Migraine and the Politics of Gender and Health
Migraine is one of the most common, painful, and disabling disorders in the world, yet it is routinely considered, at best, unimportant or, at worst, a mere excuse for avoiding one’s expected duties in life. This remains true, even though researchers now believe that migraine is a neurobiological disease with potentially serious outcomes. In Not Tonight, Joanna Kempner grapples with this paradox, arguing that this “legitimacy deficit” can be traced back to migraine’s long-standing association with neurotic women. In other words, we often let who we assume experiences pain determine how we understand their symptoms and their suffering.
Kempner’s wide-ranging approach takes concepts from sociology, anthropology, literature, history, and science studies to explain how “old” ideas about effete men and hysterical, neurotic women with migraine have been replaced with “new” ideas about people who have a hypersensitive, neurotic migraine brain. She traces these highly feminized ideas about migraine to scientific journals, pharmaceutical advertisements, and even patient advocates’ arguments for why we should take migraine seriously. This analysis casts new light on how cultural beliefs about gender, pain, and the distinction between mind and body influence not only whose suffering we legitimate, but which remedies are marketed, how medicine is practiced, how knowledge about headache is and is not produced, and how we make policies about people in pain.
Winner of the 2016 American Sociological Association’s Medical Sociology Section’s Eliot Freidson Outstanding Publication Award
Winner of the 2016 Society for Medical Anthropology’s Eileen Basker Memorial Prize for its contribution to anthropological scholarship on gender and health.
(Charles E. Rosenberg Harvard University)
“This insightful and eloquent account of our evolving understandings of migraine, from a condition of weak-nerved women, to a “real” neurobiological disease, does far more than document the cultural framing of headache. Kempner illuminates the complex, tangled relationship between medicine, morality, and meaning making in contemporary American society as she demonstrates that despite its biomedicalization and a shift from thinking of migraine as ‘all in the head’ to a genuine brain disease, migraine remains a disorder of personhood—and a particularly gendered one at that. The acuity of her sociological analysis is matched by her compassion for migraine sufferers and their fellow travelers on the quest for legitimacy and a cure.”
(Elizabeth Mitchell Armstrong Princeton University)
“Kempner’s incisive work analyzes migraine medicine and its gendered subtext as practitioners sought to make sense of the mind/body actions or interactions causing the common, yet devastating pain of sufferers. The book is beautifully written, with a moving preface in which Kempner locates herself as a fellow migraine sufferer as well as ethnographic observer.”
(Linda Blum Northeastern University)
“Kempner expertly illustrates how social legitimation of an illness is a multifactorial process and that effective recognition of a disease, which provides the basis for serious advances in research and treatment, can only result from a broad acknowledgment that persons who suffer from it are worthy of such interventions.”
(Carolyn Merritt Medical Anthropology Quarterly)
(Paula Kamen, Women’s Review of Books)
“All in all, this is an important book, as it makes clear that medicalization is not an absolute structural power. Instead the work shows that, despite people having agency and despite medicalization efforts from the medical industry and migraine sufferers, sociocultural ideas of gender and personhood still largely structure the ‘legitimacy deficit’ of migraines as a disease. Kempner’s remarkable research can therefore be seen as a way of introducing possible solutions to the legitimacy issue of migraines: embracing medicalization is not enough, and agents should rather challenge these gendered structures of pain.”
(Maria Siermann, Medical Anthropology Theory)