Your body does this naturally, but that's gross, so change it. I feel like my whole life I've

你的身體自然會這樣做，但這很噁心，所以要改變它。我覺得我的一生都在

been trying to see these messages for what they are and unlearn what they've taught me...

我一直試圖看清這些資訊的真面目，解開它們教給我的東西......。

and yet here I am, two master's degrees deep into adulthood, still feeling like so

然而，我在這裡，在成年後獲得了兩個碩士學位，仍然感覺如此

much of what happens to my body is out of my control. And when I ask the question, which

發生在我身體上的許多事情是我無法控制的。而當我問到這個問題時，這

I always do: 'isn't it just supposed to do that?', or 'Why is THIS the way it

我總是這樣："它不是應該這樣做嗎？"或者 "為什麼它是這樣的？

is?'...The answer, most of the time, is…'we don't know.'

是什麼？"......大多數時候，答案是......我們不知道。

So, hi. I'm Maren. This is Body Language, and we're gonna talk about all the stuff

所以，你好，我是馬倫。這裡是 "身體語言"，我們將討論所有的事情。

the world usually tells us not to. Because the truth is, what we don't know

世界通常告訴我們不要這樣做。因為事實是，我們不知道的東西

far outweighs what we do.

遠遠超過了我們所做的事情。

I mean, we know so little about female reproductive

我的意思是，我們對女性的生殖系統所知甚少。

system in the first place that things like ovarian, uterine and cervical cancers can

卵巢癌、子宮癌和宮頸癌等疾病可以在第一時間內得到治療。

go undiagnosed for way longer than they would if we like...actually understood what 'normal'

如果我們......真正瞭解什麼是 "正常"，那麼他們不被診斷的時間就會更長。

is supposed to feel like, or felt more comfortable talking about the fact that, 'hey, something kind of

是應該有的感覺，或感覺更舒服地談論這樣一個事實："嘿，有種東西是......"。

weird is happening with my vagina. Maybe I need to get that checked out.'

我的陰道發生了怪事。也許我需要去檢查一下。

So, there's a gap between our common understanding of 'health', and what that means

是以，在我們對 "健康 "的共同理解和它的含義之間存在著一個差距。

for bodies that aren't, well… male.

對於那些不是......男性的身體。

And this gap isn't exactly something new.

而這種差距並不完全是新的東西。

-We have historically considered men and male

-我們在歷史上一直認為男人和男性

animals and even male cells as the default for clinical research. And that's really limited

動物，甚至雄性細胞作為臨床研究的默認對象。而這確實是有限的

our ability in terms of research understanding for everybody. When we talk to you about the

我們在為每個人的研究理解方面的能力。當我們和你談及

difference between women and men, it's not just the cells in our body and how our

女性和男性之間的差異，不僅僅是我們身體裡的細胞和我們的方式。

organs interact with each other, our systems work together within our bodies, but it's

各個器官之間相互作用，我們的系統在我們的身體內共同工作，但它是

also about how we experience the environment.

也是關於我們如何體驗環境。

-See, medicine has historically seen women

-看，醫學在歷史上一直認為女性

as reproductive bodies more than anything else, this is a phenomenon sometimes called

作為生殖機構比其他任何東西都重要，這是一種現象，有時稱為

'bikini medicine'. It essentially reduces women's health to just the body parts that are different from

'比基尼醫學'。它基本上把婦女的健康降低到只是身體的不同部位，與

men: mostly the breasts and reproductive organs. And back before our modern understanding of

男人：主要是乳房和生殖器官。而早在我們對現代的理解之前

anatomy, ye olde doctors of yore actually thought the womb would just like...detach

解剖學，你們以前的醫生居然認為子宮會像......脫離一樣。

itself and wander around the body. And that's what caused illness in women? Really scientific

本身並在身體周圍徘徊。這就是導致婦女生病的原因？真的很科學

thinking there, guys. But seriously, medical misinformation like

想到這裡，夥計們。但說真的，醫學上的錯誤信息如

that was used for centuries to support the idea that things like menstruation and pregnancy

幾個世紀以來，人們一直用它來支持月經和懷孕等事情的觀點。

made women the weaker, inferior sex, things that were reflected in society.

