Ep. 104 Medical Misogyny and the Medical Me Too Reckoning with Micah Larsen

Show Notes Charna Cassell: [00:00:00] Welcome back to Late Open Podcast. I'm your host, Charna Cassell, and today's guest is Micah Larson. She's a writer and podcaster who reveals the taboos of women's health and healthcare, like menopause, diet culture, and beauty standards, and her podcast is called Modern Hysteria. Michael Larson is a remarkable woman who courageously chooses to share her story and do a deep dive into, into the taboos of women's health and medical misogyny. Taboos that don't often get talked about because there's so much shame that women feel or there's a lack of information and research that our medical field is doing on behalf of women. Also wanna, I put out a warning for people who are sensitive and feeling like some heavy material would be too much right now. You can always listen to it in small doses or decide to listen to it on a different [00:01:00] day, but ultimately it's pretty inspiring and hoping that a women's medical rights movement Get started soon. It feels like we're on the brink, Welcome, Micah. [00:02:00] Charna Cassell: so you're the host of Modern Hysteria podcast. Micha Larsen: Yes. Charna Cassell: And I'm really curious how that started. What inspired you to wanna put your voice out into the world this way? Micha Larsen: That's a great question. , It's a long story, but I have had. Over the past decade, a lot of experiences in which I now feel like I, I've slipped through the cracks of the system of women's healthcare, and it has had some very difficult consequences. And so much of that time, s Shana, I felt like I was so alone and I kept doubting myself because in isolation you just think, oh, well I, this just must be an isolated experience and this is a me problem. Mm-hmm. And [00:03:00] because there's so much silence around so many of the topics having to do with reproductive health and mental health, and I have had a lot of experiences at the intersection of those two things. So I started writing my memoir about this particular decade of my life. So there's so many topics that came up that said, I really want to explore this. I'm fascinated in conversations about mm-hmm. IUDs and natural childbirth and perimenopause and I have so many questions. Mm-hmm. So my dream was on be to be able to ask experts all these questions that I assume if I had other people had to mm-hmm. And I have always been a question person and a big picture person. And so the podcast was kind of like a side passion project, I'm about to end season one and we've surpassed [00:04:00] 11,000 downloads. So I am like, it's become something where we're having conversations that I'm hearing from listeners, oh, this helped me so much to ask the right questions of my provider at this appointment. I also feel that I may not have made it through a lot of those experiences had I not had immense privilege. One of those pieces of privilege being my husband is a physician and he has been an incredible advocate for me and done everything that he can to use his privilege to get me the care I needed and also like, translate so much of the experience and like the medical jargon. , And the health insurance stuff too, charna. So I don't know how people navigate this without that. I don't think that I could have done [00:05:00] it. I don't think that I could have survived it. So I want to speak from that place of here's where I am. I wish I knew this 10 years ago. We're not having conversations about period pain, endometriosis, , postpartum psychosis. Let's talk about it. I, I'm, I'm gonna ask I people who know, that's the short answer. Charna Cassell: Yeah. And, and I wanna get into a lot of the different things that you talked about. , And one of the things that I think is so important that, that is your passion is, is having conversations about taboo topics, right? The things that remain silent and don't get attention. Not only because there's not the funding, there's not the research done, , but also because there's so much shame around all the topics that you mentioned. I know that, uh, incontinence is one of your, your highest downloads, right? Yes. and [00:06:00] it's like, oh, okay. So think about it. Everybody right? You, you push a baby out, you know, and your pelvic floor is something that helps you, , contain, and, you know, and you, you can get into more of the details of all of that, but, but the, the point being, it's like. The, the ways that women use their bodies to give back and to, and to produce life has long-term consequence and none of that is getting discussed. Micha Larsen: No. it is fascinating to me to see just on the, um, the analytics side mm-hmm. What are people responding to. Mm-hmm. And across the board the most by far downloaded, , streamed episodes are about pelvic issues. Yeah. And that says a lot to me. I'm paying attention to that because I want to ask more questions about what audience. And my audience is Gen X and Gen Y, , women [00:07:00] who have had interactions with the healthcare system. Mm-hmm. And. Just the sheer number of questions I get about issues like, is my vagina normal or is it normal to have this change in my libido during menopause and yeah. I can't jump on the trampoline without peeing. Is this normal? Is this normal? Charna Cassell: Mm-hmm. Micha Larsen: and a common thread that I found in this podcast is common but not normal. So, yeah. Having incontinence after childbirth or postpartum depression or, , depression during perimenopause, common, not normal. And that so says so much about mm-hmm. The experiences of women and people assigned female at birth in our, in healthcare system. , And I'm never afraid to like. [00:08:00] Dive into my own personal experiences. 