Busted

Dr. Jen Gunter joined us at the Rotman School of Management to talk about her new book, Blood: The Science, Medicine, and Mythology of Menstruation. In this conversation with GATE’s founding director, Dr. Sarah Kaplan, she discusses the many myths around menstruation and the impact that misinformation and stigma about menstruation have on women’s health and on society. Listen in to learn about how periods and reproductive health are linked to purity culture and patriarchy, as well as to social, economic, and political outcomes. 

GATE’s Busted podcast is made possible by generous support from BMO.  

Featured Guests:  

Dr. Jen Gunter, OB/GYN, pain medicine physician, and bestselling author 

Dr. Sarah Kaplan, Founding Director of the Institute for Gender and the Economy, Distinguished Professor of Gender and the Economy, Professor of Strategic Management, and Fellow of the Lee-Chin Family Institute for Corporate Citizenship, Rotman School of Management, University of Toronto 

Produced by: Carmina Ravanera and Dr. Sonia Kang 

Edited by: Ian Gormely

What is Busted?

Does achieving gender equality only benefit women? Are gender quotas thwarting meritocracy? Are women more risk averse than men? If you think you know the answers to these questions, then think again! Busted is an audio podcast series that busts prominent myths surrounding gender and the economy by teaming up with leading experts in the field. We uncover the origins of each myth and give you the tools to bust each myth yourself!  

Busted is a GATE audio series production from the Institute for Gender and the Economy.

Dr. Sonia Kang:

Welcome to a special episode of Busted. I'm doctor Sonia Kang, Canada research Chair in Identity, Diversity, and Inclusion at the University of Toronto.

Carmina Ravanera:

And I'm Carmina Ravanera, senior research associate at GATE.

Dr. Sonia Kang:

Today, we've got an exciting guest conversation. Back in February, doctor Jen Gunter joined us at the Rotman School of Management to talk about her new book, Blood, the Science, Medicine, and Mythology of Menstruation. She spoke with GATE's founding director, doctor Sarah Kaplan, about the many myths around menstruation and the impact that misinformation and stigma about menstruation have on women's health and on society. We're featuring that conversation in today's episode.

Carmina Ravanera:

This was such a great conversation. Jen not only talked about how a lot of myths around periods and reproductive health are linked to purity culture and patriarchy, but also how they can be linked to social, economic, and political outcomes that affect women's lives. She also mentioned how employers can better support women's health and how crucial it is for us to vote for politicians who will protect reproductive rights.

Dr. Sonia Kang:

So without further ado, let's get into it.

Dr. Sarah Kaplan:

So, my first question is, you know, as a reader of this and someone who's had her period not a few times in my life, I found that there were very many surprises in this book. Very many, even though I thought I knew a lot. So as you did your research for this project, even though you've had many years of experience as an OB GYN, what was the biggest surprise for you?

Dr. Jen Gunter:

Oh, I think the biggest surprise for me was some of the historical information. So, you know, when I wrote the chapter on period products and I wrote a chapter on the history of period products that so little had ever been recorded about what women had used throughout time. And when you think about it, of course, all of history was recorded by men and so they wrote things that were of interest to them. But even in women's own journals, they didn't write about their menstruation. And I just find that fascinating there, you know, I, you know, a book written by a midwife in the 1600, no mention of how to take care of menstruation.

Dr. Jen Gunter:

But and it can't be that they were prudey because she actually described the the average length of a man's penis which was called man's yard. As if. But you know, so it's not like that, like there was obviously graphic information in there. Right? Right.

Dr. Jen Gunter:

The I found someone who in her, PhD, in her dissertation, she had actually gone through journals of women who had traveled through the American West at the time of the gold rush. And had looked at their journals and they wrote down like how many socks you'd need for the journey and how many shifts and how many this. They didn't write anything about menstrual products.

Dr. Sarah Kaplan:

Right.

Dr. Jen Gunter:

And it's just amazing to me that that that was so sort of obliterated from history.

Dr. Sarah Kaplan:

And so taboo. Right. It's not only obliterated from history that people couldn't even bear to put it, write it down.

Dr. Jen Gunter:

Right. And one of the really shocking things was, you know, one of the very first times a woman spoke publicly about her period was when she was accused of murder. And this was in the old Bailey and the records are there, and, you know, she was eventually executed because that seemed like she might have done it. But, but it's a good defense. Right?

Dr. Jen Gunter:

Blood on your shift, where did it come from? She said it came from her period. And so, you know, so it just it's fascinating that it took that, like your life being at stake to talk about To admit

Dr. Sarah Kaplan:

that you even had a period Yeah. After all. Yeah. Okay. So that that was very surprising.

