We had the privilege to be present at the early start of Alkeline’s career: at the interfaculty department of Women’s Studies at Tilburg University. As androgologists (Alkeline) and psychologists (Ine and Marrie), we collaborated with a substantial number of colleagues on a large variety of feminist issues. The three of us shared a huge common field of interest: the female body and women’s subjectivity. One of the early highlights was the fantastic conference ‘Scopophilia’ in the early eighties of the previous century. We addressed all kinds of aspects of female body and related phenomena, such as bodily appearance, sexuality, eating disorders. Burned into every participant’s retina is the exhibition of women’s corsets, representing the immemorial repression and restriction of women as regards their bodily experiences and autonomy, but also their subjectivity within patriarchal contexts. Another memorable joint feat was the publication of the book Feminist Utopias in a Postmodern Era, edited by the three of us some fifteen years later (van Lenning, Bekker & Vanwesenbeeck, 1997).

In this paper, we celebrate our friendship and collaboration with Alkeline by reflecting on one of the biggest feminist utopias: women’s bodily freedom and autonomy. Now all reaching emeritus status, we can look back on decennia of describing, analysing, and investigating feminist issues related to the female body, each in her specific expertise area. Vanwesenbeeck will here focus on achievements and challenges around (the study and education of) gender and sexuality. Bekker will address gender, mental health in particular eating disorders, and autonomy. Both will explore to what extent we as researchers and society succeeded in granting women the bodily freedom, equality, and autonomy so central to any feminist utopia. And we will shortly reflect on educational utopias that would, could, and should help us getting there.

Achievements and Challenges Around Gender and Sexuality

Nowadays, ’heteronormativity’ is the buzz word in the study of the relationship between gender and sexuality. The core of heteronormativity and the related sexual double standard lies in a conception of female and male sexuality as fundamentally different (’hetero’) and complementary. Sexual desire is culturally defined as active and masculine and the seductive, passive object of that desire as feminine. Female sexuality is surrounded by great ambivalence. Although women represent the ultimate sexual attractiveness, they are curtailed in and (therefore) diminished in their value by sexual behaviour and initiative.

A plethora of research documents the harmfulness of heteronormativity for the sexual subjectivity, health and well-being of (sex/gender minorities and) girls and women. Objectification and sexualisation have been shown to have a crippling effect on women’s overall self-esteem, emotional and social well-being, cognitive capabilities, and sports, school, and professional performance. Not least female sexual expression and pleasure are curtailed by the difficult balance between norms of seductiveness versus restraint and by the constant threat of reputational damage and of sexual violence. Agency and self-determination are denied or punished. At the same time, an overly one-sided emphasis on the evils of objectification should be guarded against, as it could once again reinforce the hesitant, minimizing, guilty way in which women often deal with sex. We also need to be critical of how sexual pleasure as a theme is appropriated by commerce and can become an empty, apolitical version of what was originally intended.

Heteronormativity is also detrimental to boys and men. The norm of masculinity limits the development of emotionality, openness, responsiveness, and connectedness. These qualities are often perceived to be a gay thing, not a guy thing. This draws on romantic partnerships and all social relationships. Homonegativity and homophobia are frequent outcomes. Moreover, where masculinity becomes machismo, it is associated with aggression and risky behaviour, both not least in sexuality. The sexual double standard strongly influences the power dynamics within heterosexual relationships and is in fact the recipe for fundamental inequality.

Surely, there is important societal progress around gender and sexuality. Clearly, bit by bit, the harness of heteronormativity is broken open. But the world remains only half-changed. Publications reach us from all over the world showing that groups of young people deviate from traditional scripts in a variety of ways, but that a majority use them unabridged. Heteronormativity is still pervasive. Women’s sexual pleasure and safety are still vastly under-catered and, all too often, under threat. Did we free the female body and women’s sexuality? At most in part.