'cause I have a lot of questions too. Charna Cassell: Mm-hmm. Mm-hmm. Yeah. Yeah. Well, and, and I think that you, you said it well, which is like, if, if I have these questions, then there are so many others out there. Right? There's something I remember in high school, I wrote a letter into a magazine, can't remember the name of the magazine. It was kind of like a edgy teen, Mademoiselle whatever, Cosmo Magazine. Bus? Bust maybe it was called. Anyways. And , I learned that for every person who writes a letter, you know, there's like at least a hundred people that have the same opinion or the same thought. And I'm sure the number is, you know, bigger than that. Anyways, I'll just say that there are conversations that previous generations have not engaged in regarding menopause and women's health, and there was just a, I have to lie here and tolerate it. And there are just so many, so [00:09:00] many horror stories of what was normalized, you know, from by like my mother or her, her generation, the boomers. Um, and there's so much more permission as we keep asking questions. It grants more permission to the next generation. And as we go, wait, there's something not okay here. And that's what you, you know, your podcast is a big stand for that. And so I really, really appreciate it. So thank you. Yeah. Yeah. It's, um, I, I started dealing with, , gynecological problems in high school. . And, you know, there were a lot of assumptions made about me and my body and, you know, like misinformation and the ways that we would treat. I've had, I had a client come to me who was being encouraged to have a double mastectomy and a hysterectomy because she had certain, , markers for cancer and her mother had had cancer multiple times and she was in her twenties.[00:10:00] And then it raises all the, all the questions about, you know, does, can she, and will she freeze her eggs? Will she make that choice? Um, and then how they would treat that 15 years ago when I started working with her versus what they would recommend, what, what the treatment is now is completely different. And just curious to hear from you. 'cause you went into, , you had surgical menopause. Micha Larsen: Yeah. Charna Cassell: If you could speak about that, about your experience with that, and then also what you know in terms of how, um, that's being addressed. The conversation around menopause is being addressed now versus what it was when you started dealing with this. Micha Larsen: Hmm. Yeah. I am so relieved. , Also like shocked [00:11:00] and. Not surprised at the same time that just a couple weeks ago, uh, the Atlantic had a headline that said Menopause is having a moment. Mm-hmm. Mm-hmm. And I gave this a keynote address a couple weeks ago and like, had that in my presentation. I'm like, yes, menopause is having a moment also, as long as there have been females, there has been menopause. So like, thank you. Yes. And wow. , It's only like thousands of years overdue. , And I am fortunate to be going through this, me this in my personal life at a time when we are having more public conversations about it and I get to contribute to those conversations about it. , I went into surgical menopause when I was 29 because I had these persistent gynecological issues I had. A lot of pain, [00:12:00] bloating. , I found out later ovarian cysts. , I felt like there was a bowling ball in my pelvis, and this is after I had my son in 2019 and I looked pregnant. I, , was in pain. I had a lot of anxiety, panic, depression and paranoia during the luteal phase of my menstrual cycle. , And I begged my surgeon to like, I thought maybe I had endometriosis, which I actually heard about from my hairstylist. Mm-hmm. I didn't know what it was, and I brought it that to him, and he took me seriously. He did an exploratory laparotomy with a camera. Charna Cassell: Mm-hmm. Micha Larsen: And he was like, I don't see overt endometriosis, but things are messed up in there. Mm-hmm. , your uterus looks like the size of a six month pregnancy. , And so we're [00:13:00] gonna take that out and I'm gonna leave one of your ovaries, the better one, , without as many cysts. Mm-hmm. Because I don't want you to go into menopause at 29 if you don't have to because it's brutal on your body. You need estrogen and progesterone and testosterone and all of those sex hormones to function normally. , And yeah, so when I was 29, I got, , my fallopian tubes, my uterus, and one ovary taken out. And, , they, afterward it was. My surgeon said, yeah, I could like use my gloved fingertip and poke into your uterus and it would just, the dent would just stay there. He called it boggy and, , I should still have it, it, I asked it back to have it back from pathology and it's all cut up and it's in a jar and my office and it was a very strange time to be menopausal that I started to have symptoms of menopause because I had one ovary. , [00:14:00] It was real confusing because I never knew when I was ovulating. Mm-hmm. And then in 2022 I heard about something on TikTok called Premenstrual Dysphoric Disorder. Mm-hmm. And again, so like I found out about endometriosis for my hairstylist, I saw someone post about PMDD on TikTok and my husband was working the night shift. So, and I was just like googling it late into the night. Like, what is this? This sounds, mm-hmm. This sounds like my experience that, , my mental health just seems to deteriorate every month. , Now it's all wacko because I've got one ovary. I don't even know, like, is it ovulating? When and how, and my husband came home from his night shift and he had printed out like stacks and stacks of literature on PMDD. He'd never heard of it either. [00:15:00] And he's an internist. Yeah. , So he works with adult, , medicine. He works in the ICU, so that's not his. He doesn't work in women's health specifically. Right. But he said this, you have this, you definitely do read this. And I just sat down and started reading the diagnostic criteria and, , it was like reading out of my own journal. Mm-hmm. , And yeah, I never heard of PMDD. I think now there's maybe a little more conversation about it, but I ended up going back to surgery and having a couple years later my other overtaken out, and so mm-hmm. , but in order to do that, you charna, am I just going on a monologue? Charna Cassell: I'm enjoying your monologue, but there's plenty of things that, that we could have conversations about in each one of these, you know? One of the things that I would love [00:16:00] for you to talk about because there are other people who, who have that and don't know the steps to take to actually attend to it. Oh, sure. And