Dr. Sarah Kaplan:

And then there was a lot of the scientific stuff that was also very interesting to me. But I wanna spend most of our time talking about the social health and economic ramifications of your findings. But can we do a little bit of science? Sure. Can we talk about this the statement, menstruation itself doesn't appear to be a beneficial adaptation, rather, it's a trade off?

Dr. Jen Gunter:

Yeah.

Dr. Sarah Kaplan:

You know, because we all think that, oh, everything is evolved for a purpose, except for our appendix. We know that that's sort of not necessary. But so what that also, that whole idea that it wasn't actually it's just a trade off, can you talk

Dr. Jen Gunter:

a little bit about that? Yeah. So, you know, we all have this idea that evolution is perfect, and, you know, really, evolution's motto is just good enough. Like, let's patch you on the door and send you out. Good enough.

Dr. Jen Gunter:

We have some duct tape holding you together. Can you make the next generation great? And so, you know, like, perfect is the enemy of good. That's like evolution's bottom. So so the I I got very fixated on this when I was a kid because I had very heavy periods, and I used to wonder, like, what was the point of this?

Dr. Jen Gunter:

Yeah. This, you know, like, my knees didn't leak. I didn't have fluids spewing out of anywhere else. Like, this seemed like a really stupid design to me. And if anyone's menstruating, I think the same thing.

Dr. Jen Gunter:

And so, you know, menstruation is the byproduct of the menstrual cycle. And so if we didn't have a menstrual cycle, we wouldn't have what's called spontaneous decidualization. So that means having a very very thick uterine lining. And we need that very very thick uterine lining to handle a human embryo because they're incredibly invasive. So think about it like a catcher's mitt, we need a really thick catcher's mitt for an embryo, otherwise it's gonna go all the way through.

Dr. Jen Gunter:

The other reason we need this thick specialized decidua, is to actually be involved with the initial immune signaling of pregnancy. So you've probably all heard about how, you know, maybe 70% of early embryos and then miscarriage, that's because of the decidua. It actually senses abnormal embryos. Because a human pregnancy and raising a child is an incredible biological effort. Right?

Dr. Jen Gunter:

So it's not just the pregnancy or the breastfeeding, which is the most metabolically taxing thing a human can do. It's on par with the Tour de France. Okay? So just from a metabolic standpoint, right, that was something that actually shocked

Dr. Sarah Kaplan:

me. Right. Right.

Dr. Jen Gunter:

And then

Dr. Sarah Kaplan:

I was

Dr. Jen Gunter:

like, okay, it makes sense. So very, very intuitive if you've been pregnant. So so this idea that you have this incredibly metabolically taxing thing. You have the trauma of childbearing. You have the fact that there is infant mortality.

Dr. Jen Gunter:

You have to raise and feed a child until it's old enough to look after itself. I mean, we're not giraffes, we can't just like drop a fetus 8 feet and it's gonna stand up and be able to eat. Right? So to to make this incredibly long journey worthwhile, you need to have some selection at the beginning. So that's great.

Dr. Jen Gunter:

We have this thick lining that can help sort of select the best embryo and we have this thick lining so we can have this invasive placenta so these brains can get all this oxygen. But if you don't get pregnant, then that thick lining has to go some wear. So what happens with ovulation is the lining changes from cells, one type of cells into another. And if anyone has ever passed a piece of tissue or what looks like tissue with your menstruation, that's decidua, It looks just like tissue. Your body can't break that down, it would need a digestive tract.

Dr. Jen Gunter:

So the only way to cope with it is to get rid of it and start anew. So when I say menstruation is the by product, it is. It's that's the by product of not getting pregnant. So the it has very little to do with, you know, it's just about getting the new cycle started all over again.

Dr. Sarah Kaplan:

Right. And so that's the trade off.

Dr. Jen Gunter:

That's the trade off.

Dr. Sarah Kaplan:

In the ideal world, we wouldn't have it, but we have to have it if we actually want successful pregnancy.

Dr. Jen Gunter:

If we want big brains, if we want, you know, all of these things that come along with being human, we need that trade off. But, you know, we all benefit from the menstrual cycle. But it's half the population that bears the financial burden. Right? And so I one of my big, you know, ideas is that we need to democratize this.

Dr. Jen Gunter:

We shouldn't be financially penalizing half the population whether it's purchasing menstrual products, whether it's lack of research, whether it's expensive, you know, more expensive tests or things like that. So, you know, we have all of this care that's surrounding the reproductive tract but yet that reproductive tract benefits everybody.

Dr. Sarah Kaplan:

So you have talked about in this book and in your previous books, the patriarchy as I've talked a lot about the patriarchy myself. But can you tell me why it's been so important that you talk about the patriarchy? Here you're talking about, you know, the vagina, menstruation, menopause. Why is it so important to talk about the patriarchy and specifically talking about periods?

