FINAL EXAM REVIEW

Women Studies Final Child Birth Midwife ? looks for signs that things aren?t in normal category Home birth has less c- sections than hospital 30 % in hospital for c- sections Unnecessary c - sections Births at home have better outcomes ¼ cesarean 84% use drugs in hospital America doesn?t have essential component for maternity care Lost midwifery Countries with midwives loose less babies Episiotomy ? cutting of perineum (muscle) Has in birthing center, doctor decides if necessary or not Perineal Massage ? massage perineum with warm water Le Boyer Method ? baby delivered in water. Doesn?t make a difference to baby because baby swims in placenta ( natural because coming out in dry environment is shocking to the baby Critique: Only thought about well being of baby Soft music, dim lights, quiet environment ALL about the baby, not the mother Pain Medication Epidural block ? don?t feel anything, but women doesn?t feel contractions and brain doesn?t know to push Forceps ? sucks the baby out if cant push OR C ? section ? take baby out through the stomach Natural birth ? birth has become medicalized Vagina birth with no medication, natural Dilation of the cervix ? with epidural block its still dilated Baby is ready to come out One Medicalization will bring another and another ? chain reaction Fetal heart monitoring ? aggressive/invasive Prevents some deaths to babies Inside vagina and connects to head of baby Counts heart beats of baby according to the contractions of women Doesn?t work with epidural block because women don?t feel contraction and baby?s hearts beating Domestic Violence Against Women (reflects and perpetuates inequalities in society) Gender analysis which affects men and women Violence hurts men Mental and physical health ramifications and role of health care system for an issue that needs to be addressed in society Child birth (with violence against women) Violence (and women?s heath issues) mental and emotional health issues must be important for physical health issue Ex: miscarriage Violence against women = example of how inequalities between different groups of women mean those inequalities impact on preventing ending violence Rich/poor, valued/no status in society Power and control wheel (abuse 1 person to another) can help understand institutional power and control (1 group abuse to another) Movie Trailer Pulled because didn?t include violence against men ? only women Men get hurt too! Men are left out, shows success of women because it excludes men Gender analysis shows difference in men and women getting hurt Men learn ?real man? = tough guy/manly Real man = physical, powerful, respected, tough Not a real man = pussy, bitch, emotional, whimp 90 % physical assault = man ¼ men use violence in partner in life 93% dating violence 93% child sexual abuse 99.3% sex abuse in jail Violence ( cyclical for men Not anti male, honest. What is the difference? 1 in 4 women will be hurt by violence in their relationships. (some woman hurt MANY women) 1 in 4 men will hurt women (many men don?t hurt) Once abusive, if don?t get help will hurt someone else in a different relationship Victims of Homicide 76% = men 24% = women Homicide rate 4x higher for black then white women Black men killed rate 25x higher then white women Violence against men and violence against women 70% of violent crimes against strangers = crimes against males 77% violent crimes against relative/partners= crimes against females Why are men much more likely to be hurt by strangers and women with people who they love? Differences / general trend is felt in women differently then men For women its someone she loves and is an ongoing pattern Women knows if goes to emergency room, the abusers told them that she will destroy the family if she talks Men tell someone ? brings the family closer Women who get hurt are scared to leave, when tries and leaves, violence escalates Cycle of Violence Battering incident ( honeymoon stage ( tension building Isolation ? control over someone else ? ?how to isolate her? Clever abuser doesn?t say wants to isolate. Fights and say if don?t do this (hang with sister, church group) I could be at home ( more time with abuser and abuser becomes only voice. 1 in 4 teenagers experience violence Teenagers more likely to think violence as a sign of love more so than women Center of violence = power and control 3 Factors that makes someone violent Growing up learning how to be violent Having an opportunity to be violent Personally choosing to be violent Domestic violence / intimate partner violence Social context that gives opportunity for abuse Unique issues of how power and control can be used Barriers to safety ( what are the options? Ex: homophobia ( if leave I?ll tell parents you?re a homosexual, in court will get custody of kids because your homophobic Teen dating violence is different because of context Love is most passionate during teen years Power and control ( knowing schedule, same school, turning friends