Defending the Unnatural (Part 1)

When I tell people what I do, I’m often asked ‘Why do you research language? You know English, don’t you?’ Certainly in the early days of my studies, I was inclined to agree. I knew my nouns from my verbs, my compound clauses from my subordinates, and I could even tell you a fair bit about the Received Pronunciation evolution through the 20th century if I really wanted to impress. It didn’t seem all that important though, and I occasionally wished that I could have gone into the sciences to give my writing some real world consequence. But six years on, I’ve found the perspective offered through a fine-tuned awareness of language has its very own significance and value in how we relate to, understand and change the world.

We’re still not sure to what extent language is a natural phenomenon. Under normal social conditions, we acquire language spontaneously, without conscious effort or intention. The human oral cavity is optimally designed to produce an enormous repertoire of sounds beyond the capacity of any other known animals, and certainly the brain is developed so much so that it can obtain, organise and access a mass of linguistic information without much awareness of this cognitive phenomenon. And yet there is much about language that is unnatural. A majority of the words we use are arbitrary – they hold no obvious or intrinsic connection to what we refer. And we certainly don’t all speak the same language, or even share the same structures across them. We manipulate language all the time to create new meanings, describe new realisations, execute different actions. It is we who shape it, and also it which shapes us.

What I mean to say is that the boundaries between ‘natural’ and ‘unnatural’ are not so clear cut as we often believe. There’s no certain distinction between what would be in the world if we let nature take its course, and, more importantly, whether that alternative is definitely better.

The natural dichotomy

The ‘natural’ and ‘unnatural’ dichotomy isn’t a prevalent discussion in language and literature – at least I’ve never heard anyone speculate what may have happened if William Shakespeare had never learnt to write, if Jane Austen were never permitted to read, and the printing press had never been invented to give us Harry Potter, Game of Thrones and Fifty Shades of Grey. But it seems to be a constant preoccupation in science. Whether it’s food, pharmaceuticals, or digital technology, we all believe we have a solidified and irrefutable idea of what ‘natural’ and ‘unnatural’ means and how this property impacts us.

A few weeks ago, an email from a reader landed in my inbox asking for my opinion on birth control. She questioned whether I thought the pill was safe or dangerous, and mentioned that the idea of putting synthetic hormones into her body scared her. But she wasn’t sure if the natural remedies she’d read about online were much good either, and she wanted to know what was best to take. Now, I’ll caveat this by saying that seeing as I have little-to-no experience in reproductive health, I was in no position to give any advice on the subject, and returned to her with a recommendation that she speak with a qualified GP. But the content of the email flagged three common beliefs about the natural and unnatural dichotomy that are seen all the time in science. Number one: that ‘natural’ and ‘unnatural’ are categorically different; number two: that our bodies have an innate ‘knowing’ of what is ‘natural’ and ‘unnatural;’ and number three: that ‘natural’ is inherently good and ‘unnatural’ is inherently bad.

Thankfully, there are some clever cookies out there with a wealth of knowledge about reproductive health, such as Dr. Anita Mitra, an NHS doctor working in Obstetrics & Gynaecology. She is also the author of the blog Gynae Geek, where she shares no-nonsense information on ‘down-there’ healthcare, so she was the perfect person to impart some wisdom on our natural/unnatural health conundrum.

How are ‘natural’ and ‘unnatural’ different?

Natural hormones are produced by the body. Synthetic hormones are produced in a lab, but these also include bioidentical hormones usually derived from plants (yams or soy), which are referred to as ‘natural.’ These need to be manipulated in a lab to get them into an administrable form such as tablets or creams though. The structure of natural and synthetic hormones are slightly different, largely because synthetic need to have a slightly different structure to natural ones to aid their absorption by the body.

Can the body tell the difference between ‘natural’ and ‘unnatural’ hormones?

The body cannot technically tell the difference. All it knows is that there is a chemical there that is activating the particular hormone receptor in question. Differences can manifest themselves between natural and exogenous hormones (those we put in, both natural or synthetic) as side effects which largely arise due to the slightly different activity they may have at other receptors, because of the different structures as mentioned above. With natural hormone levels fluctuating massively in the body on a minute-by-hour-by-daily basis, it’s always going to be difficult to mimic a natural situation with something you take once a day.

Is ‘natural’ always better than ‘unnatural?’

There’s no firm evidence that the naturally-derived bioidentical hormones are more effective or safer than traditional hormone replacement therapies (HRT) containing synthetic progesterones. Furthermore, several randomised controlled trials have shown that naturally-derived hormones still cause common side effects seen with synthetic HRT, compared with untreated control subjects. Though there are plenty of other ‘natural/herbal’ medicines out there, an important consideration is that they can be difficult to standardise, because of subtle differences in, for example, plant species, growing conditions, seasons, and therefore it can be difficult to compare from brand to brand and even bottle to bottle of the same brand. It’s important to note that these are completely unregulated and unlikely to have gone through the stringent testing that is required for a pharmaceutical drug to come on the market. So, while natural may seem like a safer choice, it may not be the case at all.

Hormonal contraception has offered both sexual freedom, as well as improving quality of life for thousands of women, many of whom were previously unable to carry out their normal daily activities. It’s also important to remember that pregnancy comes with its own medical and psychological complications. One example is the risk of blood clots. Use of the combined contraceptive pill is associated with a slightly higher risk of blood clots compared with women who don’t take the pill, however this risk is less than that of a pregnancy where the change in oestrogen and progesterone levels cause an even higher risk of bloody clots. This is an example of natural hormones produced by the body having the potential to cause harm, even when they’re doing the most natural job in the world.

Of course, no medication is without its risks. But the pill has that massive benefit of no unwanted pregnancies. It also has health benefits as a result of the actions of the synthetic hormones it contains – reduced acne, less osteoporosis and decreased risk of endometrial, ovarian and bowel cancers, and ovarian and breast cysts, less risk of anaemia. These are some pretty important outcomes from synthetic hormones.

In sum, though yes there are some differences between natural and unnatural, it’s not feasible to ascribe good or bad characteristics to them on this fact alone. There are many confounding variables at play that we need to take into consideration. Further still, even our understanding of what counts as natural or unnatural can be sketchy at times. The takeaway: don’t make health decisions on naturalness alone.

So, that settles it, right? Now you can go away, be a little more sceptical and inquisitive about whether natural is always your best option, and be happier, healthier and wiser for it.

Hang on, not so fast. If there really isn’t a consistent distinction between ‘natural’ and ‘unnatural,’ then why do we still have such strong beliefs about it? Why are there whole groups, commissions, committees fighting all the way to keep the world as natural as possible? Why, with all the unnatural innovations in biomedicine saving lives every day, is there still cause for concern? This is the question I’m most interested in, and it’s going to require far more words than I’m sure you want to read right now to uncover them.

Look out for part two coming next week, where I will explore the emergence of this dichotomy, the many (completely rational and not-so rational) reasons for such phobias, and the many social, legal and ethical consequences of it.

Find Anita on Instagram and Twitter.

Maxine Ali