Patriarchy vs. Feminism
The concept "patriarchy" designates a particular social construct and discourse, in which those recognized as "male" exercise hegemony over the remaining members of society. In this regard, it is important to underscore that patriarchy is not entirely reducible to a purely biological category, but rather that the discourse of patriarchy decides who to include and exclude in its definition of male, and thus who to include or exclude within its normativities of power. For example, despite obviously being males, homosexual men will often be excluded by the patriarchy because of their sexuality. Therefore, what is crucial to understand about patriarchy is that it is a particular discourse and ideology that structures society in a correspondingly particular way, affecting both the relationships within this society and how one thinks about relations and societies as a whole.
Such an account of patriarchy is made all the more clear when we consider the specific ways in which patriarchy affects and determines the roles and existence of women within society. This can be made manifest, for example, in reflecting on how women conceive of themselves, i.e., the questions of their own subjective identity: women have specific ideas about what it means to be a woman. The questions of idealized feminine body image can be considered symptomatic of patriarchy, because women are conditioned to think of a certain body image as perfect - this is not a personal choice, but rather indicates the function of a social construct. Furthermore, to the extent that such body images can be considered to be harmful to women, this is therefore indicative of patriarchy.. At the same time, patriarchy can also operate by excluding some individuals from participating in various aspects of society: for example, the opposition towards women achieving certain professional positions clearly indicates that the power in society does not lie with women. Accordingly, we can understand that there is both an implicit and explicit component of patriarchy: on the explicit level, patriarchy can prevent women from realizing their aims in society; on the implicit level, patriarchy can affect how women conceive of themselves, their identity and their relations to others, without women being aware of the affectivity of patriarchy.
In the case of the implicit level of patriarchy, personal identity is crucial: The feminist critique of patriarchy can begin by realizing that identity is fundamentally changeable. As Belzer writes when reflecting on her own biography and how it relates to feminism, she recalls her own plastic surgery as a teenager and notes that it was "only the first of many identities I would eventually embrace." By understanding that one has many identities over the course of one's life, it becomes possible to recognize that the apparent intimacy of identity is socially conditioned. In cases such as Belzer's, the identity she attempts to achieve by undergoing plastic surgery is to attain a certain idea of female beauty. This ideal, however, insofar as it forces women to adapt to its mandates, shows that the choice for plastic surgery is not personal, but rather social. By demystifying our identities, we can start to think about why particular identities exist. Accordingly, we become able to identify possible instances of a patriarchal discourse, which exerts control over women by controlling apparently personal decisions regarding their body.
One of the key dimensions in which patriarchy is realized is women's health, precisely because here patriarchy is most difficult to detect: women's health at first glance seems to be a purely biological phenomenon, and not a social one. However, feminist theorists suggest that "women's health cannot be understood simply in terms of their biological characteristics"; rather what becomes necessary to theorize is "the causal links between women's daily lives and their experiences of health, illness and disability." The necessity of this gesture lies in the notion that patriarchy advances a "reductionist model of health and illness", which posits women's health issues primarily "in terms of their reproductive systems." The reduction of women to a mere reproductive machine is a means by which women are segregated into a specific role within society. Accordingly, this is indicative of the presence of a patriarchal discourse.
In order to become conscious of patriarchy, the theorization of women's health therefore must understand the crucial difference between gender and sex, a difference that patriarchy manipulates by reducing everything to sex. Serano defines sex as follows: "sex commonly refers to whether a person is physically female and/or male." On the other hand, gender is a more wide ranging and diverse concept that can "refer to various aspects of a person's physical or social sex, their sex-related behaviors, the sex-based class system they are situated within, or (in most cases) some combination thereof." The theorization of gender is needed because, as Doyal notes, "research has shown that social and economic factors such as class, race, and country of origin are crucially in mediating the biological processes underlying disease, death, and disability in both sexes." Biological sex does not determine existence; rather, gender can determine sex. Women's health issues necessarily must be thought of in terms of gender and the influence of social phenomena. Accordingly, such arguments from biologism become explicit means by which patriarchy exerts control over women - for example, the argument against abortion conceives of the woman purely as a reproductive machine. The question in this regard is: where does such an image of the woman come from and why does it exist? If a particular social discourse advances this account of women, it is most likely a patriarchal discourse, precisely because it reduces the woman to a particular identity, as opposed to acknowledging the changing nature of identity. Accordingly, the opposition to, for example, abortion is the opposition to the autonomy of the woman: if the woman were allowed to choose, this would be a radically antagonistic act to a patriarchy that attempts to restrict such autonomy.
Feminism thus can oppose patriarchy by "learning to honor the inevitable contradictory realities that come from occupying multiple identities." The acknowledgment of multiple identities is the resistance to a singular identity conferred to women, such as, in the case of women's health, the notion of woman as reproductive machine. According to Greaves, "women can be either 'passive victims' of or 'active resisters' to patriarchal domination or possibly both, depending on their cultural or subcultural milieu." The passive victim is one that accepts the identity which patriarchy has conferred to them; the active resister is the opposition to the attempt at categorization.