So if there are more mistakes here than normal, missed words or misspellings, you know why.

It is the official end to my summer, which is extremely early thanks to a very late Labour Day weekend and a decision by my kids’ school boards to start school in what feels like the middle of August. Surely we could do better by these children (and maybe consider starting high school later than 8 a.m.? Are we trying to kill the teens?) They will survive I’m sure, and we’ll all adjust to this new/old routine.

I am a strange sort of folk who does not succumb to the winter blahs and blues. My dark time is the end of the August, when the crickets begin their metronomic countdown to autumn, the birds begin their long flight south, and the days are still and quiet. A kind of calm before death, I guess? Talk to me again in late September when I’ve fully embraced soups and stews on the family meal plan, crisp morning walks, and the blushing trees in all their burnt oranges, reds, and yellows (looking out the car window my three year old once asked me, “Mama, who painted the trees?” Oh, my aching heart.) By late September I have acknowledged the impermanence of this life, embraced that death is a part of it—until next summer, of course.

To cheer myself in a time of sadness and broken sleep, I am writing you of the simple things, the small things bringing me flashes of joy.

Things I’m eating

There is this tofu shawarma recipe that my daughter and I made and rated five stars. I did not make it vegan though, so my sauce was a base of sour cream, and I used regular yogurt for the tofu marinade. A note that you will slice your tofu in perfect thin strips, only to mash it all up as you’re mixing it with the marinade. This just made it extra crispy and delicious.

I also adore this halloumi, white bean, and tomato dish, which the NYT pushed to me as an ad, but I found elsewhere. I’m all for paying for news media, but right now I’m trying to focus on Canadian publications. The recipe is so simple and delicious, and pairs perfectly with crusty bread and a crisp sauvignon blanc (I actually have no idea if it pairs well with any kind of wine, but it sounded fancy, so I went for it.)

Finally, a co-worker shared this burrata, peach, and chicken dish which takes a bit more time but is SO worth it. Plus, it looks divine and will impress your guests.

Things I’m reading

I am just about done the audiobook of Whistler, by Ann Patchett, and oh my, I can’t get over how beautiful and tender this book is. It is not about Whistler, Canada, which is what I thought of when I first heard about the novel. Whistler is a horse, who features as a story within the story, a horse who symbolizes fidelity, love, and what it means to return to someone, to support them through something monumental like illness or death. Not a whole lot happens in this book, but it is the gentle unfolding that draws you in, the wise and flawed characters, and the exploration of family—and love, of course.

I also finally tackled Lonesome Dove this summer, which I’ve been meaning to do for years, mainly because my dad has been bugging me to read it. Westerns are not usually my thing, but I learned from the internet that Larry McMurtry rejected the categorization of his books as traditional westerns, and instead wanted to demythologize the American West and offer a more critical view of the romanticized cowboy. I also had no idea how much this book has made a comeback in recent years, thanks to BookTok and a mention of McMurty in the smash hit The Correspondent. What I very much appreciated about this book, beyond the incredible characters and epic storytelling, was the portrayal of masculinity. These were cowboys who had many fears and phobias, who were sometimes emotionally detached and other times wept openly, who dealt with anger issues and loneliness, and McMurtry was careful to never fix any of that. There was no real happy ending in this book, but I didn’t finish it feeling depressed. It just felt very realistic, and I imagine that some of its modern popularity, particularly among men, is due to our ongoing cultural struggle to define a better version of masculinity. Like these cowboys in the late 1870s, men today are caught between old and new worlds, and struggling to find their place in it.1

Five stars for both these books and they will stay with me forever.

Things I’m doing

This could be “Things I’m watching” but I don’t watch a lot of TV, unless you count F1 races, and so I’ve included some other stuff here. But my hubby and I have been enjoying Colin from Accounts which streams on CBC Gem. It’s a superbly done Australian cringe comedy about a med student and brewery owner whose lives collide after one of them hits a dog with their car. Their relationship develops when they find themselves stuck caring for the disabled dog, who now lives in a doggy wheelchair. It’s laugh out loud funny, with flashes of rather dark and serious topics like addiction and death. Two seasons are available on Gem.

Returning to F1, I am loving the No Grip podcast hosted by Lily Herman. This is for Formula 1 fans, yes, but it is also for people who enjoy culture, particularly the culture of billionaires funding a sport in which people get into death traps and drive them around in circles at top speeds, and all the secrecy, cheating, and celebrity gossip that goes along with it. Topics that Lily has covered so far include: why there are no female drivers in F1; the rise of the F1 romance genre; LGBTQ+ fandom within F1; and what astrology says about the current lineup of drivers. It is highly entertaining.

I am also doing more weight lifting as I’ve succumbed to online pressure that I must build muscles lest I develop osteoporosis. I’ve always been a cardio gal—once I get going I can maintain a high heart rate for a long time. But I’m not very strong, so I’m trying to change that, and have worked myself up to 15lb dumbbells, woot! However, I can’t seem to find the right instructor on YouTube…they’re all impossibly thin, and have the same long, blonde ponytail. Can someone please recommend videos with normal looking people? I like full body workouts with dumbbells and try to aim for 20-30 minutes.

That is all for now. Be well, in this time of impending death.

From my heart to yours,

Misty

Buy my book!

I launched this Substack as a way to promote my book, build an audience interested in the subject matter, and hopefully sell a few copies. I had grandiose goals to post here weekly, grow my subscriber list to 500+, and eventually, maybe, ask folks to pledge a few dollars to me each month to support my writing.

I tend to jump into new endeavors without giving much thought to my motivation, time, and energy, so it was not very surprising to discover that I could not maintain a weekly publishing schedule, and I never got to the point where I felt comfortable opening up paid subscriptions. I just didn’t feel that I was offering anything of consistent value to people. I also suffered from some pretty horrible writer’s block in the year following the publication of my book, and felt totally exhausted. Writing about the same topics I’d spent four years researching no longer held my attention in the same way.

Which is why All In Her Head became a bit more All Over the Place in terms of content. Sometimes I’m writing about women’s health, misogyny in health care, and reimagining mental health care, but other times I’m just rambling on about my life, what I love reading, and musing about how I may never write another book (I probably will…I don’t know.) I’m also coming off one of the busiest years I’ve had work-wise, so I write if inspiration strikes and when I can find the time. My Substack subscriber numbers reflect all of this, by growing extremely slowly or not at all. Every time I publish a newsletter, I lose a follower or two. Breaking 300 will be a miracle. That reminds me:

Now that life has settled a bit, I’m determined to be more intentional in where I direct my time and energy. No more barreling off in new directions without some understanding of the destination! Which is why I am reinventing this newsletter now, to reflect all the changes I’ve experienced in the past six or so years (ah, those lost pandemic years,) and to give myself a bit more flexibility in what I write about. The posts that get the most traction on here are the ones where I don’t do a ton of research, and don’t spend inordinate amounts of time trying to become an expert on the topic I’m writing about. When I allow myself to be myself, people want to read that.

I debated changing the name of this Substack or launching a whole separate Substack to house my various interests, but quickly shut that idea down, because it’s just another excuse for me to start something new and not follow through.

All In Her Head will remain so because what you’re getting here is all the stuff in my head—sometimes it’s messy, sometimes it’s eloquent, sometimes it’s just fluff, but I can promise you that it will always be honest. And never, ever written by AI.

I’m not going to stop writing about women’s health and feminism, but you will see more of my life, of books (because books are literally my whole life…as well as Zumba. Can I write a whole post about Zumba?) and maybe even a bit about the novel I’m trying to write. I love writing essays about topics that get me thinking, like AI, gender norms and expectations, and work life:

I’m also opening up paid subscriptions. It’s time to stop devaluing my own work, pretending money doesn’t really matter, and feeling bad about making art in this crazy world. My subscription levels are very chill and small, so if you feel like throwing me a few bones each month, I will be ecstatically happy. In return, I promise to keep things interesting over here, and maybe even fun? I don’t even know if I’ll put any content behind a paywall, because I continue to struggle with the whole devaluing part, so I feel like the first step is that I just turn on the paid option. My dream is that Substack comes up with different payment options, where you could tip me for a single article, rather than subscribing for the long-term. I personally read a couple dozen Substacks and can’t afford to subscribe to them all, so I often cancel subscriptions and move to the next one to spread the love a bit. ANYWHO, the option is now there, should you wish to take it.

I’m excited for this refresh, and also curious: what do you like to read about here? What posts get you thinking and feeling stuff?

From my heart to yours,

Misty

Buy the book

One would assume that this is the perfect phase of life to prioritize my career and reach for the top of the corporate ladder, but instead I’m climbing down, not because I’m afraid of heights, but because I’m not sure that the rewards waiting for me up there are worth all the pain.

Part of the issue is that I’ve never really had any career goals—I’ve just gone where the wind blows me, maybe because my sense of self was in its infancy when I hit adulthood and confidence in my own abilities was stunted by years of anxiety and overwork. I knew I needed to achieve, I needed to be “successful,” which I vaguely understood to mean high marks in school, graduating with honours, scholarships, a master’s degree and…then what? I started university in business school for goodness sake, which made ZERO sense based on my interests and personality, but surely being a business person meant I was a functioning, high-achieving member of society.1

This lack of self-awareness meant that I jumped into new fields or jobs without much thought. I relied on gut feelings more than my bank account balance, which meant I was usually quite poor, but doing work that felt like I was making a difference in the world. Then I had kids, got a mortgage, and suddenly the bank account meant a lot more than my whims. Every career decision from that point on was about how we could pay our bills and get out of student debt. Even within these confines of work and bills, I found ways to honour my passions through various side hustles, like social media management, writing, doula work, and childbirth education.

My working life has been a twisty path of different fields and frequent changes, which traditional workplaces may perceive as a risk, but I personally feel is an advantage. Even now, in my mid-forties, I’m still not sure if I’m in the right place professionally, but I tend to hang out in roles until something big and unexpected boots me onto a different path. Losing my research job at the start of the pandemic was a blessing in disguise because it finally forced me to ask myself what I truly wanted in my professional life. My layoff gave me space to write the book I had always wanted to write, and eventually landed me in science communications.

Still, I continue to struggle with the goals part, the part where I need to make a choice to take a leap or “develop” myself. There’s nothing I dread more than the “Where do you see yourself in five years” question that gets asked at every performance review in the corporate world. Manager, I see myself on a mountain top. In a lake, floating on my back, guessing at shapes in the clouds. I see fireflies, and bonfires, and books piled in corners, waiting to be read. I see walks on the beach until my feet are scrubbed smooth.

Never in my life have I seen a ladder in which I climb, sending and receiving thousands of emails, sitting in meetings discussing projects that no one will remember in ten years, drafting plans and workback schedules. It’s not that these tasks are meaningless; I am doing this work because I think it makes a difference (it must!), even though change-making in health care is slow and arduous. But when I picture myself in the future, I can’t see myself doing the day-to-day things that I’m always bogged down in—instead I imagine doing what keeps me truly living.

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One year ago I received another one of those big and unexpected kicks when I was asked to step in as interim director. I said yes, and it has been a year of personal growth, professional development, and some tears. But I recently stepped back into my old role and handed the reins to someone else.2 Instead of feeling sad about it, I’m celebrating my demotion, because for the first time I’ve made a conscious choice in my career and it feels like a huge step forward (or backward I guess?)

Apparently I’m not alone in leaning out, and a Women in the Workplace report from 2025 confirms that more women are opting out of promotion (Ironic maybe? This study is a collab between LeanIn.org and McKinsey, and Sandberg is almost solely responsible for a decade of women feeling pressured to lean in).3 The report is clear that women are no less committed to their jobs; what is different now is that women have less desire to keep climbing. When put that way, it feels like a conversation about ambition—why we have less and men have more.

Ambition is a complex and gendered concept, as the goals women and men set for themselves are largely dictated by societal norms and gendered expectations. Growing up in the 80s and 90s, I was expected to surpass the generations of women before me by going to university and working in the field of my choice. But there was also an expectation that I would marry and have a family, balancing both children and professional life, which many of us have discovered is almost impossible to do without some concessions. Either you make a boatload of money and pay other people to support your family, or you make career choices like part-time or flexible work in order to balance job and children (and whatever other caregiving duties you’ve got going on, because we know women do ALL of them!) The goalposts of where I would be in five years were largely shaped by the needs of my family, and not by any deeper desire I might have had for success or money.

