Infertility Treatment for the Rest of Us

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

Reproductive Justice is defined as the right to have children, the right to not have children, and the right to parent those children in a safe and healthy environment. The Repro community is most often associated with the right to not have children, but I would like to focus today on the first right listed—the right to have children. Recently, Domenico Dolce (the Dolce in Dolce and Gabana) made news with his derogatory comments about in vitro fertilization.  I won’t warrant them with the dignity of repeating them here. But, as celebrities—rightfully–sounded off rebuking his comments, I was reminded that infertility treatment is something that many everyday women and men don’t even consider as an option. As usual, money has a lot to do with it.

Only fifteen states require insurance companies to either cover or offer coverage of infertility diagnosis or treatment. Even among these states the level of coverage varies. Among these states, thirteen have laws that require insurance companies to cover infertility treatment, but three of these states—California, Louisiana, and New York– specifically exclude in vitro fertilization. According to a recent Kaiser study, 22 states Medicaid programs cover infertility testing and only 16 states cover some level of infertility treatment. And, even in those states, the treatment and testing is only covered in limited circumstances.

More attention needs to be paid to the issue of infertility. Around 12% of women of reproductive age had difficulty getting pregnant or carrying a pregnancy to term and about 9% of men between the ages of 15 to 44 reported some form of infertility. These estimates are likely underestimated given infertility isn’t often discovered until individuals are attempting to get pregnant. The information available notes that Latino, black, and white women had similar rates of difficulty getting pregnant, and Asian women had a lower rate. Due to lack of documentation on infertility, it is largely unknown if racial and ethnic disparities exists between those able to get pregnant.

What is known, however, is that there are racial and ethnic, as well as income, disparities in the conditions that have a causal relationship with impaired fertility. For instance, environmental and occupational hazards are suspected to decrease sperm quality, and communities of color are more likely to work in strenuous jobs and live in neighborhoods with polluted and unsafe environments. Communities of color, also, often have higher rates of chronic illnesses, such as cancer and HIV, and the treatment for these illnesses can cause infertility. Untreated STI infections, such as chlamydia, can also lead to infertility and there are higher rates of chlamydia among people of color.

There are also racial and ethnic differences in those who are seeking infertility treatment. According to the CDC, 12% of women or their partners have ever used some form of infertility treatment. Assisted reproductive technologies (ARTs such as in vitro fertilization or IVF) were used in 1.6% of total births in the U.S., however, one study published in 2008 found that 84.6% of ART cycles involved white women.  This is largely contributed to the economic access to infertility treatment.

As for next steps, more research needs to be done to understand the causes of infertility. And, more states need to require insurance, both public and private, to cover infertility testing and treatment. This will give more women and men who want to have children the tools to do so.

The Washington Area Clinic Defense Task Force- Past, Present, and Future

Emily Gillingham, Resident Blogger (’15, Michigan State University College of Law)

The Washington Area Clinic Defense Task Force is an all-volunteer, anti-violence group founded in the 1980s to promote peaceful and safe access to women’s health clinics in the Washington, DC metropolitan area. WACDTF sends volunteers to abortion clinics that are being harassed by “pro-life” protestors (or as they call them, “antis”). WACDTF volunteers are not counter-protestors and aren’t there to engage with the antis; rather, their goal is to de-escalate the situation, deter antis from trespassing, help patients get safely inside the clinic, and provide a calming presence for patients, their companions, and clinic staff.

I’m studying in DC this semester and have been volunteering as a clinic escort with WACDTF. As law students, a lot of our reproductive justice advocacy is more high-level and nebulous, on the policy side; I have found volunteering with WACDTF to be really rewarding and enjoyable because I feel the impact I’m making right away. Plus, check out these fly shirts (pictured below)!

Gillingham blog

The coalition became WACDTF and made their role to be a calming presence at clinics. “At the beginning some people would hold signs and do chants, but the understanding was always to keep things calm,” said Alicia.

Alicia said that in response to the blockades, “Clinic Defense would throw a monkey wrench in the antis’ plans. They would take advantage of the fact that they organized very hierarchically. They wanted it to be a surprise what clinic they would blockade or else Clinic Defense would be there, so they didn’t tell anyone until that morning.”

Once, a WACDTF member determined where the antis’ rendezvous point would be ahead of time, arrived there before the anti with the maps, and gave out fake maps that led somewhere else entirely, thus leading the antis to a random shopping center instead of the clinic. Another time, a WACDTF member’s car “happened to break down” at the entrance to the parking lot where the antis were meeting, preventing them from going to the clinic. Alicia also recalled, “one time we were in a long line of cars [antis on their way to protest at a clinic] and we turned left and they followed us.” As Alicia pointed out, “these were not official WACDTF decisions.  Rather they were done thoughtfully by smaller groups of people in WACDTF but working on their own.”