Dr. Jen Gunter:

Well, the reason why so many people have trouble even saying the words vagina or menstruation or periods is or period diarrhea is because they've been shamed by this, you know, this sort of system that we all live in that those of us with uteruses did not create. Right? And so imagine your very basic biology being considered dirty or inferior, and we're still carrying that legacy today. I mean, how many times I mean, let's have a show of hands. Who has done what I call the tampon Olympics, where you have a 100 yards to get to the bathroom, you put a tampon and you stuck it, you kinda dash because you don't want anyone to see your pad or tampon.

Dr. Jen Gunter:

Right? Let's have a show of hands. Look at this. Look at the number of people who have done that. Right?

Dr. Jen Gunter:

That's the patriarchy. Nobody would feel badly with walking with a Kleenex. Right? So why do we feel shame about a pad or a tampon? We are starting to see changes and one of the first things is you have to be able to name something to get rid of the shame.

Dr. Jen Gunter:

Right? If you can't say the words bleeding, if you can't say the words menstruation, then that the implication is they're wrong and shameful or you're bad for having sex or bad for not having sex. Right? It's like both. You're always walking on.

Dr. Jen Gunter:

You know, to be a woman is really to walking on the edge of the knife. You know, you're you're you're always too much in one direction or the other.

Dr. Sarah Kaplan:

And you just mentioned this idea that there isn't as much scientific research on the women's bodies and these kinds of functions. And, you know, you say early on that, quote, diseases unique to the reproductive, biology, attached to ovaries in the uterus are woefully underfunded. So can you say more about that dynamic and what it means for us?

Dr. Jen Gunter:

Yeah. So, you know, if we consider, you know, endometriosis, a condition that affects about 10% of women, and it causes pain, it causes infertility, and sometimes it doesn't cause any symptoms. We don't understand, for example, though, we can, I, you know, there are many times I've done surgery on women for, you know, maybe they having a precancer? So they have their uterus removed for, you know, pain related reasons. And they're full of endometriosis.

Dr. Jen Gunter:

And I ask them after, do you have any pain or not? Nope. Not at all. And then other times, we're operating on women with chronic pain and they have just a very little bit of endometriosis and it caused severe pain. We don't understand, are these different diseases?

Dr. Jen Gunter:

Are they different expressions of the same disease? And we don't know that because we haven't had the investment in the basic biology to understand that. You can't design fancy new drugs until you actually understand what's going on at a cellular level versus something like Crohn's disease, also a very serious condition, but affects way fewer people than endometriosis. And, you know, it has been massively funded versus endometriosis. And if if I think about when I was a medical student, we only had a couple of, you know, not very good treatments for Crohn's disease just like we had a couple of not very good treatments for endometriosis.

Dr. Jen Gunter:

And now we have what are called disease modifying drugs that actually change lives for people with Crohn's disease, and we do not have disease modifying drugs for endometriosis. And when you look at the vast difference in funding at a federal level in the states, never mind what's happening with pharma. But, you know, the secret is, you know, pharma often ponies off a lot of basic science research that's funded by the government. Right? So, you know, they're looking for what's there.

Dr. Jen Gunter:

So I just think what if we'd had that same investment, where would we be?

Dr. Sarah Kaplan:

If there were a disease altering medicine that would sell a lot, that would make

Dr. Jen Gunter:

a lot of money. It would absolutely make a lot of money.

Dr. Sarah Kaplan:

And so that's what amazes me about the patriarchy. Is that companies are willing to leave money on the table to not research these topics.

Dr. Jen Gunter:

Somebody has to convince them it's worthwhile and can make money, and if they can't see it themselves. Right? You know, it's it's just, you know, it's really one of those things that until you start, I think, getting women in these spaces and having these conversations. I mean, the other issue that's part of it is, you know, for a long time, a lot of funds that were, you know, earmarked for, you know, quote, quote, women's health went to pregnancy. And I'm not saying that's not important, but we also need to care about, like, the times that you're not pregnant as well.

Dr. Jen Gunter:

Right? Like, it can't just be, oh, you super matter for 12 months for those first three months of breastfeeding and the pregnancy, but then you don't really matter all after that. You know, like, you know, we have to we have to think beyond that. That's why I hate the concept of sort of, like, maternal and child health, like, all being focused into 1. Like, I think that, you know, we need to think about pregnancy health.

Dr. Jen Gunter:

We need to think about then health otherwise. And not also just parse out reproductive health because your reproductive system touches many other aspects of your health.

Dr. Sarah Kaplan:

Right. So you said in your previous books that there's a lot of misinformation that's why you're, you know, public enemy number 1 for Gwyneth Paltrow. So first let me ask you, when it comes to periods, which this book is about, what are some of the most common or most dangerous myths? And then, you know, maybe you call out so many different people and companies who are trying to make money off of people who are poorly informed because they believe in these myths, whether it's period coaches or unregulated supplements to fix broken periods or vulvar washes or sunset delight frequencies or libido industrial complex. You have a lot of different ways of describing the ways that people are making money off of the misinformation.