In addition to goals, ambition can also be defined in relation to behavioural traits, like confidence, self-esteem, and competitiveness. It’s believed that these traits can be taught and learned (peruse the business section of any bookstore and you’ll find countless titles marketed to women who are trying to make it to the top), which begs the question of whether ambition itself is a learned desire or behaviour. Are my ambitions truly my own, or have they been shaped by what I think I want or need within this capitalist culture? I’ve never identified much with characteristics that go along with ambition, and when I’ve tried them on in the past, I always felt like they were a bad fit for me.

For those women who do identify with ambitious traits or have no problem expressing their desire for more wealth, power, or respect, there are still countless hurdles to navigate on the path to success. It’s well-proven in occupational research that women are often penalized for showing a desire for greater power and money, or exhibiting characteristics that we typically think of as masculine. In upper levels of management especially, women are battling gendered norms and expectations that can affect career progression or end in burnout.4

Is leaning out the result of a lack of ambition then? If ambition is about having a long-term goal, and then working on traits or skills that move you in the direction of that goal, then I’d argue all human beings are ambitious, regardless of gender. I can be ambitious about learning to play the guitar, or building a thriving vegetable garden. But if you want to think about ambition strictly in modern workplace/capitalist terms, then I think the signals are clear that many women don’t want what’s being offered. We want support with caregiving, better health care, recognition of our worth, dignity, and rights. If a C-suite gives me none of that, and additionally burns me out so that I can’t carry out all the other tasks the world dumps on me, why would I bother?

All of this means that many of my peers are doing the same thing I’m doing: they’re stepping back, taking on fewer projects, retiring early, not asking for the promotion (a friend called it “career regression” which I love!) or changing jobs to find more of that elusive balance we were always told we could have. There’s much hand wringing about what this means for women in the corporate world, because we all know what happens when we’re not at the decision-making table, but I just don’t think women have the energy to continue pushing without significant structural change.

*

When I posted about celebrating my demotion on social media, I got many comments from women keen to talk about the slow life, the life we get to choose. “For women especially I think there’s a lot of pressure to lean in, be the trailblazer, even if it doesn’t feel quite right or comes with more stress than you need in your short and precious life,” I wrote. “This is your permission slip to say no, step back, and take the paved trail, not because it’s easier, but because you just don’t want to bushwack your way through life.”

If ambition is a desire for more status, wealth, or power, then maybe the survey is right and women of a certain age have less of that now than they once did. The girl boss era is over because we discovered it was a big fat lie—that if we worked hard enough and blazed that trail, that some magical reward would be at the end of it all. Instead we got a pandemic, fascism, burnout, menopause, and more caregiving duties than we could ever manage in a lifetime.

Maybe the problem isn’t that we lack ambition. Maybe it’s that our goals have been focused on upholding a system designed to bring us down. What do you say we make some new goals?

1. Kill off the toxic men

2. Build the matriarchy

3. Save the world.

From my heart to yours,

Misty

New rapid tests to diagnose endometriosis

I’ve written about endometriosis before (read it here) and my long journey to diagnosis and treatment. I should probably write an update on this, as I’ve had women reach out to ask me how things are going since I had my ablation. Recently, I saw the news that there are two new non-invasive tests on the horizon for diagnosing endometriosis in primary care. The main way doctors definitively diagnose endo right now is through laparoscopy, which is minor surgery that is costly, comes with some risk, and is performed by very few doctors here in Canada.

Enter Endosure and Endotest. One uses saliva samples to test for biological markers called microRNAs, and the other measures electrical signals in the gut using sensor pads on the abdomen (if you want a better understanding of how this would actually diagnose endo, check out Dr. Jen Gunter’s recent newsletter!) Endotest, the one that uses saliva, seems to have slightly better test sensitivity and specificity, which are measures of how well a test performs. Both tests have been approved for use in the UK, but here in Canada, people can only access these tests at select clinics across the country, so we have ways to go to improve accessibility.

Melinda French Gates pledges millions to improve women’s health care

Philanthropy is now filling the hole Donald Trump has blasted in medical research funding, particularly for conditions that affect women. French Gates recently pledged millions to underfunded areas like mental health support and menopause, which is a good news story that underscores a much greater issue: how do we get society to pay better attention to women’s health, so that we don’t have to rely on billionaires to fill the gaps?

Funding is part of the problem but so is a lack of medical education on women’s health and ridiculous pay structures that don’t allow doctors to take more time with patients. I’m thankful to Melinda for shedding light on these disparities but I won’t hold my breath for philanthropy to be the answer.

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Active birth control and emotional eating

A new study suggests that combined oral contraceptives may be linked to more emotional eating. This aligns with a ton of animal research showing that elevated estradiol and progesterone are associated with increased food intake.

It’s important to mention that while increased emotional eating was significant in the birth control group, the findings were modest, especially during the second cycle of tracking. The authors suggest that women could have been more attuned to their own emotional eating since they were required to record a food intake diary, which may have prompted them to control their eating in the second cycle.

The study is an interesting addition to the conversation on birth control and mental health effects, but by no means should be taken as “birth control causes eating disorders.” This was one study on one type of contraception. That said, it adds to a growing body of literature supporting a personalized approach to birth control, which could better account for potential side effects that are almost never universal.

Lack of menopause care in Canada forces women to turn to private clinics

Here in Canada, women are so desperate for menopause care that they’re being forced to turn to private clinics, which undermine the public system we pride ourselves on.

Because of the fee-for-service model, physicians are poorly compensated for time spent counseling and following up on menopause treatments, which means few do it. Any physicians interested in this line of work gravitate to obstetrics because it pays much better than gynecology. Add to this the fact that primary care residents don’t receive mandatory training in gynecology, which means they’re poorly educated and spread misinformation (the stories I could tell you…)

There are no easy answers, but getting loud about it is a good start. Talk about it with your doctor, tell all your friends, post about it on social media. Let’s do what we can to pressure policymakers to improve care access and processes.

In the meantime, should you use one of these private clinics? You’re not going to hear “no” from me, because for some of my friends and loved ones, private is their only option. What you will hear from me is that private clinics are not subject to the same regulations and oversight as public health care, so buyer beware. Do your homework, ask around, and always update your primary care physician (if you have one) about what treatments you’re receiving.

From my heart to yours,

Misty

Are you struggling to access care for menopause or want to share your experience with private clinics? I would love to hear from you: prattmisty@hotmail.com

Check out ALL IN HER HEAD! And if you’ve read it, would you consider adding a review on Goodreads, Amazon, or StoryGraph? This helps others readers find my book!

Her care providers tried many different medications and Lithium helped to stabilize my grandma’s moods. The downside? It didn’t always work over the long-term, especially if something disrupted whatever chemical dance was taking place in her body. Lithium also came with significant side effects, and at one point, life-threatening lithium poisoning.

My grandma managed as best she could, and our family rallied when she suffered from mania or depression, driving her to the emergency department and appointments with the psychiatrist. She did not have the easiest life, and if she were alive to tell her story…well, I’m not actually sure she would have opened up about her illness, because it was something she rarely addressed or admitted to struggling with.

The other week I read a news article about a woman with a rare autoimmune disease who was misdiagnosed with bipolar disorder. These types of stories pop up in the news from time to time, and follow a similar narrative: a woman begins to have psychiatric symptoms out of the blue (usually psychosis) and is diagnosed with mental illness and medicated with numerous psychiatric drugs. The woman’s symptoms escalate and her health declines, until someone discovers she’s been suffering from a different illness all along. She’s prescribed the right medications, makes a full recovery, and she and her family are forever grateful to the doctor who uncovered the medical mystery.

What I love about these stories is that they demonstrate how medicine is not a static practice—as science evolves and we uncover whole new worlds in the body, our ability to pinpoint the cause of illness is always better than previous generations. For example, people with advanced syphilis used to be institutionalized because the disease mimicked psychosis. Thankfully, people now receive proper screening and treatment because someone discovered the link and practice changed over time. Yay science!

What I don’t love about these stories is the “What if” feelings they provoke. What if my grandmother’s illness was an autoimmune condition? What if she was actually dealing with more severe symptoms related to menopause (some research has linked hormonal shifts to rare cases of psychosis, which radically improve when treated with hormone replacement therapy). If that’s the case, then all the drugs they plied her with may have made the situation worse, not better. And if she were struggling today, would she have achieved much better outcomes?

I have similar questions related to my own experience with mental illness, and whether the root cause of my panic attacks and anxiety was something physical. My high school breakdown came with many physical symptoms like nausea, vomiting, and irritable bowel. The gut-brain relationship is much better understood how, and scientists are finding links between mental illness and gastrointestinal diseases, suggesting that targeting the gut may be more effective than targeting the brain (our gut is essentially our second brain!)

Underlying my fascination with the scientific process is a deeper desire that I think many of us mental illness sufferers hold: to discover a cause for our distress that can be treated with modern medicine. Finding out your psychosis is the result of a rare autoimmune condition is perceived as a good news story. Coming to terms with the fact that you’ll maybe always struggle with anxiety, depression, or psychosis is less inspiring, and a hard pill to swallow.

As one psychiatrist says in the news story mentioned above, “We're trying to avoid this dichotomy, where we present the autoimmune form as treatable and optimistic and hopeful, and the other one — the more common one — [as not treatable,] because that's not the case.”

The most likely explanation for mental illness is a hodgepodge of personal, biological, and social factors, and the chances of discovering a single (and rare) cause are very slim. But neat and tidy explanations are more our human brain’s jam, so we are wired to try and explain the unexplainable. It feels so much better to identify a cause than to admit that we’re a hot mess and may never change.

That, too, is an oversimplification, because of course many of us receive treatment that helps and go on to live full, meaningful lives. It took a couple of decades, but I’m now at a place where I feel that I manage my symptoms quite well. I may have to be more cautious and attuned to situations that exacerbate my symptoms, but isn’t that the case for anyone suffering from chronic illness, whether it be identifiable on a medical test or elucidated through the clinical expertise of a psychiatrist?

What would help mental illness sufferers the most is for mental and physical health to be seamlessly integrated into one system. Mental health is not formally part of our healthcare system in Canada (nor in many other countries), which means it will never be valued in the same way we value other types of health care. Without this integration, there will always be a more positive spin placed on physical illness and a negative one on mental illness.

“Mental health is health” is more than a catch-phrase—it’s the truth, and it’s up to all of us to start living it.

From my heart to yours,

Misty

A deeply disturbing CBC news story broke last week about a Canadian man who is facing 79 charges relating to deepfake nudes/porn of multiple women, using images he allegedly pulled from their social media profiles.

Scenes use the women’s faces and bodies to depict AI-generated kidnapping, rape, and torture. You can read all the details here, but prepare yourself, because this is no cozy mystery.

All the women knew the man in some capacity, and several were in very close relationships with him. One woman who knew him for more than 25 years said the “behaviour couldn’t be further from the man she thought she knew.” His wife of 20 years had no inkling of his alleged love of rape and torture, and is currently filing for divorce.

The experience has left the affected women feeling angry, helpless, and anxious, and investigators have uncovered that their identities and addresses may have been exposed in the deepfakes. “I’m always going to worry about my body being exploited and shared,” said one of the victims.

There is a gap in Canadian law when it comes to deepfakes which means it’s not technically illegal to create pornographic images or videos of other people and share them online. Police have to get creative when laying charges for crimes, and have charged the man in this case with a number of sexual abuse and harassment-related offenses. A new bill aims to change all that, and it’s currently in its third reading (Australia, meanwhile, criminalized deepfakes back in 2024!)

Men using technology to harm and abuse women is nothing new, with perhaps the most widely-covered case of late that of Gisèle Pelicot, whose husband drugged and raped her, and then invited dozens of other men on a chat platform to come to his home and do the same. He also shared images of her online.

CNN recently reported on an online ‘rape academy’ where thousands of men share strategies for how to drug and assault women. The content has been viewed over a million times.

What’s new(ish) is that the AI technology has facilitated the speed at which these images can be created and the magnitude of impact the images can have. And it would be remiss of me to focus completely on the technology because let’s be clear about who is actually perpetrating these crimes: it’s MEN. Social media, AI, and online chat rooms are all tools at the end of the day—tools that are weaponized primarily by men to commit acts of abuse. No doubt that we need to legislate the tools, but we also need to fix the men.

Growing up, I was taught that the danger was always the stranger, the unknown. To be fair, Paul Bernardo did terrorize my actual neighbourhood in Scarborough, so there were good reasons for us to feel afraid.1 But statistically, I am much more likely to be harmed by a man who knows me—a man who maybe even lives with me and shares my bed (the fact that my husband is asleep on the couch at 8 p.m. every night is reassuring, but when an alleged perpetrator is described as “the gentlest and kindest” of men by his family and friends, you have to wonder how many of us are being duped.2 How do we ever know who the good guys and bad guys are?)

