Cost of Silky Soft full transcript
ALLISON: Krystal Kim was 10 years old when she joined her town’s baseball team. It was the 1970s. It was a big deal because it was the first year that they were allowing girls to play.
Before her first practice, her mom had a talk with Krystal.
KRYSTAL: She just sat me down and she was like, ok, you will be becoming a young lady. And there's certain things that you need to take care of as far as hygiene, and smelling good. And, you know, women have certain odors that we don't want coming out. So there’s things that you can do to take care of yourself and one of them is putting baby powder in your panties and under your arms and making sure that you stay dry so that you don't smell.
ALLISON: Krystal went off to practice. Growing up, there was always a big white bottle of J&J baby powder underneath the sink in the bathroom. And from that day forward, she used it almost everyday — sprinkling it on her body and in her underwear.
KRYSTAL: The routine was always, you know, shower with soap, lotion. Johnson and Johnson's powder and deodorant. And in our community, we would always see like older girls with powder on their necks and in their cleavage. So that was kind of like a statement, like, I'm clean. See, I have my powder on. And that kind of stuck with me.
ALLISON: Nearly four decades later, when Krystal was 47 years old, she went in for fibroids surgery. She had been bleeding a lot during her menstrual cycle and she was very anemic. The surgery was to shrink the fibroids. The surgery went well and a year later, in 2014, she went in for a follow up ultrasound. She was feeling healthy.But the doctor found something in her ovaries during the ultrasound — it looked like it might be cancer. They needed to do an exploratory surgery right away.
KRYSTAL: I said, if you find anything, just do what you need to do. I'm not having any more children. I'm OK with the hysterectomy.
ALLISON: When Krystal woke up from surgery. The doctors told her they had found cancer in her ovaries and they had done a full hysterectomy. They told her she would need to start chemo for her ovarian cancer right after she recovered from surgery. It all happened so fast and she had A LOT of questions.
KRYSTAL: How? Why? Why didn't anybody see it? Where did it come from? How did I get it? And I was like, are you sure? Because you said, you know, we're sure we took everything out of you. And I was like. All right. I didn't know what to think.
ALLISON: Ovarian cancer is rare, but one of the most deadly cancers — the five year survival rate is about 50 percent.
KRYSTAL: I asked the doctor if there was anything I could have done to prevent it. And he said no. But he told me that the demographic is middle aged, overweight, white women who have never had children. And I didn't fit into any of those demographics.
ALLISON: Dazed, Krystal went home to recuperate.
While she was healing, she spent time on Facebook and as she scrolled, she started seeing articles about a connection between ovarian cancer and Johnson & Johnson’s baby powder. At first, she was a little skeptical.
KRYSTAL: I'm like, baby powder. It's in the name. Something that's for babies. Why would it cause cancer if it's marketed to babies? You know that that doesn't even make sense in my mind.
ALLISON: But it did make her wonder: Could baby powder have caused HER cancer? Krystal decided to fill out an online questionnaire about her cancer and about her baby powder habits. And soon after, she got a call from a lawyer.
Ater a lot of conversations with the law firm, Krystal signed on to join a group of women suing Johnson and Johnson, alleging that the company’s baby powder caused their cancer. And as it turned out, she was one of thousands.
This is Bodies, a show about people solving the mysteries of their bodies. I’m Allison Behringer.
We’ll be right back.
ALLISON: So for this episode we’re going to do something a little different. We’re going to come back to Krystal, but we’re also going to be looking deeper in the science and the history and marketing of baby powder.
We’re gonna be talking a lot about the types of products marketed to women in this episode, and we just wanna say that we understand that not all people with vaginas are women, and that not all women have vaginas. But since we're talking a lot about research on ovarian cancer and how these products are advertised, in this episode you'll hear us use the language that advertisers and researchers use — and they usually just say "women" when they mean "cis women."
Also, later on in this episode, you’ll get to meet one of the reporters on our team.
Johnson and Johnson includes about 250 companies and sells products in nearly every country in the world. They make drugs and medical devices. They make Band-Aids and Benadryl and birth control. And their most well-known product: baby powder.