Using context of friends and class only make sense to teens Barriers to safety ( many domestic violence center won?t serve under 18 unless with parents Principles, counselors must tell parents ? not confidential, therefore teens won?t tell Cultural Humility Incorporates a life long commitment to self evaluation and self ? concepts to redressing power imbalances and to developing mutually beneficial partnerships with community and behalf of individuals and defines populations Being flexible and humble enough to assess a new cultural dimension of the experiences of each person Being flexible and humble enough to say we do not know Being Curious Moment when one becomes newly curious about something = a good time to think about what created previous lack of curiosity So many power structures Ex: in our households Mythical Norm When see poster / sign that says sign up for this free thing and know that posters ?for other people? that?s not for me White, thin, male, young ( valued in US Heterosexual, Christian, financially stable ( trapping of power resides in society Mythical Norm in racism is white people aren?t affected If think of self as not a mythical norm, you benefit Well always be fat until we get fit MYTHICAL NORM OPPRESSION Target White Racism People of color Thin fat phobia Fat people Young Ageism Old and very young Heterosexual Heterosexualism/ homophobia Gays, lesbians, bisexuals Mal Sexism Women Reproductive Rights = More white dominated movements which have focused very much on abortion and contraceptive issues Reproductive justice ? organization with women of color leadership which have worked on a wider range of issues related to women?s reproductive lives If we choose pregnant, is their good health care? Broaden out ? connects women health, reproductive health, and human rights (Loretta Ross) Ask why all rights not more connected Broadest way to analyze women?s health ?The priorities of women of color are different from those of white women because of their different experiences. Thus, the reproductive rights agendas have been shaped by the dynamics of race and class? Sterilization abuse campaigns (1970s) Hyde amendment (1977) Long ? term hormonal contraceptives Depo ? provera and Norplant RU ? 486 Narrow definitions of pro ? choice movements Continuum Attitudes and organizing related to reproduction Internal controversies about reproductive issues A narrowly defined (defined by middle class) Anti - abortion AND / OR AND / OR A wider reproductive, reproductive, justice agenda Anti ? all birth control Ways in history of mainstream reproductive movements have done things that we learned Sterilization White women begging for it, and women of color were being forced/talked into it ? don?t understand 1990 color women made sure don?t sterilize without consent Hyde Amendment Passed through congress soon after Roe vs. Wade Abortion = legal Federal money could not be used Poor women on Medicaid don?t have money for abortion Person cannot afford more children if cant accord abortion Watershed moment ? not right! Why didn?t white women say what was the key issue? Mainstream said abortion legal = key but no good being legal if can?t afford it Long Term contraceptives Depo ? provera kept off market because safety studies Mainstream women who wanted hormonal form of contraceptives thought drug was amazing Black people were upset because had just fought sterilization RU 46 Studies NOT done on women of color Narrow Definition ? pro choice movement Only care about abortion being legal No good legal if women can?t pay ?The Pill? Video Contraceptive mentality ? the assumption that people will plan their pregnancies Major impact of the pill was the societal change to ?contraceptive mentality? The assumption that many people will plan there pregnancies 98 % of women between 15 ? 44 20% of people using contraception use condoms Conception, Pregnancy and Contraception Pregnancy ? after fertilization egg implants in endometrium HCG only produced after implantation Methods of Contraception Combination Hormonal Methods 4 mechanisms of action (how they work) Prevent ovulation Thicken cervical fluid (which inhibits sperm travel) Slow egg transport in the fallopian tubes Alter the endometrium to inhibit implantation Health issues and effects Benefits of patch/ill are very effective 98 ? 