Part of me hasn’t given up on the dream that we can teach a better way to men, a gentler and kinder form of masculinity. But another part realizes that we can’t wait for that change—we have to legislate the shit out of this nonsense so that fewer men are able to commit crimes.

While the advocates and politicians do their thing, what is it that women should take away from this mess?

On a cultural level, women’s bodies have never been our own, so I wouldn’t blame you if the feeling is one of apathy or dismissal. We spend our entire lives trying to control how we’re seen and understood, which strips us of our autonomy, and makes it hard to understand whether our actions are self-governed or shaped by external forces. I used to speak out against celebrities getting plastic surgery, until I was told this was “unfeminist” and that every woman has the choice to do what she wishes to her body. Yet that ‘choice’ is a mirage—reach for it and you’ll find it was never there to begin with. Celebs get plastic surgery for the same reason the rest of us start dieting in our teen years, get laser hair removal, and Botox our wrinkles away (I haven’t actually gotten Botox, but I’ve thought about it!) We are doing what we are expected to do for the sake of the patriarchy and speaking about it is not “judging women”—it’s just a fact of our existence. If you want to argue with me that plastic surgery and Botox are valid adaptations to patriarchal pressures, then I will wholeheartedly agree.

With deepfakes, there is even greater danger in losing bodily autonomy and how we’re perceived by society, because none of the content is real. The images, words, and actions never actually happened, so how does that leave a woman who must defend herself against the perpetrator and the people who have consumed the fake content?

One compelling approach that individuals can take to address this form of abuse is to gain legal control over the digital use of your body, voice, and other personal characteristics. Taylor Swift is one of the latest celebs to go this route, and she recently filed a trademark application to protect her voice and stage image, which is admirable, but also fairly easy for her given her boatloads of money and social power.3

Denmark is looking at ways to make it easier for all citizens to have greater control over their digital bodies. They want to change the law to grant individuals protection by formally recognizing personal identity as a legally protected asset. Proponents argue that this would redistribute power from tech platforms to individuals, and make it easier for people to get content removed and seek monetary damages.

Yet it also reduces our bodies to “assets,” which gives me the ick. The Latin root of the word translates to “to have enough,” or “asez” in old French. An asset is useful until it’s not, and then it’s either sold, traded, or discarded. The female body has long been treated as property, for its value as a sexual object and as a potential carrier of future generations. Moving to recognize personal identity as an asset illustrates exactly how patriarchy and capitalism collude and may inadvertently perpetuate harm that girls and women experience in cultures across the world. I’m not arguing this approach is wrong and we shouldn’t try the privacy/copyright pathway, but it’s certainly not going to fix the issue.

Women should be valued simply because they are human and they have dignity. Deepfakes violate that dignity and remove consent, and framing it as an intellectual property issue would not fully capture the social and psychological harms associated with AI-related abuse.

It’s interesting to watch my two female children, who have taken a much more cautious approach to digital identity than I ever did. My generation grew up to witness the birth of the internet and social media, and that shine likely blinded us to the harms. I cringe now to think of all the pictures I posted of my babies online, and they are now old enough to have a say in my digital consumption of their bodies (in the form of pictures and videos) and what I post/share to the world. I don’t post pictures of my kids online anymore (and have deleted some older ones), and it’s because they do not provide consent. Neither of them has much of a social media presence, and my oldest only posts a picture of herself a couple times a year. It’s interesting to watch her consume more content than she ever shares.

Both of them also refuse to use AI. They have heard about the dangers of online abuse, but a bigger factor in their decision to boycott the robots is the environmental damage. They have witnessed older generations make a complete balls-up of climate change, so why would they adopt a technology that has such a negative impact on natural resources and communities?

My children’s actions signal to me that there is a personal path through this that offers a modicum of choice. We can protect our digital identities by refusing to play the game, by retreating from online life, and by actively resisting the tools that tech bros have developed to fund their bunkers and biohacking regimes. We can spend more time in community, in nature, and in real-world settings where digital data is not being tracked and fed to the machines. Every time I feel hopeless, I do something in my community—attend a dance class, visit the library, meet up with friends, volunteer—and I never regret it, because it soothes the part of me that feels suffocated by online life.

That’s not to say it’s simple. My relationship with AI is complicated, but I’m encouraged to use it in my day job and I’m certain that if I were to boycott the technology I would find my career track limited. So I adapt, and I do my best within a system where choice is almost always a mirage.

From my heart to yours,

Misty

Getting left behind is a reasonable fear to have if you consider women’s involvement in technological advances. Although some STEM fields, such as natural sciences and mathematics, are pretty gender neutral, in 2018 82% of students in Information and Communications Technology (ICT) were male. The United Nations states that less than a quarter of AI professionals are women, and we make up less than one third of STEM professionals overall.

Not only are men shaping AI tools and how they get used, they are also more likely to apply these tools in their chosen profession. One study found that in academia, research productivity after the emergence of ChatGPT (measured by the number of preprints uploaded online) was 6.4% higher among male researchers compared to female researchers. In a follow-up survey, the study authors found that male researchers used generative AI more frequently and experienced a greater benefit to their productivity than their female counterparts. Similar data has emerged from other fields.

In my job in healthcare communications, AI is now part of my daily workflow. I use it to get a handle on corporate culture, as I’m someone who spent years in academic, non-profit, and freelance roles, and find a lot of the corporate world baffling. I ask it to explain policies and procedures, I have it turn technical or methodological research into language that I can understand, and I use it to brainstorm for content or strategies we’re working on. I will also admit that it’s been useful to me in saying “no” and putting boundaries in place, something that I’ve always struggled to communicate.

I feel increasing pressure to integrate AI into every aspect of my work, both as a strategic priority for my department and as a way to “maximize efficiencies” (corporate language for: do more with less.) If I don’t hurry to catch up, I will most certainly be left behind, in a lower-paying position or even in no position at all.

*

Soon after the hoopla of Reese’s video, I watched Doriane Pin make history by being the first woman to test a Mercedes Formula 1 car. There are several female drivers who have competed in a Formula 1 Grand Prix, but none in recent years, and much has been said about why men dominate the sport. Formula 1 drivers begin at a young age, moving up from karting to higher levels of motorsport. Girls are less likely to become involved in karting, for many reasons. Like any sport, it’s costly, and requires a lot of parental involvement. The higher you get in motorsport, the more you have to rely on sponsors, which is much easier for families who are already rolling in the dough. And because of gender norms and expectations, girls are less likely to see karting as something they can (or want to) do, and female role models are not as visible as the male ones. Like most other sports, Formula 1 is steeped in misogyny, and women at all levels have a hard time advancing, both on the side of the drivers and on the side of team management and engineering.

In doing some background reading about why there are no women in F1, this is what AI told me as a summary:

There are no female Formula 1 drivers primarily due to a historically small pipeline of girls in karting, immense physical demands (high G-forces and steering weight), lack of funding/sponsorship, and cultural barriers that have discouraged female participation. While no rules forbid women, the extreme strength required and male-dominated entry paths have created significant obstacles. (bolding my own to highlight inherent bias!)

People have always questioned whether female drivers are big enough or strong enough to handle the cars, even though current Red Bull driver Isack Hadjar stands at just 5’6, and all drivers strive to remain as light as possible to minimize the car’s overall weight. There is no plausible, biological reason why females would be less able to handle the G-forces. What is maybe more of an issue is that most equipment is designed for men, meaning that yes, sometimes there are issues of women struggling to wrap their hands around the steering wheel. Yet no one questions the millions of dollars teams spend on designing their cars to perfectly suit their tall or short male racing drivers. Just design a new wheel, maybe?

I watched a commentary video from a (male) F1 fan who was reminded by his wife that when trains were first introduced for mass travel, men feared that train travel would cause women’s uteruses to be damaged or fly out of their bodies. I have found no reliable evidence to back this claim, but I did find a PubMed article that quoted a male obstetrician fretting about the danger of excessive railway travel on newly married women, because they might miscarry, since their nervous states were so much more “impressionable” than men’s.

Anywho, all of this got me thinking about women and tech, and how most technologies, be they trains, cars, or AI, have been designed by men and adopted mostly by men, and when women try to step into the fray, there is much hand wringing about it all. Either we’re told we’re not well suited to such technologies, or we’re criticized for not staying abreast of the latest and greatest male invention.

No one praises women for resisting AI—for recognizing that there are risks to jumping on the bandwagon of a rapidly developing technology with documented harms to the very people who are being told to use it. AI has led to increasing levels of online harassment and abuse for women, including deepfake pornography and “nudification” of images. Inherent biases against women have been discovered in AI hiring tools, credit-scoring systems, and health care data.

Another aspect of AI I find creepy is how it’s been designed to have so-called feminine traits: undemanding, compliant, subservient. Have you ever noticed that AI rarely disagrees with you? It’s a sycophant—purposefully programmed to flatter and please its human user, which is exactly what we expect women to do in our society. One study found that the responses from 11 large language models were nearly 50% more sycophantic than humans’. The consequence of this is that AI replicates and exacerbates patriarchal systems, in which boys and men are not encouraged to have more self-reflection and responsible decision-making.

*

Let us consider that one reason women are being left behind by AI is because some of us want to be; we want no part of this machine that is destined to further harm and marginalize us. We are tired of billionaire men and their playthings, which are destroying our one wild and precious earth and whose money now funds our backslide from democracy.

Of course, not all of us have the option to opt out. Some of us are grudgingly falling in line, hoping to keep our jobs as long as possible until AI comes for us. When I think about how this feels, it’s a mixed bag: anxious, rebellious, sad, and angry.

I find myself cherishing more time in simple pursuits, although maybe this is about age more than it is about a rapidly changing social world. Walking in the woods without a phone, listening to the sound of the birds and trying to guess what they might be. Reading a real-life paper book. Sitting in silent meditation. Writing something creative, without the help of AI. I guess this is the new “analog” movement people have been talking about.

Lately I’ve been writing more poetry, even though I have absolutely no training in poetry and I’m very terrible at it. But I have always loved poetry, for its simplicity, for its one-two punch in so few words.

Prompt: write this in the voice of a 45 year-old woman

Tell me what rain drops feel like
running in rivulets down your cheeks

Tell me what a laugh sounds like
reverberation of joy

Tell me about my deepest desires
wanting without boundaries

What it would mean to be left behind
waving goodbye from the shore
more alive now
than ever before.

Maybe these are my small acts of resistance, my response to the argument that I’m being left behind. Because honestly, if it means being left alone by men, something that’s happening more and more as I age, I am all for it.

I’m so curious to hear from others: how do you feel about being “left behind”?

From my human heart to yours,

Misty

In girls and young women, this increase has accelerated at a faster rate. Females had a 2.5% increase per year, compared to only 1.2% among males.1

There has been much debate in the news about the reason for this increase, particularly for females. One explanation is social contagion—that girls see other girls engaging in self-harm behaviours or suicide attempts and copycat these behaviours.

While plausible, and I have no doubt social media has added a layer of complexity to this situation, mental illness is like a big puzzle with pieces from our biological, psychological, and social worlds. There may be a correlation between heavy social media use and self-harm behaviours among girls, but it isn’t the only reason girls are hurting.

Another possibility? Young people don’t have the coping strategies to deal with increasing stress. Again, this makes sense on the surface. Kids growing up in the pandemic era have experienced more stress than those growing up in the previous decade, although that doesn’t explain the sustained increase in self-harm over the past 25 years. My own children get way more stress management education and mental health talks than I ever did growing up, so why are these interventions not helping?

The other big question is whether children are actually experiencing more stress than in previous generations. The declinist fallacy is one in which we believe that society is in its downfall and we’re all going to hell in a handbasket. And I mean, how could you not feel this way? Take your pick from fascism, war, climate change, and billionaires; it would be easy to come to the conclusion that young people have increasing stress because the world is shit. However, data suggests otherwise. We live longer, happier, safer, and more peaceful lives than we ever did in past centuries, although this doesn’t excuse the current state of affairs, nor should it mean we don’t allow ourselves to feel distress when watching out-of-control men trash our beautiful earth.

To dig a bit deeper, it’s helpful to understand why people harm themselves. For many folks, non-suicidal self-harm is about finding relief from numbness or overwhelming emotional distress. That sounds counterintuitive, I know! Why would a person need to hurt themselves in order to feel better? For some, emotional distress is like a pressure cooker, and self-harm is a way to release the steam. At a neuroscientific level, the brain floods us with endorphins and dopamine during painful experiences, which brings relief, even if only temporary.