so a full, a full hysterectomy is one option, right? Yeah. And then there might be other things that you've learned along the way in terms of how can someone treat this? Yes. , You know, which, yeah, I can say more about that in terms of my own experience, but, but so that's something that I would love for you to Okay. Address. Yes. Micha Larsen: So I was unique in that I was understanding that I had PMDD after I had a hysterectomy, but if you're ovulating, you still have these shifts in your hormones. And premenstrual dysphoric disorder is. Hypersensitivity to this change in your levels of estrogen. , And the symptoms are emotional, mental, physical, social. Mm-hmm. In [00:17:00] this paperwork my husband printed out was what? And he was printing all this stuff out from the hospital, from UpToDate, which is the medical provider's resources. Mm-hmm. He printed out the diagnostic criteria. It was, the instructions were to, , diagnose PMDD. You need several months of data tracking. , At least it's like 12 to 16 symptoms every day. Mm-hmm. And that included, paranoia, bloating, breast tenderness, , rejection, sensitivity, anxiety, depression. , So I got to work and I, it helped me so much to mm-hmm. Rate, like every day you rate your intensity of these, and if there's a pattern established where all of these symptoms start to worsen around the luteal phase of your cycle mm-hmm. Which I was just guessing at because I didn't know what I was ovulating. , Then you may have a [00:18:00] PDD diagnosis. And so I took this stack of papers to my, , OB surgeon's office and. And he is wonderful. Mm-hmm. He, I spread them all out on the floor to show like month by month, by month, by month. Mm-hmm. And he was like, yeah. Mm-hmm. Yep. Okay. And he is, he's very conservative with like taking, he didn't want to put me into menopause. Mm-hmm. It was kind of like me, me arguing my case. Yeah. Because I was so desperate. I was suicidal once a month. Charna Cassell: Mm-hmm. Micha Larsen: , or had si suicidal ideation and severe depression paranoia once a month. Yeah. , And I said, I don't wanna live like this anymore. And so he took out my ovary. , Well first, so that's kind of the diagnostic process of PMTD. There is no blood test. It's just, , do your symptoms. You have to have to be able to check off enough of the symptoms to establish this pattern. , And in order [00:19:00] to, , so my surgeon was not totally down to just take my ovary out. He wanted me to go through a test phase, which is when I. I started taking Lupron injections once a month, which is a nasty drug that is very old. , It's often used as a trigger , hormone in IVF and egg donation, which is something I had done 10 years prior. Mm-hmm. So I was familiar with this drug. Mm-hmm. But it shut down my remaining ovary and I also have that one, it's in a jar next to my jar with all my other organs. And it is so shrunken. It's like the size of a clear jelly bean. You could see after six months of taking these Lupron injections, it was just a defunct, shrunken little mm-hmm. Thing. , But that was like the trial period of mm-hmm. Of menopause. And it was horrible. It was horrible, but it was still better than the unpredictability and my mental health just falling off. Charna Cassell: Can you say more about that, because I think that is, that's so important. [00:20:00] To, to the fact that as horrible as it was going into a, a menopausal state, which we'll I wanna get into as well, it was still better than what you were dealing with. Yeah. Every month. And the distinction between those two things, because I think that people, there's so many myths around like, oh, she's crabby, it's her period. You know, and just like, um, so much minimizing and dismissiveness around how impacted people are during their cycles, and then also how impacted people are during menopause. And if you could speak to the difference between the two, that would be great. Micha Larsen: Yeah, so I'm a social scientist by training, uh, so I'm interested in this anyway. Mm-hmm. It was my, as I went through this process, you know, I was documenting my state every day. Mm-hmm. And that was comfortable for me to create, establish a pattern, understand what's going on. When I started the Lupron [00:21:00] injections, , insurance was a nightmare. I spent hours and hours. My husband spent hours and hours on the phone trying to get approval for this. , Even with the insurance, even with the copay card, they cost $2,000 a month. And so I didn't even want to do it because I said like, what about our mortgage? What about our child's college account? Like what? And, um, my husband, bless him, said, this is more important than anything because he saw me. Not wanting to live for a part of every month. Yeah, so Lupron is a nasty drug. , It savagely shuts down the function of your ovarian, so you kind of, your, your estrogen and goes off, estrogen levels go off a cliff. Mm-hmm. It's an, an agonist drug. You know, in estrogen levels also correspond with levels of serotonin and other really [00:22:00] important, , hormones that help regulate our emotions and help our brain function. And so JI couldn't figure out what was worse for a little while, like being in. The, the hysterectomy solved the problem of my chronic pain and, um, bursting ovarian cysts and the anatomy that was all fused together in my pelvis, which I now know to be adenomyosis. There's a whole origin story there with egg donation. Mm-hmm. But, mm-hmm. The, , I lost the plot chart. Where was I going with that? It's Charna Cassell: okay. It's okay. , So I was asking the difference between your experience, your monthly cycle experience and when you were starting to experience menopause based on your ovary being shut down and the distinctions that people can start to have a sense of like, what are their symptoms? How can I identify if I am going through this? And it's, you [00:23:00] know. Compared to what I'm going, what I may experience going through menopause. Mm-hmm. And even as bad as menopause is, you still made that choice? Micha Larsen: Yes. Okay. So PMDD, there are a few levels of treatment for this disorder. The first is, like I think the first line