Johnson and Johnson actually sells two kinds of baby powder in stores. One is made from corn starch — and you’ll see it labeled as corn starch on the front of the bottle. But the more common version — that classic kind we’ve all seen in drugstores — that is made from a mineral called talc. It’s an ingredient in a lot of cosmetics, especially the ones that have that velvety soft feel — like eyeshadow and face powders. It’s mined from the earth and then crushed into talcum powder.
And when you mine for talc, there is another mineral that is sometimes found next to it. And that is asbestos.
Asbestos is highly carcinogenic and the known cause of a deadly cancer called Mesothelioma — and has also been linked to ovarian cancer.
We talked to Sean Fitzgerald, a geologist and someone who’s testified against Johnson and Johnson. And he explained that talc and asbestos are made of the same basic building blocks.
SEAN FITZGERALD: So if we have an asbestos deposit there's talc somewhere in that deposit. If we have a talc deposit, we may have asbestos. It depends on exactly how the talc formed, but they're very closely related. These are the same mineral family, if you will.
By law, any talc used in cosmetics or personal hygiene products must be tested and certified as asbestos free. But not all talcum powder on the market is asbestos free.
Sean has spent his career testing talc for asbestos and recently made headlines when he found asbestos in a makeup kit at Claire’s — a store for pre-teen girls. He’s also found asbestos in Johnson and Johnson’s baby powder.
And there are documents that show Johnson and Johnson has known about the asbestos for a long time. Internal communication at the corporation shows that since the 1970s — the same decade that Krystal started playing baseball and using its baby powder — Johnson and Johnson’s talcum powder had tested positive for small amounts of asbestos. Executives at the company were aware of the problem, but they didn’t tell the FDA or warn consumers.
And it’s important to note: There are studies that show an association between talcum powder and ovarian cancer. But there was also recently one major study from a highly regarded medical journal that did not find an association between baby powder and ovarian cancer. We’ll get into the specifics of these studies later.
Around this time in the 70s and 80s, pediatricians actually stopped recommending talcum powder for babies — there is no medical benefit and they were concerned about babies inhaling the powder.
Throughout all of this, Johnson and Johnson has always maintained the same message: their product is safe. In 2018, they posted a video of their CEO, Alex Gorsky, defending it.
ALEX GORSKY: So I want you to hear it directly from me. We know our talc is safe. In fact, for over 100 years, Johnson and Johnson has known that the talc in our baby powder is the purest, safest pharmaceutical grade talc on earth. J&J baby’s powder has never contained asbestos.
ALLISON: But less than a year later, in 2019, Johnson and Johnson did a recall of 33,000 bottles of baby powder after the FDA found small amounts of asbestos in one of the bottles. This was the first time that Johnson and Johnson has ever done a recall on baby powder because of asbestos. This video is still on their website.
So is talcum powder safe? Or isn’t it? Johnson and Johnson’s reassurances didn’t make Krystal feel any better. Especially once she started learning more about her own body.
After Krystal signed on to be part of this lawsuit against J&J, the law firm started collecting evidence for her trial. One piece of evidence was a sample of Krystal’s tissue that had been removed during hysterectomy. The law firm sent some of that tissue to an expert. The test results showed that there was talc in her the tissue of her ovaries and fallopian tubes and there was asbestos in her lymph nodes.
KRYSTAL: I'm just like, are you kidding me? And I just cried. That's when all the dots were connected. It was like, wow, I've used this for all my life. I used to like to put in my hair, put it in my makeup, put it on my dog, put it in my, in my sheets, in my pillowcases. So I'm rolling around in it all night.
Everybody knows asbestos is deadly. And it's like, oh, my God, I got to get a will. Who's going to take my children? My mind was spinning. It was just going so fast. I was just thinking about everything that needed to be done before I died because I knew I was just gonna die.
ALLISON: So there’s a big element of this story we want to focus on. And that’s race. Studies show that Black women use baby powder at higher rates, compared to white women. And to talk more about all this, I wanted to bring on one of our reporters, Kalaisha Totty.
ALLISON: Hey Kalaisha
KALAISHA: Hey Allison.
ALLISON: So Kalaisha before you started working on this story, what was your experience with baby powder?