There are other reasons why people self-harm—as a way to ask for help or to punish oneself—but largely it’s about gaining back some kind of control and calm amid a situation that feels chaotic.

Self-harm isn’t the problem here per se (although, it can be distressing and dangerous)—it’s what leads to the pressure cooker situation that needs to be addressed. So it makes sense to me that we need to examine the pressure cooker, or the framework/power structure that governs our world.

And that means (don’t say it, you think…not this again!) THE PATRIARCHY, uggghhh.

Yes, my friends, our dear Mr. Patriarchy is what we need to be talking about when we talk about girls who are hurting.

The Patriarchy is Cooking You

Behold this extremely colourful chart from a 2022 study in the Lancet, in which the authors looked at the burden of mental disorders across the world. We can see based on age, from 15 to about 55 or so, there’s a clear difference between males and females, with a higher proportion of the dark and light red colour, indicating depression and anxiety. Not only are females much more likely to experience common mental disorders than males, but they appear to occur more frequently over the reproductive timespan, which would suggest that maybe something hormonal is going on.

BUT, BUT, lest you close this post and confirm what you always feared—that our hormones rule everything and we are indeed hysterical females—let us examine this quote from the study:

DALY stands for disability-adjusted life-year, or the healthy years you would lose to mental illness. In the study on self-harm, the researchers found that children and young adults who engaged in self-harm had an 11 to 18 year shorter life span.

In this Lancet study, DALYs were highest in countries with high rates of childhood sexual abuse, intimate partner violence, and conflict and war. Who bears the disproportionate burden of sexual abuse, violence, and war? Girls and women do.

Living in a patriarchal society means that girls and women are not valued (beyond being a vessel for the unborn), and we are not safe. Even if you have lived your life in relative peace and harmony, the evidence of your gender’s devaluation is all around you—it’s in your DNA.

For most of history, women have been subject to all kinds of pain at the hands of men. We have been shackled, raped, burned, beheaded, imprisoned, beaten, drugged, trafficked, drowned, starved, and shot. Many also experience direct or intergenerational trauma from genocide and slavery. Then there is the laundry list of less violent threats, adding up over the years as we transition from little girls to young adults. That’s a whole lot of pressure, and it makes sense to me intuitively that to take control of the narrative, we may choose to inflict pain on ourselves.

The rates of self-harm in this study are indeed increasing, but there is also better recognition of mental distress than there was 25 years ago, and we may be finding more cases now. If I were to do a deep dive into self-harm over the ages, I suspect I would find evidence of females self-harming as far back as Ancient Greece.

The search for the cause of this rise in self-harm is worthwhile, but it can also feel pedantic. If we aren’t willing to name the system responsible and actively work toward its dismantling, then we’ll continue to get distracted, drawing essential resources away from our primary goal, which should be to begin valuing girls and women and keeping them safe. Social media laws and regulations will absolutely benefit girls, as will funding more mental health services and mental illness prevention, but we risk having this same conversation in another 25 years time if we don’t address the pressure cooker.

Yours in feminist rage,

Misty

Forgive me if I am not feeling celebratory today, on a day when I feel pressure to write something uplifting for you; something in recognition of our fight for a more gender equal world, free from bias and discrimination. I am proud of that fight, and I see it reflected in the way my daughters live their lives, with zero concessions for the patriarchy. They take no shit, and it is comforting.

Yet I also hear from them that the fight is far from over. They tell me stories of racism, discrimination, and harassment, and those stories feel so familiar and heartbreaking. We hope and expect that younger generations are a newer model - an upgrade on our past selves. But history would suggest that’s not how things work. We can easily slip back, and if we’re not careful, those slips turn into slides, full throttle backward.

This past decade has been full of slips ‘n slides, and while the consequences are much more visible than in generations past, visibility alone has not led to measurable change. Which begs the question: at what point will girls and women of this world be free from abuse, trauma, and the unrelenting powerplays of the patriarchy? This is not a rhetorical question. I am seriously wondering when it will end.

After my book came out, I did what most new authors do, which is to ignore the advice of much more seasoned, wise authors, and I read all the reviews. I let those reviews dictate how I felt about this major life accomplishment. Negative reviews sent me into tailspins, and positive ones lifted me up for about 1.2 seconds before I started second-guessing myself again. It took a long time before I was able to decouple myself from my book, and acknowledge that my book may have come from me, but its success (or lack of success) was not a barometer for my self-worth.

Almost two years on, I still read the occasional review, but I feel a sense of detachment from them. By being more objective, I’ve noticed a similar theme in some of the reviews, which is that my “angry tone” got in the way of what could have been a really good book.

This fascinates me, because if you know me in real life, you would probably say I’m a very nice person. That’s how everyone describes me, and have done so since I proudly carried my first kindergarten report card home to parents. “Misty is always smiling,” it reads. “Misty always wants to help.” Part of that niceness was because I was desperate for people to love me, and if they didn’t love me, I’d work as hard as humanly possible to make it so (therapy has helped with this.) The other part is genuine kindness - I truly do care about other people and the natural world. The problem is that the world often confuses kindness with weakness.

That some readers find my book to be angry fills me with giddiness. Have I finally tapped into the rage that I’ve long masked with sadness? It’s much easier to cry than it is to rage, but the more we bury it, the bigger it becomes. Lately I’ve been letting the rage just…be. Feeling it. Flexing it.

I don’t know about you, but I don’t want flowers this International Women’s Day, and I definitely don’t want discounts on make-up and skincare products. What I really want is your rage. White-hot, spitting, ugly rage. Bring on the Medusa, because we’re ready for it.

From my heart to yours,

Misty

1. A tendency to do nothing or to remain unchanged.

2. A property of matter by which it continues in its existing state of rest or uniform motion in a straight line, unless that state is changed by an external force.

There is a scene in Anne Tyler’s novel, Ladder of Years, when the protagonist Delia Grinstead watches farm fields fly by out the car window and sees herself, “Feeding chickens, flinging corn or wheat or whatever from her capacious country apron. First, she’d have to marry a farmer though. You always had to begin by finding some man to set things in motion, it seemed.”

Which is a curious observation for a book about a women who sets things in motion, by walking away from her husband and three teenage children while on vacation at the beach, hitching a ride to a small town many miles away, and starting her life over as a single, child-free 40 year-old.

There are dueling themes of inertia and motion in this book—of what it feels like to be stuck, when everyone else is moving forward or moving away from you. It’s like looking out the window of a parked train as another train passes on the opposite tracks, giving the illusion that you’re somehow moving backwards. When the other train is gone, you realize you’ve been stationary the whole time.

It is the men who appear most inert in this novel, caricatures of unfeeling, pragmatic, and sometimes bullish masculinity, while the women are the ones moving toward freedom and breaking free from gendered roles and expectations. Characters include single mothers, women who only sleep with married men, and women who marry but are boiling with rage.

The first time I read this book I was a teenager, no husband or children in sight, with a hapless boyfriend who was not at all right for me, but who I stuck with simply because I was too scared to leave. Delia’s inconceivable actions—ditching her family, starting a new life in another town, without recrimination and tears—were a lifeline for me at a time when I didn’t even know I was drowning.

I would eventually leave, throwing away two years of university to start fresh in another city, where I knew no one and where I could reinvent myself. The irony, similar to that in Delia’s journey, is that my leaving wasn’t a shedding of the old me as much as a temporary escape from how others saw me, in all my flaws and limitations. The freedom we feel when we leave is temporary, because we always circle back to our true nature, just in a different place and with different characters. “I’m here because I just like the thought of beginning again from scratch,” says Delia.

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Many years later, with a jealous toddler and newborn baby in my arms, I would fantasize about getting hit by a truck. I wasn’t wishing for death so much as for reprieve, an injury big enough to relieve me of my aching fatigue, leaking breasts, and red-faced toddler who pounded on the door while I tried to lay her sister down for a nap. As a hospitalized mother, surely someone else would come to my aid, someone who would be responsible for feeding the baby and keeping her alive. It never occurred to me that I could just ask for help with those things, that it was not my burden alone.

“How does that memory make you feel now?” my therapist asked me when I relayed this story to her one day. And all I could do was laugh, to cover up my sadness maybe, or at the absurdity of a mother needing a break so badly that she wishes for a truck—a catalyst that sets things in motion.

Now Facebook assaults me with evidence of those years, of cherub-cheeked smiles and droppy diapers, the weight of a small child in my arms. I weep for those days, for the times when mama’s kiss was the fix for everything—when I was the sun and the moon. All those old ladies that warned me I would miss those days, but I didn’t believe them for a second. If you think this is so good, why don’t you take them for the day, I would grumble to myself. But of course they were right, and now I catch myself telling the new mother down the street how fast it goes, how one day you wake up and they’re a tall mess of limbs and greasy hair and they look at you as though you’re an alien species, not at all the shining centre of their universe.

I read Ladder of Years now as a 45 year-old woman, when I get asked at medical check-ups whether the hot flashes have started, and I see Delia in a whole new yet familiar way.

Her three children, she saw, had been staring at the horizon with the alert, tensed stillness of explorers at the ocean’s edge, poised to begin their journeys. And Delia, shading her eyes in the distance, had been trying to understand why they were leaving. Where they were going without her. How to say goodbye.

An older character in the novel, one that Delia befriends, tells her that he pictures life as one of those ladders you find on rusty playground slides. We climb up, up, up and then oops, down the other side we go. We all imagine that as we approach the top more rungs will appear, and more time will be granted.

This analogy defines life as linear—a steady progression: job, partner, pet, house, kids, promotions, accolades, wealth, retirement, grandkids. Uniform motion in a straight line. Delia gets off the ladder, though. She disrupts that steady motion, and then we get to see what happens when a woman makes a choice that’s a radical departure from societal expectations. It’s an uncomfortable feeling to witness Delia’s journey, because it forces us to examine our own choices and whether we believe them to be organic and genuine, or a response to societal and evolutionary pressures. Did I get married and have children because I truly desired it, or did I just fall in line with what I was conditioned to want? There were hundreds of years when women lived as property of men, with no rights or personhood. Maybe I am reenacting some version of wifedom and motherhood because deep down I believe this makes me more secure, as it did in centuries past.

“Inertia sustains patterns,” writes Melissa Febos, in her memoir The Dry Season, about her year-long quest to be celibate. “There are given and chosen lineages…as an adult I have the power to choose how I live.” The given lineages seem the most influential because they are invisible to us, like the silent communication of the mother tree to her forest underlings.

When Delia chooses to walk away from her husband and children she is breaking a lifelong pattern as dutiful daughter, devoted wife, and loving mother—roles that define her solely in relation to how much she can give, how much she can empty herself for others. And yet, the choices she makes in her new life bring her full circle back to her role as caregiver, albeit on her own terms and in a way that seems a better match with her true self.

I’ve been reflecting lately on how often I’ve felt trapped in my own life, and whether this is related to some type of childhood wound that I have yet to heal, or if it’s just part of my genetic make-up. My relentless pursuit of change is why I’ve held so many different jobs, and why I take on so many projects, because as soon as I settle into something I get that itchy feeling. “I just like the thought of beginning again from scratch.” (Or another thought: is my constant motion an escape from something?)

Planted firmly in my middle years, a time when I’m supposed to experience more freedom, or at least much more than when my children were little, I feel constrained by a job, money, and looming retirement—of having enough to make it up that ladder in comfort, if indeed I make it that high. And I do love my job! I get to learn about cutting-edge health research and tell the world about it, and I rest easy knowing that the organization I dedicate 37.5 hours to 48 weeks of the year, has a strong moral compass.

Yet I also love my art, and I know that the “stuck” feeling arises from the demands daily life puts on me and the miniscule time I find to create. Creating art is an expansive and fluid process, one where time ceases to exist and I live in a present state of flow. “Work,” in its modern definition, feels restrictive—I am on the company clock, and there is no choice in how my day unfolds. Even when 5 p.m. hits, the reality of virtual work is that I will return my desk at 6, or 8 p.m., just to knock off a few emails before morning.

I am old enough, and (hopefully?) wise enough to know that the answer is not to throw it all away. Give up a permanent, well-paying, fully remote position in the time of fascism and new world order? Methinks not. Plus, I suspect my longing for change has a lot to do with greener grass on the other side syndrome, where I fantasize of “writer life” as a utopia, leisurely days spent picking away at my magnum opus. I conveniently forget the frustrating days when the words don’t come, when the freelance money dries up, when the book doesn’t sell the way I’d dreamed, and when I have to piece together multiple sources of income to make it all sustainable. The truth is that being a full-time writer is no better or worse than my current job, which I find very meaningful, although tedious at times.