treatment is try an oral birth control. , This with maybe theoretically we're leveling out the hormones that your body's getting. So there's not quite a roller coaster during the luteal phase. The second is an antidepressant or other. . Psych meds. Mm-hmm. Lifestyle optimization. So are you exercising, are you meditating? The, there's an endless list there. Are you in therapy? And then like, the very last page of the recommended treatments is in rare, , extreme cases, hysterectomy. Mm-hmm. That's like an after. It was a footnote. It was an afterthought. [00:24:00] Um, I had already arrived there having had a hysterectomy for other reasons. The difference. Between going through PMDD each month theoretically was that between that and menopause theoretically was that if I was in surgical menopause and I did hormone replacement therapy, then I would have a steady dose of estrogen in my system every day. So there would not be this, the cycle would be done. , It wouldn't trigger the PMDD. Mm-hmm. What I didn't understand is that even you still have the mechanism of PMDD, even after you have a hysterectomy. Mm-hmm. Mm-hmm. Any change in your levels of estrogen, other sex hormones, your sex hormones and your stress hormones are inextricably linked. So, mm. I'm still have that mm-hmm. Mechanism. Mm-hmm. I just changed a dose of my [00:25:00] hormone replacement therapy and it messed me up. Yeah. Pretty bad. So I went into this thinking... and my lovely surgeon'll be saying, yeah, in theory we dose you every day with the same exact level of estrogen and it controls for the PMDD, the, you know, you can't have PMDD if you don't have a period. And that didn't turn out to be true. , Right. And menopause, when I was on Lupron, I started to have a lot of the physical aspects of menopause. My bones hurt, my body ached. I couldn't, I was so tired, I couldn't, , like stay awake until 4:00 PM just, uh, the brain fog, nausea and those things. And it was exact, those are menopause symptoms. Mm-hmm. But they were greatly exacerbated. Charna Cassell: Mm-hmm. Micha Larsen: By, . Plunging into menopause. And rather than going [00:26:00] through para, I didn't really have perimenopause. I went straight into menopause in six weeks and I stayed on those injections for six months and we introduced some, , hormone replacement and things gradually got better. My quality of life now is much better, but I had to seek out a menopause specialist, which I didn't even know was a thing. Yeah. And she, a lot of my advice now is if you are struggling with the physical or mental emotional symptoms of menopause, please use the Menopause Society's, , search function to find a trained menopause specialist in your area. I actually travel from Montana to Utah to see mine, but it. Was life changing because she's actually able to create an individualized, educated hormone replacement therapy plan, which for me, I know I'm 33, [00:27:00] I really need a lot of hormone replacement, but at any age a lot of those symptoms are treatable. You just need somebody who really knows what they're doing. Charna Cassell: What's so enraging to me is that, I mean, I'm so happy that you have the resources that you have to, to pay out of pocket, I'm assuming, for this menopause specialist, because that's definitely not covered by our insurance. The limited testing that our insurance will actually cover. The limited lab work, I'm, I was dealing with that yesterday and I was like, I don't actually feel like I'm dealing with a lot of, you know, in like rage and heightened emotions. I'm on HRT, um, and yesterday I was having fantasies of like killing this. Doctor, I was like, oh, maybe I am on too high a dose of testosterone because I'm having very violent fantasies right now. Or maybe it's just American of Western medicine. Yeah. Our system. , So what's, what's so [00:28:00] frustrating is that you have to have that much proof, like I'm picturing you laying out all of this paperwork. You had to have the resources to have like a, a, an edge of educated partner, not just a loving partner, but someone who had access to this material to be able to bring it to you for you to then try to prove your case to a doctor. Right. Yeah. I mean, it's just, it's, it's maddening. It's like who, who, who has that access? Right? Micha Larsen: Right. And I have a master's degree. I understand. Like I. I am coming at it from a research point of view. I, I'm certain that my master's degree is in health communication and so I'm, I can, I'm literate in academic research articles. Like I can navigate that system and I have had to educate myself a lot and I wanted to dive [00:29:00] into what are the limited studies that we have about what is PMDD, why does it happen? What is this association with trauma mm-hmm. And chronic illness and, , what's actually happening in our brains when we're having mental health side effects of menopause. Yeah. And that was for my comfort, but also so I can advocate for myself and. I have had the fortune of sometimes having my husband in the room with me, like that day I went to see my mm-hmm. Doctor and I, I think that my ob surgeon would have treated me the same whether my husband was there or not. Mm-hmm. , I'm fortunate in that, because that's not always the case, but, , yeah, people listen to my husband, Eric. Mm-hmm. He was the chief of medicine at that hospital at the time. Mm-hmm. And so, Charna Cassell: of course, Micha Larsen: He, he's opened doors for me. Mm-hmm. For sure. Mm-hmm. So I don't know how, and he spend like all day on the com, the phone with insurance companies. Mm-hmm. , so he's very literate in that [00:30:00] world. And so how, how, how do, do people navigate this? I, I don't think that they do Charna. I, I think, Charna Cassell: oh, they give up and Micha Larsen: they give up. Charna Cassell: Yeah. I. Micha Larsen: I can see why I, I had all of these resources, I have all this privilege, and still I had a provider two separate times, years apart, , prescribed me progesterone, , inadvisable now, now I know. Mm-hmm. That while providers are split on this, do women who don't have a womb who are in menopause need progesterone. My menopause specialist said