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Bearding, Balding and Infertile: Polycystic Ovary Syndrome (PCOS) and Nationalist Discourse in India

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Abstract

This paper investigates the gendered and racialized discourse on Polycystic Ovary Syndrome (PCOS) in India. A complex metabolic, endocrinal and reproductive disorder, PCOS is one of the most common endocrinopathies in women of reproductive age today. Due to an unclear etiology, there is no single clinical definition for PCOS, contributing to a sense of confusion around the syndrome. India has one of the highest rates of PCOS in the world. Medical and social discourses on PCOS suggest the high rates are due to the failures of Westernized lifestyle and diet in women from developing countries. Taking the example of India, I argue that the lack of a clear etiology creates a discursive vacuum and that PCOS in itself is not a gendered and racialized syndrome, but the discourse on it is. Through the figure of the “new Indian woman,” I address the socio-political anxieties of nationalism projected onto the female body and suggest that the discourse on PCOS in India is in reaction to a rising nationalist rhetoric. As a syndrome that presents through “masculine” symptoms, PCOS acts a unique entryway into the intersectional issues of gender, race, sexuality, class and national identities. An analysis of the Indian setting might shed light on PCOS discourses that are increasingly relevant globally.

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  1. Department of Gender, Race, Sexuality and Social Justice, University of British Columbia, 038 – 2080 West Mall, Vancouver, BC, V6T 1Z4, Canada

    Shruti Buddhavarapu

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Endnotes

1 The sources I cite in this paper are split between referring to it as “Polycystic Ovary Syndrome” and “Polycystic Ovarian Syndrome.” For the purposes of this paper, wherever I am mentioning the syndrome without its abbreviation, I am sticking to the former, unless a part of a direct quote. As we shall see through the course of the paper, this contested nomenclature is not new to PCOS.

2 Keeping in mind, however, my limited academic proficiency in the four Indian languages I know compared to English, looking for research in languages outside of English would have been inaccessible to me.

3 An ideology that seeks to establish the moral authority of a national identity and consciousness based on Hinduism.

4 The first international conference on PCOS was held at the National Institutes for Health in the United States in 1992. Although there was no consensus on the syndrome’s definition, the conference proceedings eventually helped in developing diagnostic criteria (Farquhar 2007).

5 One of the leading researchers of PCOS, Dr. Richard Legro reminds us, however, that though a male phenotype for PCOS has been hypothesized, there need to be more “rigorously established clinical or biochemical features” in order to identify them (Legro 2007, 26).

6 This also stimulates further questioning: what about those who identify beyond the binary as queer or trans? Early studies on the incidence of PCOS in trans men indicate that upwards of 50% of trans men have PCOS (Baba et al. 2007; Rachlin, Green, and Lombardi 2008). It has also been noted that PCOS is significantly higher in lesbian women (Agrawal et al. 2004).

7 Interestingly, if you type “PCOD” or “polycystic ovary disease” into Google’s search bar, the results are automatically corrected to show entries for PCOS. On the University of British Columbia library database Summons 2.0 the same phrase yields 43,236 results, without corrections. [Accessed on Dec 29, 2016.]

8 This is by no means a unique sentiment. In an article in The Journal of Obstetrics and Gynecology of India, endocrinologist Suvarna Khadilkar proposes yet another name: HA-PODS or Hyperandrogenic Persistent Ovulatory Dysfunction Syndrome. According to Khadilkar, HA-PODS overcomes the diagnostic pitfalls of “PCOS” especially for female patients whose primary consequences of PCOS are more metabolic than reproductive. By proposing “HA-PODS,” she argues for consistency of diagnosis as well as immediacy of appropriate treatment (2016).

9 Although this seems to be a point too important to make with a single citation, Kitzinger and Willmott’s study appears to be the only one that specifically looks into the lived experience of women with PCOS, and how they navigate and envision themselves as women post-diagnosis. The two social science analyses I later look at in this essay come close to investigating how women with PCOS express anxiety about being deviant from conventional norms of femininity and womanhood (Manlove 2011; Pathak 2015), but Kitzinger and Willmott’s work still remains one of the only social scientific studies to explicitly articulate feelings of abnormality, freakishness or monstrousness.

10 The theorists that both of them cite, though, like Thapan, Chatterjee, etc. do engage with the anti-colonial roots of the new Indian woman. Thus, it is imperative we note that it’s not that a connection doesn’t exist but that it’s a connection that Manlove and Pathak are not making.

11 This erasure is often times a self-erasure. For women with PCOS, the first site of discrimination or social disgust seems to be themselves (Kitzinger and Willmott 2002; Manlove 2011; Pathak 2015). Which is, in turn, indicative of how pervasive our gendered conditioning is.

12 Not to mention the kind of ignorance/confusion for patients that comes from an excess of information.

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Buddhavarapu, S. Bearding, Balding and Infertile: Polycystic Ovary Syndrome (PCOS) and Nationalist Discourse in India. J Med Humanit 41, 411–427 (2020). https://doi.org/10.1007/s10912-019-09567-9

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