Barriers and pitfalls

Heteronormativity is so hegemonic that alternatives are often difficult to imagine, let alone put into practice. We have come to realise that gender stereotypes are culturally produced and baked into everything. Moreover, persistent essentialism and biologism are relentless counterforces in the pursuit of gender transformation. The renewed popularity of evolutionary psychology has once again stimulated views on gender differences as hard-wired and binary. Environmental influences, not only on human behaviour and experience but on biological processes themselves, is all too often undervalued. Connected sexism may also be flaring up in response to acquired power and status of women. This recoil strongly manifests itself in the emergence of ’new hard right’. This ’New Right’ does not believe in equality and finds it a bad thing that typically male values have lost out over ’female’ values. Overlapping with this is ’anti-genderism’, a movement that judges gender theory to be fundamentally at odds with ’civilization’ and (Catholic) faith. On a global level, an ‘unholy alliance’ of conservative Islamic, Catholic and Protestant fundamentalistic countries with the USA as a strong voice, are a substantial threat to gender diversity and gender transformation and, thereby, to the autonomy and safety of girls and women, as well as to the well-being of men and humanity more broadly.

Persistent ’feminist sex wars’ are yet another notorious obstacle to progress in the field of gender and sex. Radical views tend to proclaim heterosexuality as inherently violent, dangerous, and risky and portray women as victims in need of critical protection by laws and regulations. Liberal views tend to see heterosexuality as the outcome of inequality but view women as agents whose pleasure is not catered enough and whose empowerment is crucial, first and foremost through education and prevention. The controversy is still most sharply focused on the themes of pornography and prostitution, where the commercial representation or deployment of (women’s) bodies is concerned. While the ’radfem’ analysis stresses the ultimate objectification of the sex worker and denies their subjectivity, the liberal camp emphasizes her (or his) agency and choice. It is my personal conviction that if the fight against objectification implies denial of the subjectivity of ’victims’, we are, to put it mildly, fundamentally overshooting our goal and frustrating progress. Moreover, the one-sidedness of the radical feminist approach reinforces the status quo re women’s objectification and vulnerability. Even victimhood is never total; there is always an agentic subject. An overly strict distinction between subject and object positions falls short of understanding complex sexual dynamics.

The role of science and education

There is no doubt that an ongoing and intensified contribution from the science and education is indispensable. But theory and practice in the area, scientific or otherwise, still all too often remain stuck in the grooves of patriarchy and biologism. In school-based sexuality education worldwide, the need of gender transformative approaches is now widely endorsed. Criticism applies to the custom of presenting girls’ sexuality primarily as risky, dangerous, and vulnerable, and of silencing’ girls’ sexual pleasure. For girls in particular, sexuality education should focus on sexual empowerment, agency, and sexual pleasure. The first meta-studies evincing the effectiveness of addressing gender, pleasure and consent in sex education when looking at sexual health outcomes, are appearing. But dealing with gender in sexuality education does appear not to be without pitfalls. Teachers and educators, even if they are aware of the importance, struggle with the treatment of gender and certainly sexual pleasure. Gender sensitivity too often translates into a confirmation of alleged gender differences rather than into an undermining of gender stereotypes or binary thinking. Too often, sexual pleasure is treated simply as an individual sensation rather than as a complex feeling of entitlement and subjectivity influenced by many factors. Moreover, if attention to sexual pleasure is understood as an obligation to have fun, it becomes an extra burden on girls.

Clearly, sexuality education is not an easy task. Educators and teachers, across the board but most certainly in primary education, need more support and education themselves. In the classroom, an extremely precarious balance must be found between recognition and dismantling/perverting gender differences and gender stereotypes, between attention to the vulnerability and agency of potential victims and between focus on perpetrator and target of transgression. Also, there is discussion on how to balance individual capacity building and empowerment with approaches that address environmental contexts and structures. We must acknowledge that gender inequality in sexual pleasure and safety ultimately grounds in the structures of patriarchy, not least in disproportionate access to sexual literacy and entitlement. Bad sex is a political issue. Privatising that reality as in the demands of female self-knowledge and consent is not a structural solution.