no. Mm-hmm. Because it can cause severe mental health fallout. It can cause psychosis, it causes severe depression. Um, and I ended up in the mental hospital in December of 2024. , I was there over Christmas because I, [00:31:00] not for the first time, I, I didn't wanna live anymore. Charna Cassell: Yeah. Micha Larsen: Not just because I was so tired of fighting this battle of the immense effect on my brain and body of all of mm-hmm. The missteps and falling through the cracks, but also just because I was in severe recurrent depression Charna Cassell: mm-hmm. Micha Larsen: And the progesterone didn't help. So I think I've also had a lot of anger about some of the, the times that my case has been overlooked by providers. Mm-hmm. Mm-hmm. In fact, one of the reproductive health topics I'm most passionate about is called the Last Fertility Taboo. Mm. And that is egg donation. Mm-hmm. [00:32:00] Because I learned. Not too long ago that PMDD, premature birth preeclampsia, , all of these things that I have experienced can be traced back to 2013 when I donated my eggs and the reproductive endocrinologist overstimulated me. And I donated two to four times the recommended amount of eggs. I had something called ovarian hyperstimulation syndrome. And instead of hospitalizing me, he gave me an emergency procedure without anesthetic in a back exam room. And my theory and the theory of amongst my providers, some of them, is that the enormous amounts of estrogen and hormones and Lupron. I was exposed to in [00:33:00] 2013. Yeah. The fallout from that is, um, kind of got me where I am. Mm. And it made me essentially infertile. So had I known that, I don't know if I would've been brave enough to try to have my son, but he's here somehow. Yeah. Yeah. I couldn't carry him to term, but I think that I, I'm open about my story because I think it exposes something that's extremely common mm-hmm. Not normal. Mm-hmm. In our women's healthcare, which is that, , our bodies are treated as dispensable. And when you complain of, I don't even like the word complain, when you report, I'm having these side effects. This is affecting my body and my brain and my quality of life that. It's not always taken seriously. Charna Cassell: Well, and what you're [00:34:00] speaking to is re you know, very relevant right now in our political climate regarding like women's bodies not only being dispensable, but it's like they're serving a purpose. They're to produce more children, but women's health, the mother's health is irrelevant. Micha Larsen: Yeah, yeah. And we're seeing Adriana Smith being held on life sustaining measures in a hospital in Atlanta. Mm-hmm. , Against her family's wishes, to my knowledge. That we're just, this is what it takes. This isn't the first time this has happened. I worked in the Texas House of Representatives Oh. In, um, 2013 to 2014. Mm-hmm. During my egg donation when Marlise Munoz was in the same situation down the street from my office at John Peter Smith Hospital in Fort Worth. I wrote about that at my job. And, this is what it takes for so [00:35:00] many of us to realize that your advanced directives in many states don't apply when you're pregnant. If you are to have an accident, if you're pregnant, then all of those things are void and you no longer have the legal right to your advanced directives or your own care. And like horrible things have to happen for us to be able to have these conversations publicly. Charna Cassell: Which is absolutely insane. Which in case someone doesn't understand what that means, that's basically if you're like, I do not wanna be resuscitated if I'm, you know, they think I'm brain dead or something. And basically you have to be kept alive as an incubator. Mm-hmm. And your family loses their rights as well. Yeah. And has to just witness that and, yeah. The, this is, a side question. To add [00:36:00] insult to injury, I wonder if you then even have to pay the medical bills. Do you know what I mean? That the surviving family, do they have to pay the medical bills of the person who is being kept alive against her will and their will because Oh, I believe so. Oh, yeah. Yeah. That's, I, that's, and, and that's, yeah. It's totally insane. Micha Larsen: Yeah. I know Adriana Smith's family right now has a GoFundMe. I haven't looked at the site yet, but I do know of it. And it is ostensibly to collect money for medical bills. And I was in the hospital, uh, for a month before my son mm-hmm. Was born prematurely. And, um, the day that I was admitted, the nurse was like, oh, don't worry about like your length of stay here because you'll have hit your deductible by lunchtime. And I was like, oh, okay. and he was, The whole thing was a [00:37:00] quarter of a million dollars. Like, and that was one month and a stay in the nicu. I know Marlise Munoz was, uh, on life support, homeostasis support. I don't know if it's really life support. , From November, 2013 to January, 2014, and Adriana Smith has been, so she was nine weeks pregnant, now she's 21 weeks pregnant. like there's no end in sight. The only way that the previous case resolved is that Eric Munoz, , Marlise Munoz's husband sued the hospital for like criminal abuse of a corpse. That's the only way he could get it. Her taken, like let her die with dignity. Charna Cassell: And I was even in listening to your story, like that's, that's, that's medical abuse. Mm-hmm. Right. I mean, and would you [00:38:00] go so far as to say, I mean the, the definitions of what constitutes sexual assault? Like, I'm curious about if, if something is being done to your body against your will or if it's not, you know, if it's, it's not something that you want to happen. I don't know the technicalities of this. I mean, I, I did a whole episode. There's a really amazing documentary, if you haven't seen it, At Your Cervix. Have you seen this? nuh-uh. Oh, you have to see this documentary. , I interviewed imagine is the name of one of the, the, the filmmakers about, , pelvic exams that are performed in teaching hospitals while people are anesthetized like, you know, unconscious and they've signed a stack of papers when they go in for like their knee surgery and they're not even aware that