使婦女成為弱者、低等性別，這些都反映在社會上。

Can you imagine?! Making a whole human being and then

你能想象嗎？製造一個完整的人，然後

pushing it out of a tiny hole in your body making you the weaker sex?! Yeah, ok, sure.

把它從你身體的一個小洞裡推出來，使你成為弱者？是的，好的，當然。

I mean, just having a female body in itself was basically considered an illness.

我的意思是，僅僅擁有一個女性身體本身就基本上被認為是一種疾病。

Take the term 'hysteria; It first appeared about 4,000 years ago in Ancient Egypt, and

以 "歇斯底里 "一詞為例，它首次出現在大約4000年前的古埃及，並且

over the centuries, it became a catch-all term for women's pain that doctors couldn't

幾個世紀以來，它成了婦女疼痛的總稱，醫生們無法對其進行治療。

diagnose medically. And in the 19th century, it gained that notorious meaning

在醫學上進行診斷。而在19世紀，它獲得了那個臭名昭著的含義

we know today, used in psychiatry to describe 'women who couldn't control their emotions'.

我們今天知道，在精神病學中用來描述 "無法控制自己情緒的婦女"。

-The surgical removal of the uterus was considered a procedure that was performed

-手術摘除子宮被認為是一種被執行的程序

for the purpose of improving women's mental health. And by the way, it didn't work. However,

以改善婦女的心理健康為目的。順便說一句，這並不奏效。然而。

the word for surgical removal of the uterus today is still hysterectomy. And it comes

今天，手術切除子宮的說法仍然是子宮切除術。而且，它來自

from that, that idea of hysteria being related to women's reproductive organs.

從這一點來看，歇斯底里與婦女的生殖器官有關的想法。

And while the term hysteria is rarely used in medical settings today, we do still see

雖然歇斯底里一詞今天很少在醫療場合使用，但我們仍然可以看到

the echoes of it. This bias is maybe most obvious in how clinical

它的回聲。這種偏見也許最明顯地表現在臨床上的

trials have typically been conducted. Clinical trials are where we get our most important

試驗通常已經進行了。臨床試驗是我們獲得最重要的

scientific knowledge about how medicines or surgeries will affect the human body. And

關於藥物或手術將如何影響人體的科學知識。而且

for most of medical history, researchers... only ever tested stuff on men. Which, once again, seems

在大多數醫學史上，研究人員......只在男性身上試驗過東西。這一點，再一次，似乎

like the opposite of scientific thinking, but go off, I guess.

像科學思維的反面，但走了，我想。

See, in 1977, the FDA passed a policy that banned women of “childbearing age” from

請看，在1977年，FDA通過了一項政策，禁止 "育齡 "婦女進入

Phase 1 and Phase 2 clinical trials. And in case you're wondering, that range usually

第1期和第2期臨床試驗。如果你想知道，這個範圍通常是

means women between the ages of 15 and 52. Though women in this age range were allowed

指年齡在15至52歲之間的婦女。儘管這個年齡段的婦女被允許

to participate in later trial phases, some argue that the policy still discouraged women

一些人認為，該政策仍然不鼓勵婦女參加後來的試驗階段。

from participating at all. The policy was put in place following a few high profile

不參加任何活動。該政策是在幾個備受關注的事件之後出臺的。

cases of drugs that did cause severe birth defects, but it meant that we just didn't get to learn

導致嚴重出生缺陷的藥物案例，但這意味著我們只是沒有機會了解

about how so many drugs affected female bodies. Even though women were eventually

關於這麼多藥物是如何影響女性身體的。 即使婦女最終被

going to be prescribed those drugs if they passed clinical trial.

如果他們通過了臨床試驗，就會被開出這些藥物。

Now luckily, in the mid-1980s, a National Institutes of Health policy did encourage more

現在幸運的是，在20世紀80年代中期，美國國家衛生研究院的一項政策確實鼓勵更多的

inclusion of women and other minorities in clinical research for exactly this reason,

正是由於這個原因，將婦女和其他少數民族納入臨床研究。

and later in 1993 the FDA did reverse the ban. But even after that, many studies still

而後來在1993年，美國食品和藥物管理局確實撤銷了禁令。但即使在那之後，許多研究仍然

didn't include women. This is because the scientific community has long-considered the

並不包括婦女。這是因為科學界長期以來都認為

menstrual cycle and female hormones as variables that would throw their trial data out of whack,

月經週期和女性荷爾蒙是會使他們的試驗數據失常的變量。

and would make the study more complicated and therefore, more expensive.