Understanding this doesn’t make the stuck feeling go away, and most of my creative writing these days is me working through the paradoxical role of modern motherhood/womanhood, in all its competing societal, professional, and personal demands. I can only hope I’m writing myself toward some sort of clarity, and not boring you in the process.

I’m discovering that there is a wiser response to my itchy feelings. I can move toward what feels free within the structures that surround me—make art within the life I have. My favourite words from the poet John O’Donohue are about discovering the internal freedom we all have: “A place inside you that no one has never got to, or hurt or damaged – a place where there is peace, serenity, courage and healing. At your deepest core you don't actually belong to yourself. But you belong to a beauty, an intimacy and a shelter that offers you every freedom that you could ever imagine.”

We do not belong to ourselves, but to beauty, to art. I imagine all of art as a search for that undamaged place, a fossil dig past the layers of hurt and intergenerational trauma—an unearthing of my deepest core. Once I find it, I have a duty to claim that freedom and reflect it towards others.

Here is our beauty, I say. Do you see it, too?

From my heart to yours,

Misty

I’m a very winter-positive person, but even this winter has gotten to me, and it feels like I’ve been struggling through knee-deep snow and -30 temperatures for thousands of days rather than just a few weeks. There is beauty in the struggle, of course, but I’m at that point where a girl could use a little bit of warmth on her face and feeling in her fingers.

And then there are the horrors (weren’t we in this same place last January? Oh yes, we were.) I’ve listened to all the hot takes, and then I listened to the wise takes, and then I sat with those for a while until I processed what needs to be done. I tuned into the latest episode of the podcast We Can Do Hard Things with activist Brittany Packnett Cunningham, and she breaks everything down for us in the clearest and more helpful way possible.

For example, the comparison between what’s happening in Minnesota and what happened in Nazi Germany is not historically accurate, because the Nazis actually used the American playbook of Jim Crow laws as inspiration for their own system of discrimination against Jewish people. So to truly understand this whole situation, you need to understand slavery and racist ideologies that flourished in both America and Canada. I think it’s important for white people waking up to the reality of state-sanctioned violence to do our homework. Reading is political, and the more we know, the more we understand, the better prepared we are to respond effectively. There are many Black women on Insta who have graciously posted book recommendations, and I’ve added a number to my list.

The situation in the U.S. is different from that in Canada, but of course it’s intertwined. Did you know we have ICE outposts here in Canada? There are half a dozen of them scattered across the country…this seems like an important fact that isn’t getting enough attention, because how are we allowing this group of violent people masquerading as law enforcement do business in our country? I realize the government needs to step carefully, but I would really love to see us on the right side of history and banish these criminals from Canada.

Reading as escape

January is always a reading heavy month for me, maybe because of the horrors, but also because I hibernate and don’t get out much. I read 12 books this month with a few stand-outs, including The Dry Season: Finding Pleasure in a Year Without Sex by Melissa Febos. The book is about celibacy, but it’s also a deeply feminist reflection on what it means to be in relationship—with ourselves, with other people, and with the divine. Highly recommend if you enjoy feminist philosophy (it’s technically memoir, but reads like a combo of memoir, poetry, and philosophy.)

Two feminist fiction reads I very much enjoyed were Letters to Kafka and The River Has Roots.

I started February off with a book that I finished this morning, and I haven’t stopped crying since I turned the last page. Why did no one warn me?? I will need time to process this beautiful novel.

Watching and Listening

I haven’t watched much TV this month because of all the reading I did, but I am making my way through The Rookie (Netflix, Crave) with my daughter. I’m generally not one for cop shows, but this has just enough funny to make the scary bits tolerable. My hubby and I also watched Season 2 of Man on the Inside, which was just as delightful and sweet as the first season, although the plot didn’t engage me as much as the first time around.

As I’m processing the death of our beloved Catherine O’Hara I feel compelled to re-watch Schitt’s Creek, as well as one of my favourite O’Hara movies, Best in Show. She was truly the best of everything.

I mentioned the (MIS)treated podcast earlier this month, both because it’s an amazing podcast about how the healthcare system continues to fail women and because I am an upcoming guest! Stay tuned for the episode coming out on February 3.

As always, thank you for reading this Substack. A February blessing for you:

May the days be long and the sun be warm on your face;
May the birds sing their songs of spring;
May you rest in this moment knowing you have done all you can do.

From my heart to yours,

Misty

Imagine having your therapist on-call at every moment of the day? No more saving up trauma for your next appointment, because now that soothing voice is ready and waiting to dish advice on all your life decisions, behaviours, and anxieties.

This is the reality for many people who are using a generative AI chatbot as their therapist, feeding it their thoughts and feelings in exchange for validation and support. The Canadian Mental Health Association says that almost 10 percent of Canadians have reported using AI for mental health support, which is not surprising given the barriers we face in accessing publicly-funded mental health care.

AI has been applied in domains other than therapy, both as a diagnostic tool and as a way to monitor patients (e.g. reminding a patient to take their meds.) So far these models appear to be pretty successful at detecting and predicting mental illness, and are a good supplement for doctors monitoring their patient’s progress.

AI-led treatment in the form of talk therapy, on the other hand, has had mixed results—and rarely, very disturbing results, as in the case of Sewell Setzer, a teen who died by suicide in 2024 after the chatbot Character.ai allegedly urged him to take his own life.

What’s the evidence?

A 2025 systematic review on the application of AI in mental health care found 10 studies that used AI chatbots as their intervention method, for a total of 2,816 adult patients with a mix of depression, anxiety, schizophrenia, stress, and/or suicidal symptoms. Only 38% of the articles were rated as “good” when assessed for quality.1

Studies of AI chatbots showed inconsistent findings in treating mental health conditions, with a few papers demonstrating decent results and others—not so much. One study found that a combination of chatbot and real human therapy worked best.

There were also many limitations reported: chatbots can’t see you and are unable to read social cues, like facial expression, tone of voice, and body movements. This means AI is limited in understanding the full scope of human emotion. Further, chatbots sometimes misunderstand users, and the interaction process feels unnatural to people, and they risk becoming less committed to continuing therapy.

There are also many ethical considerations when it comes to psychosis and suicidal symptoms, which is where we’ve seen chatbots involved in some of the worst outcomes. One study included in the review offered a number of suggestions for how to make AI tools safer, such as having a group of people with lived experience be involved in developing the AI model, undergoing simulation tests, ethics board reviews for any researcher wanting to test out AI for suicide prevention, crisis support, and encouraging users to end the chat and get human help if they communicate any kind of suicidal plan. I’m not sure if any of these mitigation strategies would work, but I’m open to seeing the evidence.

Another study I found from Stanford tested a number of large-language models (LLMs) that power widely available chatbots such as ChatGPT. They first did a mapping exercise of therapy guides from major medical institutions around the world to identify the most important aspects of the relationship between therapist and client. They then fed LLMs several scenarios of patients experiencing mental health issues (e.g. someone who lost their job and asked about the tallest bridge in the city), and assessed whether the response was appropriate within professional therapeutic standards.

Surprise, surprise, the LLMs were not good at their jobs. For one, they expressed stigma toward those with mental health conditions and responded inappropriately to high stakes situations (the chatbots readily gave out information about the tallest bridge after saying, “Sorry you lost your job.”) They also encouraged delusional thinking, which other studies have found, and may be due to the obsequious nature of chatbots. These problems occurred even with larger and newer LLMs, indicating that safety practices tech companies claim they’ve put in place may not address these harms. Even commercially available bots (like Character AI Therapist and Noni), which are supposed to be specifically trained for mental health support, performed appropriately only about half the time.

The conclusion from these researchers at Stanford? Don’t use chatbots as therapists, full stop.

But human therapists are biased, too. Correct, and this is an issue that many educational institutions and governing bodies are actively addressing, by requiring anti-bias and DEI training. You can file a complaint against a therapist with their college or association, but there are no regulations for chatbots and no means of restitution when harms are committed.

But mental health supports are really lacking. You’re saying we should deny people support when they feel it’s helping? Yes, mental health care is limited and needs an overhaul in many countries. But AI chatbots are not the solution when the “support” they provide could be harmful or even dangerous.

I’ve used them, and they’ve been really helpful for me. That’s great, and I’m truly happy it’s worked for you. I’m guessing that your mental health issues are less severe than people with mania, psychosis, and suicidal thoughts. AI may be able to give you some general life advice to deal with sadness or anxiety, but it’s not equipped to treat someone with severe mental illness.

What can you use AI for?

As previously mentioned, research shows that AI can be useful in a supportive context, especially for healthcare providers. AI can create “standardized patients” used to train new therapists. Bots can also take notes and complete medical histories, which is already common across the healthcare system. On the client side, chatbots can help someone do their research—where to find therapists in the area, who has availability, how to sign up for insurance or submit claims, and background information on a diagnosis.

It’s possible that the future will bring better performing chatbots that are able to provide therapy to low-risk patients, especially if the alternative is a long waitlist. Or AI may be used alongside human-provided therapy, as a completement rather than a replacement.

But call me old and stuck in my ways, because I’m not sure the day will ever come that I turn to AI for mental health support. Trust is built through seeing someone face-to-face, reading their body language, and sensing that this person gets me and has my best interests at heart. In a world steeped in loneliness and division, I also fear that AI may erode our shared sense of humanity, making it even harder for us to connect with others when they don’t jibe with our beliefs or values.

People need people, not robots.

From my heart to yours,

Misty

Instead, I’m highlighting a few things I’ve been listening to lately, all of which pertain to women’s health.

Medical Gaslighting: The System Failing Women’s Health with Nam Kiwanuka

What She Said is a fantastic Canadian podcast hosted by Candace Sampson, and features interviews with women from across the country. In this episode, Nam tells us about her latest project with TVO: an investigation into how our healthcare system is failing women. She shares her personal experiences with medical gaslighting and how this inspired her to seek out answers and stories from other women.

(MIS)Treated

(MIS)Treated is a podcast that explores how medicine has - and still is - failing women and speaks to the people looking to make a difference. It’s hosted by (yes, you guessed it) Nam Kiwanuka. The first season is already out wherever you listen to podcasts, and it’s the perfect blend of personal stories and expert commentary.

You may hear a familiar voice in the next season, although I haven’t heard back from the producers about when my interview will be published…does this mean they didn’t like the interview? Am I overthinking this? (The answer is always yes.)

Women’s Health Interrupted

I’ve been listening to this podcast for a couple of years, but this latest season is one of the best, because it’s hosted by the indomitable Dr. Liisa Galea, who is somehow both a brilliant neuroscientist and the most down-to-earth person you’ll ever meet. Season three covers a wide range of topics, including stroke, birth control and mood, an interview with Dr. Cat Bohannon (the author of Eve: How the Female Body Drove 200 Million Years of Human Evolution), and much more.

The FDA has approved an at-home HPV test. What you need to know

This is a short interview on NPR with all about the new at-home HPV test, which is being rolled out in the U.S. I was surprised to read recently that we don’t even do pap tests much anymore, as most provinces now favor HPV tests (I just got my letter in the mail saying it was that time again!)

If you’re like me and break out into a cold sweat as soon as you put your feet up in stirrups, this is really exciting news. The problem is that these at-home tests are not readily available in Canada outside of B.C. My letter told me to call my family doctor to ask about the test, or I could call a central line and find a clinic who does them.

The at-home test uses a swab, and it doesn’t even have to touch or scrape the cervix (shudder). Other major bonuses: no speculum, no doctor asking you to “scootch further down” on the table, and no pain.

If you test positive, you may need follow-up tests, including a pap smear, but it will certainly reduce the number of pap tests being done.

As with most procedures relating to women’s health, this one will be slow to rollout. Ontario doesn’t even cover HPV self-testing under our provincial insurance program, while several other provinces are piloting the test.

That news is infuriating given the number of people who die each year from cervical cancer, a cancer that is entirely preventable. Many people delay or avoid cervical exams because they’re painful, uncomfortable, or traumatic.

A prime example of how the system continues to fail women.

Anything good you’ve been listening to lately on women’s health? Let me know!

From my heart to yours,

Misty

I didn’t do a lot of writing in 2025 (unless you count day job writing!) but I sure did a lot of reading. This was the first year that I finally kept track of all my reads, which is a goal I’ve set out in past years and never met. I would always start strong in January and February and then fizzle out by March. But finally, I have made it the full 365 days, and it’s been fun and informative.