that could be happening. They could get a hundred pelvic exams while they're under. Micha Larsen: [00:39:00] Yep. Charna Cassell: And so that's still happening. That's still legal. Micha Larsen: Okay. That is fascinating. I just wrote down the documentary because I'm aware of this. It's definitely on my list of things I want to write about and explore because Yeah, add it to the list of ways that, , we don't really know what informed consent is. I think that's another through line, or we don't often get the opportunity to give our informed consent. Consent that is a through line. I have seen in women's healthcare, in my own healthcare and I think the, the question about sexual assault mm-hmm. And the conversation about consent is very interesting. I am a survivor of sexual assault and I know that my ability to dissociate when my body is being violated came in handy when it happened so many [00:40:00] times in medicine. Charna Cassell: Mm-hmm. Micha Larsen: And like when I was having my eggs. Retrieved or had that, um, emergency procedure or, , yeah, I think that's an excellent question about where can we even consent. Charna Cassell: Even, a, a mother going in dealing with complications about to give birth, um, not knowing it's her first child, not knowing what's about to happen, not being given a blow by blow as to what to expect and what is typical and what is atypical and what's an appropriate amount or expected amount of pain. Like how do you even know what to ask for when Yeah. If it's your first time or your first experience doing something. Micha Larsen: Yeah. Charna Cassell: [00:41:00] Yeah, it's a, it's a complicated question. Micha Larsen: Yeah. There's so many. I mean, from the time that you hit puberty mm-hmm. Like, there's so many experiences that we have or we don't realize that our boundaries are violated, that we should have had boundaries. There's no guidance because we don't talk about, , you know, menopause and, , postpartum care. And that's why I love having so many of the conversations I have with guests on modern hysteria. Mm-hmm. I want to talk about what's a postpartum doula. Didn't know that was a thing mm-hmm. When I had my son. But there is a huge effect, , on postpartum parents' mental health when they have the right community and support. And that's why there are postpartum doulas, you know. , We don't know what we don't know. Mm-hmm. And we don't know what questions to ask. Charna Cassell: You know, In this experience, when you think of, [00:42:00] I know that I've spoken in the past of birth trauma, my own experience of being born prematurely and the, the, the, the birth trauma that impacts mothers, right? Yeah. What's, what's the fallout, what's the process of, of, um, what they're going through when they, when you go into premature labor or, you know, you don't, you don't know what, what's happening with your baby. You're in the hospital for a month, and that whole experience, and then what, how does that impact you? Once the baby's there? Like you have, you don't get an opportunity to process the trauma of all the not knowing and all the fear. , You have to go immediately into caring for another being. So it is like you have to press pause on your experience, but what we know about trauma, it's like, okay, all that energy is just bound in your tissue waiting to be activated. And, and so then, and then you have hormones that kind of push the button periodically to activate it. Right? And then it's like [00:43:00] amplified, you know, experience that has been placed on hold and laying latent to be felt. Micha Larsen: Well you said that so perfectly. Charna Cassell: Mm-hmm. Micha Larsen: Yeah. I, I had the mistaken assumption that, well, to give context, I was 29 weeks pregnant when I was hospitalized with preeclampsia. Now I know. Potentially related to egg donation. Charna Cassell: Mm-hmm. Micha Larsen: And every day, every week was, can we go another day before your organs fail? , Relatedly I have wondered if Adriana Smith, that was what ended up ended her, got her to the hospital, is that she was complaining of some of the symptoms of preeclampsia and she had blood clots in her brain. That's what happens if, if preeclampsia goes untreated, to my knowledge. Mm-hmm. so [00:44:00] they keep you in a special place in labor and delivery ward called antepartum, which is where the moms who can't give birth yet live until it's, their bodies are not going to survive or the baby's gonna come out. It's a very, uh, liminal space because you're hearing other people give birth and you're hearing babies get rushed into the nicu and you're kind of just like waiting every day to see what does my, what do my labs look like? Can I push it another day? To give my baby a better shot at being, , you know, being equipped to be born. Mm-hmm. And I was so fortunate in that I was able to hold out till 34 weeks. I am very stubborn and willful and I said, well, I'm going to retain the only control I have over this experiences that I want to have, do this without an epidural. But I was being induced, you know, six weeks [00:45:00] early to have my son and my same, same doctor, same ob surgeon was like, I respect that so much your decision, but please know that this is, this is not like you're going into labor naturally. This is like, we are forcing your body to have this baby right now. , And I. Was so dead set on having things go the way that I planned, the only piece of like childbirth mm-hmm. That I felt like could control. And so I labored for like 24, 26 hours without pain man management. My body kind of gave out at that point and my blood pressure was over 200, over, I don't know what mm-hmm. Because I started to lose consciousness and mm-hmm. We lost my son's heartbeat. And so I, I thought I di was dying and I was close and so like, [00:46:00] I didn't understand, I didn't understand, I. The risk of that I and I, so much of that is my, was my responsibility. Charna Cassell: Hmm. Micha Larsen: but after that, I mean he, after he was born, he was in the NICU and I still lived in the hospital to shuffle down there in my Birkenstocks every two hours to feed him. And Yeah, you go from, I thought that he and I were