這將使研究更加複雜，是以也更加昂貴。

And as you can imagine, this has led to some problems.

而且你可以想象，這導致了一些問題。

-We know that mice are not small humans, and women are not small men. So women and men may

-我們知道，老鼠不是小人，而女人也不是小男人。所以女人和男人可能

metabolize drugs in different fashions, and drugs may be metabolized differently, depending

藥品的代謝方式不同，藥品的代謝方式也可能不同，這取決於

on the hormonal environment in which the drugs are taken. And so if we haven't studied the

在服用藥物的荷爾蒙環境中。是以，如果我們沒有研究過

drugs on women and men, we may not be applying the right doses.

對女性和男性的藥物，我們可能沒有應用正確的劑量。

-And it's not just about drugs. It's also about how healthcare treats women...literally.

-而且這不僅僅是關於藥物。這也是關於醫療保健如何對待婦女的問題......真的。

Women are more likely to experience delays between the onset of symptoms and a diagnosis.

女性更有可能在症狀出現和診斷之間經歷延遲。

That's for all kinds of issues, including many kinds of cancers, and is in part because

這是針對各種問題，包括許多種類的癌症，部分原因是

their symptoms are still being attributed to 'stress'...sounds a lot like a modern-day

他們的症狀仍然被歸咎於 "壓力"......聽起來很像現代的

hysteria.

歇斯底里。

-The thing that's really dangerous about this

-這個問題真正危險的地方在於

idea that mental health in women is is somehow related to their anatomy, is that it's, it's

認為女性的心理健康與她們的解剖學有某種程度的關係，是，它，它是

led to the dismissal of women's health conditions. When we've gone back and looked in more depth

導致了對婦女健康狀況的否定。當我們回過頭來，更深入地看一看

at some of the conditions that have been traditionally thought of as in women's heads. There's

在一些傳統上被認為是在婦女頭上的條件。這裡有

actually a physiologic basis for many of these conditions.

實際上，這些情況中有許多是有生理基礎的。

-One of those conditions Dr. Temkin is talking about is endometriosis. That's when the

-滕金博士所說的這些情況之一是子宮內膜異位症。那是當

lining of the uterus, or the endometrium, grows outside the uterus, into the pelvis

子宮內膜，即子宮內膜，生長在子宮外，進入盆腔。

and abdomen, which can cause a lot of pain. Even though 1 in 10 people with a uterus struggle

和腹部，這可能導致大量的疼痛。儘管每10個有子宮的人中就有1人在掙扎

with this condition, we don't know what causes it or really, how we can treat it effectively.

對於這種情況，我們不知道是什麼原因造成的，也不知道我們如何能夠有效地治療它。

In fact, women seeking treatment for abdominal pain are much less likely to be prescribed

事實上，因腹痛而尋求治療的婦女不太可能得到處方。

pain medication than male patients presenting with the same level of pain.

與出現相同程度疼痛的男性患者相比，他們更需要止痛藥。

-They often go from provider to provider and wait years to get a diagnosis or treatment

-他們經常從一個醫療機構轉到另一個醫療機構，等待多年才得到診斷或治療

because their physical symptoms of pain are dismissed as in their heads.

因為他們的身體疼痛症狀被認為是在他們的腦子裡。

And this is an even bigger problem for those from minority groups. Like one study found

而對於那些來自少數民族群體的人來說，這更是一個大問題。像一項研究發現

that Black women have an even more difficult time getting diagnosed with endometriosis

黑人婦女更難被診斷出患有子宮內膜異位症

than their white peers. Lower income women have less access to health care in the

比起他們的白人同齡人，他們的收入更低。低收入婦女獲得醫療保健的機會較少。

first place, and studies show that they are less likely to receive important preventative

研究表明，他們不太可能接受重要的預防措施。

care, like mammograms.

護理，如乳房X光檢查。

Trans women and non-straight women are less likely to receive the care they need because

變性婦女和非異性戀婦女不太可能得到她們需要的護理，因為

providers don't receive training on how to properly treat them.

