In Defense of the Gluten-Free: Autoimmunity and Women’s Knowledge Production

Since the mid 2010s, comedians of all stripes have gladly picked at the new lowest-hanging fruit: gluten-free and vegan diets. I know this because I performed improvisational comedy during these years, and if there is one thing improvisational comedy teaches you, it is how to make an easy joke. When gluten-free became trendy, with as many as one in three Americans participating in the diet (that statistic was published in a NY Times piece defending gluten’s reputation, which was necessary, it turns out, in 2015), it became a joke. Same with veganism; the two were easy to mesh into one stereotype. Sometimes in the panic of live performance I would choke and turn to a tried and true Valley accent: “Actually, I only eat kale…?” Guaranteeing myself a laugh at the expense of developing a real character.

 Yet there’s some question as to what we’re actually laughing about when we laugh at these restrictive diet jokes. On the surface, they’re jokes about privilege. They come at the expense of rich white women who have the privilege to buy expensive leafy greens and pressed juice. At least, that seems to be the collective image of the vegan we have in our culture.

What makes these jokes low-hanging fruit is a combination of their overuse and their vague punch upwards: it is presumed that we are laughing at these privileged women, though it’s uncertain how much privilege one really needs to assert control over their diet (some, but perhaps not as much as these jokes assume). What makes these jokes particularly tired is their underlying misogyny. For the character of a restricted dieter is always a woman. (Even the newly emerged vegan bro character is distinguished by his masculinity: he is a new type of “bro”—his restricted diet is explained in relation, re: opposition, to his masculinity.) These jokes imply that restricting one’s diet is a frivolous use of a woman’s money and time, that diets are dumb and women are even dumber for following them. What’s dangerous about these jokes is that they’re wrong. While weight-loss diets have increasingly been shown not to work, restrictive diets can still have huge health benefits for millions of women.

According to the American Autoimmune-Related Diseases Association, over 50 million Americans, or, 15 to 20% of the country’s population, suffer from autoimmune diseases. 70 to 95 percent of these people are women. These diseases have been on the rise recently, with many of them producing three times the diagnoses they produced three decades prior. From 2012 to 2016, there was a 2.5-6 percent increase in autoimmunity diagnoses, depending on the disease. That’s an uptick of between 1.25 and 3 million cases. All of this is pointed out in Anne Elizabeth Moore’s essay, “Consumpcyon,” which traces the root cause of autoimmunity to “the far-reaching machinery of globalized food production.”

How does globalized food production cause autoimmunity? Food additives. For seasonal food to survive global transport, it requires some additives, like gluten, salt, and glucose. The most common food additives were found to cause intestinal leakage, which, as Moore explains, “create the conditions for autoimmunity.” Autoimmunity, a disorder that causes the body’s defense system to attack itself, is a result of global capitalism.

Unfortunately, the knowledge that food additives may be behind autoimmunity has been slow to impact the medical community. (The study that proves this link was only released in 2015.)  Moore writes, “Despite extensive anecdotal evidence, however, scientists have been slow to look into a relationship between consumption and autoimmunity.” Moore has a couple theories as to why this might be: Big Pharma stands to profit from the autoimmune, and women are poorly represented in STEM fields, which makes it difficult for them to advocate for curing women’s diseases. It seems quite clear that, whatever the myriad holdups are, the gender of most autoimmune sufferers is significant. It is also significant that autoimmune diseases remain largely a mystery to the medical community, and often show no symptoms besides pain.

It is significant because doctors can’t cure what they can’t recognize, and doctors have a hard time recognizing women’s pain. There are multiple studies proving that women’s pain is treated less seriously than men’s, despite women feeling pain more intensely and more frequently than men. Doctors are significantly more likely to prescribe female patients sedatives over pain medicine. Women wait, on average, sixteen minutes longer than men to receive painkillers for intense stomach pain in emergency waiting rooms. In 2000, it was found that women are seven times more likely than men to be improperly diagnosed and dismissed in the instance of a heart attack. This was (and still is) due to understandings of heart attack symptoms being based on male patients and male body patterns. These gender biases are still happening today. For instance, 80% of pain studies employ male mice or humans, despite the fact that 70% of chronic pain sufferers are women.