both dying to like, okay, but he's out now and you need to feed him. And then we just moved on and I was a mom and like we, no one ever asked about like, are you okay? , And that's one of the one thing I think that drives me now is that I want to put my story out there and be open [00:47:00] about. The reality of, of the fallout, because I want other people who have had that experience, and I've had so many people since, you know, all these aspects of, , egg donation and preeclampsia and preterm birth and traumatic childbirth and menopause. And say like, me too. Yeah. And that it's common, but it's not normal. Mm-hmm. And yeah, we don't take very good care of new moms, especially those who've experienced traumatic childbirth. Charna Cassell: Yeah. I think that you're, you're, first of all, I'm just, I'm glad you're here and that you made it and that you're as tenacious and well supported as you are because you're really making a huge contribution. So thank you. Micha Larsen: Thank you. Yeah. I'm like a cockroach. I, Or like a horseshoe crab, like I am extremely stubborn and hard to kill. I will like just keep coming [00:48:00] back. , My friends hate when I say that so much. Yeah. They hate it. but I am a scrappy and I have so much more story to tell. Charna Cassell: Yeah. I mean, I, you know, there's, there's, I feel like we just, we just got into one of the threads. There's so much more that I wanna talk to you about and I think what you just said, , that so many women have said Me too, regarding these topics, and I wonder when there will be a medical me too movement. I think like, I think that that's, that's a really important, I mean, I could say like PCOS, you know, polycystic ovaries. Me too endometriosis. Me too. I almost donated eggs in my twenties to a sweet gay couple. You know what I mean? It's like, oh wow. And I already had all these gynecological issues, and that's the only thing that kept me from doing it. Micha Larsen: Yeah. Charna Cassell: Right. And, and so it's this, this thing of like, you don't know what, what you're saying. You don't know what you don't know. And when you're young and you decide you're, you're gonna do something like that and you don't have all the information and [00:49:00] the, and there's no medical research that's informing, and the doctors who are doing it or treating you like you're disposable and, you know, there's just, it's really scary. Micha Larsen: And I think the medical hashtag me too movement is coming because I'm starting to see, and this is probably so swayed by my algorithms and what I , what I looking for, what I'm reading. Mm-hmm. But I see people writing about medical misogyny and how that, that's what I do public speaking and write about mm-hmm. too is that it's not about individual providers, it's that the system was truly built in America. The obstetric and gynecological foundations of our medical system were built on the backs of enslaved African women In the south who were completely unable to consent obviously, and were used as test subjects. And that, , legacy never really went away. Yep. [00:50:00] There's the medical system and education and training is... still has misogynistic and racist roots, I do not think that it is a coincidence that Marlise Munoz and Adriana Smith, right, who is a black woman. I don't think it's an accident that, or it's not a coincidence. Mm-hmm. Mm-hmm. Right. That there's one, you know, Spanish speaking woman and a black woman who are, who are now emblematic of this horrible treatment of women's bodies. Charna Cassell: Mm-hmm. Mm-hmm. Yeah. That get, the, the documentary At Your Cervix gets into that a little bit and I think it's a, it's a really important history for us to know. And it's, yeah. You know, there's, it's unfortunately, I feel like we're in the backlash right now, and that it's like, the medical Me Too [00:51:00] is will come. Yes. But right now we're, it's like we're in the belly of taking women's rights away and it's, it's pretty terrifying. Micha Larsen: It's terrifying. Yeah. That is why these conversations mean so much to me, because Yeah. I'm like, we should give more women microphones because like, this allows us to still be connected to each other and even while it feels like we're in a dumpster fire, we now in America, at least, like my thought is that's why I'm using my privilege mm-hmm. To talk about this because I can, and I don't want anyone to feel like they're in this by themselves. Charna Cassell: Yes. Agreed. One of the things, so, I was on your podcast and we realized that we share a deep love of gardening. And I, we, we just had a really hard [00:52:00] conversation that I think maybe hard for, uh, people to listen to. And I wanna come back to something that is resourcing and enlivening. Mm-hmm. Right. And, and so you live in Montana and I'm just really curious to hear about, um, how your garden, how your home life, how, how can being connected to land resources you and how it feeds you during this? 'cause this is still an ongoing process that you're in. Yeah. But also how you landed where you are now. Micha Larsen: Oh, this is the greatest question and I love to talk about our farm. , It was actually. Between my hysterectomy and ectomy. , When we saw a, a coworker of my husband's said, I'm selling my farm and I just want you to come look at it. I met my husband in Texas. He actually like our first date, , he was a medical student. I asked him to come to the [00:53:00] fertility clinic with me before my egg donation and then we started dating. And, , what a that, if that doesn't tell you what a patient meant he is. , And or accepting and bombproof man, he is. Then I don't know what will, but he, . He moved to Wyoming to do his residency, and , we bought a house there and then it was my turn to decide where we were gonna go after he finished residency. And I fell in love with Missoula, Montana, and this little three acre farm. The first time I came here, it was, I was feeling really depressed and it was after my first suicide attempt and I walked around in the snow on this little, , historic farm and I said, I could feel like I could heal here. And so I emptied my business bank account, paying