Achievements and Challenges around Gender, Mental Health in Particular Eating Disorders, and Autonomy

Texts and practices in which women appeared as mental health care ‘patients’, and men as ‘doctors’ go back to very early history. These discourses and practices of sexual inequality emphasize the out-of-control female body, falling prey to lost or wandering uteri, repressed sexual urges or outrageous hormones, resulting in unmanageable panic attacks, mysterious depressed moods, impressive conversions, or alien eating patterns like starvation (anorexia nervosa) or bingeing (e.g., bulimia nervosa). Especially anorexia nervosa fascinated Alkeline and inspired her to writing her dissertation on the subject. Mine concerned gender and autonomy in relation to anxiety- and eating disorders. To what extent did we, with our fellow feminist scholars, contribute to more insight into these gendered phenomena; and if so, did that help ‘solving’ them?

Major and limited achievements

To get most straight to the point, the answer to the first question should be: yes, we did! Mental health discourses before ‘our’ time were either mainly patriarchal in nature and unproven (what men thought about what was going on in women, e.g., Freudian theory), or ‘gender-neutral’ (e.g., cognitive-behavioural therapy, often ‘the golden standard’ during the time of our careers). Our generation of scholars was the first who addressed and, as women, examined the gender issues in the phenomena under discussion, and: from a multidisciplinary perspective. We described the empirical reality of mental health (care) which was obviously full of gender inequality; with sex differences in prevalence, symptom manifestation, comorbidity, seriousness and course of symptoms, etc... We tried to understand these sex differences from cultural, historical, medical, and psychological perspectives. And, last but not least, we asked women and girls themselves what they experienced and why. The resulting papers and books cannot be faded out, and are now part of the scientific literature. When we started, we found only a few publications on our topics; nowadays ‘gender and depression’ or ‘gender and eating disorders’ generate thousands of hits in the international scientific databases. Notice however, that not all these publications were developed from all (gender studies’) principles stated above…!

Also, regarding eating disorders we can observe this trend. More and more scientific journals, dissertations and books regarding these issues appeared, and many of them pay at least some attention to gender issues. A central gender theme here, aside from their remarkable extreme unequal prevalence between the sexes, is effectively touched by John Berger’s famous quote: “Men act and women appear. Men look at women. Women watch themselves being looked at. This determines not only most relations between men and women but also the relation of women to themselves. The surveyor of woman in herself is male: the surveyed is female. Thus, she turns herself into an object of vision: a sight.” Here, we have the aforementioned objectification of women, also by themselves, somewhere instanced by masculine dominance and the ‘right’ to determine the ‘ideal’ female. And what is the core aspect of this male vision’s object? Slenderness.

Bodily attraction is among the highest feminine values; deviating from the norm appears highly stressful. And female attraction means slenderness in many, particularly Western cultures, an internalized norm along which we evaluate our bodies (and ourselves) from early puberty. Thin ideal internalization and its predictive power for eating disorders was investigated and established numerous times. However, in her dissertation, Alkeline already critically noted and quoted interesting similarities between resisting food in girls with anorexia nervosa and self-starvation among mystics in the Middle Ages for religious purposes. Same sex, same behaviour, same result, but with completely different motives and experiences; and without any ‘drive for thinness’...

Remind that women’s and girls’ own idea about what they experience and why, is essential in the scientific approach of Women’s studies. At the eating disorders website Proud2Bme they argue: “An eating disorder is not about eating. An eating disorder is not about weight, calorie counting or wanting to look beautiful. It is about something deeper than this; about complex feelings and emotions that you cannot deal with any other way. An eating disorder is an expression of deep-seated psychological problems.”

One of the founding mothers of eating disorder theories, Hilde Bruch already expressed similar statements. But mental health care for eating disorders, although so largely increased, did not embrace this important, crucial insight yet. The field too seems dominated by food and weight obsession and just like the entire other mental health care, by gender neutral cognitive-behavioural treatment aimed at getting rid of (eating disorder) symptoms. Therapy results are poor. How then should the girls deal with, and get attention for the complex feelings and emotions that you cannot deal with any other way …?

