Podcast Summary: "The Politics of Hysterectomy" | All Of It with Alison Stewart

Episode Details:

• Title: The Politics of Hysterectomy
• Host: Alison Stewart
• Guest: Andrea Becker, Author of Get It Out on the Politics of Hysterectomy
• Release Date: August 4, 2025
• Duration: Approx. 29 minutes

Introduction

In this episode of All Of It, hosted by Alison Stewart, the spotlight is on the multifaceted topic of hysterectomy. Andrea Becker, a sociologist and author of Get It Out on the Politics of Hysterectomy, joins the conversation to delve into the historical, medical, and sociocultural dimensions of this prevalent gynecological surgery.

Understanding Hysterectomy: Definitions and Misconceptions

Andrea Becker begins by clarifying common misconceptions surrounding hysterectomies. At [05:56], she explains:

"A hysterectomy is the surgical removal of the uterus and it can also, but doesn't necessarily also involve the removal of the ovaries and the cervix."

Becker emphasizes that many listeners confuse hysterectomy with vasectomy, which is specific to cisgender men. She highlights the lack of public understanding about what the procedure entails, which contributes to the stigmas and misconceptions surrounding it.

Prevalence and Historical Context

Andrea Becker discusses the alarming statistics related to hysterectomies. At [02:49], she notes:

"When I was a doctoral student looking for a dissertation topic, I stumbled upon a really troubling statistic. At the time, one in three people born with a uterus would come to have it removed by the age of 65. But even though I was immersed in the reproductive health research areas, I realized that this conversation around hysterectomy was widely left out."

Becker traces the history of hysterectomy back to ancient Greece, highlighting how technological advancements have transformed it from a high-risk procedure to a more routine surgery with options like laparoscopic hysterectomy ([06:25]).

Sociocultural Implications and Bias in Medical Practice

A significant portion of the discussion centers on the sociocultural dynamics influencing who gets a hysterectomy and why. At [12:36], Alison Stewart brings up a poignant story from Becker’s book:

"A black woman living in the south, who does not want children, experienced a conflict in the operating room where one surgeon wanted to remove her uterus against her wishes."

Becker elaborates on how race and gender biases play a critical role in medical decisions:

"You see that over and over where doctors are really keen on protecting white women's fertility, oftentimes protecting them from their own desires, and then pushing the same surgery on black and Latina women." ([12:47])

She attributes these disparities to entrenched structural inequalities and implicit biases within the healthcare system ([13:13]).

Medical Advancements and Elective Nature of Hysterectomies

The conversation shifts to the evolution of hysterectomy techniques. Becker outlines the transition from high-risk, invasive surgeries to minimally invasive laparoscopic procedures, which have significantly reduced recovery time and complications ([06:17]).

Moreover, Becker discusses how hysterectomies are often categorized as elective procedures, even in cases involving severe health issues like endometriosis or fibroids. This classification can obscure the urgency and necessity felt by patients ([07:33]).

Personal Stories and Callers’ Experiences

The episode features multiple callers sharing their personal experiences with hysterectomy, providing emotional and practical insights into the procedure's impact.

1. Rachel from Nyack ([08:59] - [10:12]):

   • Rachel, a 65-year-old retired healthcare professional, recounts her unwanted hysterectomy during a stressful divorce. She felt a lack of informed consent and agency in the decision-making process:

     "I never felt like I was informed, and I really feel like that's kind of weird." ([09:51])

2. Denise from Sunnyside ([14:09] - [15:32]):

   • Denise discusses the challenges of finding reliable information about the long-term effects of hysterectomy and her frustration with a dismissive healthcare professional when she raised concerns about potential risks like dementia.

3. Mark and Amanda ([16:27] - [25:32]):

   • Mark, a retired nurse, challenges the etymology of "hysterectomy," linking it to outdated and sexist medical terminology.
   • Amanda reflects on intergenerational perspectives, sharing her grandmother’s experience and her own contemplation about affirming womanhood without a uterus.

4. Danielle from Brooklyn ([22:47] - [23:09]):

   • Danielle talks about her proactive approach in opting for a myomectomy instead of a hysterectomy after extensive research, criticizing the limited options presented by her healthcare providers.

Each story underscores the diverse motivations and consequences behind choosing or resisting a hysterectomy, as well as the varying levels of agency patients possess in these decisions.

Biomedicalization and Technological Fixes

Towards the end of the episode, Becker introduces the concept of biomedicalization in relation to hysterectomy ([27:26] - [29:38]). She describes hysterectomy as a “techno fix,” a term that encapsulates the use of medical technology to alter or "perfect" the body beyond merely treating disease. This perspective ties into broader societal trends of biohacking and the pursuit of optimal health through technological means.

Becker advocates for expanding the range of biomedical interventions available to women, ensuring that hysterectomy is not the sole solution for gynecological issues:

"We need to biohack the uterus in various other ways as well so that a hysterectomy isn't the only biohack at our disposal." ([27:38])

Concluding Insights

Andrea Becker emphasizes the importance of decoupling gender identity from biological functions, challenging the notion that femininity is inherently tied to having a uterus ([26:54]). She shares:

"Some people felt more feminine after the uterus was removed because they were able to have freedom away from constant bleeding, constant pain." ([26:54])

The episode closes with Becker's call to reframe societal and medical narratives around hysterectomy, advocating for greater autonomy, informed consent, and diverse biomedical options for women and non-binary individuals.

Key Takeaways:

• Prevalence and Accessibility: Hysterectomies are more common than widely recognized, with significant variations in access and recommendation based on race and gender identity.

• Sociocultural Biases: Medical decisions around hysterectomy are influenced by societal biases and structural inequalities, often disadvantaging women of color.

• Medical Evolution: Advancements in surgical techniques have made hysterectomy safer and more accessible, but the procedure remains controversial and emotionally charged.

• Personal Agency: Patients' experiences highlight the need for better-informed consent processes and respect for individual choices regarding their bodies.

• Biomedicalization: The trend of using medical technology to modify and perfect the body extends to hysterectomy, raising questions about autonomy and the range of available medical interventions.

Notable Quotes:

• Andrea Becker [02:49]: "Around 600,000 hysterectomies are performed every year. It is the most common gynecological surgery worldwide."

• Andrea Becker [05:49]: "There are so many taboos and stigmas around these organs and the many functions that they have."

• Andrea Becker [14:58]: "We are still in the dark ages of understanding these organs and how to make sure they thrive, particularly outside of the realm of pregnancy and childbearing."

• Andrea Becker [27:37]: "Removing the uterus can be viewed as customizing or perfecting the body, but we need to biohack the uterus in various other ways as well."

This episode of All Of It offers a comprehensive exploration of hysterectomy, intertwining medical facts with personal narratives to shed light on the complex politics surrounding this common yet deeply personal surgical procedure. Andrea Becker’s insights provide a critical lens through which listeners can understand the intersection of healthcare, gender, and societal norms.