the down [00:54:00] payment on this place. And it's like a rambling little kind of rundown, , farm. I have a farm stand. , I. Chickens, ducks, rabbits. We have bees, we've got an orchard, we've got huge gardens, and this is just a hobby farm. But, , I found myself again, or a new version of myself when I was able to heal. I think I have been able to heal largely because of this setting. , We're in my office right now, which is an outbuilding in the alfalfa fields, and I really threw myself into just pulling weeds and making compost and pre sprouting seeds and gardening and growing food. And that allowed me to be present while I was going through a lot of physical and psychological turmoil [00:55:00] that it was like. , It returned me to myself. I paid attention to the seasons I paid. I pay attention to, um, the, my flax is, is blooming outside right now. The apricots are are growing. , It took me out of the past and the future and keeps me in what is happening right now. Mm-hmm. And is there anything more therapeutic than, like, digging in the dirt with your hands and planting little baby sprouting vegetables while your chickens, like are pecking around you? It's just like the soothes my soul. Mm-hmm. Charna Cassell: Mm-hmm. I'm so glad you have that. I, I notice for myself, like, just even yesterday I was really tired and I rallied, actually it was like two days ago now, but I've noticed that for the last two days when I'm super fatigued. If I can rally and get my body into my garden, I wanted to go out and just pick some [00:56:00] blueberries for my breakfast. And then next thing you know, I'm harvesting all my strawberries. I have a lot of strawberries. And then I was like, wait a second. I think I actually wanna make some nettle soups. I was like getting my nettle, and then I was weeding, and then I was, you know, and it's like, next thing you know, it's been two hours and the sun's going down, and I feel better than when I, than I went outside two hours prior. And so that's a, that's been a repeated lesson and experience for me, is that my system, um, comes alive and perks up. I feel like a plant that's growing towards the sun when I just get myself out into the garden mm-hmm. Rather than like, you know, if I'm like, oh, I'm just really tired. I think I'll just, I'll just stay here and I'll just like, you know, like, watch a show or, you know. Yeah. Yeah. And even if it's a little thing, like I had a client who kept alive, like had one cucumber, one cucumber on one little plant on her balcony in New York City, you know? Mm-hmm. And it's like that little [00:57:00] thing. And, and attending to something outside of you can also help you if you're feeling physically or emotionally strained or drained mm-hmm. To come back to the present moment. Right. It's like, rather than worrying about the past or thinking about the future or being in the present moment with that cucumber. Micha Larsen: Yep. Charna Cassell: Yeah. So this is a, a question that I, I ask most of my guests and given our conversation, what, what do you consider embodied freedom to be and to mean to you ? Micha Larsen: I would say something that really shocked me about going through menopause early and intentionally is that I found a lot of freedom in, as in acceptance and self-acceptance has really forced me to, , reckon with a lot of my thoughts about my [00:58:00] body and beauty culture and diet culture. And because I went through all the, these series of events that led to premature menopause, it forced me to get clear about what do I value about myself? Who am I. Like, what legacy do I want to leave? And it's not gonna be what I look like and the freedom to just embrace who I am authentically, to not stop worrying about taking up too much space, stop trying to keep myself small and like fit into some kind of mold has been so freeing. Hmm. Does that answer the question? Charna Cassell: and it's perfect because it's, you know, we're talking about, um, [00:59:00] a culture that supports women's disembodiment in every possible way. Micha Larsen: Mm-hmm. Right? Charna Cassell: Because it's a body you can control. Yeah. If you're not, if you're not home, if you're not there, you know? Micha Larsen: Yeah. Charna Cassell: So thank you so much. And how can listeners find you and your podcast? Micha Larsen: Yes, modern Hysteria is on Substack, apple Podcasts and Spotify. You can find that and more on my website, Micah, M-I-C-A-H, Larsen, L-A-R-S-E n.com. And I am on Instagram and TikTok at Micah Larson underscore. , I'm on TikTok a lot. I have, I found a great community there and on Instagram a lot. , And it's connected me to so many fabulous people like you, Charna. , Yeah. And there, the podcast, we've covered a lot of really fascinating topics, so I encourage, if you're [01:00:00] interested in this conversation Look up modern hysteria on your favorite podcast player. Charna Cassell: Thank you. So good. And I, I, I feel compelled to say, give your husband a hug for me. You know? Right. I'm just really, really. Glad that you've had such a good cheerleader so that you could do the work and be here. Micha Larsen: You know, he is truly amazing. He is. Um, yes, he's the love of my life. Mm, for sure. And he's a great dad. Charna Cassell: Beautiful, beautiful. All right. Yes. I look forward to future conversations with you. Yes, me too. Thanks, Charna. You're welcome. If you appreciated this episode, you can like rate. Review and share it with your friends. I'd appreciate that. If you'd like to stay connected, you can find me on Facebook and Instagram at LaidOPEN Podcast. That's L-A-I-D-O-P-E-N-P-O-D-C-A-S-T. If you go to charnacassell.com, you can sign up for my [01:01:00] newsletter where you can receive discounts and you'll be the first person to receive certain resources and information about upcoming events. At passionate life.org, you can get more information about my private practice if you're interested in working with me as a client, and you can learn more about my approach to healing. This has been LaidOPEN Podcast. I'm your host, Charna Cassell. We all have different capacities, but I believe in our capacity to grow and change together. Until next time.