Angelina Jolie Double Mastectomy: Support Her Health and Recognize Her Privilege

After reading Angelina Jolie’s op-ed in the New York Times Tuesday, it’s easy to be left with the feeling that all a woman really has to consider, when confronted with aggressive or fatal breast cancer, is whether to have a mastectomy and/or oophorectomy (removal of one/both ovaries).  

After reading responses to that op-ed on this site and others, it’s easy to see that people find a hero in Jolie … and for good reason. Her actions are heroic! So, let’s support Angelina Jolie.  Without pause or apostrophe, let’s recognize her courage in preventing treating breast cancer and her heroism in publicly disclosing that treatment.  Let’s support Angelina Jolie. 

And let’s make sure that support is grounded in the full complexity of her statement and the privileged context surrounding her testing, treatment, and eventual disclosure. Let’s support Angelia Jolie, and let’s realize (as Jolie alluded) that there are many, many women who won’t have the opportunity to be tested, treated, and discuss those tests and treatments on the op-ed page of the New York Times. Let’s support Angelina Jolie, and let’s inform our accolades so that women who don’t (or can’t) act as she acted could still be called brave and heroic.

In 2009, 211,731 women were diagnosed with breast cancer and 40,676 women died from it. And although white women had the highest incidence of breast cancer, black women had the highest fatality rate. This incidence-fatality gap is motivated by poverty, obesity, and heredity. The decision to have a mastectomy and/or oophorectomy is motivated by privilege, ability, and culture. 

YES! Angelina Jolie is a hero. AND, her heroism is as much a product of her privilege and ability as it is her personal endurance and courage. No woman, when faced with breast cancer, has a lack of endurance and courage … yet, many women lack privilege and ability.  So when we celebrate Angelia Jolie, what are we celebrating? Who isn’t being celebrated? Why?

Although many insurance companies treat Angelina’s preventative measures as “medically necessary” and covered when one is at high-to-moderate risk, these procedures still cost nearly $157,000 in inflation-adjusted dollars. Women without the luxury of insurance, ability to pay out of pocket, and privilege of paid-sick-leave are priced-out of this option; or face relatively higher costs. And although Jolie notes the cost of BRCA1 and BRCA2 testing at more than $3,000, the average private sector cost of $53 per test, is only effective if women who screen positive proceed with prophylactic surgery (mastectomy and oophorectomy). So, for women who can’t have the surgery, testing isn’t even cost effective! What becomes these women? What of our beatitudes? Are these women heroes … too?

Are the disproportionately black and brown and poor women who don’t have access to Angelina’s fortunes or the New York Times, heroes in the same regard? Especially when (lack of) fortune and access lead these women to have higher fatality rates when diagnosed with breast cancer? Are the women who hesitate when considering mastectomies and/or oophorectomies heroes … too? Especially when we their lives are implicated by a media and culture that equates women’s ability, beauty, femininity, and worth to the presence, shape, and men’s use of their breasts; and, their ability to have children. Is my mom, a poor black woman who was diagnosed with breast cancer and haunted by the specter that a radical mastectomy may make her less of a woman … a hero … too? Are women who go on to have mastectomies and are unable to afford reconstructive surgery; or, have poor reconstructive surgeries … heroes too?

Let’s support Angelina Jolie! Let’s do so without pause or apostrophe. Let’s do so while being grounded in a universe that recognizes the privilege of her choices and disclosure.   Let’s do so while knowing many women don’t have access to those choices and routes of disclosure. Let’s do so knowing that if breast cancer were as common and fatal to men, we would have long progressed past the point of chopping off breasts and telling survivors that they’re still a whole person. Let’s support Angelina Jolie.