外刊阅读20241216｜“育龄女性”的说法为什么有问题？

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“Hey, did you know that a woman’s fertility starts to decrease by the age of 25?” a powerful male character asks early in the film. “At 50, it just stops,” he later adds. He never explains what stops, exactly, but to the viewer the message is pretty clear: If you’re a woman, your worth is tied to your fertility. Once your fertile window is over, so are you. The insidious idea that women’s bodies are, above all else, vessels for growing children has plenty of negative consequences for us all. But it has also set back scientific research and health policy.

Earlier this week, I chatted about this with Alana Cattapan, a political scientist at the University of Waterloo in Ontario, Canada. Cattapan has been exploring the concept of “women of reproductive age”—a descriptor that is ubiquitous in health research and policy. The idea for the research project came to her when the Zika virus was making headlines around eight years ago. “I was planning on going to the Caribbean for a trip related to my partner’s research, and I kept getting advice that women of reproductive age shouldn’t go,” she told me. At the time, Zika was being linked to microcephaly —unusually small heads—in newborn babies. It was thought that the virus was affecting key stages of fetal development.

The experience got her thinking about the ways in which attitudes toward our bodies are governed by the idea of potential pregnancy. Take, for example, biomedical research on the causes and treatment of disease. Women’s health has lagged behind men’s as a focus of such work, for multiple reasons. Male bodies have long been considered the “default” human form, for example. And clinical trials have historically been designed in ways that make them less accessible for women.

Fears about the potential effects of drugs on fetuses have also played a significant role in keeping people who have the potential to become pregnant out of studies. “Scientific research has excluded women of ‘ reproductive age,’ or women who might potentially conceive, in a blanket way,” says Cattapan. “The research that we have on many, many drugs does not include women and certainly doesn’t include women in pregnancy.”  Women are also often subjected to medical advice designed to protect a potential fetus, whether they are pregnant or not. Official guidelines on how much mercury -containing fish it is safe to eat can be different for “women of childbearing age,” according to the US Environmental Protection Agency, for example.  And in 2021, the World Health Organization used the same language to describe people who should be a focus of policies to reduce alcohol consumption.

The takeaway message is that it’s women who should be thinking about fetal health, says Cattapan. Not the industries producing these chemicals or the agencies that regulate them. Not even the men who contribute to a pregnancy. Just women who stand a chance of getting pregnant, whether they intend to or not. “It puts the onus of the health of future generations squarely on the shoulders of women,” she says. Another problem is the language itself. The term “women of reproductive age” typically includes women between 15 and 44. Women at one end of that spectrum will have very different bodies and a very different set of health risks from those at the other.