When Goop, Gwyneth Paltrow’s health and wellness empire, launched its first In Goop Health conference last June in Culver City, California, there seemed to be more journalists and eye rollers in attendance than true believers. The day-long celebration of proper chakra alignment, activated crystals, and Moon Juice was covered by Fast Company, Glamour, the Guardian, The Outline, the Los Angeles Times, USA Today, and many others, each in the exact same way: the young female reporter would go “undercover,” sip the collagen martinis, and sarcastically report back on the loonies who take all this seriously.
“Gwyneth’s First Goop Health Summit Was Half Great and Half Cray!” “The Craziest, Weirdest, and Most Inspiring Things I Learned at Gwyneth Paltrow’s Goop Conference!” “Gwyneth Glows Like a Radioactive Swan—My Day at the Goop Festival!” “Gwyneth Paltrow’s Goop Conference Made Me Sick!” The headlines, the jokes, and the anecdotes were the same across every publication.
To be fair, the jokes write themselves. Goop built its business by exploiting the body dysmorphia and health anxieties of upper-middle-class women, warning them of the deadly, gut-clogging toxins that hide themselves in things like corn and aspirin. The quest for optimally wholesome consumption represented a natural progression from the faux health empire built by Oprah, who amplified the voices of dubious supplement-peddlers like Dr. Oz and anti-vaxxers like Jenny McCarthy; and Paltrow managed the transition ably—while also making the underlying business model whiter and richer. With official Goop products like $395 wool pajamas, $75-per-month vitamin and supplement subscription plans, and toxin-free scented candles with “healing properties,” how can one talk about any of this without a mocking tone?
Still, it’s a mistake to dismiss Paltrow’s embarrassingly named business as just another study in well-heeled feminine self-care gone wild. Just for starters, there’s actually not all that much difference between this Goop-branded suite of bogus health information and products targeting credulous self-improving women and the same glorified snake oil being marketed to credulous self-improving men. Conspiracy theorist Alex Jones hawks vitamins and supplements like The Real Red Pill (loaded with a mystery wonder drug known as Pregnenolone) to his mostly male audience; Silicon Valley companies market nootropics and nonfoods like Soylent to mostly male programmers, promising them enhanced concentration and elevated minds. Bodybuilder forums are filled with men swapping anecdotes and recommendations, speculating as to whether GMO corn interferes with the endocrine system and which combination of supplements helps the body burn fat most efficiently. The Google ads on these sites will gladly take you to online stores illustrated by acres of photos that proudly display flexing, veiny man arms. And while these industries do receive their share of debunking and eye rolling, no one attacks them quite as gleefully as Goop is routinely harassed.
It’s a mistake to dismiss Paltrow’s embarrassingly named business as just another study in well-heeled feminine self-care gone wild.
But the pursuit of male strength and prowess is the taken-for-granted backdrop of American fitness culture. What was on display here was not self-improvement, exactly, but self-healing, marketed to a room full of “white, educated women in their twenties, thirties, and forties with perfectly highlighted hair and svelte, Pilates-toned bodies,” as Rina Raphael described the Goop conference crowd in Fast Company. Before the Goop faithful, Raphael notes, Gwyneth Paltrow spoke the words that function as the company’s mission statement: “Why do we all not feel well? And what can we do about it?”
I have a pretty empirically sound reply to the first query: we live under patriarchy. But Paltrow and her team of specialists and celebrity friends, ever attuned to inner bodily imbalances, went on to identify an esoteric array of other causes, like gut flora, eating nightshades, and vitamin B deficiencies. And the fit, radiant young women in the audience seemed to agree with her assessment; why else, after all, would they have paid $500 to $1,500 for the opportunity to discuss their health issues? Make what you will of Goop-sanctioned diagnoses and remedies, but the fact remains: we women do not feel well, and we are legitimately skeptical that the traditional medical industry can or will help us.
Tired of the Patriarchy
To get a closer look at the sources of this distrust, consider the diagnostic history of chronic fatigue syndrome (the more common name for myalgic encephalomyelitis). In November, the New York Times website posted a small dispatch: “New Recognition for Chronic Fatigue.” Both the Centers for Disease Control and the National Institutes of Health were revising their assessment of the disorder as psychological in nature, the piece reported, which meant potentially overhauling the recommended treatments of exercise and cognitive behavioral therapy. The agencies were now suggesting that the disorder does in fact have a physical cause.