99% effective Separate from intercourse (use daily basis) Risks Interactions between oral contraceptives and drugs and antibiotics Smoking risk for all women who use combination methods Oral contraception reduces ovarian and uterine cancer Pregnancy reduces risk of ovarian cancer Questionable of increase risk cancer from combination Menstrual Suppression (seasonal, seasonique) Women take fewer placebo pills ? take every 3 months/once a year (4 periods a year Women had fewer periods Exposes women to 9 extra weeks of hormone exposures with increase hormones Don?t know what increase hormonal exposure does to women?s bodies 25% of women have 20 plus days of bleeding Benefit ( 4 periods a year, but studies show 65% of women have 7 plus days of bleeding Special pill marketing Conditions for Conception Ovary must produce a healthy egg ? many cycles women don?t ovulate (period when cycle = regular but don?t ovulate) Fallopian tube must allow egg to travel ? so skinny (must be open! Minor infection can block Healthy sperm need to arrive in vagina ?on time? Sperm need to travel through vagina, cervix, and uterus to the fallopian tube Healthy zygote must be able to implant in the uterus ? estrogen levels high before ovulation, progestin increase after NEED fat and juicy lining Egg/sperm together in fallopian tube All conditions must be perfect to support/maintain pregnancy Maximizing on chance of conception Egg lives 12 ? 24 hours Sperm can survive in a women?s body for 3- 5 days If fertilization doesn?t occur within less than a day after ovulation, egg begins to deteriorate and die Women can become pregnant from sex up to 5 days before ovulation Fertile time in women is 7 days before and 3 days after ovulation Reversible Contraceptive Methods Women on the patch compared to the pill 60% more estrogen because means of transmission (skin not digestive) and because of steady stream Increase risk of blood clot from patch If studied long before market, could have seen this Ring Leave in for 3 weeks, one week out Combination (E+P)/ Progestin only Oral contraceptives / progestin ? only pill Ortho Vera (patch)(white skin color)/ depo ?provera, mirena Nova ring Progestin ?only hormonal methods Mechanisms of action Don?t impact milk production Health issues / effects (progestin only) Depo ? black box label (injectable contraception ? lasts 12 weeks) Risk of bone loss when not on for 2 + years ( Black box (normally life threatening if do ( need long terms studies Mirena IUD (hormonal) Implanon ? one IUD in women?s arm for 3 years (on market) Lesson from Norplant ? implantable contraceptive 6 rods and prevent pregnancy 5 years (off market in 2002) Lacks long term research Norplant Clinicians trained on insertion, not removal 5 years ( scar tissue developed and increase difficulty (would have known if did comprehensive testing) Long term methods of any kind of method is discouraged to women of color (racist / sexist) Women had headaches ( Medicaid didn?t pay and poor women had no money to get removed 2 women took it out themselves Emergency Contraception: used 2 PREVENT pregnancy (progestin only) Morning after pill ? plan b Used to prevent pregnancy after unprotected sex Interferes with implantation if fertilization has already occurred Works because sperm in fallopian tubes for 3 to 7 days. May have sex on Monday, and ovulate on Friday 2 pills ( take both together (used to be 12 hours apart) Works 5 days after unprotected sex Most effective closest to unprotected sex RU 486 ? used to terminate pregnancy Medical abortion Sold under mipheprex Only used after implantation Alternative to cervical abortion Available through 7th week of pregnancy (need positive test) Mifepristone ? progestin blocker, breaks down endometrium Misoprostol ? prostaglandin, causes uterine contraction Forces a miscarriage 100 dollars more than abortion Hormonal Methods Barrier Methods Patch Condoms men and women Pill Diaphragm Depo ? provera Spermicide Nova ring Sponge Norplant / Implanon RU ? 486 Plan B ( emergency contraceptive How do contraceptives interfere with conditions necessary for conception/ how contraceptives prevent conception? On going hormonal control Combination estrogen and progestin method = oral contraceptives, patch, ring, injectable, seasonale Progestin only pills, implants, injections, progestin IUD Close fallopian tubes (female sterilization) Interfere with implantation of fertilized egg IUD Prevents egg and sperm meeting Chemically destroy sperm, comobination Interferes with sperm production and transport Getting Pregnant Contraception Infertility Healthy sperm Block/destroy sperm Something kills sperm Healthy ovulation Artificially prevent ovulation Women aren?t ovulating Healthy fallopian tube Purposely close the fallopian tube Something causes 1 or both fallopian tubes to be blocked Causes of Infertility 40% = male factors 40% - female factors 10% = combined factors 10% = unexplained ( Could be under counted because people feel uncomfortable talking about it and getting help Discovering you are infertile Good model of Medicalization Male infertility Cause: sperm production Test: sperm analysis, sperm protein Treatment: lower scrotal temperature, lower insemination husband, split ejaculate, intrauterine insemination, donor Female Infertility Cause: fibroids Test: physical exam Treatment: myometcomy Male and Female Cause: incapability Test: post coital test Treatment: bypass cervix Invetro fertilization ? very expensive (10,000) 1/3 of procedure = healthy pregnancy Fibroids ( does NOT mean infertility High rate for African Americans Very often has heavy bleeding Uncomfortable periods ? maybe fibroids Common example of why have uterus removed Non cancerous growth Myomectomy ? remove fibroids and keep the uterus Endometriosis ? endometrial (lining of uterus) growing in the wrong place Sexuality and Health People believe men and women are naturally different Biological essentialism (B.E) Idea that men/women differences are biologically given Leads to: Stereotypes of men and women sexuality Sexual double standard Criticism of some behaviors (ex: women being sexual) Justification of others (ex: boys will be boys) Emphasis on difference No physical evidence for B.E. Men and women are more similar than different Evidence for similarity Embryonic Sex differention ? men/women genitalia = morphologically similar Clit ? penis (from genital tubercle) Outer labia ? scrotum (from labia ? scrotal folds) Inner labia ? underside of penis (from uno ? genital groove) Men prostate gland Women urethral sponge skenes gland PLUS: some arousal sites not differentiated ? nipple, anus Physiological process of arousal/orgasm = same in men/women Vasocongestion ? erectile tissue engorges with blood Source of vaginal ?lubrication? or ?wetness? Myotonia ?muscle contractions characteristics of orgasm Myths/stereotypes of women?s sexuality NOT TRUE biologically At same time (difference exists in sexual outcomes Orgasm gap 75% of time men can orgasm during sexual experience with a women 29% of women can orgasm during sexual experience with a man (if they want to) Biological? Women with female partner rate = 80% Women alone (masturbating) rate = 80% Orgasm gap doesn?t show ability to get aroused What we learn about sex helps create orgasm gap Sex ed: sex= reproduction = penis and vagina Sex ed brochure Clitoris survey Puberty advice books Abstinence education is not the culprit Not what causes girls to not know about clitoris Foundation for inequality Learning in childhood sex = babies No names for women genitalia Women more likely to know names of male parts Men have greater permission to touch themselves Inequality already established before ?Puberty ed? ? 4/5th grade with no indication that women experience arousal What is NOT taught Normal appearance of external genitalia (femalia) Variation in size, shape, color, textures, tissues = normal! Silence may lead to labioplasty Clitoris hood covering glans, visibility of shaft Most structure below skin Size/visibility/location of urethral opening? Very visible ? not visible = normal Shape/location of urethral sponge inside vaginal wall ( g- spot) Amount of ejaculate produced Depth of vagina Erotic Responses Clitoris Glans ? high concentration of nerve ending, high sensitivity Bulbs and perineal sponge ? strongest tissue ( vasocongestion Direct or indirect stimulation = orgasm trigger Urethral sponge Usually felt on lower anterior wall of vagina Contains paraurethral (skene?s) glands Produce ejaculate ? few drops to 1 to 1 ½ cup Now recognized as ? g ? spot? (erotic sensitivity) Direct or indirect stimulation = orgasm trigger Nipples Erectile tissue, sensitive to touch, cold Stimulation ( arousal (orgasm possible) Explains pleasure in breast feeding Women with spinal cord injuries and sensitive here, other areas Vaginal Penetration Can produce orgasm regularly in1/3 of women Indirect stimulation of cultural structures Direct rhythmic pressure in cervix Potential trigger for uterine contractions (mytonia) ?a? spot or T ? zone ( erotic sensitivity of anterior formix Anus Many nerve ending = erotic sensitivity Close proximity to perineal sponge Message/penetration potentially pleasurable because Orgasm triggers Direct stimulation Indirect rhythmic on cervix during penetration Infectious diseases, the immune system, and diseases of sexual and reproductive organs Antibiotics ? allergies easily formed More exposed, more likely to produce allergy Bacterial resistance ( bacteria mutates and antibiotics cannot work, develop large colonies of bacteria If in hospital, odds are if get bacteria you?ll be resistant 17% of Doctors in ICU washed their hands appropriately Trying to get 100% hand washing in hospitals Main way body protected ( immune system Prevents body to be susceptible to disease after been exposed to disease causing agent Immunity Active: antigens introduces (foreign agent into body) Long lasting / permanent exposure to diseases Natural vaccine to weaken disease causing agent so cant causes disease Passive: antibodies (body?s reaction) introduced Temporarily Breast feeding Antibodies crossing placenta Emergency treatment Bit by a dog with rabies HPV Virtually all cervical cancer is linked to HPV In women 19 ? 59 in US, 26.8% have HPV New vaccine (Grandisil) effective against two strands (16,18) that cause 70% of cervical caners and 2 strains (6,11) that cause 90% of genital warts Age 20 ? 24 = 44.8% HPV vaccine is best if given before becoming sexually active can be transmitted by a variety of sexual activity Recommended for girls/women 11 ? 