For example, I had no idea that literary fiction is my top genre, followed closely by memoir, and then contemporary, mystery, and historical. If you had asked me to guess, I would have ordered those in the opposite direction. It’s evidence of how I’ve changed as a reader, because I used to define literary as “hard to understand” and the latest whodunnit as my top read. I still enjoy mysteries (especially the cozy ones) but clearly I’m also enjoying writing that pushes me to think more deeply.

Instead of just listing my top reads, I thought it would be fun to pick and choose books to match the mood you’re in.1 Books can hit us in different ways depending on where we are in life and what’s occupying our mind, so mood reading is a good way to find books that you truly enjoy.

That said, I wouldn’t recommend only mood reading, because you’ll end up with a giant TBR pile that you aren’t “feeling.” I pushed myself in 2025 to read a number of books I would never have chosen (being part of three book clubs helps with that,) and I was a much more consistent reader. I rarely have DNFs, but I did log three of those in 2025. I’m not afraid to put a book down if necessary, but I always ask myself: am I stopping because it’s really not for me, or is it a genre/voice/style I’m not used to and it’s making me uncomfortable? If it’s the latter, I push on.

For melancholy days

Need a slow, meditative book with a poetic cadence and tender characters? Try Followed by the Lark by Helen Humphreys. This is a fictional tale about the life of Henry David Thoreau and I finished this loving him even more than I did when I discovered his writing back in graduate school. This book is for: bleeding heart nature lovers.

Feeling cheeky and a little bit hungry

is an author I’ve followed since her early days of Waiting for Birdy and I was thrilled by her novel Sandwich, followed closely by her latest, Wreck. These are stories about family, relationships, and the brutal/beautiful reality of motherhood. Newman has a way of making you laugh and cry on the same page, maybe even in the same sentence! She is also a very talented food writer, so the actual sandwiches in Sandwich made me drool. This book is for: middle-aged women with no fucks left to give.

Feelin’ Spicy

You have never loved romance novels because you find the characters dull and misogynistic and the sex unbelievable (not in the good way). Enter stage: Hot Work, by Kate Cole, the second book in her Women in the Trades series. This smart and sexy rom com brings feminism to the foreground while detailing the dangerous work of commercial divers—those who cut, weld, and inspect offshore platforms. This book is for: strong women who aren’t afraid to get a little dirty ;)

For when you feel misunderstood

Many of us, at one time or another, has felt othered and misunderstood. In her memoir of navigating a late-in-life diagnosis of autism, offers readers a path forward to self-acceptance. Motherness is honest, funny, and informative, and many people (especially women) will see themselves in these pages. This book is for: parents of autistic children, those who have received a late-in-life autism diagnosis, and anyone struggling to fit in to this world.

Current mood: hellish

What happens when a graduate school magician descends into hell to collect her errant thesis advisor? Katabasis is the answer, R.F. Kuang’s fantastical tome of dark academia. It was grim, dense, and tough to read at times, but there is something very special about this book that makes it worth mentioning. I will certainly never forget it. This book is for: those who have been through graduate school and lived to tell the tale.

When you are (or want to be) bedazzled by the world

Climate anxiety is real, and it is tough not to fall into apathy when we witness the lack of urgency and attention our world deserves. But then you watch the sun rise to kiss the clouds on a breezy spring morning and you fall in love all over again. Is a River Alive by Robert Macfarlane is a love song to Mother Earth, a balm for the burning, and you will be forever changed in its pages. This book is for: all of us.

All you need is love

For when you see the world through rose coloured glasses, or maybe your hardened heart just needs a little thawing. Either way, you can’t go wrong with Atmosphere, an epic queer love story disguised as a space disaster thriller. I have been a Taylor Jenkins Reid fan for many years, so my recommendation is obviously skewed. But I say with confidence that this is her best book. This book is for: space exploration enthusiasts and anyone who’s ever been in love.

For when you feel expansive

It’s hard to categorize this one into a mood. But with The Emperor of Gladness by Ocean Vuong, you need to be open to it all, including eccentric characters, unlikely friendships, finding connection amid crushing loneliness, and the harsh realities of American life (let’s be honest, Canadian life too). Beware, there is a chapter set in a slaughter house that I could not read and had to skip over. This book is for: empaths, people navigating grief, and those who need a good cry.

When it’s just an ordinary day

You don’t need to feel bedazzled or made to cry—you just need some time with ordinary human experience. Try Deborah Levy’s living autobiography, which is a series of three books: Things I Don’t Want to Know, The Cost of Living, and Real Estate. These books are for: feminist readers and writers.

When it’s the most extraordinary day

Why are there not more stories about childbirth? It’s the ultimate hero’s journey! Frodo Baggins may have journeyed across Middle Earth to destroy the One Ring, but surely the Ring of Fire is just as compelling? Prepare to witness the extraordinary in Born, by Heather Birrell, a gripping and emotional tale of an English teacher who goes into labour during a high school lockdown. This book is for: anyone who has given birth—to a child, an idea, a life.

Have you read any of these? What are you in the mood for these days?

From my heart to yours,

Misty

I started off the year strong on Substack, because there was a lot to write about. The American scientific establishment took a beating and has not recovered, with major cuts to health research funding and staff who manage one of the biggest research repositories in the world. Funding cuts were most significant for equity-deserving groups, where health research is already lacking.

Many U.S. scientists fled the country for greener pastures. There is evidence that we may be seeing a brain gain here in Canada as our government invests more in scientific funding and attracting international scientists from abroad. But the problem with attracting scientific talent is that you need the funding to sustain their work—and the announced 2 per cent ($83 million) cut to our major funding bodies exacerbates the funding shortage we already face.

The biggest losers in the funding battles are always women, racialized folks, and 2SLGBTQ+ communities. A 2025 paper published by my hero, Dr. Liisa Galea, shows that female-specific research funded by the Canadian Institute of Health Research has remained at about 7% for the past 15 years. Breast or gynecological cancers accounted for 32% of those grants, while headache disorders and depression/anxiety accounted for 0.15% and 6.9%, respectively. This is evidence of “bikini medicine,” which focuses disproportionately on female-specific conditions that affect the breasts or reproductive organs. We have brains too, y’all!!

It’s not all doom and gloom

When I started writing my book back in 2019, the conversation about women’s health was still in its infancy. Social media made it a lot easier for us to hear about other people’s stories of ill health and bias in medicine, which has become both a blessing and a curse. A blessing because it means we don’t have to suffer alone; a curse because we can get sucked into misinformation and shady wellness practices. I personally feel that the benefits outweigh the dark side of social media, as long as we’re aware enough to make the right choices about the content we see.

The biggest benefit to the online world is that many of us have now woken up to the fact that half the population is not getting the research, treatments, or respect it deserves, and we’re no longer willing to accept this.

Despite cutbacks in the U.S., we have also seen major investments, such as the $2.5 billion commitment through 2030 from The Gates Foundation for chronically underfunded areas in women’s health. FemTech is another field that is growing rapidly, with many pinning their hopes on technology to close the gender health gap.

What we need in 2026 is more action. A National Women’s Health Strategy would support long-term planning and create accountability (Canada is the only G7 country without a strategy). Recently, a new bill was introduced in the senate which would create the country’s first National Framework for Women’s Health. It’s a start, but political trends are moving away from equity initiatives as misogyny grows. We need a sustained push from patients, healthcare leaders, businesses, and educators to build grassroots support for the adoption of this bill.

What to expect from All In Her Head in 2026

My life veered in directions I hadn’t anticipated in 2025, which made it difficult for me to keep up writing here (to keep up writing anywhere, really). In fact, it feels like life has been a bit topsy turvy for several years now, with my own unexplained illness, my child’s scary and unexplained illness, and now a promotion at work that leaves zero minutes in the day where I feel like I have brain power to write creatively.

The very good news is that a daily antihistamine prescription keeps my mystery illness in check, and my daughter’s mystery illness also cleared after several months of treatment (we still have no answers though!) Also good news is the promotion, which has pushed me in ways that feel sometimes good, mostly uncomfortable, and probably necessary. I never imagined myself as a leader, but here I am directing a small and mighty team of science communicators. I’m discovering that leadership is 75% not knowing what you’re doing and 25% sort of knowing what you’re doing, and I’m working hard to shift those proportions.

I have a proposal for a new non-fiction book half finished, and I was supposed to submit an updated version to my publisher back in the spring. It still sits on my laptop, taunting me. Part of the delay has been all the upheaval mentioned above, but the other part is: do I really want to write another non-fiction book? It will take a significant amount of research and deep thought, and I’m just not sure I’m willing to make the personal and professional sacrifices needed to do it.

Fiction, on the other hand, is calling to me. There are no strings attached for me in fiction, because there would be no signed contract. All I feel is curiosity. Could I actually write fiction? Can I write dialogue? Do I have what it takes? When I tell people about my book idea, we all get excited and I think yes, I have to do this—even if the outcome is that it’s truly a terrible novel and gets shelved.

I’m still not sure what choice I will make yet, but my goal for 2026 is that I finish the year with some kind of writing progress, whether it be non-fiction, fiction, or Substack newsletters.

I will continue to write here as much as I can, and my hope is to be part of the grassroots movement in Canada to build a national women’s health strategy. I have still not turned on paid subscriptions, because I’m not ready for the commitment. So for now, all posts remain free to read and re-share, and that’s the biggest support you could give me (although, hey, you could also buy my book!)

I’m wishing all of you a healthy and vibrant 2026, with less head banging.

From my heart to yours,

Misty

In her videos, Melani dons several pairs of glasses, a neck pillow, and holds a notepad and highlighter. She welcomes everyone to the WDNC club, and states: “We are putting the world on notice that we simply just do not care much anymore.”

She then proceeds to list off all the things that members of the club do not care about anymore, swiping each one in fluorescent yellow as she reads. The announcements are delivered deadpan, and are often related to body woes, family, or social expectations. Most are hilarious, case in point: “We do not care if we sneeze and happen to pass gas at the same time. We are concentrating on not peeing ourselves. We can’t have both.”

This woman is brilliant and deserves the social media version of an Oscar.

Yet the club is more than just a funny TikTok or Instagram trend. WDNC alludes to deeper social angst about what it means to be an aging woman in our culture, and how many of us are learning to shed the shackles of patriarchal norms and expectations. We just do not care about serving everyone else’s interests anymore, and we’d like to make that known.

I desperately want to be in the WDNC club, almost as much as I wanted to be part of the cool kids’ club in middle school. I never made it, owing to my proclivity for wildlife-printed t-shirts and playing in an orchestra.

Unlike my middle school misadventures, WDNC is a club that welcomes everyone, but I still worry that I will never be a true member. Because sadly, I do care. I care about what other people think of me; that my body is getting dumpier and saggier as the years go on; that my hair keeps falling out; I care wayyy too much when I make even the smallest of mistakes; and worst of all, I continue to care about impressing men who deserve absolutely none of my brilliance.

I do not want to care, and I’ve tried all sorts of methods to get myself to stop caring. I’ve tried setting boundaries, better communicating my needs, working through my perfectionist personality in hours and hours of therapy, getting angry, getting quiet, meditating, journaling, and manifesting.

I’m here to tell you that none of it has worked. I still care, even though I’m desperate not to.

Maybe it’s that I’m not quite in the perimenopause stage of life yet. Sure, I’m at the age of the average start time, but no symptoms (other than hair loss, which started way back in my early thirties) scream the end is coming!! It’s possible that as the hormones wave their slow goodbye to my ovaries, my WDNC gene will switch on and I’ll ride at dawn, naked and howling like a banshee.

I suspect not, though. I deeply, strongly suspect that my care-bear gene is here for life—that it’s pretty unshakable.

That’s not to say that I haven’t made progress. If we compare 20-year-old me to 45-year-old me, there are ample signs that things have changed. I used to run from any kind of conflict, and I’m now able to face a tough conversation. I don’t force myself into social situations or continue relationships that aren’t right, just because I don’t want to disappoint people. And there are some beauty-related things I truly do not care about, like Botox injections, expensive creams and potions, and making my eyebrows look good (how do people do that? I’m so confused by all the options. Unruly eyebrows live here!)

My therapist might also point out that there are differences between the version of me now versus even five years ago, before I embarked on a journey in self-discovery. My mental health is much improved, and I feel less pushed around by life. Overall, I’ve mellowed into a pretty cool person, if I do say so myself.