Dr. Sarah Kaplan:

So what is the what are the most important kind of areas where that's happening, and what do you think what do you think about this kind of industrial complex that's making money off of it?

Dr. Jen Gunter:

Well, there's so many of them, it's really kinda hard to to pin down, but I mean, I think this idea that, you know, that you can balance hormones with a supplement. Because this sort of sounds sciency, so you can see how people kinda get it. But you you there's no supplement that that can change your hormones unless it's got a hormone in it which of course many are adulterated. So, so that's an important thing. And supplements aren't tested any better in Canada than they are in states.

Dr. Jen Gunter:

By the way, Health Canada just takes whatever the supplement company says at face value. So there you go. So it's not like pharmaceuticals where there's a different level of testing. So I think this idea that there's something wrong and broken with your body, and if you come and buy my supplement, only I have the cure, only I can fix you. And that's really exploiting, you know, that gap in medicine that we've talked about.

Dr. Jen Gunter:

Right? So we have, you know, underfunding. We have especially in many places in Canada lack of access to getting to a healthcare provider, and then we have, you know, people who the healthcare providers who sadly aren't as well educated as they should. So we have and some who are very well educated and are just really bad communicators. So we have these gaps.

Dr. Jen Gunter:

Right? And then we have people that are coming in with, you know, cross my palm and I will fix this problem for you. And, you know, the one of the things that bothers me the most about all of these sort of supplements and coaches and all this kind of stuff is that they're all tied into purity culture. Connotation to them. And, you know, that's a really positive connotation to them.

Dr. Jen Gunter:

And you know, that's a really problematic way to think about a female body, right? What does pure mean? It means unspoiled, right? So this whole idea that you are only, you can only achieve health if you are not spoiled by sort of the modern world, by modern society that you're, you know, and somebody just showed me a TikTok for some woman who was saying that if you give up wearing menstrual products, then your periods will get lighter and you won't have any pain. I'm like, oh, so so staying in the home and bleeding on your clothes and not leaving the house for 3 or 4 days, what does what does that sound like?

Dr. Jen Gunter:

Where have I heard that before? Right. You know, so there's always this tie in. And I think that because of the patriarchy, purity culture speaks to us on a visceral level that we can't quite understand. Because if my mother was exposed to it and her mother you know, it's just everywhere and all the subliminal messaging.

Dr. Jen Gunter:

So I think it's very important that people be aware of kind of the rhetoric that's involved with these products and that they're really actually they're sinister undertones.

Dr. Sarah Kaplan:

So on another, aspect of this, you devote a whole chapter to what you call the binary ideology, and I I I was very interested in that because, of course, we have a robust conversation in Canada for sure, and obviously a super politicized one here and in the states. Why is it why is that an ideology in from the standpoint of a medical doctor when you're talking about this? And, you know, you also say some of the names of things that are problematic in in just the naming of the scientific naming of things, like the word estrogen, which can mean sexual season, gadflies, sting, madness. So talk about the binary ideology and how this kind of even the naming of things is kind of sucked into that.

Dr. Jen Gunter:

Yeah. So, you know, when they were first discovering, you know, hormones and chemicals back in the day, you know, everything that was associated with, you know, a classic female body got some kind of associated with, you know, a classic female body got some kind of derogatory term or, you know, it was sexual madness, things things like that. And everything that was, you know, believed to be related to a man had, you know, had had some kind of positive connotation to it. And this, you know, now we know that to ovulate, you have both estrogen and testosterone and, you know, that they both do their important things. And whether you have more or less of one doesn't matter.

Dr. Jen Gunter:

It's like a recipe. Yeah, you might have more flour than you have yeast, but you can't bake bread without yeast. Right? So this idea that, you know, one hormone is more important or not. It's all like a symphony all working together.

Dr. Jen Gunter:

So, you know, it's problematic because then it makes us think of bodies in certain ways. And, you know, while I'm sure no doctor today knows Latin or Greek really well, you know, the ones who were writing the seminal textbooks in the thirties and forties did. And, you know, you know, even like the hormone prostaglandins, which are hormones that are made at any time in different places in body because of injury inflammation. They're called prostaglandins because they were first found in the prostate. Right?