This was more than thirty years after the 1984 outbreak near Lake Tahoe that left 160 patients with crippling fatigue, high fevers, and body pain. Virologist Stephen Straus of the National Institutes of Health, who—like all of the other experts sent by the government to assess the situation—refused to examine any of the patients directly, dismissed the outbreak as any sort of physical condition. The official CDC diagnosis was hysteria, and that is how the syndrome has been treated by most of the medical community ever since.
In a scene in her documentary Unrest, which aired as part of PBS’s Independent Lens series, director and myalgic encephalomyelitis/chronic fatigue syndrome sufferer Jennifer Brea is taken to the hospital incapacitated and barely able to speak. As they wait for a doctor, her husband reminds her, “If you say too little, they can’t help you. And if you say too much, they think you’re a kind of mental patient.”
Brea recounts the years she spent trying to have her medical condition taken seriously by her doctors. Her troubles began when she mysteriously came down with a 104.7-degree fever; once the fever passed, she was left with lingering problems involving exhaustion, pain, and impaired cognition. When she explained her condition to doctors, she was told she was probably just dehydrated, stressed, or suffering from depression or anxiety.
When she finally did receive her diagnosis, there was not much medicine could do to help her. While Australian researchers have recently announced there is a possibility for developing a test for the syndrome based on breakthroughs in research, the disorder is misunderstood and poorly treated due to longstanding prejudices of the medical community and severe underfunding for the study of the disease’s causes. The National Institutes of Health more than doubled its funding for ME/CFS research in 2017—from $6 million to $15 million. The CDC allocated $222 million to study and fight the Zika virus, which had a reported 631 confirmed cases in 2017. Meanwhile, it’s estimated that at least a million Americans, and 17 million people worldwide, suffer from ME/CFS.
And here is where talking about the medical community’s response to chronic fatigue syndrome gets a little murky. Why isn’t the disorder taken seriously by individual doctors, researchers, and government institutions like the CDC and NIH? It seems clear to some, like Brea and the patients she interviews for her documentary, that this inattention is directly related to the fact that 85 percent of its sufferers are women. Medicine is a science—i.e., a discipline we uncritically assign to the domain of rational thought and as a result ritually treat as an impartial undertaking, protected against unconscious bias of any kind. And yet study after study has shown that doctors are less likely to take women’s symptoms seriously—and that when women patients complain of pain, doctors are more likely to dismiss their symptoms as “psychological” than is the case with their male counterparts.
On January 6, 2018, Twitter user @kindnessroast tweeted:
doctors in medical dramas when a patient has a mystery illness: i must examine every symptom and run every test! i won’t rest until i’ve cracked this case!
doctors irl when a patient has a mystery illness: hmmm have you considered that you’re faking it
Within days, the tweet had more than 43,000 retweets and 164,000 likes, as well as hundreds of responses, mostly by women, sharing their stories of misdiagnosis and condescension from male doctors. Women with broken bones were sent home and told there was nothing wrong with them; women with lupus were told their problem was hypochondria; women with Lyme disease, strokes, chronic fatigue, organ failure, severe anemia, and other organic disorders were told that their conditions were either caused by mental illness or excessive weight. (The replies were also filled with doctors, mostly male, defending their profession against accusations of sexism using a “nobody’s perfect” line of thought.)
With so little time, money, or attention spent on understanding what chronic fatigue syndrome actually is, once women do receive a diagnosis, there is no known cure or even effective treatment. The Mayo Clinic’s website still lists “antidepressants” as the most effective medication for ME/CFS, and studies have shown for years that the usual suggestion of exercise for the syndrome may have deleterious effects on the patient. In Unrest, Brea is given an anti-viral medication that temporarily alleviates her symptoms, but she soon crashes again. Frustrated by all that the medical community does not know, she turns to the internet for options.
This is, of course, the same internet that tells women their children’s autism is caused by vaccines and that Goop uses to distribute its theory that walking barefoot on the grass helps realign the electromagnetic fields of the body. It’s also the same internet I turned to when I was vomiting up the iron supplements the doctor prescribed for my chronic anemia. He refused to give me anything else, other than the suggestion to “eat more spinach,” but an online forum told me about the easily absorbed nettle tea, which I have been using effectively to control my anemia for years. It’s also the same internet that told me I had scabies or syphilis when really I had an allergic reaction to my soap, and the same internet that tells me my coffee beans carry a toxic mold and are slowly killing me. And it’s the same internet that led me through an experimental two months of trying to cure a low-level but drug-resistant yeast infection—increasingly a problem for women as fungal drug resistance, much like bacterial drug resistance, grows—taking me from acupuncture to wormwood pills to radical dietary changes to shoving garlic cloves up there to finally having things just kind of resolve on their own.
