Forty years of technological and political changes haven't softened the group that launched a controversial and groundbreaking women's health book in 1971.
"Our Bodies, Ourselves," with its iconic cover photo of protest-marching feminists, bluntly discussed female sexuality and reproductive health during an already politically-charged time in American history. Generations of women (and men) have flipped through the massive paperback to quell their curiosity about menstruation, childbirth, and heterosexual, bisexual and lesbian relationships.
The new, ninth edition of "Our Bodies, Ourselves" ($26, Simon & Schuster) continues to challenge a medical and political establishment the editors believe is greatly influenced by the pharmaceutical industry and a fear of malpractice, says Judy Norsigian, editor and spokeswoman for the nonprofit Boston Women's Health Book Collective.
"Every chapter in the book is in part a call to action," she says. "The book has always been informational, factually accurate, and political in the sense that it helps individuals connect locally, nationally and globally with others to bring about change."
Since its inception, the book has been a blend of scientific evidence and feminist political agenda. The first authors were patients -- not doctors – sharing their personal experiences and perspectives on health and sexuality. The first incarnation, in 1970, was so organic it was no more than a stapled booklet.
The first, formal edition of the book released a year later turned traditional medical mores upside down, Norsigian says.
"In those days, doctors didn't even tell women when they had a diagnosis of gonorrhea or VD; they told the husband," she says. "There were some pathetic conditions in those days."
Attitudes toward women and their health are better today, Norsigian says, but it's still far from perfect. She points to abstinence-only sexuality classes in schools, the abundance of cosmetic surgery and the ongoing political debate about abortion.
"It's now worse than it was," she says.
The book's frank, layperson language appeals to many of its estimated 20 million readers. Anatomical diagrams and charts break down the nitty-gritty on topics such as orgasms, sexually transmitted infections, contraceptive choices and violence against women.
That same information, as well as a graphic black and white photograph of a woman killed during an illegal abortion, also riles the book's many critics. "Our Bodies, Ourselves" has been banned by schools and public libraries. And in the early 1980s, conservative activist Jerry Falwell railed against the book, which he called "obscene trash."
"It's not as bad as it used to be," Norsigian says of the criticism. "We did get a big kick out of Jerry Falwell going after our book. That was really something."
The editors understand that not everyone will agree with their take on women's health, and the book repeatedly lists the pros and cons of any issue within its pages. Also, contributors must base their writings on scientific research, which is then reviewed by physicians who volunteer their time to the project, Norsigian says.
There have been internal conflicts at times. For example, the latest edition includes the ongoing debate over mammogram screenings.
A government panel recommendation of biannual screenings for women over 40 upset an enormous number of breast cancer survivors and advocates. "Not all of us were totally happy," Norsigian says of the final version of that chapter. "But it is accurate from both sides."
Time has changed the tone and content of some chapters of "Our Bodies, Ourselves." Early, angry essays about lesbian sexuality have evolved to address gay marriage, parenting and a broader understanding of sexual orientation, Norsigian says.
Technological advancements over the past four decades aren't always embraced by the authors. Fertility treatments, the use of overseas birth surrogates, and the increase in cesarean section deliveries all raised ethical questions, Norsigian says.
"Using a technology just because it is there may not necessarily be the best approach. One has to look at the whole picture," she says. "We don't tell women they are bad if they are using a certain technology. We want them to get information and be better informed as they make these kinds of decisions."
Women also should scrutinize the improvements in pharmaceutical treatments, Norsigian says. The industry's use of direct-to-consumer marketing and its influence on physicians can mislead women who don't know the risks and benefits associated with the medications.
Forty years ago, the information simply wasn't available to women. Now, she says, "They are really too busy to see beyond the hype."