Beyond pink

Gayle A Sulike, PhD, a medical sociologist and 2008 Fellow of the National Endowment for the Humanities for her work on breast cancer culture, is the author of Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health (Oxford University Press, 2011). Each chapter is followed by pages of footnotes for this carefully researched book that points out the dark side behind the pink ribbon. It is not a cheerful picture, nor a completely hopeful one, as very little true progress has been made in the battle against breast cancer, for all the fanfare of pink products, awareness, and the popularity of "the cause."

Certainly, every woman should read about how mammograms could actually fail women and, in some case, cause harm and should be aware of the risk/benefit ratio, the costs, and the questionable motives of some who benefit.  "Screening mammography is largely responsible for the ever-increasing diagnoses of stage 0 breast cancers, the types that are not technically breast cancers at all." (p.183). Such results stack the deck for the claim that early detection saves lives when the lives "saved" were never in danger in the first place.  In addition to false positives, mammograms can yield false negatives, meaning that the cancer that is there will not be detected. Generally, they are more effective at detection in women over 50 than younger women. In an article that appeared in 2009, "Chief medical officer of the American Cancer Society Dr. Otis Brawley said: 'I'm admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated" (p. 20).

Sulike also examines the mythology of the "she-ro" who must rise above her suffering according to the script tied with a pink ribbon. She also touches on "pinkwashing" as a serious problem that gets in the way of true progress, as well as the infantalization of women that ensues with pink culture that considers it appropriate to offer teddy bears and Barbie dolls dressed in pink to those afflicted to show caring. Pink, of course, is the color strongly associated with little girls.  Would men be treated the same way?  Of course, some of this is based on feminist analysis, and reader may just find her take on the significance of Power Puff Girls debatable. But it is, certainly, an intriguing argument.

Here main points are encapsulated both at the beginning and the conclusion of the book. On p. 374 she says:  "Pink ribbon symbolism not only distract the public from the harsh realities of breast cancer and the actions that would be necessary to move toward  its eradication, it also produces a feel-good culture in which the idea that breast cancer is a good cause translates to a belief that supporting it is a good thing that will always lead to good outcomes. The pink ribbon effect demonizes and isolates those who do not happily accept all of the pink goodness the culture has to offer."

The only weak part of the book is that she does not really build a substantial case for what would work to truly make a difference.  Is it even possible to eradicate breast cancer?  She does say that certain chemicals used by companies are linked to breast cancer, but I'm not quite clear on if she would say that the solution lies there. There are always contributing factors, but so many health conditions do prop up unexpectedly with no known cause. Nevertheless, the book is worth reading for its wealth of information and for its infusion of some healthy skepticism. It's good to  think before going pink or joining up with anything just because it is popular and seems to be  going for a good cause.

For some further reading on this approach, available online, see

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Abba's Rantings said…
whatever the merits of the arguments presented in the book, what about the contribution of the pink ribbon and the larger breast cancer awareness campaign toward making it less of a stigma?

and the feminist critique of davka using pink is stupid (imho)

incidentally, iirc when i was in school we learned that mamograms only recommended under 50 if risk factors are present. also controversial are the new guidelines that frown on self breast exams.
Ariella said…
Are you a doctor? You know, it's an interesting thing. At a practice I used to go to, the doctor I usually saw never said a word about mammograms, but when I saw one of the partners, he wrote me out a prescription for one because he like to start women on them from their upper 30s. At the time I thought, perhaps, he is more cautious, as many take 40 for the age at which to start. But given that there is absolutely zero history of that form of cancer in my family or any other significant risk factors that I am aware of, it didn't really make sense to send me off for that. I didn't end up going.

As for pink, the color was chosen quite deliberately to be a shade that would be considered pretty and feminine and inoffensive. This ribbon actually followed the AIDs one, which went for the more striking shade of red. But it's not the pink ribbon that she object to so much as little girl associations that go with it that extend to Barbie dolls for the cause that are offered to fully grown women diagnosed with this cancer. Granted some women don't mind being given teddy bears and such, but some do find it offensive and counter the good intentions with an observation that no one offers men toy cars when they get diagnosed with prostate cancer.
miriamp said…
Ooh, I like that toy cars comparison. I hope to not have the opportunity, but I may actually gift a toy car. (Actually, probably a construction vehicle) to a grown man undergoing cancer treatment some day.
Abba's Rantings said…
not a doctor (unless a PharmD counts)

i don't understand the barbie dolls.

"no one offers men toy cars"

are we talking remote controlled cars?
Ariella said…
Well, Abba's Rantings, that sort of ties into the source for the complaint about Barbies and toys. It came from Barbara Ehrenreich who talks about things only women understand in "Welcome to Cancernland" on her confrontation with "pink ribbon culture" after her own diagnosis of breast cancer.

That type of thinking is what gave rise to
"Think Before You Pink™, a project of Breast Cancer Action, launched in 2002 in response to the growing concern about the number of pink ribbon products on the market. The campaign calls for more transparency and accountability by companies that take part in breast cancer fundraising, and encourages consumers to ask critical questions about pink ribbon promotions."
Ariella said…
miriamp and Abba, the point in mentioning the toy cars is not to come up with particular varieties -- only to show the ludicrousness of treating a grown up as a child because of a diagnosis of cancer. I'm not saying you have to agree, but that is the position Barbara Ehrenreich took. She did not like being expected to conform to the pink mold.
Abba's Rantings said…
coincidentally, tonight the All in the Family episode was where Edith finds a lump.

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