Gradually, the antis’ tactics began to evolve. Alicia explained, “In the mid to late 90s, the blockades were tapering down because of a number of things. A number of injunctions, bubble laws, ordinances, that made it more difficult for them to do it.” There were also changes in how the police enforced trespassing and other existing laws, and the things WACDTF did to protect the clinics which made it harder for the antis. The antis fell in numbers and smaller groups began to do more extreme things. They would disable a car in front of the clinic entrance to block access; they engaged in “lock and blocks,” locking themselves with chains and locks to things like the bar of the front door.

I asked Alicia whether the Freedom of Access to Clinic Entrances Act (FACE) impacted WACDTF’s work. She said that FACE is “about the penalties you can get. It doesn’t do anything right there in the moment. Joe Anti may still block. It may be a deterrent, but it doesn’t do anything except that we can say that you could be charged with a FACE violation.”

Although the large blockades and lock and blocks are largely a thing of the past, current anti-choice tactics at clinics, while different, are still deeply problematic. “The harassment is every week, directly accosting and harassing women seeking reproductive health care including abortion and many other services,” Alicia said. “Some anti groups also try to turn landlords against the clinics, harass them in other ways.  Week in and week out.” So, WACDTF’s work is still needed in front of the clinics. This is still needed, this is about basic access to healthcare.”

I agree!

Do you want to learn more about WACDTF? Visit their website at




Can you design a Teen Pregnancy Prevention Campaign that does not shame Young Mothers, Insult Low-Income people . . . And Oh yeah, and is not Racist?

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

May is Teen Pregnancy Prevention Month–a month that Gloria Malone, a young mother, described as “the month of getting it wrong.” Malone was referring to the problematic teen pregnancy prevention campaigns that are displayed throughout the year, but are really touted during May.

Such campaigns include a Milwaukee campaign launched earlier this year that includes young parents as huge toys, such as a jack-in the box, puppet, or pull toy, with the message “Have a Baby too Young and it will Control Your Life.” In 2013, the Candies Foundation launched and continued an ad campaign, complete with celebrity endorsements (all women from what I can tell), with such messages as “You’re supposed to be changing the world, not changing diapers.” With taxpayer funding that same year, New York City launched an even more offensive campaign. One of the campaign ads featured a black toddler with the words “Honestly, Mom, chances are he won’t stay with you. What happens to me?” and another that read “Got a job? I cost thousands.”

These campaigns are problematic on so many levels that I don’t know where to begin. The Milwaukee campaign conveys to young parents a message of hopelessness. The Candies Foundation continues to place all responsibility for reproductive decision-making on young women, excluding men from any role in the matter. The New York City campaign ads, which featured mostly people of color, suggests that it is these communities that need to have their reproductive activities monitored and contained. Also, the message that the child will somehow be lost if Daddy doesn’t stay in a relationship with Mommy is insulting to all of the single parents who have raised and continue to raise healthy and happy children. Further, intertwined throughout many of these campaigns and others is the message that poverty is solely attributed to a person’s decision to have children. In addition to shaming teen mothers generally, the overall problem presented is that she is poor—and it is poor people of color who should not have children.

There are public health benefits of individuals of all ages having the resources and ability to plan births. According to the Guttmacher Institute, unplanned pregnancy is associated with delayed prenatal care, premature birth, and adverse physical and mental health effects for children. Eighty-two percent of teen births are unplanned. But, it is worth noting that teens are not alone in unplanned pregnancies given that around 50% of pregnancies in the United States are unplanned.

There are equally important public health concerns created from the societal shaming of young adults, particularly, mothers to whom the stigma is usually attached.  Such shaming, often makes young parents feel isolated and prevents them from seeking the assistance these young people and their children need.

It is important to empower – not shame – all young adults to take charge of their reproductive decision-making. This can be done by providing teens with evidence-based and comprehensive sexuality education in schools and creating a space for one-on-one discussions about sexual health in medical providers’ offices. Teens should be made aware that their health insurance plan may have to cover contraceptives with no out of pocket cost to them, even if they are a dependent on their parents plan.  Further, any discussions around sexual health and pregnancy prevention should be addressed to young men, just as equally as it does to women. This education should include LGBT youth who are often overlooked in these discussions with the assumption that they will not get pregnant. A recent study of New York City high school published in the American Journal of Public Health found that among sexually active teens, those who identified as lesbian, gay, or bisexual were almost twice as likely to report becoming pregnant or getting someone else pregnant.

