The hairy-women scale

Do you have hair on your face? Of course you do. All over your face. All over your body in fact. Hair is everywhere. In some places it is darker (terminal hair), and in others lighter (vellus), but there are few places on your body where it doesn’t grow, except if your skin or follicles are damaged.

And except in places where you have shaven, plucked, threaded, or burnt it off. After all, we do things to make ourselves look nice. But what’s nice? Part of the answer lies in what scientists have been telling us is nice, which is what this post is about.

The seemingly innocent activity of grooming gets less innocent when we expect everyone to do the same; when we start judging people because of their hair. It may sound silly to take such an insignificant part of a person and make it the basis of our judgment of them. But it happens all the time.

It all begins with making categories. Categories based on hair.

In the nineteenth and twentieth centuries, European ethnographers went into the bush (!) looking for primitive people. They stripped these people naked, measured their every limb, and eventually their methods resulted in the following: the Ferriman-Gallwey score.

A Ferriman-Gallwey scoring diagram (unknown clinical source, published on what-when-how.com/acp-medicine/hirsutism-part-1/)

The idea is that women’s body parts (not men’s) should be scored for terminal hair on a scale of 1 to 4. Adding up these scores tells a doctor whether a woman deviates from the standard. This is another representation:

Ferriman-Gallwey scale, modified by Hatch (1981). Published on medical-learning site http://www.e-sanitas.edu.co/Diplomados/endocrino/modulo_9/causas_hiperandrogenismo.html

Black fur has crept over this ‘healthy female’ like an extraterrestrial species over Sigourney Weaver. Is it comical or disturbing?

The woman on the left, numbered ‘1’, displays only slight signs of being ‘too’ hairy.

The woman on the right is fully ‘abnormal’. She is a hirsute! (Not all parts of the body need to grade ‘4’ for this diagnosis.)

Scientists devising scales like this start out with the whole breadth of human variation (they have rightly seen that we are not all the same), but then they do two things:

1. They put everyone in line so they seem to fit a single ‘scale’.
2. They attach a judgment to this scale.

For the early ethnographers, people on the left end of this scale were civilised. People on the right-hand side: primitive. It was one of the many instruments Europeans had in assigning ‘races’ to people. (How about the 1922 article entitled ‘A Study of Facial Hair in the White and Negro Race’?)

But you have even more reasons to be nervous if your own hair patterns resemble a score ‘4’.

Ferriman and Gallwey were two medical doctors who took up these ethnographers’ ideas, and applied them to medicine. The Ferriman-Gallwey score is now the measure commonly used by doctors who want to assess whether a woman is not ‘too hairy’. (Other scales also exist.)

So: women with a low score: healthy, feminine women.

Women with a high score: sick, masculine women.

(It is true that certain hair-growth patterns can also be a side-effect of a health problem, but this does not need to be the case – and a lack of hair can as well. My point is that we are not dealing with a neutral diagnostic tool named ‘patterns of hair-growth’, but a morally charged classification of ‘hirsutism’ as a ‘disorder’. Ferriman and Gallwey themselves tended to the former, by the way, but they are commonly used in the latter, pathologising sense.)

Many women do in fact count as ‘hirsute’ according to these medical standards: 10, 30, even 50 % of participants in various studies, depending on how they were scored and what part of the world they were from.

I have already mentioned the racist implications of this scale. Yet it does not only simplify and moralise the differences that exist between people in different parts of the world. It also simplifies and moralises the differences between women and men. Women with hair-growth that in the European world is considered feminine, are ‘civilised’ but also ‘healthy’. Masculine women are ill. And if they don’t fix this ‘illness’, by shaving, or taking hormones, then they are inconsiderate, selfish, dirty – is the wider social opinion.

Take a look at the exaggeratedly feminine body in the second picture: no nose, broad hips, narrow waist, and a tiny mouth. (Is this perhaps how the doctors who write this medical textbook prefer to see women?) The use of such a feminine model makes her moustache and hairy legs extra freakish. She is like the bearded woman. These pictures have a rhetorical knack of juxtaposing two ‘opposites’, in order that the reader will instinctively feel this is ‘just wrong’. The first image does a more neutral job in this regard.

Calling hair on women masculine – and masculinity in women a problem – also happens in descriptions of the scoring system. The same educative website instructs the learner to compare a female patient’s hair-growth with that of the men they know (hardly an objective measure), and see whether it is ‘equivalent to an adult man’ (scoring 3 points) or even to ‘virile healthy adult men’ (4 points). What happened to sticking to commonly observable facts and identifying actual hair? Instead, writers jump to the conclusion that patients’ very identity, their femaleness, is at stake.

A moral judgment is also implicit in the many medical descriptions of hirsutism calling these women’s hair ‘excessive’.

A somewhat older study that went through the trouble of examining two thousand patients, is particularly naive about it own assumptions. It writes:

a disperse upper border of the pubic hair is only found in men and never in normal women.

In a sublime example of circular reasoning, healthy women are defined by being… ‘normal women’!

Later researchers sometimes acknowledge this problem – a little:

Determining what is an abnormal amount of terminal hair growth, and thus what is hirsutism, is difficult.

Ok: so because there is simply an enormous amount of human variation, we cannot tell what should count as abnormal. Still, these writers did not wonder whether the endeavour itself of ‘determining what is abnormal’ may therefore be flawed.

Again, there is this huge urge to put people into categories: either you are (self-contradictively) masculine and therefore primitive or ill; or you are feminine and therefore civilised and healthy.

Interviews with women show that they are up against a lot of hatred and disgust if they show to be ‘hairy’. This freakification of hair also gets formalised, for instance in the world of sports. The International Association of Athletics Federations has even used the Ferriman-Gallwey index to see if they might disqualify sportswomen from competing because of an assumed unfair advantage. Apparently, women with uncivilised amounts of hair are really men in disguise. (If they really try to fool us, why don’t they shave? For this example from sports: see the book cited below).

As medical doctors and their lay disciples continue to use grading systems such as Ferriman-Gallwey on their patients and subjects, and to diagnose them with the serious-sounding ‘disorder’ of ‘hirsutism’, they only perpetuate the idea that the hair scare is justified. They make life harder for the hairier woman, creating unnecessary anxieties and feelings of guilt. May I then be excused in deeming the following reassurance to patients a little hypocritical?

Usually, excess body hair is only a […] psychologic concern.

Thanks to Ellen Samuels for showing how hairy sexism is tied up with hairy racism, and both with ableism, in her book Fantasies of Identification (New York, 2014), chapter 9.