Dear supportive friends, and new subscribers — thank you for holding a space of patient care around me while I disappeared into the period of hyperfocus required to complete my thesis and finally submit it. While there are still some important formal requirements (a viva voce, or oral defense) to wrap up before officially claiming the title of Dr. Hunter, I have managed to stagger forward holding aloft a series of published or in-press journal papers and book chapters, threaded together into a coherent body of work. While one might expect a triumphant feeling, the anticlimax of this moment is enveloped by a bewildering miasma of emotions: hazy relief / disbelief, nervous system downregulation in jagged steppes (though still easily triggered), exhaustion coupled with uncertainty, and muddy shades of grief that come with the ending of anything. It really is that monstrous an experience; nevertheless I do love the monster text (replete with images of artworks) that I somehow managed to birth. As a hallmark, I was given a ceramic mug featuring a clip art logo of a jumping generic graduate to mark the occasion: PhinisheD!
I write this postscript, the meat of which I will get to in a moment, from my tucked away home on my dad’s farm in the remote, still jungly parts of Maui’s north shore. I wanted to briefly follow up on my last post regarding Maui, which I wrote after the wildfires had consumed Lahaina. Maui today, four months post-wildfires, is more like Maui of the late 1980s that I remember (except that Lahaina is still totally off-limits while the cleanup and recovery efforts continue). Traffic is lowkey and local for the most part, tourism is relatively minimal even though it is the holiday season, and the overall mood is unhurried. Things seem to have returned to the Maui nō ka ʻoi island-style vibe it was once known for. The infamous (in recent years) “Paia crawl,” a line of slow-moving cars stretching from Paia town as far as Mama’s Fish House (about 1.4 miles) is much less and the Twin Falls parking lot is 2/3 empty. The late night drag racing ‘meth heads’ that I used to hear on the Hana Highway seem to have been quietened, perhaps with proper care; support systems have been established for those struggling with housing needs and other disruptive life challenges. The spillover of crisis management has had some far-reaching benefits for a number of the citizens of Maui, beyond those impacted directly by the wildfires. While Maui experiences this new bloom of community care and slight reprieve from the unmitigated madness of tourism capitalism, the long-term effects remain to be seen.1
I am here for a few months to spend time with my family and recover from something akin to post-PhD PTSD, while I weigh options and decide on the timing of my next steps (there are some exciting events on the horizon that I will share later). Part of my recovery is not only psychological, but also physical, and so my postscript delves back in to the central theme of my thesis: menstruation and the menstrual cycle. In the final two or three weeks of thesis writing, which saw me at my desk approximately 10-12 hours a day, not only did my body suffer but my anxiety levels were on high performance alert mode (I now have nightmares about this). These factors seem to have impacted my menstrual cycle in the same way that covid (and the vaccines) had, perhaps indicating a blow to my immune system: prolonged and heavier than usual bleeding.2 Or, am I finally experiencing the symptoms of perimenopause, now that I no longer require my body to perform for my research?
What I want to address specifically is my inability to discern what is going on with my reproductive body, due in part to a lack of knowledge that comes from the medical overwrite/ erasure of my matrilineal health history. Both my paternal grandmother (who was alive until late last year) and my mother experienced necessary, life-saving medical interventions that put them into surgical menopause and/or onto hormone replacements, before they’d experienced (peri)menopause. My grandmother, who suffered severe menorrhagia to the point of hemmorage, requiring repeated hospitalizations, had a hysterectomy in her early 40s. My mother, a thyroid cancer survivor, had her hormone production halted by the removal of her thyroid. Both women then required lifelong pharmaceutical maintenance of some kind of hormonal ‘balance,’ skipping any organic development towards an end to their menstrual cycles. My maternal grandmother didn’t live past my early teen years, so I know nothing of her hormonal states outside of a noticeable lady moustache. Thus, aside from my own similar trend towards increased hirsutism in the past year or two (and bleach kit in my bathroom cabinet), I have no actual idea of what menopause might look like for me.
This lack of an embodied knowledge legacy in the form of matrilineal health history feels problematic for me because it limits my capacity for bodily autonomy as I inevitably approach the interruption and cessation of menses (though there is still no indication of this happening, and my 51st birthday is this month). A lack of health history, particularly around a topic still relatively under-researched and misunderstood (and stigmatized), means that I have no teeth with which to address the kinds of care I may need, or lack of care I may encounter within the medical realm. And, as my esteemed colleague (and one of my PhD supervisors), Tarsh Bates noted in our conversation about it, this is likely to become more common as successive generations of menstruators are either subject to or opt for medical interventions that shift hormonal production. For example, a hysterectomy may be a choice for dealing with relentless PMDD, fibroids, endometriosis, preventing any further pregnancy, or for gender affirming surgery for trans men, etc. For those who opt for surgically induced menopause, matrilineal medical history may be less relevant, but for those who want to know what to expect of the perimenopausal and menopausal body based on the experiences of their forebears, there will be a knowledge gap.
Genetics alone won’t account for the menopausal symptoms I may experience—for example, my grandmother’s habits, diet, social environment and ecology of place were very different from mine (and epigenetics are an interesting and relevant thing), but I still lack the advice they may have had to give in dealing with what they would have dealt with had their bodies been unmediated by medicine. Who, then, do we go to for advice based on unique lived experiences that may be notably similar? This is such an important aspect of negotiating bodily transitions that can otherwise unpredictably impact our senses of self, and our cognitive tools for dealing with such transitions. I have a project in its infancy that may be able to investigate some of these questions, but that is a post for another day! Stay tuned, dear ones.
I found an interesting article that addresses “tourism’s role as one of the main forms of global capitalist expansion” and looks at alternatives. See https://www.tandfonline.com/doi/full/10.1080/14616688.2021.1965202
I’m not alone in my experiences of menstrual cycle disruption caused by covid and vaccines, either. For more, see https://news.ohsu.edu/2023/08/10/global-study-finds-covid-19-disease-may-cause-change-in-menstrual-cycle-length