“A leopard can’t change its spots.” This saying reminds us that, even if someone or something pretends otherwise, the chance that they’ve altered their true nature is pretty slim. It’s a phrase that perfectly captures how I think about the breast cancer industry and the true nature of “pink ribbon culture.”
It’s been more than 30 years since the multinational pharmaceutical corporation AstraZeneca established National Breast Cancer Awareness Month and nearly as long since the pink ribbon burst onto the scene. Susan G. Komen was technically the first to start pushing pink ribbons, but it was Self Magazine and Estée Lauder that launched the ribbon as an icon of breast cancer awareness and a marketing tool.
And whenever I think about the history of the breast cancer movement and the machine that is the breast cancer industry, I get angry.
I’m not angry because over the years people have banded together with the hope of figuring out how to end an epidemic or find a “cure.” I’m angry because so little has really changed over the past three decades, especially when it comes to breast cancer treatment, metastatic breast cancer, mortality rates, the language we’re conditioned to use when we talk about breast cancer and…that damned color pink.
We just entered a new decade — we’re literally living in the future — isn’t it about time we started talking about breast cancer in a way that reflects that? We live in the era of #MeToo and #TimesUp, and we can’t continue to deny that the winds of change need to rattle the breast cancer movement, too. It’s time for a real shakeup. It’s time for us to finally peel every shred of that sickly-sweet pink ribbon off and shed all the ideological trappings of gender, female sexuality, and female sexual identity that have come to be associated with it. It’s time to tear out the patriarchal belief system that’s woven into the fabric of the pink ribbon, and set both it and the ribbon aside.
The color pink has hijacked the way we think about and talk about breast cancer for decades, which has set the disease up, disingenuously, as a palatable women’s issue — one without teeth, without politics. But this is all a big fat hegemonic lie. Breast cancer isn’t palatable. It’s a devastating disease with harsh realities and treating it can be a significant financial burden and take a lasting physical, sexual, and emotional toll.
And it’s political. It’s political because breast cancer still kills female-identifying humans (approximately 40,000 every year, for more than 30 years) more than male-identifying humans, which means that it is primarily a women’s health issue. Women’s health has always been political, and is especially so right now.
But, here’s the thing: as a disease, breast cancer doesn’t really care about gender identity or gender expression. It kills humans regardless of where they sit on the gender spectrum. Covering that fact up with a pink ribbon hides the truth of individual lived experiences and the need for important changes that can improve our health care experiences and health outcomes.
The pink ribbon, the color pink, even the word “pink,” have narrowly defined and shaped conversations about breast cancer until now because, as scholar Veronika Koller explains, “People are culturally socialized into colour meaning.” In other words, the association that stems from a particular color or shade isn’t indicative of the color or shade itself, “but of the cultural and historical formation in which it is constructed as having particular characteristics and being suitable for particular social groups.”
We know the cultural association of pink with femininity very well: the color is a marker of stereotypically feminine traits and has historically been linked to restrictive and ideological definitions of female sexuality and female bodies. When we swaddle baby girls in pink blankets we cloak them not only in that color, but also in deep-seated, typically white, patriarchal beliefs and ideas about female passivity, helplessness, and dependence — ideals that are often proclaimed as biologically predetermined. As such, it’s impossible to fully disentangle ourselves from the color pink’s problematic and gendered cultural meaning. In turn, this stunts conversations about breast cancer before they even start, and constrains how we then think about someone living with or dying from the disease, awareness, activism, and what the path to preventing breast cancer and ending the epidemic looks like. 
The pink ribbon doesn’t serve the breast cancer community, and it never really has. It serves the companies and organizations that make billions of dollars off breast cancer every year, by slapping a pink ribbon on their products; or running a pink ribbon campaign while also making or selling products linked to breast cancer (Breast Cancer Action calls this “pinkwashing”); or coming up with “edgy” new campaigns that do little more than reinforce gender stereotypes and toxic ideological assumptions and expectations about female-presenting and -identifying humans, like Walgreens’ 2018 campaign, “Battle Beautifully.”
We need change. Real, and meaningful change. Not the tiny incremental change that white patriarchy tells us is the only thing possible. It’s not good enough.
We talk about breast cancer publicly more than we did a century ago, and that’s reduced some of the stigma and taboo surrounding the disease. But, we need a more radical, nuanced, and intersectional discourse that’s not constrained or stunted. We need a discussion that doesn’t sexualize the disease or objectify female-presenting and -identifying humans. Slogans like “Save the Tatas,” “Save Second Base,” “Check Your Headlights,” or “Keep the Lumps Out of Your Cups” are not cute, funny, or witty. They’re demeaning and miss the mark of what’s truly at stake. Not our breasts, but our lives.