KALAISHA: My grandma used it on me. My mom used it on me. It’s something that I had never thought twice about.
My mom said in the summertime she would put it in her sheets to keep her cool and dry.
My grandmother used to put it under her boobs and like some people would put it in their hair on their legs. It’s like, once you get out of shower, you get out of the bath, you put baby powder in your underwear and you’re good to go basically.
ALLISON: Why are women putting baby powder on their underwear? Like wha — Where is that thing coming from?
KALAISHA: So advertisers tried to push this idea that women needed to improve the smell of their bodies, particularly their vaginal odor. As early as the 1920s, companies like Lysol were marking their disinfectant spray as a douche to women.
ALLISON: So wait, the same product they’re telling people to clean their house with, they're telling women to use that on their vaginas?
KALAISHA.Yeah. I know. So yeah, I found a bunch of these old commercials, from the 70s and 80s and 90s for vaginal products. Do you want to watch some of them?
ALLISON: Yes, definitely. Please.
KALAISHA: Ok so one of these commercials is from the 80s for a feminine wash called Summer’s Eve.
ALLISON: What is Summer’s Eve?
KALAISHA: So it’s basically a soap specifically made for your vagina
ALLISON: Oh my god. Ok, let’s see it.
ADVERT — Summer’s Eve Wash : The following is for women only. Summer's even introduces a new and totally different idea. The first external feminine wash...
KALAISHA: It’s like a silhouette of her, she’s getting undressed, it’s so sexy.
ADVERT: So you can use it every day to feel feminine, fresh and confident.
KALAISHA: So I found A LOT of ads for vaginal deodorant products.
ALLISON: So as you were going through all these, what was your overall impression of them?
KALAISHA: It implies that your natural body odors are an issue that needs to be dealt with.
ADVERT — Massengill Douche : Freshness you can be sure of...
ALLISON: And so wha — what’s the deal with douching? Why were women using douching products?
KALAISHA: The idea is that you douche after sex to clean yourself out. And you douche after your period or when you’re on your period to clean yourself out. It’s just this idea that you need to clear yourself out.
Today, we know that OBGYNs don’t recommend douching because it can be very harmful. You're putting products up your vagina that don’t belong there. But here’s the thing. We found that Black women in particular use these vaginal deodorant products at higher rates than white women. And it made me curious and ask: Why?
BHAVNA SHAMASUNDER: How do you know that it's not a cultural norm and that marketers are not actually responding to the cultural norm?
KALAISHA: So that’s Bhavna Shamasunder, an associate professor at Occidental College. Her work looks at how low income communities and communities of color are more negatively impacted by toxic chemicals.
BHAVNA SHAMASUNDER: There’s a question that people ask her over and over about her research — It’s something she thinks about a lot too. Basically — is this a black thing? And she says, No.
BHAVNA SHAMASUNDER: I think the pressures really do originate outside of the community and then are perpetuated within the community. I think the advertising messages were insidious. And told a falsehood and people believed it.
KALAISHA: It wasn’t something inherent in black communities. It was popular because it was specifically pushed on black women by advertisers.
Jet Magazine 1989. Photo credit: Michelle Ferranti
KALAISHA: So one the researchers I found named Michelle Ferranti looked at how douching was advertised differently to black women and white women throughout the 1970s. Specifically, she looked at white magazines like Life and Black magazines like Ebony.
And found that there were no ads for douching in Life , but there were a lot more in Ebony magazine .
ALLISON: Ok, so this was an intentional advertising decision that companies made. Makes sense then that Black women would use the products more.
KALAISHA: Exactly. And as women, we know we're held to higher beauty standards than men. Even though we know some of the stuff we use, like nail polish and hairspray, is probably not good for us, we keep using it. There’s all this sexist messaging in advertising, that our vaginas smell, that we need to be skinny...
But for some black women that standard is EVEN higher... that need to look "clean" and "presentable" in order to fit into white spaces. Like, in the United States, many schools will still not allow black girls to wear their hair natural. And the more you're trying to change your body, the harsher the chemicals need to be.
ALLISON: Yeah that makes sense. And is there research about this?
