In my undergraduate years I lived in Las Vegas, and I often guest spoke to classes and groups about transgender issues.  One of the things I would often discuss was hate crimes.  I had statistics on other affected groups, and the rate at which they were victims of hate crimes.  But the number of people who fell victim to hate crimes based on gender identity always surprised people, zero.  There was no such thing as a hate crime against someone for their gender identity. 

 

On Wednesday October 29, 2009 President Obama signed the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act.  After 10 years of disagreements over the bill, this new federal hate crimes act affords protections based on someone’s actual or perceived sexual orientation and/or gender identity. 

 

Over the last 10 years there have been various barriers to the final passage.  The bill made it through the House of Representatives in April.  However, to get it through the Senate, Democrats attached this bill to the 2010 National Defense Authorization Act, a $680 billion defense bill.  (http://www.washingtonpost.com/wp-dyn/content/article/2009/10/28/AR2009102804909.html) (more…)

A recent NY Times pair of articles focuses on the human, medical, and social costs of implanting multiple embryos via IVF and IUI, resulting in a spike in both multiple births and a litany of health risks to these babies. The articles, and ensuing barrage of public comments, can be read here: “The Gift of Life, and Its Price,” “Grievous Choice on Risky Path to Parenthood.” In IUI, parents who conceive multiples also face the decision of whether to terminate some fetuses using the procedure termed “selective reduction”. IUI is much cheaper than IVF, and more readily covered by insurance, but the chance of success is lower and ability to control multiples non-existent.

 

The most startling assertion in the IVF article was an analysis by reproductive health experts and providers explaining the financial and business motivations on providers to disregard medical guidelines by implanting more embryos than may be safe for mom or her babies. Fertility practices want to boost their success rates and attract clientele in a highly competitive and lucrative medical field, and parents apparently think that implanting more, or rejecting selective reduction in IUI, will secure greater chances of a viable pregnancy and satisfy their emotional or religious needs to a degree that makes the risks worth taking. If the underlying reason for the increase in multiple implantations and subsequent births is really a symptom of our profit-based medical system, some suggest we utilize insurance schemes as a way to address this issue. If insurance companies are required to cover IVF, whereas many now only cover IUI, they could regulate the financial incentives by only reimbursing doctors for single implantations. (more…)

At Comic Con this year, “Family Guy” creator Seth MacFarlane revealed that Fox would not be airing an episode of the new season focused on abortion.  As previous references to abortion on the show have been in line with the taste and sophistication that we have come to expect from Family Guy (read: sarcasm), we probably aren’t missing much. However, the uproar that has been raised about Fox’s censorship has brought has called attention to the relative dearth of portrayals of abortion in the media. The website for a documentary called “The Abortion Diaries” has a by-no-means comprehensive list of choice stories in U.S. media.  Especially in recent years, it seems that a show will either have a character consider an abortion then back out at the last minute (sometimes with an accompanying miscarriage to avoid actually having a baby on the show), or they will have the abortion and have a tremendous amount of guilt over this procedure. In the most extreme example, Jack and Bobby had a character get an abortion, and promptly die in a car accident.

For one of the best representations of choice on television, however, prospective viewers should watch one of the first. Maude, a spinoff of Norman Lear’s All in the Family, was the first primetime TV show to have the main character choose to have an abortion. The episode Maude’s Dilemma (conveniently available online) illustrates what choice was like for women before 37 years of guilt were forced down our throats. Maude wants to make the decision that is best for her family and herself. They ultimately decide that they don’t want to be parents of a teenager when they turn 60.

When CBS broadcast the episode in 1972, two affiliates decided not to run the episode, and 32 were pressured to not air the rerun the following summer. There were also 24,000 protest letters mailed in response to the two airings.  But the network still decided to air the episode. Which leaves the question, 37 years later, why is the question being stifled?

-Jake Johnson

Last week, like many San Franciscans, I got geared up for a weekend full of LGBT Pride activities, culminating in a Sunday festival in the streets of San Francisco. 