26 Requires 3 doses over 6 months (about 360 dollars) Prevalence of strains of HPV covered by vaccine are under 1- 6% in population of women HPV related cancers annually (38 states) 1998 ? 2003 Cervix ? 10,800 cases Oral cavity ? 7,400 Anal ? 3,000 Vulva ? 2,3000 Penile ? 800 Vaginal ? 600 T ? cell (HIV) ( B ? cell ( antibodies As t cell count decreases, risk infection increases Host cell ( cell virus puts RMA that produces new virus Opportunistic infection ? infectious agent takes advantage of low functioning immune system and spreads PID (pelvic inflammatory) Yeast infections Abnormal pop / cervical cancer HPV ( more common HIV person HIV Receptive partner is at much greater risk than incertive partner Risk of male to female transmission 17 ? 35x higher than female to male Higher load of semen then vaginal fluids ? higher amount of disease Women are higher on menstruation ? higher concentration in blood Increase viral load in semen Vaginal membrane more susceptible than skin of penis Reduced if men are circumcised Foreskin has cells for HIV Microbosides ( kill off viruses (HIV) and bacteria Idea ( some kind of gel that would have microbosides on it that can be inserted vaginally HAART ( helps against aids Not cures, genius side efforts, very expensive Women and Food Themes Everyone requires a good nutritional diet to obtain maximum health Women have special nutritional needs Anteing which interferes with fulfilling nutritional needs will impact on women more than men Fatphobia = why women don?t fulfill nutritional needs Fatphobia = example of internalized oppression Fat = most victim blaming of all forms of oppressions Fat people do not eat more than non ? fat people Short term loss followed by weight gain is medically harmful ? frequent dieting is perhaps the single best predictor of future weight gain NO idea how to make fat people thin McAfee and Lyons ( emphasize increasing individual support, regular exercise, and consumption of fruit and vegetables and fiber The ?continuum of women?s relationship to food? makes food a special issue for women More emphasis on exercise will be healthier way to maximize women?s health Women and nutrition Why do women require a very nutrient rich diet? On average, average healthy man needs to take in more energy than a healthy women Menarche Age of menarche is related to nutrition Menarche increases iron requirement Critical fat / weight theory explains why average weight at menarche = 103 pounds Amenorrhea Menstrual cycle can stop if a women of normal weight loses even 10 -20 pounds Fertility/ infertility Fertility linked to weight ( both over and under Weight change 3-5 pounds can turn cycle on and off. Hypothalamus responds to small differences Conception Heavier women have much less margin on BC pill If forget to take pill, more likely to get pregnant Choice of contraception increase or decreases nutritional requirement Menstrual Cycle Energy requirement varies during cycle Women need more energy premenstrually Alcohol metabolism = influenced by menstrual cycles Breast - feeding A women needs an extra 600 calories a day to breast feed Exercise = only healthy way to increase Basal Metabolic Rate (BMR) Exercise increases strength of bones, muscle strength, flexibility and balance, and cardiovascular benefits One mile exercise = 100 calories Women?s food is less than men because women have lower energy levels Still needs some amount of vitamins in smaller pile that man has in big pile CALORIES 2/3X X Calcium 1200 mg 1200 mg Iron 15 mg 10 mg Same amount of calcium for men and women but women need calcium rich diet because smaller piles in comparison to men?s pile Women?s nutrition needs are different than those of men Contraception and nutrition / body image issues Women who use UD suffer 5x iron deficiency Iron Oral contraceptives lower iron requirement IUD increases iron requirement Average women on IUD bleed for more days. 2/3 menstruation flow Body Weight Diaphragm must be refitted every 10 ? 20 pounds weight change Oral contraceptives ? post pill Amenorrhea ? issues for low weight women and women who lost weight on the pill Tipping the Balance of nutritional needs Do something to body about body metabolizing / amount of blood Vitamin b6 Low vitamin b6 = related depression Folic acid (women on pill use more of folic acid) ( Oral contraception may require supplementation Low folic acid = more likely pap smear seams abnormal Hormones Impact Alcohol Metabolism Menstrual cycle changes Blood alcohol highest (women get intoxicated more rapidly) when ovulating and are premenstrual Oral contraceptives Change alcohol metabolism Some women stay intoxicated longer Drinkorexia Get drunk fast Spend hardly any money Maintain weight Eat less to compensate for calories in drinking Commonly alcoholics People need on excess or deficiency (over time) of 3500 calories to gain or lose one pound of body fat Women uses up 2000 calories/day is on 1000 calories/ day diet Takes 3 ½ days to loose one pound 7 days for a normal person Menopause, mid life products, and wider implications Menopause = no menstruation for one year Average age = 45 ? 