KALAISHA: Yeah, Studies actually show that products marketed to Black women are generally more dangerous.
In one study, researchers found that black women who douched had more phthalates in their body — which is a chemical that negatively affects reproductive health.
Another study tested household and beauty products to see which ones were the most toxic. And the MOST toxic product was called “Just for Me.” It’s a hair relaxer kit — which permanently straightens your hair. And It was marketed specifically to black girls.
ALLISON: Oh wow. So even young black girls are getting hit with these kinds of messages.
KALAISHA: You know, we talk a lot about how corporations are racist, but sometimes it’s hard to pin down exactly how. But I feel like after doing this research, it’s really clear. White beauty standards aren’t just dangerous to our self esteem — they are actually dangerous to our health.
ALLISON: And here is where we come back to baby powder. Internal documents from the early 90s show that J&J’s baby powder sales were declining. And that if they targeted African American women, they could boost these sales.
So they shifted their marketing plans — and then, about a decade later, in 2006, the World Health Organization said that using talcum powder in the gential area is possibly carcinogenic. Johnson and Johnson’s baby powder sales started to fall even more, as people became aware of the possible risks.
We looked at some Internal powerpoints from that time period and found that J&J doubled down on it’s marketing efforts to African American women.
J&J made plans to hand out free samples of baby powder out at black churches and beauty salons.
I asked Krystal whether she remembers seeing ads that she felt like were specifically targeted to her.
KRYSTAL: We didn't know that was specific to the African-American community because we were in it, so we didn't see other communities. So we think everybody's getting this marketing. Everybody sees this commercial. Everybody sees this poster or whatever. So it didn't dawn on me until a reporter called me about it and told me and I was like, are you kidding me?
Johnson and Johnson knew for decades that it had asbestos in it. So when white women stop using it, they figured, OK, we’ll get the money from the black women and make them feel that they need to smell better or we're going to. Our product is going to make them smell better and feel smoother or whatever. But ultimately it's gonna kill them.
ALLISON: In a statement, Johnson and Johnson wrote that “our campaigns are multicultural and inclusive. ...We are proud that we have been pioneers in multicultural marketing.”Here’s Kalaisha again:
KALAISHA: It wasn't bad that Johnson and Johnson was marketing to black women.
It was that they were using stereotypes linked to black women to manipulate us and to encourage us to buy a potentially dangerous product. And like, does it make me mad? Yeah, of course it makes me mad. But to be honest it's not surprising.
Because black people have always gotten the short end of the stick on everything, no matter what. We’re treated as if we’re disposable, like we’re an after-thought.
ALLISON: In 2018, Krystal traveled to Missouri for the trial and met the other women who would be part of this case.
The trial went for six weeks. Johnson and Johnson making their case. The law firm and the women making theirs. Each calling experts, each referring to studies.
One of the big questions in this case of course is whether talcum powder causes ovarian cancer. This has been difficult to answer.
The best way to figure this out would be to put humans in a lab and expose them to a potentially carcinogenic powder. Obviously, scientists can’t do that!
Studies that survey women about their baby powder habits have shown mixed results.
One of the early studies that found a link was in 1982 by a Harvard doctor named Daniel Cramer. In a study of 215 women, he found that those who used talc on their genitals were at a 92% increased risk for ovarian cancer. Dr Cramer wrote a letter to J&J and recommended that they put a warning label on their baby powder. But Johnson and Johnson did not put a warning label on. In the time since, there’s been over 20 mostly small studies that have found an increased risk.
But other studies did not find a link.
In January of this year, a highly regarded medical journal called JAMA published the largest study to date and found no statistically significant association between baby powder use and ovarian cancer.
We spoke to the lead researcher on this study, Katie O’Brian. And she talked about the strengths of the study. It included more than 250,000 American women. The researchers pooled data from several long-running studies that were following women over the course of their lives. They found that rates of ovarian cancer were roughly similar in women who didn't use powders on genital area and those who did.
But there are some major issues with the study, which the authors acknowledge.
First, the studies they pulled from did not collect information on what kinds of powder products women used — so we can’t know if the people who said they used powder were using cornstarch or talc.