Ways ‘out of this labyrinth’ (van Lenning, 2019)! New challenges

Expressing ‘complex feelings and emotions’ seems a basic need here; and awareness of one’s own needs and ability to deal with these needs in social relationships are core to agency and autonomy. In my research I investigated if certain women are more at risk for internalizing mental disorders due to autonomy deficits; feeling steerless and out of control seem due to (gendered) insecure experiences with their primary attachment persons in the past. As a result, they seem to lack a complete thus strong sense of ‘self’.

Wanting to examine this hypothesis I stumbled across the lack of a sound gender-sensitive autonomy measure. Autonomy in classical psychology was one-sidedly defined as a traditional masculine ideal: being independent and extremely self-reliant. However, healthy adult women expressed they wanted to be in relationships and to feel connected. I developed a gender-sensitive concept, autonomy-connectedness (AC), also including sensitivity to others. Using this instrument, I learned that psychopathology types with higher prevalence in men were linked to low self-awareness and capacity for managing new situations (the other two AC-components), together with low sensitivity to others. However, psychopathology types with higher prevalence in women, e.g., eating disorders, were related to low self-awareness and capacity for managing new situations, together with extremely high sensitivity to others. This ‘feminine’ pattern was exactly the one we repeatedly found in women with eating disorders. Moreover, we found autonomy being the strongest predictor of recovery from eating disorders.

This agrees with other robust psychological sex differences: women’s higher orientation to connectedness, social support seeking, tendency to affiliate under stress. Their higher sensitivity to others may imply they more likely conform to norms and others’ expectations, including thin ideal norms. But also, at a deeper level, their willingness to put the needs of others above those of themselves may coincide with a weak contact with own needs and emotions; and suppression of negative affect. However, such suppression might not resolve earlier problems and negative moods experienced. Avoiding the expression of negative emotions toward appropriate targets might be redirected to a less threatening target: the body…as Bruch said before. Inhibition of particularly anger, criticism, and conflict contributes to disturbed eating behaviour in women with poor autonomy-connectedness but not in men. Men with poor autonomy find other ways to deal with anger and frustration.

Our work is ‘in progress’: A current effect study will show if our gender-sensitive autonomy-enhancing therapy (AET) will lead to better effectiveness than therapy does so far.

Conclusions

Taking a gender perspective on body-related phenomena like sexuality, eating- and other mental disorders, etc. proved highly fruitful. It resulted in new insights into the phenomena themselves and in practices that really helped women (but also men) forward improving their well-being. However, not all professionals in science and practices involved appear equally informed about gender-related and -sensitive knowledge or practice. Alkeline here once compared this awareness with the dust her mother firmly used to clear away. If you didn’t see dust, you were not aware of the necessity to clear thus to change. The three of us often noticed the ‘dust’ of gender-inequality; and we did our utmost to analyse and ’clear’ it. Fortunately, we see that more and more people acknowledge the worth of this endeavour, as for example clearly illustrated by the MeToo movement.

Despite clear progress, heteronormativity, the double standard, and overall sexism are still highly influential, with obstacles to gender transformation still strongly present, sometimes even increasingly so. Much work remains to be done. Science, practice, and education clearly have a crucial role to play in freeing the female body, realising gender justice and reaching feminist utopias.

Without a doubt, Alkeline contributed greatly to reaching feminist as well as educational utopias during the past decades. And knowing her, we are convinced that she will continue to do so in the decades to come. But she can now do so in the relatively free context of private daily life, educating a grandchild rather than academic staff and students. We will be all too happy to stay in close touch during her further endeavours…

References

Van Lenning, A. (2019). Out of the Labyrinth. Inaugural address, Tilburg University Press.

Van Lenning, Bekker, M., & Vanwesenbeeck, I. (Eds.) (1997). Feminist Utopias in a Postmodern Era. Tilburg: Tilburg University Press.