53 Normal = 35 ? 60 Average = 5 years when bodies changing and getting ready to not have reproductive capacity Transition in women?s life when she?s passed reproduction Just like adolescence Ironic ( body designed for us to live out or reproductive capacity Less estrogen needed for 80 years olds Genetics have a lot to do with menopause Hear/know more about dropping estrogen then progestin Hormonal changes Lower estrogen and different types of estrogen Estradiol = strong estrogen = major estrogen reproductive years (ovary = main source) ( talked about most times Estrone = weaker estrogen = major estrogen post ? menopause (adrenal glands and ovaries make androgen which Is converted to Estrone, fat and muscles help concert androgen to Estrone) Much lower progesterone High levels of FSH and LH Follicles are NOT used up but follicles STOP responding to FSH Medicalization of Menopause ( women are routinely offered hormones ERT = Estrogen ?replacement? therapy (estrogen only) = associated with endometrial cancer (shedding causes lining to clean up) HRT = hormone ?replacement? therapy (estrogen and progestin) = considered safer in relation to endometrial cancer Throughout 70 ? 90s women taking hormones = the norm Goal = the development of new ?designer? estrogen products SERMS (selective estrogen receptor modulators) Act like estrogen in bones and blood vessel (help prevent osteoporosis and heart disease) Act like an anti ? estrogen in breasts and endometrium (so does not cause breast or endometrial cancer) Phytoestrogens (plant estrogens) appear to act like SERMS 1979 ( 30 years of estrogen 1983 ( selling of PMS How pharmaceutical companies get women to use product Women?s health movement in US (Grass ? professionalized) Original grass roots tried to look at whose body ( talk about everything As more money came in ? became specialized and forgot how to look at whole body Women going through menopause Each cycle, hypothalamus stimulates FSH to stimulate follicle In menopause ( decrease estrogen, decrease progestin so LOOKS like end of cycle, so hypothalamus is doing everything to get ready but nothing happens, follicles lose ability to respond to stuck at day 1 Breast Cancer Themes Shift emphasis from treatment to prevention Shift emphasis from individual ( collective Specific issues for specific groups of women of color 7% drop in breast cancer rates in 2003 when women stopped taking HRT because of the WHI study. Tamoxifen ( helps prevent or treat breast cancer by blocking the effect of estrogen ?Upstream vs. downstream? Public health model Model for how do we shift emphasis to treatment and how do we prevent it Prevention, detection, treatment Xenoestrogens = agents which are not produced in the body but are ?outside chemicals? which interact with the body and have the effect of functioning directly or indirectly as estrogen and thereby increasing one?s lifetime exposure to estrogens (estrogens outside the body) The rate of breast cancer mortality in pre ? menopausal women in Israel decline by 30 % following regulating in the mid 1970s reducing the high level of chlorinated chemicals Power and Control (physical and sexual) Using coercion and threats Using intimidation Using emotional abuse Using isolation Minimizing, denying, and blaming Using children Using male privilege Using economic abuse Equity wheels (non violence) Negotiation and fairness Non- threatening behavior Respect Trust and support Honesty and accountability Responsible parenting Shared responsibility Economic partnership Adolescent battered women Women battered every 15 ? 18 seconds 1/3 women experience physical violence in long term relationships Consequences of violence Isolation Lowered self esteem Unhealthy coping mechanisms 25% of battered women experience 1st physical abuse during pregnancy 40-60% of battered women were abused during pregnancies 65% of teens have not talked to anyone about abuse 75% of battered women have children living at home Same ?sex battering Theory that incorporates psychological principles and sociological concepts Can explain domestic violence as it occurs in all relationship configurations Many people deny the problem exists Domestic violence is a gender ?based phenomenon, a socially based illness used to keep women down- accepted explanation 4 misconceptions about same sex partner abuse Outbreak of gay male domestic violence is logical, but lesbian domestic violence does not occur Same sex partner abuse is not as severe as when a woman is battered by a man Because partners are of same gender, it is mutual abuse The perpetrator must be the manor the butch and the victim must be the women or the femme Island and Letellier ( not a gender issue, a behavior issue 3 categories of caution of battering Learning to abuse Opportunity to abuse Choosing to abuse Batter those with less or equal social power because less consequence