Fat Zebra: Science & Health

From Gonzaga Magazine's Summer 2021 feature, "A Critical Eye on Gender & Power Dynamics" 

Spotlight: Sara Díaz, Ph.D. | Associate Professor of Women’s and Gender Studies

Sara Diaz studied chemistry and Spanish literature as an undergrad student, and worked in biotechnology for six years. It isn’t the usual trajectory for a professor of women’s studies, except that it did foster an inquisitiveness for the ethnic and cultural perspectives on science. When she began grad school at the University of Washington, she took a women and science course with a professor who became a mentor. In her Ph.D. program, she explored the intersections of gender, race and science.

Before long, Díaz settled on health science, bringing in social science and critiquing the care and treatment of people with disabilities. It’s urgent, she says: “People are dying because of medical bias.”

It’s fascinating intellectual work that includes difficult, real-world problems, says Diaz. It’s also deeply personal.

Dual Diagnoses

Díaz suffers from Ehlers Danlos Syndrome (EDS), a genetic disorder of the connective tissue that causes joint hypermobility, and commonly is misdiagnosed. As if that hasn’t impacted her enough, she has mast cell activation syndrome, which sometimes causes life-threatening allergic reactions but for Díaz, presents mostly through chronic migraines and fainting. With these complicated conditions, one might think Diaz was predestined for the studies she chose. 

Díaz’s allergic responses required constant and cautious experimentation with food to determine her triggers. Making a food plan to deal with her conditions also collided with the stressors of fatphobia and diet culture.

“Weight science often stigmatizes fatness and is counter-productive,” she says. “That meant I had to actively protect my own mental health as I pursued care for my conditions.”

During her sabbatical in 2019, Díaz began work on a book with a companion blog. She called it “Fat Zebra,” explaining that zebras are often the mascot for rare diseases, like EDS.  She boldly used the term “fat” because it is often harder for fat people to get diagnosed with conditions not typically associated with “obesity.” On her blog, Díaz was open, vulnerable, about the sensitivities of having physical therapy as a fat person, about the struggle not to place a moral value on the food plans she needed to follow. She created a community where others could share their struggles, too.

Viewing Health through the Lens of Feminism

“I was exploring how medicine has historically pathologized women’s bodies ,” says Díaz. “Dating back to the late 60s, feminist began describing how the female body was thought of as a sick male body. Disability studies, which emerged alongside feminist studies, changed the way we think about the sick or disabled body.”

There are all kinds of ways to think about how gender impacts medical care, she says. Women are more prone chronic illnesses – and they’re more likely to seek care than men. But, the medical community often thinks of women as complaining, or dismisses their pain. Until the Women’s Health Movement intervened in the 60s, most medical research took place on men only, without regard for the different ways women’s bodies may respond to a condition or treatment, which accounts for the fact that it has historically taken longer for women to receive a proper diagnosis.   

“Social science researchers are only just now documenting the depth of stigma in medical settings,” says Díaz. “In the medical humanities, we are in a moment where medicine and bio-ethics are pushing to move away from the male model of medicine. There’s a lot of work to be done.”

Díaz teaches about the role of feminist epistemology (knowledge systems) in criticizing the idea that science is always objective.

She offers the field of fat studies as an example. “We can look at a study and see where the data shows that a specific diet didn’t work, but the study ends before showing long-term outcomes. The culture we live in shapes the conclusions we draw from the data right in front of us, and even the questions we ask. Sometimes, the conclusions we draw don’t make sense, but we can’t see that because of our bias.”

Díaz says, the stigma towards fat people is connected to deeply seated ideas of gluttony, one of the seven deadly sins. Her exploration of fatness centers on other Catholic values such as human dignity. 

“We have a cultural aversion to both fatness and disabilities, as if people brought these things upon themselves,” says Diaz. “While science shows ‘obesity’ is correlated with certain diseases, it does not prove that fatness causes them. Correlation is not causation.”

Rooted in Activism

Many of the shifts in health care, pertaining to gender, are results of activism, says Díaz. That’s true of any aspect of society where women’s rights are brought to the forefront of conversation.

Does that make feminism political?

“We don’t pretend we’re not political, where other fields have been disciplined to hide their political traits,” says Díaz. “But it isn’t just about the politics, it’s about our values, and our values in women’s and gender studies are feminist.”

None of the traditional ways people have negatively described feminism – man-hating or female-superior – are authentic to feminism itself, she explains. “I don’t ask my students to become feminists. I say, ‘Here’s a way to look at the world, try it for a semester.’ And they usually find that perspective really valuable for other fields of study.”

Bridging the Gap between Generations

“I’m very intentional about wanting students to learn to have conversations with their older family members,” says Díaz.

She assigns students to sit with their mother or another close woman to talk about feminism and what they think about it. Often, she says, students learn that even if their mothers aren’t self-described feminists, their values are consistent with feminist values, albeit sometimes unknowingly.

For those who were raised Catholic, Díaz encourages students to center conversations on the elements of dignity that are so central to the faith.

“Fostering those values, ” says Díaz, “It’s so important for bridging the gap.”