Dr. Jen Gunter:

And it's, you know, it's just things like that that it's just like, really, can we not, like, you know, use can we not rethink this and have more modern technology or, you know, or more

Dr. Sarah Kaplan:

more modern descriptions? You know, and of course, there

Dr. Jen Gunter:

are also many people who menstruate, and I think it's really important that, you know, we have language that's inclusive. And that's why for me, you know, I personally don't like terms like menstruator or vulva have or, you know, people can describe their bodies however they want. Right. But I find that distills I don't like distilling people to a body part, and also it doesn't really work because you cannot have a uterus and still have an ovary, still have a menstrual cycle, so you're not a menstruator, so it doesn't work for that. So I just like to use the word people because I trust people know what I'm writing applies to them or it doesn't.

Dr. Jen Gunter:

They know if they've had a hysterectomy. They know if they don't. They know if they're trans. They know if they're not. They, you know, just using people's because, like, we're all people, you know?

Dr. Jen Gunter:

So I find that's just kind of the the better terminology that works better for me. But, yeah, I think we really need to do a better job. I mean, some of the terms are really problematic, like, you know, the word, pendendum, which is often used to describe the perineum or, you know, the part between the vulva and the vagina. I mean, that's from the Latin root to shame. Right?

Dr. Jen Gunter:

So, you know, this idea that we have body parts that are carrying that, you know, or the penis is from the Latin for scabbard or sword. Right? Like, you know, and vagina is sheath, like, okay. Sure.

Dr. Sarah Kaplan:

I wanna also talk, you know, in this process about birth control, which you said, okay, I have a it's a book about periods, but I wanna talk about birth control, too. And there are obviously a lot of myths about the pill and IUDs and all the other technologies. So what do you want people to know about birth control? And my I I just wanna note that in addition to the science of it, I underlined several times in this book the point that you made that the pill itself changed societal norms and life trajectories. I've been responsible for 30% narrowing of the gender wage gap, all kinds of things like that.

Dr. Sarah Kaplan:

So there's, like, this economic side to birth control in addition to the technical aspects of what it actually does. So what do you want people to know about birth control?

Dr. Jen Gunter:

Well, so don't get information about it from social media would be probably, like, my number one. Be very wary about any information about it from naturopaths because I've seen, you know, there's a lot of disinformation, from that grouping as well. You know, I think that people should know that the ability to, you know, if you're someone who, partners with someone who, you know, has sperm and can get you pregnant and you have, a uterus, then this idea that that you can have sex for pleasure and not have to worry about getting pregnant is really a revolutionary thing. And I think we've forgotten some of that a little bit and I think people are sadly rediscovering that in parts of the United States, how how how awful it is not to have control. I think also people need to know that it is really important medication because we use these medications for many people.

Dr. Jen Gunter:

There are lots of people not at risk for getting pregnant. Right? You, you know, you you have a a same sex partner. You don't have a partner at all. You have no desire to have a partner.

Dr. Jen Gunter:

You know, we have all different, you know, sort of sexual expressions. And many of these medications are so valuable for treating PMS or for treating heavy periods or for treating menstrual migraines. So there are many different, you know, things that these these medications can also treat. And sadly, because of disinformation about on social media, we're seeing people turning away and and suffering and not having therapy for their medical condition. You know, I someone reached out to me a few days ago.

Dr. Jen Gunter:

Our 15 year old daughter has very heavy periods, you know, is getting anemic and had to go in for an iron transfusion, and she won't take the pill because of what she saw on TikTok. And it's just really sad that we're at that place. And obviously, you know, I blame medicine for creating those gaps, but, you know, these predators that are exploiting it, they're they're causing real harm and, you know, they're not the ones who have to sit and counsel someone with an unplanned pregnancy who can't get access to to an abortion. They're not the one who has to, you know, give a, you know, a 15 year old an iron transfusion. So I think that it's really important that, you know, that that people try to get their information from validated sources.

Dr. Sarah Kaplan:

Okay. So speaking of choice, let's talk about abortion. Yeah. You highlight the health risks associated with pregnancy versus birth control, such as the pill, not to mention the economic risks that we know, happen for, pre you know, through pregnancy. It's obviously one of the most incredibly fraught times that we could be talking about this subject.

Dr. Sarah Kaplan:

So why do you have abortion in a book about periods?

Dr. Jen Gunter:

Yeah. Well, so we used to call abortion, you know, you know, menstrual management, basically. You know, it was a way to bring bring on a period. And so I think that, you know, it's it's in a you know, being pregnant when you don't want to is also part of, you know, of menstruation as far as I'm concerned. Your deciduous is not coming out and you wish that it would.

Dr. Jen Gunter:

So I wanted to include it in there because I'm hoping that they'll also be, you know, people who've never thought about abortion reading the book. So it might help them think about it in different ways. Think about the impact of what having legal abortion has done for maternal mortality in countries. It is the maternal mortality when abortion is illegal, It is the maternal mortality when abortion is illegal is stunningly awful. And, you know, we know from a large study in the United States called the turn away study where women were turned away because they were too far along.