Malone (mentioned above) is one of seven mothers spearheading the #NoTeenShame Campaign, which is designed to push back against Teen Pregnancy Prevention campaigns that are based on shame, and to offer messages of support and hope for young parents. There should be more campaigns like this. Instead of shame, we could equip adolescents with the education and resources they need to make decisions about their sexual health. Further, we can offer already parenting teens support that their life will go on; they can lead healthy and productive lives; and they can be good parents.

A Proposal to Preserve Reproductive Autonomy in the Face of Refusal Clauses

Emily Gillingham, Resident Blogger (’15, Michigan State University College of Law)

If a pharmacy or pharmacist won’t dispense medications related to reproductive healthcare, there is a public health interest in that information being publicly available.

Stories keep popping up in the news of women going to a pharmacist and being denied birth control, Plan B, or medications associated with abortion on the basis of the pharmacist’s moral beliefs. So-called “conscience clauses” that allow pharmacists to refuse to provide medicines to customers threaten lives, violate reproductive autonomy, and delay time-sensitive reproductive health decisions that women are legally entitled to make for themselves. NARAL has a great breakdown of refusal clauses in the U.S. here.

The idea that a pharmacist is permitted to inject his or her beliefs into others’ lives in such a momentous way is absolutely horrifying to me. In this context, I do not care what a pharmacist’s moral beliefs are.  The fact is, an enormous part of a pharmacist’s job is dispensing medications associated with reproductive healthcare. If a pharmacist’s moral system prohibits him from providing medicine to someone, either 1) he shouldn’t be a pharmacist, or 2) there needs to be an expedient way for the customer to work with a different pharmacist on-site to access that medicine. The status quo, where women can be denied access to medications that in some circumstances are life-saving because the pharmacist won’t do his job, is unacceptable.

A woman has a limited window to take Plan B, and she doesn’t necessarily have the luxury to spend her day going from pharmacy to pharmacy in search of one that will dispense it to her. The status quo assumes that she has access to transportation to get her to not just one, but potentially several pharmacies, and that she has the freedom to shirk responsibilities of work and home to do so.

If refusal clauses remain on the books, I propose the following in the interest of promoting women’s access to prescription and over-the-counter medicines that impact their reproductive health:

  1. Creation of a federally mandated online registry, open to the public, where all pharmacies register what medications they refuse to dispense on moral grounds, and whether the objection is pharmacy-wide or confined to one or more pharmacists.
  2. If a pharmacy refuses to dispense a medication on moral grounds, it must inform the woman where the nearest pharmacy is that will dispense it.
  3. Any pharmacist that refuses to dispense any medicine on moral grounds cannot be the only pharmacist on duty at that time if the entire pharmacy is not registered as a moral objector.
  4. Pharmacies that do not have any pharmacists on staff who have a conscientious objection to dispensing medication related to reproductive healthcare must post a sticker on the front door of the store noting that they will dispense all reproductive healthcare medications.
  5. Creation of an alternative distribution system for “refusal clause” medications where only one pharmacy is near the woman and that pharmacy refuses to fill them.

2 State Bars Have Done the Right Thing for New Moms Needing to Pump. We’re Making Sure the 48 Left Do Too.

Galen Sherwin, ACLU Women’s Rights Project & Lauren Hall, Legal Intern, ACLU Women’s Rights Project

When Kristin Pagano came to the ACLU after being denied accommodations to pump breast milk during the Illinois bar exam, we decided to take action on her behalf. After the ACLU of Illinois sent a letter to the Illinois Board of Admissions to the Bar, the board agreed to make nursing moms eligible for accommodations – such as breaks and a private room for pumping.

Then another new mom-to-be, Shahzeen Karim, came forward with the same problem — this time in Texas. After over 25,000 people signed a petition, the Texas board also agreed to change its policies.

Now a third case has popped up in Kentucky, where the Office of Bar Admissions has told Jacquelyn Bryant-Hayes that the single lunch break in the 8-hour test day should be sufficient for her, even though she informed the board that her baby will be just four weeks old on the day of the test and her doctor estimated she would need breaks every 1.5 hours. (Setting aside the law, something is just wrong with their math!)