We have to talk about breast cancer as a public health crisis, while making clear that it disproportionately affects female-identifying and -presenting humans. We have to talk (a lot more) about how race, class, gender identity, and our environment (the toxic chemicals in the air we breathe, the food we eat, and the water we drink) impact our risk of developing breast cancer, the quality of health care we receive, and whether we will die from the disease. We have to stop talking about mammograms as the solution, and instead figure out how to prevent the disease from developing in the first place. And, we have to talk a lot more about how the metastatic community needs more effective, more affordable, and less toxic treatments.
Then we have to do more than walk, run, or buy something pink for “the cure.” And that’s hard. I know. Especially when someone we love is dying from this damned disease and we feel helpless and hopeless. But, reaching for a pink ribbon to wrap around us in these fragile moments isn’t going to get the job done — because it hasn’t up to this point. We need to act, to agitate, to take political action, and to work for systematic change.
I know there are people who find comfort in, or identify with, the pink ribbon, but I’m not alone in pointing out that pink ribbon culture is doing more harm than good. Political breast cancer activists — like Barbara Brenner, Karuna Jaggar, Barbara Ehrenreich, Ellen Leopold, and Sharon Batt, as well as corporate breast cancer movement scholar and the author of Pink Ribbons, Inc., Samantha King, — have blazed a path forward by calling out the hypocrisy of the breast cancer industry and pink ribbon culture. And we must follow, channeling the spirit of Barbara Brenner, as “hell-raisers, question-askers, agents of change, and dogged and courageous pursuers of truth.”
Addressing and ending the breast cancer epidemic can’t be done by continuing to think that if we could just figure out the right shade of pink or if we launch campaigns called “More than Pink,” (like Komen did in 2018) that we’ll someday, somehow, arrive at the destination we all hope for — a world where fewer people die from breast cancer. The leopard can’t change its spots, so it’s high time we find a new leopard.
Kira S. Jones, M.A., is an NWHN Board Member. She was previously Breast Cancer Action’s Communications Manager, and has been writing about and working in women’s health for over 10 years. Her master’s thesis on the breast cancer movement is titled, In The Pink: The (Un)Healthy Complexion Of National <Breast Cancer Awareness> Month.
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 King S, Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy, Minneapolis (MN): University of Minnesota Press, 2006.
 Fernandez SM, “Pretty in pink: History of the pink ribbon,” MAMM Magazine, June/July 1998. Online: http://thinkbeforeyoupink.org/resources/history-of-the-pink-ribbon/
 Visco FM, “Conflicts have killed trust in the system. Advocates must rebuild it,” The Cancer Letter, 2018; 44(46): 10-12. Online: http://www.breastcancerdeadline2020.org/assets/pdfs/tcl-guest-editorial.pdf
 Breast Cancer Action (BCA), At Cancer’s Margins: Sexual and Gender Marginality in Cancer Health and Experiences of Care, Breast Cancer Action Webinars, July 2018. Online: https://bcaction.org/resources/webinars/free-webinar-at-cancers-margins-sexual-and-gender-marginality-in-cancer-health-and-experiences-of-care/
 Koller V, “Not just a colour: pink as a gender and sexuality marker in visual communication,” Visual Communication, 2008; 7(4): 395–423. doi/10.1177/1470357208096209.
 Breast Cancer Action (BCA), 4 Questions Before You Buy Pink, San Francisco (CA): BCA, no date. Online: http://thinkbeforeyoupink.org/resources/before-you-buy/
 McFarland B, Now Walgreens Wants us to Battle Beautifully, San Francisco (CA): Breast Cancer Action, March 18, 2019. Online: https://bcaction.org/2019/03/18/now-walgreens-wants-us-to-battle-beautifully/
 See: Brenner B, So Much to Be Done: The Writings of Breast Cancer Activist Barbara Brenner, Minneapolis (MN): University of Minnesota Press, 2016.
 See: Jaggar K, “Pink-ribbon culture is gaslighting women,” The San Francisco Chronicle, October 23, 2019. Online: https://www.sfchronicle.com/opinion/openforum/article/Pink-ribbon-culture-is-gaslighting-women-14554817.php
 See: Ehrenreich B, “Welcome to cancerland: a mammogram leads to a cult of pink kitsch,” Harper’s Magazine, 2001; 43-53.
 See: Leopold E, A Darker Ribbon: Breast Cancer, Women, and Their Doctors in the Twentieth Century, Boston (MA): Beacon Press, 1999.
 Batt S, Patient No More: The Politics of Breast Cancer, Ottowa: Gynergy Books/Ragweed Press, 1994.
 See: King S, Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy, Minneapolis (MN): University of Minnesota Press, 2006.
 Sjoholm B, “A Portrait of Barbara Brenner,” In Sjoholm B (Ed), So Much to Be Done: The Writings of Breast Cancer Activist Barbara Brenner, Minneapolis (MN): University of Minnesota Press, 2016, pp. 1-12.
 Saporta M, “Susan G. Komen transitions fundraising from race to walk,” Atlanta Business Chronicle, May 11, 2018. Online: https://www.bizjournals.com/atlanta/news/2018/05/11/susan-g-komen-transitions-fundraising-from-race-to.html