Dr. Jen Gunter:

The serious economic impacts of, you know, the poverty that having an unwanted pregnancy brings. There were a couple of women who died from maternal mortality because, you know, in the United States, we have terrible maternal mortality. But, you know, it it's really important that that concept of abortion is introduced early as if it's no big deal because it isn't a big deal. And it should be, you know, free and available to everybody. The the ability to choose your reproductive path should be a human right.

Dr. Jen Gunter:

And we are losing that in the United States. And I guess my message to everybody in Canada would be is that you are always a hair breaths away from losing that. So be very, very careful about who you elect because if a politician mentions it once in passing, you know, they've been thinking about it for 10 years. Right.

Dr. Sarah Kaplan:

You know, the way in the book that you tie together the medical issues with the economic issues, with the, you know, civil rights and human rights issues, it's very, to me, it was very moving to see those discussed altogether as opposed to separately. And when you see it all together, you see it in a very different way than than people traditionally who wanna benefit from polarization and all of that do.

Dr. Jen Gunter:

Yeah. I mean, when you think about, you know, the economic burden of pregnancy, the economic burden of child rearing, we know it's born uniquely by half the population. And, you know, as you know, especially in the United States where people don't have access to care and that, you know, I mean, some people have, like, 2 weeks leave after I mean, it's just so awful. You know, you think about all of these economic burdens on top of it and it is literally a way to keep people in poverty. And, you know, people need to have the option so they can, you know, make make the choices they want.

Dr. Jen Gunter:

And also that's why I put all that, you know, contraception information. They're not only because you need to learn about it from a medical aspect, but, when people have access to the contraception they want, it can make a massive difference in their life trajectory.

Dr. Sarah Kaplan:

Right. So some people, to get a better handle on their periods and things, use these period tracker apps. Can you talk a little bit about that and, you know, what struck me is, you know, the dark that there's a dark side to those technologies. Can you talk a little bit about that?

Dr. Jen Gunter:

Yeah. So, you know, no free app is free. You're paying with your data. Right? And I think we don't all realize how much we are being tracked.

Dr. Jen Gunter:

You know, we've all had that spooky experience where you talk, you know, you talk about wanting to buy, you know, some kind of dress or going to some store and then literally 5 minutes later on Instagram, you see an ad for it and you're just like, what? Now think about that with your personal health data. Right? So there's a couple of issues with apps. So one is that.

Dr. Jen Gunter:

One is selling your health data. Do you want that sold? If you live in the United States in certain parts where abortion is illegal, you know, it takes very little metadata to find out that you went to planned parenthood, you went to a pharmacy, and, oh, look, your last period was 7 weeks ago on your app. You you they could someone purchased a week's worth of metadata about who went to a specific planned parenthood for a $100. This is in every district attorney's budget.

Dr. Jen Gunter:

Okay. So first of all, there's that issue. There's that safety issue. Then there's the idea that all of the apps are I shouldn't say all because maybe there's a few that don't. Because actually and there are a few that you download specifically to your phone that don't connect with the cloud that probably are not sharing your data.

Dr. Jen Gunter:

But most are sharing your data. Do you really want your data to go free to drug companies, to other people, to advertisers? Because that's where it's going. I always think it's amazing business model to charge you to buy an app, but then you're also selling the product from that app. Like, like, that's, you know, that's a great business.

Dr. Jen Gunter:

I guess 23 and me found out long term it wasn't. Because what are they worth now, dollars 0 or something. So, so there's that aspect. But there's also the aspect that the quantified self, tracking yourself actually creates anxiety and creates problems. So there's now data with sleep trackers that show that people get anxious about it.

Dr. Jen Gunter:

Did I sleep enough? Did I not? They're checking it. Right? So you get hyper vigilant about it.

Dr. Jen Gunter:

But there was a study with so there's apps where people just they track just because they wanna know when their period is gonna come. This isn't part of a fertility awareness method. So they're not adding in a temperature or checking their cervical mucus. And for anybody out there, if you are just using when your last period was to track your you know, that is not reliable at all. So, from a pregnancy from a contraception standpoint.

Dr. Jen Gunter:

So they have people that they they took these apps and they looked at women who'd inputted their periods. And when the app said their period was supposed to come at such and such time and it came at a different time, the women blamed their bodies. These are propriety algorithms that we can test. And in fact, when researchers looked at it, it was actually that's when their period should have come. The app was incorrect.

Dr. Jen Gunter:

Now these apps are sold by people as a way for you to learn more about your body. But in fact, the evidence that we have says is actually probably you making you less in tune with your body. So to keep that in mind, and so many of them also come with incorrect information. You know, they're not just an app. They're like, hey, this is a diet you should and you have no idea who's writing that information, how accurate it is if they're involved with a supplement company.