 

The week before Pride I spent the weekend in New York, and made a point of visiting the Stonewall Inn, the site of the start of the famous Stonewall Rebellion 40 years ago.  In the 1960’s in New York, most gay bars were unable to obtain a valid liquor license, as licenses could be denied to establishments that would allow immoral behavior (such as homosexuality).  Gay men and lesbians would have to approach a peep hole, and the bouncer would have to decide based on their appearance whether they were gay and allowed in; of course they would also have to appear straight enough to avoid harassment on the way to the bar.  Raids were a regular part of patronizing a gay bar, and arrests were more likely if you were dressed in drag (guy or girl drag).  On July 28, 1969 Stonewall Inn was raided, and someone hit back, starting an incredible rebellion against the police who had for so long been oppressing queer folks.  A year after the Stonewall Rebellion, New York and Los Angeles held the first ever gay pride parades. 

 

Stonewall Inn is currently adorned in old photos of champions of the early gay rights movement.  It was the first time in my life that visiting a bar gave me goose bumps, and recounting the experience makes me want to cry.  It is a truly incredible experience to be in a place that you know began the movement for rights that you now enjoy. It was moving to know that without those who fought before us in this very bar, my whole life would be different. 

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These days it seems like all I hear about are the twin crises of budget and healthcare, so I wasn’t surprised when one of my very first assignments this summer at LSRJ was to research religious hospitals and their funding. What did surprise me, however, was what I learned about the disparate standards of care between secular and religious healthcare facilities.

 

One out of every six patients in the U.S. is cared for in a Catholic hospital. In fact, the Catholic healthcare system is the largest private non-profit provider of healthcare in the nation – 70% of religiously affiliated hospitals identify as Catholic.  Because the Catholic healthcare system has significant medical responsibility for millions of Americans, the services they choose to provide or withhold can have a profound impact on the overall quality of care in the U.S. Additionally, religiously affiliated hospitals receive 50% of their funding from Medicare and Medicaid and also enjoy certain benefits like tax exempt status, low-cost financing through government bond programs, and in some areas, use of municipal buildings.

 

Because Catholic hospitals receive so much public funding and see so many patients, one might assume that the standard of care in a Catholic hospital is comparable to the standard of care in a secular hospital. Unfortunately, this assumption may not be true.

 

Some patients treated in Catholic hospitals – women in particular – may not be receiving reproductive healthcare considered basic and essential by secular medical facilities. That is because Catholic healthcare providers are governed by the Ethical and Religious Directives for Catholic Health Care Services, with which all Catholic health care providers are obligated to comply (Directive 5).

 

Under the Directives, Catholic hospitals are prohibited from providing contraception (Directive 52), sterilization (Directive 53), most infertility treatments (Directives 40, 41, 42), condom distribution for AIDS prevention (Directive 52 prohibits all contraception, regardless of the reason), or abortion services (Directive 45).  Directive 48 goes so far as to say no medical care that could be construed as abortion can be provided, even to a woman with an extra-uterine (ectopic) pregnancy.

 

It is also difficult to obtain emergency contraception in Catholic hospitals—even as treatment for rape or sexual assault. Despite the fact that it is expressly addressed in the Directives, the language of Directive 36 is unclear on when and under what circumstances EC can be provided:

 

Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.

 

Since emergency contraception is most effective in the first 72 hours, a healthcare provider’s refusal to provide comprehensive treatment can further traumatize survivors of rape and sexual assault by forcing them to leave the hospital and attempt to obtain EC elsewhere.

 

Catholic hospitals do provide a tremendous amount of care in rural and impoverished communities – indeed, they are often the only hospital in such communities. The question remains, however, whether funding institutions that refuse to provide the full spectrum of reproductive healthcare is really the best use of our scarce federal Medicaid and Medicare dollars.

 

-Megan Mullett

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Drug policy has benefited from the harm reduction movement’s innovative approach to improving personal safety.  The application of a harm reduction model to reproductive justice has the potential to transform the way we view reproductive justice issues and mobilize support for issues that are traditionally marginalized within the movement.  I want to consider what we can learn from the harm reduction movement in advocating for sex workers’ rights and comprehensive sex education.

 

Harm reduction is a public health philosophy that emphasizes individual safety, regardless of lifestyle choices, over prohibition.  This approach acknowledges that some individuals may continue to engage in risky behaviors and aims to address the needs created by those behaviors.  The harm reduction movement spearheaded efforts to improve safety and provide services to substance abusers, such as safer injection sites for heroin addicts—the theory being that if addicts were going to use, at least providing them with clean needles would benefit the addicts themselves as well as the overall public health.  Because harm reduction focuses on social and environmental aspects of risky behavior, its application to sex work is intuitive.  

