If there’s one thing that frays my last nerve, it’s talking about women’s health solely in terms of reproduction. Not all of us choose to have kids, and even the ones who do, are more than the sum of their offspring. Classifying our hormonal and female-specific well-being under “reproduction”, to my mind, reduces us to vessels for the emergence of the future human race.
Which is overly simplistic in ways that short-change both women and the healthcare providers who view us through that lens.
I mean, don’t get me wrong – I’m not kinderfeindlich, with an aversion to kids. But talking and thinking about women as only child-bearers and child-rearers is a huge problem — from the very moment we enter into the world in our female bodies. As babies we’re treated differently, as little girls, we’re handled a certain way, as prepubescents, we’re seen as not-yet-human creatures which have just a few years to go before our bodies start serving a “useful” purpose. Throw Autism into the “mix”, and you’ve got yourself a recipe for… a very interesting life.
And then into puberty, young adulthood, “childbearing (aaauuuuggghhhhh!) years”, and on to perimenopause, menopause, and post-menopause (which I am fondly referring to as “Meh-nopause”, since the hormones which cause me to give a shit about everyone and everything outside of me have bottomed out and left me with a more than welcome sense of not really giving a f*ck about all the stuff that got me torqued up, all those years ago. Again, add Autism, and there’s your cocktail for major disruption, inside and out.
Logistically, it can be one hot mess. And conceptually, even moreso. While reproductive classification might be fine for non-autistic folks (who seem to have a general predelection for coupling — sorry for overgeneralizing, but you probably know what I mean), I think casting us as mainly reproductive agents really has serious drawbacks for Autistic women and girls. Why? Because we tend to have a whole lot more going on with us, than non-autistic females. We’ve got all these sensory issues, not to mention a whole slew of passionate areas of driven specialized focus (the fascinations formerly known as “special interests”), and a whole lot of us don’t even relate to the whole “boy thing”, the “mating games”, and so forth, as we grow up. We may be fascinated by dolls and boys, but we may not. And even if we are, that fascination can be drowned out at any moment by a sensory onslaught.
Plus, there’s the social disconnect thing. When you’re not that adept at social interaction, you can find yourself pretty much out of the whole standard-issue selection-pairing-mating reproductive loop. You don’t necessarily get socialized the way non-autistic girls and young women do, learning the rules for interacting with the opposite sex. On top of that, since the mainstream healthcare system is so geared towards “treating” us and our health along stereotypical lines, which assume a certain developmental trajectory, there’s a massive conceptual disconnect between “reproductive health” and Autistic women’s health. We may be way ahead of the curve, or we may be behind. But rarely are we treated just as who we are, how we are, because… we are.
At least, that’s my perception of it.
The other issue I have with the whole “reproductive health” focus on women, is that our monthly cycles serve a variety of purposes, not just conception, but they’re typically treated as just another way to get pregnant. Our monthly cycles affect how we heal, how we think, how we function, how extreme our sensory issues are, how we experience every aspect of our lives. But does the mainstream healthcare establishment get that? Nope. They’re so locked on the target of making sure women are able to have healthy children (which is certainly a good and needed goal), that the rest of our complex makeup gets lost in the process.
This frustrates me to no end. Not only because it treats the most significant aspects of me like side-issues (I’ve chosen to not have children, because those other parts of my life are so all-consuming, it wouldn’t be fair to anyone, to bring kids into the equation)… but also because it misleads and dismisses countless other Autistic women and girls who may have a wide variety of issues and a whole bunch of concerns which are directly related to their female physiology, but are just lumped into the conceptual holding bin of “reproductive health”.
Make no mistake — our monthly cycles are good for a lot of things. The hormonal changes we go through both give us access to different ways of knowing and seeing and sensing, and also heighten and lessen our experiences of live. And for Autistic women, this is highly, highly impactful.
For example: Back when I was still having a monthly cycle, I would have the most intense sensory experiences pretty much every month, many times leading to meltdowns. For about a week before my cycle started (and my cycles were like clockwork – 32 days apart, every single month), my hormone levels would drop, get suppressed, and really drag me down into a pit of despair. When I think about all the times I wanted to just die… when I wished I’d never been born… when I just wanted the pain to stop… If I hadn’t been keenly aware of how fickle I am — and how I was likely to change my mind within a few days — I definitely would have committed suicide. But I knew from watching myself, that those feelings passed. And in a few days, I wouldn’t feel anything like that. I’d be pretty darned glad I didn’t end my life.
Those crashes were brutal. They took a lot out of me, and the meltdowns set me back in so many ways. They eroded my relationship with my partner, they kicked the crap out of me emotionally and physically. Meltdowns on top of hormone blockage… not much fun.
But there was another side to it all that you probably won’t read about in a gynecological textbook — the incredible flashes of insight that only came after all the suppressed hormones rushed back in. Some of those “crashes” also led to some of the most brilliant connections of ideas I’d been working on in the weeks and months prior. Some of the insights were truly transformational and laid the groundwork for a philosophy and approach to life that has literally super-powered my life in important ways.
Those ups and downs correlated closely with the hormonal fluctuations of my monthly cycle, and now that I look back, had I actually realized this — and realized just how much it would affect me — I would have handled myself and managed my life very differently.
It wasn’t until I was well into the perimenopausal process that I got a clue about managing my life to match my hormonal ups and downs, but by that time, things were so irregular and even more extreme, that it cancelled out a lot of the benefit I could have gotten from being more proactive about managing my life.
And I’m sure I’m not alone.
I mean, it just burns me up, when I think about how many Autistic women and girls are struggling with not only gender issues, but also the healthcare system that sees them only as delivery agents for the next generation. Again, no judgment towards mothers. Absolutely, positively not. We need you. Where would we be without you? Nowhere. But when it comes to our hormonal health, reproduction is just one of many considerations. And the repercussions of our fluctuations and our cycles affects far more than our ability to conceive and bear children.
All this being said, I’d love it if we could deepen the discussion of Autistic women (and girls) and our health as women and girls. I want to stop using the word “reproductive” as the main point in the discussion and find other ways to talk about the cycles that make us. My hope is also that researchers and healthcare providers will “get hip” to this discussion and widen their thinking about how Autistic women and girls experience lives from with the cycling bodies we have.
Oh, and also, over at Auptima Press, we’ve got more info and resources on women experiencing the (peri)menopausal process. Check out our article Perimenopause? The Transition Stage Before Menopause, to see where we’re going with this. It’s really the start of a whole conversation we need to have within our own Autistic community — and frankly, it could be helpful for Autistic men who are wondering what menopause did with their wives/partners, and when will they return them to their once-stable state (and yes, I can joke about this, because I’ve been through it myself, as well as stuck with my partner while she was going through menopause 10 years before me – believe me, I wondered what had become of her, and if she was ever going to return).
This whole topic has been near and dear to my heart for many years, especially over the past 10 years of going through the menopausal and coming out on the other side in much better shape than when I went in. I’ve learned a whole lot about the process, what’s happening, what to expect. And now with my more intent focus on Autism, I’m putting all the pieces together to understand — and share — how women’s cycles impact (and are impacted by) Autism.
Because, I swear to gawd, the two factors are so central to our being and experience, that you cannot consider one without the other. Literally… doing so, shortchanges the whole inquiry and renders null and void any one-dimensional pronouncements about what makes us the way we are, and what makes us experience the things we do.
And for the sake of our health, safety, and sanity, we need to start connecting these dots. Too many of us have suffered for no good reason.
And that needs to change. So, I’m going to change it. 🙂