Dr. Jen Gunter:

Right? So there's all of that. That's also attached to it. Some of them have religious overtones. So you have to be careful about that.

Dr. Jen Gunter:

It's great when people have a problem. So if you have headaches and you don't know if they're related to your menstrual cycle or not, it's fantastic if you come into the office with 3 months of menstrual data. So we can look and see when it happens, but you can use the calendar on your phone for that. Right. And that's free.

Dr. Jen Gunter:

You don't have to download something. You don't have to have access to something else. You can also use an app if you want to. So but, you know, the using your phone would probably using a calendar probably be safer for you. It's great for retrospective information.

Dr. Jen Gunter:

It's don't rely on it for prospective information. So it's just something for people to be aware of. And then also when you look at the fertility awareness methods, again, if you're adding in, temperature or cervical mucus checks or other things, then then it improves, you know, from that from a standpoint of of prediction from, you know, and that can be more helpful. But again, a lot of those also come with religious information depending on which one that you're using, or they come with information written by naturopaths. Why would they come with information written by naturopaths?

Dr. Jen Gunter:

Well, who is invested in keeping you off the pill? The person who can sell you a supplement. When who is invested in keeping you off the pill, the app for contraception. Right? So it's just always important to be aware of bias and, you know, have a have I tell people if you're using an app, don't get your health information there.

Dr. Sarah Kaplan:

So you do mention that you get a lot of hate mail.

Dr. Jen Gunter:

Yeah. I love it.

Dr. Sarah Kaplan:

Do you want to say anything about the hate mail and what does that kind of hate mail that you get tell you about the work that you're doing?

Dr. Jen Gunter:

I do this, that's a really great question. I think that there are two things that tells me. So one, it tells me I'm affecting people's bottom line. Right? So a lot of people who send me hate mail are, you know, they sell supplements or they're, you know, they they, you know, it's all that kind of related stuff.

Dr. Jen Gunter:

And I'm like, I have no respect for you. I don't really care. So have a nice day. The other people that send me hate mail are people who are like and I feel bad for this group, the people who are really have gone down the rabbit hole of whatever disinformation that's there. And when you're someone who truly believes that, you know, the glucose goddess, the person who's telling you to wear a continuous glucose monitor, which is not something you should do if you don't have diabetes, it is normal to have excursions of blood sugar after you eat food just like it's normal if you run up a flight of stairs for your heart rate to go up.

Dr. Jen Gunter:

These are normal things. So, you know, the people who have gone down these rabbit holes, they really that information wasn't put in their head because of science, it's because of the belief. And to tell someone that what they're doing is, you know, not based in science, that would be like telling someone who is very religious, who really believes that, you know, when they go to communion that that the wafer is turning into the body of Christ. And so you're you're going against a belief system. Right?

Dr. Jen Gunter:

And you can't undo something that was put in there by belief. You can only undo something that was put in there by science. It's a very hard road out of belief. And so I feel really bad for those people, but at the end of the day, it doesn't really bother me because what's the option? To not give the information.

Dr. Jen Gunter:

Right? And so peep you know, and so eventually, you know, sometimes people find their way back and and but, yeah, I mean, that's and also that's how, you know, I got my saying, you know, some I know some troll was saying something to me, and I was like, bitch, I'm from Winnipeg. Like

Dr. Sarah Kaplan:

I also wanna turn to the work and employment side of this, and there was a number of different questions that what can employers do or, you know, when you have your period is so painful that you can't, you know, work and you have to stay home. I remember when I was in college one time literally lying down in the middle of the quad at school because I just couldn't walk one more step, you know. It's like, you know, many people experience that. So what what can employers do and how what is the relationship of people who are experiencing any of these kinds of things that make it hard for them to work

Dr. Jen Gunter:

Yeah.

Dr. Sarah Kaplan:

Because of their periods. How can we think about this and how can how can employers do a better job?

Dr. Jen Gunter:

Well, so first of all, if your period is bad enough that you can't go to work, then your medical provider should be involved because, you know, there are medications, there are therapies that you might need to be investigated for a medical condition. So employers should make sure that they offer enough leave for that kind of thing and they should, you know, use their political capital to to leverage for funding. So on should, you know, use their political capital to to leverage for funding, so on a greater scale. On sort of an individual scale, I think that, you know, lots of people have asked me about the concept of menstrual leave and having, you know, having, access to that at work. And I think that every business or almost every business has been based on, you know, a model that was created by people who don't menstruate.