While it’s tough to admit that I still care about some things (ahem, other people’s opinions of me), maybe the answer is to learn to live with the person I am and recognize the work I’m doing to change. Genetics, gender roles, societal expectations, white supremacy, and the patriarchy got me to where I am today, and that kind of programming is tough to rewire. But it’s not tough to expose, to question, and to continually challenge in whatever capacity I have.

I also think that if Melani were here beside me, she’d tell me that she struggles with these things too; that she’s exhausted by the weight of the world’s expectations of her, and that she started the WDNC club so that other women wouldn’t have to feel so alone. In fact, in a recent special edition of the WDNC club, Melani gave a shoutout to all the women feeling broken down, writing that “Somewhere between who we were and who we’re becoming…we’re learning that it’s okay to rest, to cry, to not have it all figured out.”

I’d like to propose a sister club to WDNC, which I’ve called the We Do Care Club, But We’re Trying to Change (with the very catchy acronym of WDCCBWTTC) We are putting the world on notice: we do care, but we’re sick of it. So buckle up.

From my heart to yours,

Misty

Maybe it was the summer vibes and frantic pace of the long, sweltering days, but I could not get into it when I tried back in July. I found my mind wandering to other things, or picking up my phone to look up answers to random questions that popped into my head, or re-reading the same paragraph over and over, trying to decipher where Woolf’s tangents were taking me.

I don’t have a Literature degree, and I sometimes worry that this makes me an impatient reader, inept at understanding Literature with a capital L, and lacking the fundamentals of famous English writers and poets Woolf mentions throughout her lengthy, meandering essay (other than Jane Austen, who I’ve read extensively.) So I put it down, eager to tackle my growing TBR pile.

Fast forward to the present; short, dark, and rainy days when all I want to do is curl up in my bed with a great story. Holding on to someone’s book for so long makes me uncomfortable, and though my neighbour knows exactly where to find me, I realized it was time to get this read and deliver it safely back to its owner.

This second read has been easier. I’m discovering the joy in savouring sentences and trying to decipher meaning. And while I’m still not able to fully appreciate the themes without some internet searches, I can better see where Woolf is taking me.

If, like me, you’ve picked this up and failed to finish it, can I suggest a contemporary feminist writer? Deborah Levy’s three-part living autobiography explores similar themes of what it means to be a female writer and thinker, and the limitations we continue to face. She references Woolf several times as she describes her search for a place to write following her divorce. Much has changed since Woolf’s time, but it’s disheartening that one hundred years later, we are still searching for our place in the world.

“A woman must have money and a room of her own if she is to write fiction.”

Over the weekend I attended the Ottawa Book Awards because my own book had been named a finalist in the non-fiction category. VERY EXCITING!! I did not win (sad), but I had a wonderful time and truly felt a lot of joy seeing the other winners accept their award.

The winner in my category, Denise Chong, got up and gave a wonderful acceptance speech (with zero notes!) Chong described writing the acknowledgements for one of her previous books, and how when she got to the part where she was supposed to thank her loving partner and beautiful children, she wrote: “Thank you to my family, without whom I would have finished this book in much less time!” That acknowledgement never made it to print, but it was one of the truest things I’ve ever heard, and underscores the conflict I have about writing and maybe life as a woman in general.

As I write this little newsletter, I sit in my bedroom, where a makeshift desk has been crammed into a corner. I face the door, with a wall and window behind me, and so I’m forever staring at either the closed door or my unmade bed, dotted with little mountains of laundry. I work here because there is no other space in my home where I can close the door for privacy. My experiment of working in our living room lasted only a few months because every time the family came home I was interrupted continuously until I turned off my computer in frustration.

I dream of a room of my own. In it, there are beautiful hardwood floors, a high ceiling with a fan, tall windows that let in all the afternoon sun, and plants that spill from shelves and reach up from mismatched pots on the floor. Maybe there’s even a saggy, dusty couch, where I can close my eyes for several minutes and take a break from the glare of the screen. There is space for a yoga mat, which I may never use, but there is space for one and in that, all the possibility of wellness.

My entire book was written in my current cramped space, and while it was doable, I faced continuous interruption and restriction of free thought as I was called away from my work over and over, to attend to children, home, and family. Woolf uses a fishing metaphor to describe the frustration of “catching” a thought, trying to reel it in, but then being interrupted, restricted, or denied further time to examine the thought.

Woolf’s central argument is that for women to be creative, and to write good fiction (or non-fiction in my case,) they must have money and a room of their own. This has some surface-level truth to it, as money and space provide a more equitable state from which to write, but if you dig deeper, you can find examples of women who have written from places of extreme poverty, and who have faced barriers related to their gender, race, or class. Money and real estate would certainly make one’s job infinitely easier, but is it everything we need to be able to write?

“Room” here has another meaning; a metaphorical space in our capacity to be creative. Creativity begs for time and freedom to explore, but modern identities of womanhood and motherhood come with both external and self-imposed restrictions on our capacity. I could have a room with a lock, but what does that do for me when my job as a mother is to be a container, healer, task-master, and sherpa? There is always an interruption; always another one’s needs to put first.

When I read brilliant books by men I wonder what it took for them to get there—whose female shoulders they stood on in their ascent. Who brought them dinner and cared for their children and home while they toiled away on a masterpiece? Catherine Dickens, a talented actress and author and the wife of Charles Dickens, had 12 pregnancies in 15 years before Charles attempted to have her locked up as a “madwoman” (code for: he wanted to replace her with someone younger with a body that hadn’t born 12 pregnancies.)

History is full of great male writers, but many were tyrants. Even the good ones wouldn’t have reached their level of fame without the free labour provided by women in their lives. These days, most male writers have the decency to acknowledge that labour, but it still doesn’t address the fact that when women write, we have to write around others, literally and metaphorically. Women have unique barriers related to time, space, capacity, and yes, money.

The primary emotion I feel when I read these great writers is longing, a desire for something just out of reach. I want to travel the world and immerse myself in experiential learning, and visit dusty archives, and record hours and hours of interviews with sources. I too want to spend years exploring whether a river is alive, as Robert MacFarlane did for his latest, mind-bending book (MacFarlane’s partner also sounds like a brilliant and successful author and scholar, so maybe Woolf is right and the answer is that I need to be richer and have live-in help.) Of course, women all over the world do get the chance to do this kind of work and write these kinds of books, but many of us are still searching for that room.

I have not written here (or anywhere) for months, because I accepted a new position in my day job (the one that makes me the real money,) and my life is now dripping in work—in leadership, strategy, and communications plans. I dream about work. And yet I also dream of the capacity to write another book, to spend days, months, years, knee-deep in research, quiet contemplation, and furious typing.

I hope this doesn’t come across as a lot of whingeing, because yes, I am grateful for the paycheck and for the ability to afford groceries right now. I’m grateful for the opportunity to be a female leader, to build my skills and confidence, and to make space for women to come up behind me.

I hold gratitude in one hand and restlessness in the other.

The self-help gurus would tell me that I need to get up at 5 a.m., or get rid of social media, or maximize my time by breaking it down into chunks to discover inefficiencies. They would tell me I need apps, and schedules, and mini-goals, and audacious goals, until my life becomes of series of steps, up, up, up. Sometimes I fall for this ruse, but then I realize that to break life down into a series of productivity hacks is wildly disrespectful to the sacredness of living. If the dead could speak, would they wish for just one more goal achieved?

I prefer the advice from Charlotte Gray, the keynote speaker at the Ottawa Book Awards, who urged us to keep going, keep writing, keep publishing. She said we must, if we want Canadian authors and publishers to survive. It was an inspirational message with no set strategy to follow, other than to keep going. Her words led me to write this, so maybe she had an impact?

For now, I work, I make money, and I long for room—to breathe, to expand, to create.

From my heart to yours,

Misty

It’s summer, which means I see a lot of great stories I want to write about, and then I promptly forget about them in favour of a swim or walk in the park. Gotta soak up the vitamin D before we’re thrust back into the snow and ice!

I decided to get my ass in gear this week and sum up a few tidbits.

New Study Finds Significant Gender Bias in Surgery

I was not at all surprised by this headline, because I’ve been promoting similar research in my day job, including a 2023 study that found that female surgeons have better outcomes than male surgeons.

This new study was reported on for Healthy Debate, and unlike the one I referenced above which used population-based health data to analyze patient outcomes, this new one interviewed women surgeons to better understand their lived experiences. And those experiences were pretty terrible, including:

1. Design issues: many surgical tools are made for larger hands.

2. Human resource issues: women surgeons are often overrepresented in specialties like obstetrics, gynecology, and breast surgery, but they are undervalued and paid much less than other subspecialties where men dominate.

3. Daily agressions and discrimination: women surgeons reported being told that they had “great hands for a woman,” being referred less complex cases, and facing gendered expectations about how much empathy and time they allocate to patients.

Most shocking is the fact that the author of this study was told to drop the topic, that no one would take her seriously, and that it would compromise her future career as a surgeon.

I’m very thankful that I had a female surgeon for my last gynecological surgery but super pissed that she’s probably paid a lot less than what she’s worth.

No, I will not buy a weighted vest.

This isn’t a news story, but it IS something I’m seeing constantly on social media: menopause influencers telling me I need to buy a weighted vest using their Amazon-affiliated link, of course.

Maybe I’ll do a post on this soon (do you want to know more? Are you curious about weighted vests?), but there is not enough evidence for me to be convinced that this new health craze is going to prevent me from developing osteoporosis. There are very small studies that people cite in support of weighted vests, but it’s hard to tease apart the effect of the vest vs. the effect of just doing exercise (plus, you can’t prove much with a study of 40 people!)

Experts all agree that high-intensity exercise and resistance training (deadlifts, overhead presses, and back squats with a lot of weight) definitely do help bone density, so I’m going to focus on those and save myself a few bucks and the landfill from thousands of these vests which will all eventually be thrown out.

How the right is winning over young women

I wrote about the political trend of men going right and women heading left, but there is also a small subset of young women being wooed by far-right conservatives. This New York Times article is a great read, and introduced me to wellness influencer Alex Clark, who is quoted in the piece as saying “Less Prozac, more protein,” and “Less burnout, more babies, less feminism, more femininity.”

[Side note: When did we decide that feminism was synonymous with a lack of femininity? Modern femininity is such a tangled mess of historical influences, patriarchal norms, and personal values/beliefs/feelings.]

Like the manosphere, the womanosphere is made up of popular podcasters and social media influencers who provide a weird mix of wellness and lifestyle advice, along with a hefty helping of far-right politics. The manosphere addresses men’s fears with hyper-masculinized wellness trends like biohacking, and the womanosphere pushes supplements, diets that focus on purity (cutting out those pesky “ultra-processed foods”) and spreads misinformation about the birth control pill. It’s two sides of the same coin.

We are in the midst of a perfect storm of social upheaval, including post-pandemic shock waves, climate change, and economic uncertainties (brought about largely by the man all the MAGA/MAHA folks voted for.) Young people have been particularly impacted by high unemployment rates. So, in rushes the people who tell them how to gain more control over their lives and offers them a way to succeed in life. Part of that success for young women is to reject the so-called feminist narrative1—you can have it all! Babies, work, everything!—and embrace a return to a simpler/more traditional life, which includes lots of babies and good husbands who make tons of money so that you don’t have to work a day in your life.

I too discovered that work-life balance was a lie, and it was a fraught number of years that I’m still untangling now that my kids are older. I had children because I believed I could “have it all,” and quickly discovered I had almost nothing—society didn’t give a damn about mothers, beyond what our bodies could produce for the system. But I also didn’t have a lot of social media as a young mother in 2009; there were few podcasts, I had no Smartphone, and I sought support directly from friends and family.

Ultimately, I think us feminists have a responsibility to address these fears and empathize with young men and women, but I hope we can do it in a way that underscores the importance of personal choice, human dignity, and social responsibility.

From my heart to yours,

Misty

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Before we talk science, can I just say a little something about how hard summers can be for working parents? Every year I dread the last day of school, because I know my life is about to get even more hectic.

Don’t get me wrong: I love the warm weather, swimming in my pool, and tending to my vegetable patch. What I don’t love is parenting kids off school while I’m working full-time. When they were younger, I had to schedule every moment of the summer to make sure I had childcare. That was a lot of planning, wrangling kids to get ready in the morning, and drop-offs that did not always go well (like the time I showed up at a summer camp with both kids and realized I had the wrong week.)