提供者沒有接受關於如何正確對待他們的培訓。

-The way that we interact with the healthcare system can be different based upon some of

-我們與醫療保健系統互動的方式可以根據以下一些情況而有所不同

our social conditions, such as gender, age, race, ethnicity, ability,

我們的社會條件，如性別、年齡、種族、民族、能力。

your socioeconomic status, all of these things really intersect with our communities, our

你的社會經濟地位，所有這些東西真的與我們的社區、我們的

environment and the healthcare system, to determine how we, how we respond to interventions

環境和醫療系統，以確定我們如何，我們如何應對干預措施

and how we respond to treatments and how and how well we live,

以及我們對治療的反應，以及我們如何和如何生活。

and how we experience side effects.

以及我們如何經歷副作用。

-BUT...things are getting better. With improved

-但是......事情正在變得更好。隨著改進

policies and laws, women now represent about half of the participants in NIH-funded trials.

在政策和法律的支持下，婦女現在佔了NIH資助的試驗參與者的一半左右。

I mean, it's a step in the right direction. And this is why more support and funding for

我的意思是，這是朝正確方向邁出的一步。而這就是為什麼對 "中國 "的更多支持和資助

women's health—everything from menopause to nutrition to gynecological cancers—

婦女健康--從更年期到營養再到婦科癌症的所有事情--。

is so necessary. We need to fill that gap that's been developing for centuries. It's actually

是如此必要。我們需要填補那個已經發展了幾個世紀的空白。這實際上是

one of the reasons I went back to graduate school for medical microbiology. Beacuse I have questions,

我回到研究生院學習醫學微生物學的原因之一。因為我有問題。

I'm frustrated with how few answers we have, and I want to be part of finding some of those

我對我們擁有的答案如此之少感到沮喪，我想成為找到其中一些答案的一部分。

answers, which is why I'm studying the vaginal microbiome.

答案，這就是為什麼我在研究陰道微生物組。

-It's important that women engage in their

-婦女參與到她們的工作中是很重要的。

own health care. So it can be something as simple as asking your doctor whether a medication

自己的健康護理。是以，它可以是一些簡單的事情，如問你的醫生，一種藥物是否

that's prescribed has been tested in women or not. We also encourage women to participate

我們也鼓勵婦女參與到我們的工作中來，因為我們的處方已經在婦女身上進行了測試。我們也鼓勵婦女參與

in clinical trials whenever they're available, you don't have to be sick to participate in

只要有臨床試驗，你就可以參加，你不一定要生病才能參加。

a clinical trial. And, that's a way that everybody can contribute.

一個臨床試驗。而且，這是一種每個人都能做出貢獻的方式。

Information is power.

資訊就是力量。

And for too long, women's bodies have been so shrouded in shame and repression that we've

長期以來，女性的身體一直被籠罩在羞恥和壓抑之中，以至於我們

been left out of so much of medicine's progress because our bodies aren't considered the

因為我們的身體不被認為是最重要的，所以被排除在醫學進步的範圍之外。

'norm', or even just for convenience's sake.

'規範'，或者甚至只是為了方便。

But the more data we have, the more we'll understand about all these essential questions.

但是我們擁有的數據越多，我們對所有這些基本問題的瞭解就越多。

Like what kind of birth control do you need, how is it going to affect your specific body,

比如你需要什麼樣的避孕措施，它將如何影響你的具體身體。

or how can you understand your own menstrual cycle to take more control of your health?

或如何瞭解自己的月經週期以更多地控制自己的健康？

So in this new series I hope we can all get a little more comfy with asking some of those

是以，在這個新的系列中，我希望我們都能更自如地問一些這樣的問題。

questions, and I'm so excited that you're along for the ride as we explore the answers

我很高興你能在我們探索答案的過程中參與進來。

we do have, and highlight the places where we need a little more work .

我們確實有，並強調我們需要更多工作的地方。

Our bodies are awesome. And I hope you think so too.

我們的身體非常棒。我希望你也這麼認為。

Thank you so much for watching Seeker's new series Body Language.

非常感謝你觀看Seeker的新系列《身體語言》。

I hope you've enjoyed this video.

我希望你喜歡這個視頻。

If there's another women's health topic you want us to cover, leave it for us a comment.

如果你希望我們報道另一個婦女健康話題，請給我們留言。

I'll see you next time!

下一次見!