Second, this is a very rare cancer. Out of the about 250,000 women in this study, less than 1% got ovarian cancer. And so it’s tricky to figure out small differences in risk when you’re working with such small numbers to begin with.
Isabelle Chaudry talks about the third limitation. She’s the senior policy manager at National Women's Health Network in Washington DC. and she advocates for safer cosmetic legislation.
ISABELLE CHAUDRY: That study is dangerously flawed. The study relies on a cohort that was almost exclusively composed of middle class white women
ALLISON: In fact, 98% of the women in the study were white women. When you look at the chart of demographics, all the other races are lumped into one category of 2% and labeled “other.” So, it didn’t include the women who used these products the most.
ISABELLE CHAUDRY: I was very upset. The study almost completely erased to black women and other women of color. Like I said, we know who uses these products more. And women of color are the most impacted by this issue. Like, for instance, a black woman who's reading this article thinking, oh, OK, this it's safe to to use talc based products.
But the study does not even consider them. And so that is very problematic.
ALLISON: So, we can't totally throw out this massive study's findings. But we can hope for more data and research that is diverse.
Until more information is available, the American Cancer Society says that people concerned about using talcum powder might want to avoid it or limit using it.
ALLISON: With all these questions about safety, it makes your wonder: why do we have so many products like baby powder and douches and hair relaxers on the market? How did they even get there in the first place? Technically, we're supposed to have protections against dangerous products. But unfortunately that’s not really the case right now.
The United States’ Cosmetics Act has not been updated in over 80 years. As the law stands now, the FDA has very little regulatory power or resources to test the safety of products.
It’s up to the companies themselves to ensure their own products are safe. But they don’t need to send data about testing or even register their products and ingredients with the FDA. Companies have been left to regulate themselves .
As of today, the US has only banned 11 chemicals from products. In comparison, the European Union has banned over a thousand chemicals. Companies will create European versions of their products without the banned chemicals — but in the US, they keep the chemicals in. So it’s not as if companies can’t make these products without them — it’s just that it’s easier and less expensive to do so.
People at the FDA know this is a problem and are asking Congress for more resources. But it’s a slow process. The only time the FDA can test a product is if they have concerns over its safety — this happens to less than one percent of products. And this is how they found the asbestos in baby powder in 2019.
But Johnson and Johnson has disputed these findings, saying that it was a problem with the testing.
And Johnson and Johnson continues to share the same message.
ALEX GORSKY: J&J’s baby powder has never contained asbestos
ALLISON: When we contacted J&J for an interview, they responded in an email reiterating the message from Alex Gorksy. That their products are safe. They also included a link to the JAMA study — the one that was 98% white women and did not differentiate between cornstarch and baby powder.
The shortcomings of the Cosmetic act hurt all Americans. But they especially impact women, who on average use 20 products a day. And they impact Black women even more because those products are generally more toxic.
This is what a racist system looks like. This is what happens when companies like Johnson & Johnson are allowed to regulate themselves.
When Krystal heard all this information during trial, she got angry.
KRYSTAL: I felt like they bamboozled us. All of their advertisements. It's pure. It's for babies. It's...And they knew. They knew. It's like a kid that's caught in a lie. You gotta keep lying. You're going to keep lying. At what point do you tell the truth and just make it right?
I have no trust because finding out that the FDA allowed Johnson and Johnson to police themselves. That's like having the fox watch the chicken coop.
ALLISON: On the final day of Krystal’s trial, Krystal and the other women gathered together outside the courtroom
KRYSTAL: It was just we knew it was a feeling. It was. The sun was out and it was just everybody was smiling. It was just a good day.
ALLISON: The jury awarded the 22 plaintiffs 4.69 billion dollars — which comes out to about 200 million dollars per plaintiff.
KRYSTAL: It was just the confirmation of what we already felt. So, you know, it was just roars and cheers and it was good. It was good.
We’re real people and this is something that happened to us. This is not just something that you read in the news or watch on television. We are real people. And hear my story, hear what happened to me.
ALLISON: But Krystal and her fellow plaintiffs have not seen any of this money because Johnson and Johnson appealed the ruling. In the time since the trial, only 12 of the 22 plaintiffs are still living. Two of those twelve are very sick.