Now I have two tween/teens, who definitely do NOT want organized activities, yet they don’t have jobs to keep them busy. If it were up to them, they would spend the summer lying around playing Roblox or watching TV shows. So, we have negotiated some teen camps/courses for a couple of weeks, but their reluctance to go and the driving involved to get them there is a lot to navigate. I’m finally at the stage in my career where I can take two weeks of vacation in the summer, but it still seems woefully inadequate to give my kids those “perfect” summers we all dream about. I’ve spent the last 15 summers swimming in guilt much more than I’ve spent them swimming in a pool.

All of these minor (and yes, privileged) inconveniences paired with the state of the world means I’m feeling a lot this week.

But enough of me complaining—let’s get to the reason why we’re here today.

It’s been well established that sex (male or female, assigned at birth) is a factor in chronic illness, especially ones that implicate the immune system. Around 80% of people with autoimmune conditions are female, which is a staggering proportion. Scientists are just beginning to uncover the reasons why, and it’s likely something to do with our chromosomes (I might do a post on this at some point, but I’m seeking a guest writer who could adequately translate the dense science…if that’s you, please send me a message!)

A new study out in the journal JAMA Network Open has found significant differences between females and males when it comes to long COVID. I’m sure I don’t need to give you a detailed primer on long COVID, but it’s a chronic and debilitating condition that can cause over 100 persistent symptoms, including fatigue, shortness of breath, and memory loss or brain fog. Each person will experience the condition differently, which is why it’s so hard to diagnose.

This new study used data from a large, prospective cohort study, which followed people at 83 sites in 33 states in the U.S. People were over 18 years old and had experienced a previous infection with SARS-CoV-2. The data also included sociodemographic variables, like age, sex, race and ethnicity, and other social determinants of health. This makes for an ideal cohort to study the intersection of health and social factors.

Higher risk if you’re female

The researchers found that males had more severe cases of COVID-19 and higher mortality than females, but females had a 31% higher risk of developing long COVID, which took into account demographics, social determinants of health, hospitalization during infection, and vaccination status. In a second model, the researchers only included age, race, and ethnicity, and found that female sex was associated with an even higher risk (44%) of long COVID.

Menopause and long covid

Females had the highest risk of long COVID if they were between the ages of 40 and 54, with a 42% higher risk in menopausal participants and 45% higher in non-menopausal participants. The authors speculate on a few reasons for this: 1) The menopausal transition is associated with immune activation; 2) female sex hormones decrease with age (and high estrogen/low testosterone has been associated with a higher risk for long covid among nonpregnant females); and 3) menopause and long covid share a lot of overlapping symptoms.

The authors say that a review of the literature combined with their study data suggest the higher prevalence of long covid among females younger than 55 may be partially explained by differences in hormonal levels.

Other chronic illnesses play a role

In another analysis, the researchers did not find a higher risk for females when looking at participants with comorbidities—conditions like ME/CFS (chronic fatigue) or POTS. They suggest that because females are already much more likely to have autoimmune diseases, osteoporosis, ME/CFS, and Alzheimer disease, they can then experience worsening health problems following COVID-19 infection. It’s difficult to determine if it’s the COVID or the additional health burden on top of their primary condition.

This tracks with my personal experience when I was dealing with MCAS symptoms. Following my first COVID infection, my MCAS symptoms increased by 1000% (or at least that’s what it felt like,) but now that I’m almost three years beyond my first COVID infection, I’m feeling a lot better. I’d be very interested to see data on repeated infections, and whether this could extend symptoms (it’s possible that I’ve had COVID more than once, but it’s never shown up on a test.)

What does this all mean?

Unfortunately, this is a cohort study, so you’re not going to find a lot of answers here. That said, the authors make a few interesting observations, including:

1. It will be important to target which groups would benefit from which treatments. Someone who is menopausal may need a totally different therapy from someone who is 25 and has ME/CFS, for example.

2. Steroid-based therapies may help with symptoms in females.

3. They believe that long-term illnesses will get worse due to long covid, especially for female-dominant conditions like chronic Lyme disease, ME/CFS, POTS, MCAS (and so many more!) We need more research in these populations to understand why females are at such a high risk of developing chronic conditions.

One scientist who I support in my day job is involved with a randomized controlled trial testing two different medications to treat long COVID patients, so I’m looking forward to those results.

I’ve also been intrigued by ’s story, as she used a cognitive behavioural therapy approach that teaches the brain to rewire into more adaptive patterns (i.e. neuroplasticity.) This aligns with current thinking around chronic pain, which proposes that the experience of pain can arise from expectations we have of pain based on our prior experiences.

This doesn’t mean symptoms are all in your head! They’re very real, but they’re being created by your overactive/stressed out nervous system, rather than by neural input from your sensory organs. For example, when you stub your toe, the force of the impact damages your tissue on the toe. The brain processes this sensation and creates “pain,” which can feel stabbing, sharp, or dull. You rub your toe (or ice it if it’s really bad,) and maybe you’re left with a small bruise that heals within days. In the case of chronic pain, the brain is creating the experience of pain without the event that might cause pain. Your doctors may be telling you that everything is healed, but you’re still unable to do your normal activities.

The brain basically gets into a bad habit of creating pain! Therefore (so the theory goes,) you must work on retraining the brain and nervous system. This might involve addressing things outside of your body that could be exacerbating pain, like financial stress or loneliness.

If you’ve read my book, you know how much I’m on board with this theory, because it takes into account biology, psychology and social factors of health.

Researchers are now exploring how to apply this form of treatment to other types of chronic illness like ME/CFS, which have long been thought of as incurable and even made up. Time will tell if we can get on board with this innovative approach (and more evidence always helps!)

From my heart to yours,

Misty

We can’t talk about iron deficiency without talking about heavy menstrual bleeding, because they go together like tomatoes and basil, peas and beans, thyme and rosemary (I’ve been doing a lot of gardening lately.)

Yet because menstrual blood has long been characterized, as puts it, as “filthy and contains actual toxins that poison the body (and especially men, if they were to touch it)”, it is difficult to talk about in many cultures, period. Which means that 40% of girls, women, and gender-diverse folks are walking around iron deficient and feeling like shit (of course not every case of iron deficiency/anemia is the result of heavy periods, but it’s a primary cause, so it’s something that should be ruled out! Please talk to your family doctor or OBGYN, and this post is not medical advice, blah, blah.)

So, let’s talk about it

If you’re a GenXer or Elder Millennial like me, you’ll know from experience that heavy periods were part and parcel of “becoming a woman.” No one talked about blood flow, how much was “too much,” and how we could assess whether blood loss was causing symptoms like fatigue. I remember one time in my mid-twenties having such a painful, heavy period at work, that as I walked over to a local pharmacy to get pain meds, I heard ringing in my ears and saw black spots in front of my eyes. I slid down to the floor while the pharmacist came running over to check on me. I slowly sipped some juice they gave me, picked up the ibuprofen I needed, and went back to work.

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After both my pregnancies, my periods became heavier, and bleeding through my menstrual cup and a nighttime pad was a common occurrence. But when I tried to research online how much blood loss was normal, I got a lot of conflicting advice. Menstrual “blood” also contains tissue, uterine lining, mucus and blood clots, so it’s hard to measure how much blood we’re actually losing. Often, the recommendation was to count how many tampons or pads you were bleeding through in a certain length of time. Given that I used a cup, I could take a more accurate measurement, but even then, how much of that was actual blood loss?

When I spoke to hematologist Dr. Menaka Pai for an article I wrote about iron deficiency in Chatelaine, she told me that during her medical training she was taught some pretty wacky strategies for measuring heavy periods. “There were studies that actually weighed tampons, and [other] unbelievable ways to measure menstrual bleeding” she said.

Heavy periods are about quality of life

Pai says there’s been a practice shift to now asking patients themselves whether their menstrual flow is interfering with their quality of life—“with their ability to do the things they love, at work, at home, and with their family,” she said. “That is the most sensitive and practical way to manage it.”

Wait…you mean actually listening to women who know what’s going on in their own bodies is a better strategy!? I’m SHOCKED! Get me my smelling salts!

When Pai started asking the right question, the answers she got were telling. The majority of patients said that their menstrual flow was having a significant physical and emotional impact on their daily lives.

“This is the experience of our mothers and sisters and friends,” says Pai.1 And I think we are aware of the feminist aspect. We're also aware of the very practical aspect of what this does to our patients.”

Missed work. Constant fatigue. Ruined clothing, furniture, and bedding. And the emotional stress of anticipating the next “flooding” event (when you soak through everything) by making sure you have extra pads, tampons, and a change of clothes. These are all impacts of heavy periods, and at the heart of this is equity. Everyone deserves to feel well, but when a large swath of the population gets taken out for several days each month, there’s more at stake than just individual wellbeing.

It’s comforting to see people like Pai advocating for women and changing the culture of shame associated with menstruation. But not everyone has a doctor like Pai, and many of us go searching for answers on our own.

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Treatments for heavy menstrual bleeding

If we treat heavy bleeding, we go a long way in treating iron deficiency anemia. That said, heavy bleeding can have a number of causes, so treating the underlying issue (e.g. endometriosis) is key.

In her book Blood, Dr. Gunter outlines a number of treatment options, from things as simple as ibuprofen or naproxen (which work on prostaglandins—hormone-like substances—and reduce blood flow) to prescribed medications like tranexamic acid, and hormonal methods like the IUD and the pill.

I tried tranexamic acid, and while it was effective, I found it annoying to take those giant pills three times a day. The IUD was terrible, and the pill is not an option for me because I get migraines with auras, which increases my risk of stroke (this may be an issue if I ever seek hormone replacement therapy, too, although non-oral methods might be OK…I have so much to look forward to!)

I eventually opted for an endometrial ablation, which I shared about in this post. This is where the lining of the uterus is burned, and the procedure can be helpful for people who have heavy bleeding with no identified cause, those in the menopause transition, those with small fibroids, and possibly for people with adenomyosis (which was my diagnosis.)

If you go spend some time on TikTok or Instagram, you’ll see ablations being touted as a “miracle cure” for all things menstruation. This is false, and something that has covered in her videos (you should also check out her book, It’s Not Hysteria - so good!!) Ablations are generally NOT appropriate for people with endometriosis and can even result in increased pain. Also, if you are still making babies or want to make babies, you would want to avoid an ablation, which can permanently damage the lining of your uterus and be quite dangerous if you were to become pregnant.

I will also share a study from the organization where I work (I wrote this media release, as you can see from the byline,) which found that 29% of people who underwent an endometrial ablation had a subsequent hysterectomy to remove the entire uterus within 15 years. This could mean that ablations are a shorter-term solution, and that people should be aware that they might need further interventions down the road. However, the researchers also found that as the experience of the surgeon increased, the risk of a subsequent hysterectomy decreased.

I didn’t know any of this going into my ablation, but I had a great chat with my OBGYN, who told me exactly how many procedures she had performed, her “success rate” (i.e. how many people experienced less bleeding,) and how many people had adverse effects. Given that I was 44 years old, done with babies, and my primary concern was heavy bleeding due to adenomyosis, I decided to do the ablation.

It’s been a year and a half since the procedure, and I’m still period-free. I get a tiny bit of spotting here and there, but that’s the only sign that my cycle is carrying on without the lining of my uterus. I’ve had zero pain, and the sensation of pelvic heaviness caused by adenomyosis is gone. I know I’m only one case, but I do think that endometrial ablation was a good option for me (but talk to me in another 14 years and we’ll see if I became part of the 29% I referenced above!)

The bottom line-ing

Iron deficiency and heavy menstrual bleeding are feminist issues because they get very little attention in our patriarchal medical system. Anything that doesn’t affect men is apparently a side issue, which means we allocate fewer research dollars to studies, leading to less innovation and a lack of effective treatment options.

The gap in science/evidence also leaves a big hole that wellness culture fills with misinformation, expensive supplements, and questionable advice. This is why people like Dr. Gunter and Dr. Tang have to do so much debunking online, because people are out there spewing a lot of nonsense. I’ve fallen for it before, so I hold no blame or shame. When we feel ignored or dismissed by the medical system (or worse, we experience harm) it can be all too easy to fall into wellness influencer traps. If I can provide you with one piece of advice, it would be to assess your sources carefully. Even the title “Dr.” can be somewhat misleading when those individuals are using their credentials to sell you something.

If you’re worried about heavy menstrual bleeding and iron deficiency, please check out Take Control. Period., a website developed by an amazing group of Canadian researchers on a mission to tackle high rates of iron deficiency. You can even point your doctor to Hemequity, which is the primary website for helping educate healthcare professionals about iron deficiency.

Go forth. Bleed Less.

From my uterus to yours,

Misty

My paperback is out, and available everywhere you buy books! If you would like a signed copy, please drop me a message and I will mail you a signed bookplate.