In Unrest, we watch Brea go through a similar experimental phase, bringing out boxes filled with different supplements, making bone broth, introducing drastic dietary changes, and installing a tent to sleep in in her backyard and forbidding her husband to go near it with his clothing on, because his clothes might be contaminated with mold. But at no point do we hear her discussing how much any of this is costing: not the emergency room visits nor the boxes of costly supplements and bunches of organic kale. Nor do we learn how much of the treatment is covered by health insurance and how much comes out of the couple’s seemingly deep pockets. None of her interview subjects, many of them in rooms filled with expensive-looking medical equipment, speak of the financial burden of ME/CFS. If there are patients suffering from the syndrome who struggle to find a medical diagnosis that allows them to receive disability coverage, or who can’t make ends meet as they don’t have the strength to go to work and so lose homes or insurance, they are not depicted here.
The Dangerously Undercovered Miracle of Birth
Surely that is part of this story: the fact that America has the most expensive, and one of the worst performing, health care systems in the world. This takes a particularly hard toll on women. Giving birth in America is not only very expensive, it is also absurdly risky. Even if a woman delivering a baby is insured, there can be hundreds, if not thousands, of dollars in costs that come out of pocket. If her insurance policy does not offer maternity coverage, an uncomplicated birth will on average run approximately $3,000. An epidural will cost an additional $2,000 on average, and once the possibility of a C-section is on the table—a procedure that, as several studies have shown, is more often undertaken for doctors’ convenience than medical necessity—the prices begin to double and triple.
Despite all this, maternal deaths from complications in childbirth are rising in the United States, even as they are falling worldwide. Women die giving birth in the United States at more than twice the rate they do in the United Kingdom, where the costs of giving birth are covered by the national health system.
With the stories of unexpected and unexplained hospital bills, unnecessary surgical interventions, uncaring doctors who disregard carefully considered birth plans, and preventable fatalities, it’s no wonder women are increasingly looking to alternatives like home birth and births overseen by midwives rather than doctors.
The history of women’s medicine is a history of doctors willfully mistreating the female body and disbelieving the female complaint.
But the decision to go with a midwife rather than a doctor is often cloaked in the language of nature. A home birth is more “natural,” the use of a doctor is “invasive,” with the implication that a male doctor is invading the private, natural woman’s domain. A whole industry has established itself around the idea that a natural birth at home is the ideal—as well as a sign of true, special womanhood. There are audio files of childbirth affirmations, essential oils and herbal teas, books and online courses, doulas and midwives with professional-looking websites, specialized meal plans, birthing chairs and tubs for water births—all to fill the hole of fear and skepticism that has opened up around medicalized pregnancy. Goop itself has a steady stream of stories about the wonders of natural childbirth and “10 Ways to Have a Pain-Free Pregnancy” throughout its website, even though Paltrow herself opted for a C-section.
Of course historically speaking, giving birth is just about the most dangerous thing a woman could ever do. During the second wave of the Plague, more women died in childbirth than died of the Black Death. Until the sixteenth century, as noted by Katharine Park in her 2006 study Secrets of Women: Gender, Generation, and the Origins of Human Dissection, pregnancy and childbirth were considered the domain of women. Births were attended by female relatives and midwives, and most male doctors hadn’t even seen a naked woman—not even a dissected one. The whole inner world of women was just part of “women’s secrets,” a mysterious territory best left to the experts who shared their biological reality.
In all other matters and health concerns, as Park puts it, the “generic human body . . . was understood as male.” The specific issues and problems of the female body were considered the same as those of the male body— the only body doctors had any understanding of. But beginning in the late medieval era, the male medical establishment began encroaching on women’s health. Doctors were usurping midwives in attending on births and managing their complications; they were also beginning to establish a literature on the subject. Midwifery had until that point been an oral tradition, with women accumulating knowledge through experience and sharing it (or sometimes not sharing it) with colleagues.