 

Sex workers face violations of basic human rights on a daily basis, including violence at the hands of clients as well as police brutality.  Additionally, many sex workers must cope with homelessness, substance dependency, and extreme poverty and desperation.  Because street-based sex workers are predominantly indigent women of color, selective law enforcement practices disproportionately target poor, minority women.

 

Sex workers are isolated from health care services because of fear of arrest and prosecution, as well as the increasingly inaccessible cost of such care.  Street-based sex workers in particular face health risks that the average worker does not, such as violence (perpetrated by police and clients), exposure to sexually transmitted infections and HIV/AIDS, and exposure to the elements.  When sex workers do access health care services, it is generally because of an emergency; thus, lack of access to preventative services is a serious health concern for sex workers.

 

In the context of providing services and outreach to sex workers, then, an application of the harm reduction model must take into account how various and overlapping forms of oppression create unique challenges for sex workers:  namely, substance abuse problems and lack of resources to access health care.  Services should include the provision of safer sex kits to sex workers and training in condom-negotiation skills, as well as free and confidential STD testing and information about HIV/AIDS.  Holistic services should also embrace substance abuse counseling and clean needles for drug use and hormone injections for transgendered sex workers who utilize hormone therapy.  Programs that collaborate across disciplines would address sex workers’ needs the most effectively by tackling substance abuse, safe housing, domestic violence, and health care.

 

So, why is this an issue of reproductive justice? First, this approach recognizes that sex workers are often in the industry for reasons beyond their control, such as economic hardship or inability to enter or reenter the workforce due to lack of recognized work experience or a criminal record.  In this respect, this acknowledgement of the multiplicities of oppression reflects the values of the reproductive justice movement—harm reduction recognizes that the decision to enter or remain in the sex industry can be (but is not always) a result of economic, racial, and gender injustice.  Accordingly, rather than criminalize, patronize or demonize sex workers, harm reduction seeks to provide safer options for those who choose to continue in the sex industry.  And, because a harm reduction approach ascribes no moral judgment to the activities of others, the traditional hierarchy assumed by service provision is disrupted.  Significantly, this challenges the notion that those in positions of power “know best” while empowering sex workers to make the healthiest choice possible for themselves under their individual circumstances.  This approach also empowers sex workers to use contraceptives and educate themselves on sexual health issues.  Importantly, then, application of the harm reduction model does not demean the work that sex workers do because it both identifies the intersection of race, class, and gender-based oppression that often create the need to continue working in the sex industry and recognizes that some sex workers remain in the industry by choice.

 

I already blogged about abstinence-only education, but I think it’s important to consider sex ed in light of harm reduction as well.  The philosophies which underlie harm reduction call for the elimination of funding for abstinence-only education in schools and implementation of comprehensive, sex-positive sex ed.  Abstinence-only education does not actually result in teens abstaining from sex, and instead denies them critical information about sexually transmitted diseases, pregnancy prevention, and, yes—sexuality itself. 

 

Harm reduction acknowledges that people—and, in this case, young people—make choices that may put their health or well-being at risk, and seeks to provide information to most safely make those choices rather than administer judgment or condescension.  Like the earliest manifestations of the harm reduction movement—safer injection sites combined with resources and support for substance abusers who were trying to stop using drugs—comprehensive sex education presents young people with information and options.  And, like its predecessors in the movement, this information is health- and life-saving.  For teens who are having sex or are going to have sex, comprehensive sex education equips them with the tools and information they need to make that decision in a way that protects them from diseases and unwanted pregnancies as well as providing them with a healthy outlook on sexuality. 

 

Reproductive justice posits that all people have a right to information required to attain sexual and reproductive self-determination.  Providing students with comprehensive sex education reflects the principles that motivate the harm reduction movement, and as such gives students the tools they need to make healthy decisions about their bodies, their relationships, and their futures.

 

-Amanda Allen

 

Today, we have a special guest blog post from Sheena Bosket, co-coordinator of LSRJ’s chapter at Georgia State University.

