The Wellness Creep

Yesterday, New York Magazine’s The Cut published a story about hormonal birth control. Like other pieces in the expanding universe of pseudo-confessional health reporting, it’s a story about a woman who also happens to be a writer having doubts about what the medical establishment has told her. She begins by questioning what The Pill is doing to her body, a concern that is shared, she writes, by “many women I know.”

We learn that while the scientific consensus may be the majority of women don’t experience adverse side effects from hormonal contraception, scores of largely unnamed women report feeling “more alive” “more clear,” “more myself” and like “color returned to the world” when they go off The Pill. Hormonal birth control is blamed for creating a “lack of vibrancy” and draining the color from the world. A somewhat baffled gynecologist explains that women are bringing these concerns to her in greater numbers. But where they are getting the idea that The Pill is making them sick, she really doesn’t know.

The story isn’t so much about a health issue as the culture surrounding it, and the reporter, who is sincere if less skeptical than I’d prefer, does appear to know where women are getting the idea that the core of their being has been compromised by taking The Pill. “Influencers” are invoked twice, though they are mentioned in asides that make note neither of the content of their posts or the money they may be receiving in exchange for their advocacy. (In the spirit of the piece, which has a habit of listing inconclusive studies to support its various inquiries, here is a paper in BMJ’s Sexual & Reproductive Health calling for more transparency in how “natural” contraceptive cycle-tracking apps are advertised on Instagram.)

It’s noted that “wellness truthers” and anti-vaxxers are responsible for much of the skepticism surrounding The Pill today, and that social media has a habit of making every complaint feel like a movement. Towards its conclusion it quotes, with caveats, two of the loudest voices in the anti-Pill movement: Holly Grigg-Spall, a writer who believes The Pill is an “addictive” drug created to keep women sexually available and in the workforce—she is also a consultant for a number of fertility-tracking companies—and Kelly Brogan, a vaccine skeptic who doesn’t believe that HIV causes AIDS. The piece’s most reasonable voice arguing for questioning The Pill’s effect on women is Sarah Hill, an evolutionary psychologist who previously published research on the post-recession “lipstick effect” and what it says about how women mate.

I bring all this up not to slam the writer, who is thorough in her attempt to answer a question that is on her and “many women’s’” minds, or because I don’t believe “many women” experience discomfort while they’re taking The Pill. I know a few. As The Cut notes, the lack of answers can be maddening: Some studies find casual correlation between The Pill and a reported “lower quality of life,” while others suggest all forms of hormonal birth control increase the risk of depression. Nothing is conclusive, and assured voices like Grigg-Spall’s and Brogan’s are filling up a measurable void.

Instead, I bring it up because of the piece’s conclusion, in the absence of being able to actually bring clarity to the issue of what “many women” feel when they’re taking The Pill: That everybody is different, and people, particularly women, with the inclination and means should think deeply about what products they’re allowing into their bodies, and why. I could have written a story with the same lesson (and one that might be more convincing) about drinking alcohol, or taking Vitamin C. It’s a lifestyle story framed as a reported feminist critique of a medical treatment, and it’s becoming a dominant genre in writing that targets cis women of a certain income bracket who are concerned about their health.

As the wellness trend has continued its inevitable creep and fused itself inexorably to ideas about women’s empowerment and ownership over the body—as well as more pressing forms of skepticism about the medical establishment—framing individual complaints about a “lack of vibrancy” as feminist testimonial has become more commonplace. Reading trend pieces like this, one could imagine that every woman of a certain social class is sick or misdiagnosed: We have leaky guts, undiagnosed chronic illnesses, gluten intolerances left unacknowledged and untreated for years. Birth control is making us ill, and so are our diets, as are the medications that we take.

These problems are linked—as they are in The Cut piece, and by various wellness influencers, and by companies selling us “natural” and “non-hormonal” solutions—to broader concerns about the historical conditions that have conspired to make the medical establishment ignorant of our needs. The result has been both an expanding and a flattening of the problem: Black mothers are dying at alarming rates for the same reasons Grigg-Spall spiraled into depression while she was taking hormonal birth control. These problems could be solved, this thinking suggests, if the medical establishment simply leaned in and listened better. Of course, given the litany of biases that apply to many women, that sympathetic ear is less likely to appear. For the rest of us, a truly feminist medical landscape is, I guess, an army of doctors and pharmacists and health coaches and gynecologists who have infinite time to field our concerns, offer alternative treatments, and listen to us when we talk about how we truly feel. The Cut piece mirrors this logic, inspiring only identification and little else. Now you, too, can wonder if it’s The Pill making you feel so listless, or if it’s an undiagnosed illness, or maybe just a symptom of being alive. Incidentally, there are products and services for all of that.

The promise of the wellness industry and the ideology it’s advanced is that every health problem is ultimately an issue of individual choice, and that a woman’s intuition is the most valuable medical currency. In some cases this is prescient; in others, it’s dangerous. At the least, it reduces complicated institutional forces to simple matters of taste. “To be a woman in the world is often to be content with choosing from a buffet of unappetizing alternatives,” The Cut piece concludes. Which is true enough, assuming you’re at that particular table in the first place, and that you can safely assume there are no tangible consequences for choosing wrong.

A previous version of this story misspelled Holly Grigg-Spall’s last name. We apologize!