This specialized brand of women’s knowledge, then, was decentralized and scattered. Maybe your midwife had encountered your medical issue before and knew what to do or maybe she did not. This loosely networked knowledge regime created a more consistent level of care and a wider library of medical information as texts on reproduction and female anatomy began to circulate—but it also created an atmosphere of hostility. Women were no longer the authority on the subject of their own bodies; the male doctor was. Women could not possibly understand the complexity of their biology—their symptoms and ailments could only be interpreted by men of science.
He Blinded Me with Science
This stable of assumptions would go on to serve as the template for patriarchal health care in the West. The history of women’s medicine is a history of doctors willfully mistreating the female body and disbelieving the female complaint. Sigmund Freud diagnosed Emma Eckstein with hysteria and excessive masturbation and, believing the nose to be connected to the genitals, had his friend Wilhelm Fliess cauterize her nose. When Freud then dismissed her follow-up complaints of pain and bleeding, it took two weeks for someone to find the gauze the two doctors had left jammed up her sinuses. Removing the infected mass caused a massive hemorrhage that nearly killed Eckstein. Still, Freud found a way to blame Eckstein, defending Fliess against accusations of negligence. His studies on hysteria—which typically encompassed nearly all women’s physical complaints and traced them to their root, inevitably some sort of psychological and sexual trauma that a psychological investigator could isolate if only he looked closely enough—still hold weight with the medical community. In Brea’s Unrest, she tells us one of her many diagnoses was conversion disorder—the new terminology for hysteria—and was told that her illness was the result of a trauma that she must have been unable to remember.
What was on display here was not self-improvement, exactly, but self-healing.
Even advances in women’s health were often the result of unethical research. As Deirdre Cooper Owens writes in Medical Bondage, modern American gynecology, particularly the surgical intervention to treat post-partum fistulae, were developed through experimentation on slave women, who were believed to be better able to withstand the pain of the procedure. The birth control pill was first tested on unsuspecting Puerto Rican women; the treatment sent hormones in this control group to such high levels that many of the test subjects suffered strokes, blood clots, and even death.
And where the medical community neglected, misunderstood, and condescended to women, there was always an open door for con men and charlatans. The nineteenth century saw all kinds of miracle cures for women’s complaints, from Lydia Pinkham’s Vegetable Compound (which was supposedly crafted to treat menstrual and menopausal disorders but, like many other patent medicine treatments, was made with a high alcohol content) to Wright’s Indian Vegetable Pills (allegedly for treating hysteria and delicate women but mostly just a laxative). Women with cramps, menstrual irregularity, infertility, or other lady problems were left by an incurious medical world to the care of frauds who were happy to sell them pills and tonics stuffed with mercury, arsenic, lead, and other toxins.
Viewed against the sobering backdrop of Western medical history, the Goop turn in female self-treatment can be seen as more than just another jaded journalistic narrative about delusional women and their soft-headed disbelief in science. In important respects, it is also an attempt to wrest control and authority back from a medical community that has mistreated women for centuries. A male-dominated medical world is no longer the authority on the female body—I am, with the help of online message boards, Goop newsletters, and random Google searches for things like “why is my discharge like this” or “how do I get rid of wrinkles” or “can a person eat nightshades and not die.” We could be regressing, then, to something like the oral medical tradition of the medieval midwife, where knowledge is come across sporadically, where anecdote is given as much credence as experimentation, and the knowledge base is decentralized.
Goop readers cannot control the world, but they can at least fool themselves into thinking they can control their bodies. Our world is awash in harmful chemicals, from hormones and antibiotics in our meat to pesticides and herbicides on our produce to carcinogens in our fabrics and detergents, so is it any wonder that one of the primary concerns of any Goop reader is an eminently justifiable fear of “toxins”? Society still values women most for their sexual availability and attractiveness—so should we really be surprised that the little designated scapegoat of the beauty myth is snarfing collagen, CoQ-10, and piles of turmeric in the hopes of maintaining value?
“Why do we all not feel well? And what can we do about it?” The problem is as much patriarchy and corporate greed as viruses, and Goop and its ilk will thrive unless and until a more equitable and widely available model of nonpatriarchal health care make such boondoggles unnecessary. In medicine as in politics, the abuse of power leads to the loss of authority. The medical industry, from doctors to hospitals to pharmaceutical industries to insurance companies, has long gotten fat from denigrating, ignoring, and prolonging the suffering of vulnerable patients in its care. If people are so worried about women taking mystery pills and chugging bone broth to rid themselves of mysterious pains, they could better spend their time fighting to socialize the whole system. Only then, with the female body given the same monetary and medical concern as the generic body, can we all finally be well.