Last night, I watched 2 episodes of the MTV show “Sex…with Mom and Dad.” The show attempts to facilitate a dialogue with teenagers and their parents about sex, where both parties can air their grievances, concerns, etc. with the help of board-certified sex and relationship therapist Dr. Drew. Both episodes that I watched dealt with teenagers who had been with a number of sexual partners and parents/siblings that were concerned about them. However, in the first episode, the teenager was female and in the second episode, the teenager was male. I was struck, though not surprised, by the contrast in treatment of the two teenagers by Dr. Drew and by the voiceovers used to describe them. In the voiceovers in the episode featuring the female teenager, she was repeatedly referred to as “promiscuous” and was said to “sleep around.” In the voiceovers for the male teenager, he was referred to as a “player” and a “male whore,” a phrase that is offensive to women because by using the qualifier “male,” the suggestion is made that usually a “whore” is female.

 

As the episodes progress, Dr. Drew uses exercises to open up the dialogue between the teenagers and their parents. The first exercise is called “The Icebreaker,” which is meant to encourage both the teenager and her/his parents to share parts of their sexual past and openly communicate with each other. The second exercise is called “The Breakthrough” and is meant to show the teenager the potential consequences of his/her actions. After each exercise, the parents and teenager meet with Dr. Drew to discuss how the exercise affected them. In the episode featuring the female teenager, even before he assigned the first exercise, Dr. Drew took a noticeably paternalistic approach to discussing her sexual history with her by suggesting that her number of sexual partners was most likely a sign of internal turmoil, which may have been true, but does not necessarily have to be the case. When the teenager was hesitant to reveal to Dr. Drew how many sexual partners she had been with, Dr. Drew asked her if she was afraid that people were going to judge her if she revealed her number. When the teenager responded affirmatively, Dr. Drew told her that her fear suggests that she feels guilty about how many people she’s been with. I don’t think this is necessarily true. I think her fear shows that she is aware of the society she lives in. The fact of the matter is if you are a teenage girl in America and it’s decided that you’ve been with more than your fair share of sexual partners, people are going to judge you. That’s just true. Accept it Dr. Drew. Also, she may have been hesitant to reveal her sexual past because she knows that her peers watch this show and she didn’t want to be called names at school; a justifiable fear that should have been acknowledged by Dr. Drew. He also asked her how many sexual partners she planned on having in her life and told her that he was concerned about “the numbers,” a concern that was noticeably absent from his discussion with the male teenager who, interestingly enough, had had more sexual partners than the female teenager.

 

In the female teenager’s episode, her “Breakthrough” exercise was designed to show her the “weight of her choices.” She, her mother, and her sister all participated in the exercise, which involved all of them going on a nature walk together. Along the way, each person had to pick up a rock for each sexual partner they had been with and put it in a bucket that they carried with them for the duration of the walk. The teenager had the most sexual partners of the three and therefore, she had the heaviest bucket and the most to consider. I do not feel positively about this exercise because I feel the subtext of it was that the teenager should feel guilty about the number of sexual partners she’s had or that she should be punished for having as many partners as she’s had. If Dr. Drew was really concerned about this teenager understanding the consequences of her actions, a much better exercise would have been for each rock to have the name of a possible STI she could have gotten written on it along with a rock that had “pregnancy” written on it, as this is another consequence of her choices.

 

Now, I haven’t said all of this just to vent. Well, maybe some of it. I’ve said it to point out that this television show, which was meant to facilitate sexual dialogue between the teenagers who watch it and their parents as well, may also have a very substantial negative effect: instead of encouraging young women to talk to their parents about what’s going on in their lives, it may convince them to keep their sex lives to themselves and be ashamed of them as a result of the sexist treatment of young women on the show. By choosing to create a television show like this, MTV has also created for itself extra responsibility. We live in a society where some young people are still being “educated” about sex solely through “abstinence-only” programs. Many of these programs give young people erroneous information and if they feel that they can’t turn to their parents to discuss this information and possibly have it corrected, what these teenagers don’t know can hurt them. Some teenagers may only receive correct information about STIs, testing, pregnancy, etc. from a show like “Sex…with Mom and Dad,” but if this information is presented via a sexist framework, it can still be harmful. If MTV wants to appropriately address the issues that the young people face who have made the network so successful, this needs to change.

-Sheena Bosket, Co-Coordinator, LSRJ at Georgia State University