In the past year, there’s been more mesothelioma and ovarian cancer trials against Johnson and Johnson. In a couple of these, the juries sided with J&J. In others, juries ordered J&J to pay out tens of millions of dollars. Just this February, CEO Alex Gorksy testified for the first time, and that jury awarded nearly 40 million to the plaintiffs.
But J&J keeps standing their ground. EVEN THOUGH there is a perfectly safe alternative — they could stop making the talcum powder version and make all their baby powder from cornstarch.
As far as Krystal’s health, she’s been in remission for almost 5 years.
KRYSTAL: It's the beginning of another journey to stay this way. So at the five year mark, they have a big party and at five years, that's when they deem you cancer free. So I saw tents at the cancer center when I went to my appointment one day and I was like, what's going on here? They were like that's a five year and more party. So that's my goal to get to that party.
ALLISON: How far away from you?
KRYSTAL: This will be my fourth year. August will be my fourth year. Yes, so I have a year a couple months to go.
Currently, some leaders in congress are proposing an update to the Cosmetics Act. And the FDA is working on ensuring talc testing methods are the most sensitive and accurate.
But in the meantime, there are actions we can take to have more information about our beauty products. The Environmental Working Group has a tool called Skin Deep where you can type in your product and find out its safety rating.
But lots of beauty products come with risks. And what do we do with that?
For Krystal, changing our ideas of what is beautiful may be our best safeguard.
KRYSTAL: You have to love yourself because you don't want to fall prey to the standards of beauty. And I think a lot of us, because Johnson and Johnson targeted the black community, because the standard of beauty was the white image, the straight hair. You know, we weren't supposed to be pretty because we had kinky hair or darker skin. So love yourself. Don't fall prey to that.
ALLISON: I’ve been thinking a lot about Krystal’s idea of loving ourselves.
But does loving ourselves mean never using makeup? Does it mean not using shampoo? Does it mean giving up eyeshadow and nail polish and all the other products we use to have fun?
Because even if we do love ourselves it doesn't mean that society will. We still live in a world where natural vaginal odor is considered a problem to fixed. We still live in a world where Black women are treated better at work if they relax their hair.
So how do we figure out which practices we just love because they make us feel happy, and which ones have been encoded into us by society and history and marketing?
When I talked to reporter Kalaisha about this, she isn't just thinking about herself. She's pregnant, and about to give birth any day now to a daughter, and she’s been trying to figure out how she’s gonna parse this all out
How is doing this research while pregnant impacted what you've been thinking about and how you want to raise your daughter?
KALAISHA: Honestly, it has scared the hell out of me. I'm not going to lie because I have to be responsible with bringing a new life into this world that seems so bad, and so out to get you. And being a black woman, I'm just like, you know, It's like I can't control anything, but I'm trying to give her the best choice.
So, like me and my mom were talking about, you know, what baby products do I use, what kind of soap, what kind of diapers, what kind of wipes. I was kind of like losing my mind over this because now that I'm more knowledgeable, I'm trying to make all these decisions. But it seems as though it's impossible to keep her 100 percent safe. Like if it's not the diapers, it's the smog in the air. It's not the smog, it's the racism. It's just like there's so much stuff. So it's empowered me to know that I can make more informed decisions.
And really, it starts with educating ourselves to educate our children. Every person has the right to make their own decisions. But if we share what we know, we're empowering a whole community to make better choices. And I guess at the end of the day, that's really all that we can hope for.
ALLISON: Every day, we make choices about how to care for our bodies. We slather them with lotions and cleansers, wash them with shampoo, maybe even dust them with powder…but sometimes, caring for our bodies means doing nothing at all, even when we’ve been told otherwise our whole lives.
While I’ve been working on this episode, I’ve been wondering about my own makeup and shampoo and soap. So the other day, I went on the Environmental Working Group's website and I looked up all my products. I ended up throwing about half of it away.
To Kalaisha’s point — It's a small change in a world full of pesticides and air pollution and who knows what else. But gathering that knowledge and then deciding what to keep and what to throw away — THAT actually made me feel more confident. Kind of like any good makeup should.