The female medical emergency has spawned a literary genre of its own: essays recalling moments of bodily horror, followed by greater horror that they are alone in this new, painful reality: no doctor will believe them. In one of these essays, “Dying to Be Competent” by Tressie McMillan Cottom, she writes, “To get ‘healthcare’ promised by the healthcare bureaucracy, it helps tremendously if the bureaucracy assumes that you are competent.” Cottom recounts doctor after doctor downplaying her symptoms, assuming she is incapable of diagnosing her pain, until her newborn baby dies, after which the nurse denies culpability, “There was nothing we could have done, because you did not tell us you were in labor.” Black women are affected disproportionately by medical distrust in female pain—as Cottom points out, black women are over three times as likely as white women to suffer pregnancy-related deaths. Even Serena Williams had to leverage all her power to get nurses to treat her after she experienced C-section complications. Williams wrote about this in an essay for CNN (though she discludes mention of friction with her medical team).

I point out that Williams wrote an essay because I think it is important that one of the most powerful, famous women on the planet chose the personal essay format to formally disclose her near-death experience of giving birth. For as long as women have been allowed to write in public, the personal essay has been a women’s genre. After all, who knows personal, or, private, space better than women—the creatures who have been historically relegated to it? Women are afforded knowledge of the personal, so we are afforded the genre of the personal essay. This is also a reason why both men and women criticize the genre: it can only reproduce the knowledge of a single lived experience. In other words, it is undesirable and “navel-gazing” to be one’s own subject.

However, when male establishments build knowledge around male bodies and brains, it becomes useful for women to become their own subjects. This is true in a literary and scientific sense. While being one’s own subject is limiting, in aggregate, these stories collect networks of meaning. Phil Papers, an academic journal article database, describes the term “Feminist Epistemology:” “Many of the key works in feminist epistemology draw on and contribute to more than one approach to epistemology making any straightforward cataloging of key works deceptive.” This is how women collect knowledge: in aggregate, in networks of understanding that draw webs from personal blogs to canonical philosophers. This is even how women use the internet, according to a 2017 study, “Women’s Knowledge Co-Production and Sharing in Online Communities:” “The main result is that a practical knowledge deriving from an intertwined process of information, experience, and experimentation that supported the decision-making process in users’ everyday life emerged. Consequently, the knowledge produced in the vertical axis of specialists’ knowledge was complemented by a knowledge produced in the horizontal axis of the peer.”

What if women’s vegan Instagram accounts weren’t totally dumb—but an important horizontal axis of women’s knowledge production? What if we valued the self-obsession of a diet blogger as attentiveness to her own personal science project? Of course, I am not asking these questions in earnest, because I believe these things to be true, as I believe that restrictive diet blogs and accounts likely have helped millions of autoimmune women.

Autoimmune diseases are notoriously difficult to diagnose, often requiring years and many doctors. When women are refused information in the vertical axis, they turn to the horizontal. What the medical establishment has recently discovered—that diet affects autoimmune flare-ups—is old knowledge to many female bloggers, influencers and writers who live with autoimmunity and/or chronic pain.

 While researchers have recently found this link, there is still no cure for any autoimmune disease, and, despite rising rates of autoimmunity, NIH funding for autoimmune research has decreased from 2017-2019. While most autoimmune diseases aren’t fatal, they cause enormous amounts of pain. The number one cause of death for the autoimmune is suicide.

So what if we all just shut up about vegans? Sure there might be someone out there going vegan or gluten-free for the attention (in which case, it seems like they need the attention), but there are tons of people whose bodies feel significantly better on restrictive diets, autoimmune or not. While there are important questions about access to these diets (and the conditions of the workers who produce popular American fruits and vegetables), stigmatizing restrictive diets as privileged ignores the fact that people of all backgrounds possess bodies that are sensitive to their food. In this way, it makes sense that our cultural picture of the restrictive dieter is a woman: she has a hands-on relationship to what goes in her body and what happens to her body as a result: she is her own subject. In this way, she knows.


Sophie Dillon

Sophie Dillon

she/hers

is still figuring it out.

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