Lena Dunham is under fire because of comments she made on her Podcast Women of the Hour. The episode, entitled Choice, begins with a thoughtful discussion of choice and how pro-life is a misnomer because those who self-identify that way are just anti-choice.

You can listen to the episode here.

The comment that has some up in arms is around the 14:40 mark. Dunham discusses how she was approached by a woman to join a pro-choice project and that woman assumed Dunham had previously had an abortion. Dunham quickly clarified that she had not and then reflected on why she was so quick to make that point. She shared some self-reflection in wondering if her rapid dismissal meant that she had somehow internalized the negative views about abortion that society had pushed on women.

She mentioned people who she knew and loved who had abortions and that didn’t affect what she thought of them. Perhaps she had become biased in a sure-it’s-fine-for-them-kind-of-way. Maybe her privilege was showing.

It was a short and, up to that point, insightful discussion with a fine message. Even the most pro-choice of us have absorbed biases, and we are often unaware of what our privilege has wrought. Once as a resident, I rolled my eyes when discussing a woman who was presenting for her third abortion. I mean really, I thought. She’d been sent home after both of her previous abortions with four months of free birth control pills and here she was just six months later. My attending, an older man, took me aside and reamed me for that display of privilege. I’ve never forgotten that. In fact, it prompted me to design a study to look at that very question, why do women have repeat abortions? Guess what turns out is a big factor? Domestic violence.

So all was well with Dunham’s podcast until this statement:

“Now I can say that I still haven’t had an abortion … but I wish I had.”

It’s a bit weird, the “wish I had” part. OK, it’s more than a little weird.

It definitely feels scripted given the measured tones of Dunham’s voice and the slight pause before “but I wish I had,” so it’s hard to believe it was a slip.

You don’t need to have cancer to be a caring, empathetic oncologist. You don’t need to have had an abortion to empathize with women who have. In fact, many great abortion providers are men so no uterus or ovaries even needed.

Having a procedure might help you understand the mechanics, but as many women walk very different paths to their abortions comparisons are hard. A woman with a pro-choice mother and money who lives in New York who needs an abortion would have no insight regarding the abortion experience of a woman with no family and who lives below the poverty limit in Alabama. And the reverse is true. The woman in New York may have had no access issues and managed to get her procedure done by eight weeks, but her doctor might have been an asshole. The woman in Alabama may have spent weeks on the Internet finding a provider and needed to work extra shifts to get the money, and her doctor may have inspired her to go back to school and become a doctor. One woman may have been raped. One may have had fetal anomalies. One may have had financial issues. One may have been in a domestic violence situation. One may have just not been ready to be a parent. You get the idea. Having an abortion only makes you an expert on your abortion, just like a vaginal delivery at term only makes you an expert on your delivery at term. The idea that having a procedure imparts some special insight or empathy is naive at best. Assuming what someone else felt or might have felt based on your own experience (or wanted experience) is the opposite of empathy.

When you say you “wish” you’d had an abortion, you are saying you wished you had a fetal anomaly or been so sick your pregnancy was killing you or been raped and became pregnant or been suffocated by societal pressures to produce a male heir or been victimized in a domestic violence situation or had an unplanned pregnancy. No one in their right mind wishes any of these things. Not because having an abortion is bad or wrong, but because women don’t want the situation that leads to an abortion. They want a healthy fetus, not to be sick themselves, to not be raped, to have a girl be worth as much as a boy, to not be beaten, and to not have unplanned pregnancies.

I know very little about Dunham. I’ve never seen an episode of “Girls” or any movie she’d been in (if she has been in a movie) or read her book. The only writing of hers that I can remember is the essay where she compares her Jewish boyfriend to a dog. I found it tasteless and humorless, which is probably why I remember it. I just re-read it, and it gets worse with time. It’s an ethnic joke wrapped up in what some might call observational humor. Perhaps it’s the kind of thing you find funny if you have privilege.

That brings me back to Dunham wishing she’d had an abortion. Was it a misguided attempt at empathy? Possibly, but if so it’s a very privileged attempt. Was it an attempt to reinforce the fact that next time she won’t be so quick to blurt out that she had not had an abortion? Possibly, although if that’s the case why not just say that? “Next time I won’t be so quick to blurt out that I haven’t had an abortion,” would have been a good end to that segment.

I’ve met many women who were happy they had an abortion. I have not met anyone who was happy to be in the situation where she needed an abortion. It’s not a subtle difference. No one wishes they could be in that situation again. No one is happy a fist was thrown or that a chromosome is missing or that their kidney is failing and they need dialysis, or they forgot their pills or they don’t have money to feed the two children at home.

If you are trying to empathize with someone you don’t say that you wished you could have been in the same sad situation. Imagine if someone said to me, “I wished I had a premature delivery so I could really support you, understand how you feel, and further my advocacy efforts.” I’d think they were privileged, self-centered and nuts.

If this has been an off-the-cuff comment, I’d let it go, but this was in a podcast devoted to choice and addressing bias and privilege. If you are devoting part of an episode to examining your own abortion privilege, then you had better make sure you’ve made a list and checked it twice — a wealthy woman saying that she wished she had an abortion is the opposite of empathy and is dripping in privilege.

Jennifer Gunter is an obstetrician-gynecologist and author of the Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

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