the years, become “a hotbed of women’s health research,” Woods says, where some of the country’s most ambitious researchers work together to extend and improve women’s lives.
We’ve Got Reproductive Choice Covered
In March 2018, governor Jay Inslee signed the Reproductive Parity Act, requiring insurers that offer care during pregnancy to also cover abortions and birth control. Two months later, the White House proposed a new rule that would deny federal funding not just to organizations that provide abortions, but to anyone who refers a woman to an abortion clinic. Inslee responded defiantly: “I will work with our legislative leaders to make sure that no matter what happens in DC, every woman in Washington state has access to all the family planning and health care services she needs.”
It’s Twilight for the “Tampon Tax”
Last October, Seattle City Council member Teresa Mosqueda asked the Seattle City Budget Office to study the implications of lifting burdensome sales taxes on tampons and other women’s hygiene products. Pads and tampons are already so costly that some American women can’t afford them. (Low-income women sometimes substitute with rags and paper towels out of desperation, according to one recent study in St. Louis.) Several other states have already abolished such taxes or have pending legislation that would do so.
Mosqueda framed the issue in terms of gender equity: “When women are making 76 cents on the dollar [relative to men] here in King County, every penny counts.”
Trans Women Have Options
Doctors in Seattle have offered specialized care for transgender patients since the late 1980s. The Polyclinic now employs a multidisciplinary team of doctors known for their work in this field. Emily Bradley, a Polyclinic urologist who performs orchiectomies (an option for gender transition that involves the removal of testicles), says an increasing number of trans women have been seeking her out since 2014, when Washington state reaffirmed its ban on insurers denying health coverage based on gender identity.
Many of Bradley’s patients tell her they moved here because of the city’s reputation for transgender support: “It’s a friendly atmosphere,” she says. “They know that they can get good care in the Seattle area.”
Immigrant and Refugee Women Belong
Public Health—Seattle and King County runs more than a dozen public health clinics that care for people who often can’t access or afford other medical care, including many immigrants and refugees. The agency also partners with community health advocates all over the county who, for instance, encourage women to get mammograms or help families enroll their children in Medicaid. These days, clinical staff and community health workers face mounting pressure to make sure their clients feel safe seeking care, especially amid the ongoing immigration crisis. Public Health director Patty Hayes insists that the agency will never turn anyone away, regardless of their citizenship status. “We want all clients and potential clients to know they are welcome here.”
Black Lives Matter in Medicine
Did you know that black women are 40 percent more likely to die from breast cancer than white women and twice as likely to die from uterine cancer? The underlying reason, according to UW oncologist Kemi Doll: Throughout their lives, women of color are treated differently by the health care system than other patients. Many report that their symptoms and concerns aren’t taken seriously. Nationwide analyses of medical outcomes suggest implicit racial bias taints women of color's treatment so significantly that they sometimes don’t receive needed tests, correct diagnoses, or life-saving treatments. “The ramifications of not listening to women,” Doll asserts, “can literally lead to death.”
She’s collaborating with other researchers and patient advocates to collect stories from women who’ve been treated for uterine cancer in order to better understand what happens when the system fails them. In partnership with Jonathan Kanter, a psychology professor at UW, she’s also developing a training program to help medical students recognize and stop subtle instances of racial discrimination, bias, and unfairness. “When the most marginalized group speaks up, everybody’s quality of life improves.”
When, If Ever, Should You Start a Family? The Question Is Getting Easier to Answer.
Ask a doctor how long you can wait to have a baby, and the answer's almost entirely based on age. After 40, on average, there's a tendency for women’s fertility to drop. But according to the Centers for Disease Control and Prevention, about 9 percent of married women ages 25 to 34 who hope to become mothers will have problems conceiving earlier. Fertility may depend on individual factors, including DNA.
Seattle Reproductive Medicine, a fertility center founded by academic endocrinologists, has recently partnered with the New York company Celmatix to search for genes that could influence whether a woman will face infertility. In years to come, says SRM doctor Gerard Letterie, such tests might offer women more decisive information about how many reproductive years they will have in their lifetimes and how early they should plan to have children, if they want them.
In the future, “I think family building is not going to be a passive process,” Letterie says. “It is going to be far more hands-on.”
The Male Pill Is on Its Way
“Anything that allows pregnancy to be planned empowers women,” says UW professor Stephanie Page, who's been part of a decades-long quest to develop methods of hormonal birth control for men, including the long-anticipated male pill. “We are putting something else on the menu of choices for people to plan their pregnancies,” she says. Page recently finished testing the pill among 83 men and will run a three-month trial with 100 this year. And the menu keeps expanding. In 2019, hundreds of couples will sign up for an international trial of a male contraceptive gel, applied daily and absorbed through the skin. It could still take several years for an entirely new class of contraceptives to clear the FDA’s regulatory hurdles. But when they do arrive on the shelves of drug stores, they could be game changers for both women and men.
Sex Ed Is Body Positive and Smart
People aren’t used to thinking about puberty as a celebration, or as a platform of empowerment,” says Julie Metzger, aka the “Puberty Lady.” A Seattle nurse and educator, she has guided tens of thousands of girls in Washington, Oregon, and California into the wilderness of puberty through a workshop series via her organization, Great Conversations. Metzger’s decades-long work is a complement to the science-based King County curriculum FLASH (Family Life and Sexual Health), taught throughout the region’s school districts. But Metzger takes an unusual approach, placing preteens aged 10 to 12 (and their parents or trusted adults) in a room together to have disarming, authentic, sometimes whimsical discussions of the adolescent body. “Beyoncé writes her music and performs in front of thousands of people with a period,” Metzger tells them. “There’s women scientists working in a lab, creating a scientific experiment that will change the world while having a period."
Researchers Decode Breast Cancer Genes
Doctors have long known that certain genes can put a woman at far greater risk of developing breast and ovarian cancer. Some versions of these genes are known to increase the odds so significantly that a patient might opt for a double mastectomy, like Angelina Jolie, just to stave off the possibility. UW genetics professor Lea Starita and PhD student Greg Findlay have worked meticulously to catalogue as many variants of breast cancer genes as they can identify in cells grown in the laboratory to determine which ones put women in greatest jeopardy. Starita belongs to a citywide genetic research collaboration called the Brotman Baty Institute, launched in 2017 as a partnership with Fred Hutchinson Cancer Research Center and Seattle Children’s. Starita believes she and her collaborators will soon be able to help decode other dangers written into a person’s genetic code, such as the risk of heart disease, the number one killer of women in the U.S.