Dr. Jen Gunter:

Right? That this, you know, this work day that how it all works was based on, you know, a man that went to an office and having somebody at home to care for them. And that's not how things are now. And I think we need to expand and

Dr. Jen Gunter:

think about ways where

Dr. Jen Gunter:

we can make work more equitable. And I think in situations where people have the opportunity to work remotely or to be flexible, with a mental leave, I'd love to see what the flexible, with a menstrual leave, I'd love to see what the studies say because I bet, I bet just like a 4 day work week that we're actually gonna see increased productivity. Because I think people, what people want is they want to be respected and they wanna know, okay, take care of my time. And and when you have an employer that cares about you, I bet you get a far more productive employee in the long run. I mean, I'm not a business major, but that seems like intuitive to me.

Dr. Jen Gunter:

So I think we're gonna see some really interesting changes. I'm looking forward to see the study. I mean, I know a lot of people when the whole idea of a 4 day work week came out, everybody's rolling their eyes, and then lo and behold, got all kinds of information. You know, it doesn't work for everybody. You know, I'm a surgeon.

Dr. Jen Gunter:

I, you know, I couldn't just cancel a day of surgery. But, you know, the different people have different occupations and where we can have the flex like, why should somebody suffer because I can't do that. Right? Like, you know, being a leader is paving the way for people behind you. And if even if you can't have access to the benefit, you know, making it so someone else can.

Dr. Jen Gunter:

So, yeah, I I'm excited to see how we can rethink the workplace.

Dr. Sarah Kaplan:

Yeah. And I feel like I've been saying this and now it's been I can't believe it's been 4 years since the pandemic started, but I have been saying since the very beginning, this is the perfect opportunity for us to run a whole bunch of experiments and how to organize. And by accident, we did run a whole bunch of experiments, like just being home and things like that. But I don't know if enough employers took up the opportunity to think there's just been so much more, like, let's just go back to work or let's just get back to normal. We can't stand it anymore.

Dr. Jen Gunter:

Right.

Dr. Sarah Kaplan:

That's the patriarchy speaking. And what you're suggesting is, there's probably a whole host of different ways that we could run these experiments to learn what what a more humane form of employment would look like.

Dr. Jen Gunter:

Right. Exactly. And you know, I think that even at a very simple, easy level, just have menstrual products available in every level, just have menstrual products available in every bathroom. Right? Like, nobody wants to be caught aware, unawares.

Dr. Jen Gunter:

You shouldn't have to walk and ask 5 different people if they have a pad or a tampon. Like, put them in every single bathroom. You know, even that's just as, you know, a sign of respect. And so, you know, there's even small ways people can start.

Dr. Sarah Kaplan:

Well, what I love about this book and every time I interview you is like, you what you what you're telling us is we have a right to health care and we have a right to good health care that actually is about what's really going on in our bodies. And we have a right to employment that accommodates the things that happen to our bodies. Right. And that that's just normal and not shameful. And that's what I love so much about this, conversation is that it's it's about just sucking the shame out of all of these, topics.

Dr. Sarah Kaplan:

So in the last minute that we have, is there any closing thought that you would like the audience to take away before they get the chance to read this

Dr. Jen Gunter:

fabulous book? Well, I would say, you know, always verify sources of information that you find online. It takes, 5 exposures to believe something or to start to believe something that is incredible. Like, the the earth is a perfect square or, you know, the tallest person is 35 feet. This was studied.

Dr. Jen Gunter:

Five exposures just start to move the needle. And so just be wary of what you're being fed. And, you you are in control of your social media algorithm. If you're watching a video and you realize, oh my gosh, this is a terrible person, don't just don't hate watch to the end, stop the video and block the person. You need to train the algorithm that you don't want that.

Dr. Jen Gunter:

When you're seeing people who are selling scams or selling supplements, if they also all do have great fashion advice, walk them. Because you know what? There's people with great fashion advice who are not selling you you scams. And finally, along the whole lines of everybody deserves healthcare. In Canada, our governments are in control of healthcare and it is so important to hold them accountable and to make sure that you get out and vote when you have that opportunity, because I'm telling you, nobody in the United States thinks, oh yeah, you know, you know, paying for healthcare is so awesome.

Dr. Jen Gunter:

So you are on the cusp here in Ontario of going in a really bad direction. And I think that I'm trying to sound all the alarms because, it's once it goes in that direction, you know, medical debt is is an incredible burden for people in the United States and you do not want to go in that direction. The changes that I've seen since I've trained here on Ontario and coming back now are really pretty catastrophic. So get out and vote.

Dr. Sonia Kang:

Thanks to doctor Jen Gunter for this episode. Make sure to check out her latest book, Blood, the Science, Medicine, and Mythology of Menstruation. Until next time. Happy myth busting.

Carmina Ravanera:

GATE's busted podcast is made possible by generous support from BMO. If you liked this episode, please rate and subscribe to Busted. You can also find more interesting podcast series from the Institute For Gender and the Economy by searching GATE Audio wherever you find your podcasts. Thanks for tuning in.