The ACLU of Kentucky is appealing that decision. But obviously, this isn’t an isolated problem. That is why the ACLU and Law Students for Reproductive Justice are today announcing a nation-wide initiative to ensure that all nursing mothers who need testing accommodations during the bar exam are eligible to receive them, no matter where they are taking the exam.

Why does this matter?

The ACLU has long fought against discrimination based on pregnancy and breastfeeding in education and career advancement. Standardized tests and licensing exams, such as the LSAT, bar exam, medical boards, serve as important gateways to the professions, and they should be administered in a way that is fair to all test takers, including women who need some extra time and a place to pump.

Failure to pump on a regular schedule (typically every 2-3 hours) can lead to serious consequences, like pain and infection. If women are not allowed enough time to pump during these marathon tests, they will be forced take the exam through pain and distraction, risking their health, or will have to put off taking the exam altogether. Women should not have to choose between pursuing their career goals and their own health or that of their babies.

Thanks to the bravery of Kristin, Shahzeen, and Jacquelyn, we’ve already won changes in two states — and hope to win in a third. Now we need to win this for everyone. The ACLU and LSRJ volunteers are researching the accommodation policies in all 48 states left and will follow up with action against state legal licensing boards whose policies penalize nursing moms.

Here’s how you can help! If you (or someone you know) are planning on taking the bar (or another similar entrance or licensing examination) and need testing accommodations, or if you have already been denied those accommodations, we want to hear from you. Tell us your story!

And stay tuned for more opportunities to get involved as the campaign kicks into full swing.

This blog is a cross post from the ACLU website.

The Unfulfilled Promise: Black Women Still Need Better Healthcare Options

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

April is National Minority Health month, and it is far past time for our elected officials to implement policies to improve Black women’s health. As a Black woman, I want to see something done to eliminate the health inequities that plague us, our families, and our community. As a public health professional, I recognize that expanded health care access can go a long way toward improving individuals’ health. As a lawyer, I know that politicians, currently, have in their hand an opportunity to make such a change. On March 23, 2010, President Obama signed the Affordable Care Act (ACA) into law as an attempt to expand healthcare access to the nearly 50 million Americans who were uninsured at the time. Five years later, some states are still playing political football with implementing the law. Continue reading

Minnesota House Tries to Undo Work of School Board and MHSAL for Transgender Students

Amy Krupinski, Resident Blogger (’14, William Mitchell College of Law)

Recently, the St. Paul Board of Education adopted a new policy that allows transgender students to use the restroom and locker room facilities that match their gender identity.  Also, the Minnesota State High School League (MSHSL) implemented a policy allowing students to join teams that matched their gender identity. This news announcement was visible only if you were really looking for it.  And it actually wasn’t even really news until the Minnesota House acted in response to it.  Although most people think these are laudable policies, the Republican-controlled House introduced contrary legislation that would require that transgender students use restroom and locker room facilities that match their biological gender.  In addition, this legislation would eliminate the MSHSL policy regarding which teams students can join.

This bill has already been shelved by the Senate. However, the mere fact that it exists as a countermeasure to these reforms is enough to spark a statewide debate, and it has drawn unwanted attention to these polices.  Whereas the St. Paul school board and MSHSL’s primary concerns are ensuring the safety and wellbeing of its students, this bill served only to perpetuate misunderstandings and fear. Clearly, the school board and MSHSL would have benefitted from the quiet implementation of their inclusive policies; the House called attention to them and tried to reverse them on a statewide level (to say nothing about local control issues). To me, it seems like a political move designed to distress voters and enflame the passions and worries of parents.

When I heard about these policies on Minnesota Public Radio one morning I immediately thought “wow, good for them”. Then I got to work.  I work in a pretty small, conservative town in out-state Minnesota (aka not the metro), and when I got to work I got a question from a co-worker who had heard the same story. He was wondering what this might mean for each school, students, and parents.  He wondered if this meant that schools were supposed to let boys and girls change together in the same locker room. Hearing someone distilling it down to this simplistic level is very distressing.  This simple question leads to a very complicated explanation of gender politics.  Its nuances are more than can be explained in a blog post with a word limit. However, I will say that I think I handled the explanation well to my coworker, and I am glad for the opportunities to provide some rational input into a controversial topic. Protecting individual students from bullying from their peers, from being made to feel uncomfortable while at school, or from being excluded or singled out should be a community’s primary concern.

When Good Intentions Aren’t Enough

Elise Foreman, Resident Blogger (’16, Emory University School of Law)

On Sunday, April 5, the Columbia Journalism Review published the findings of its investigation into the Rolling Stone piece “A Campus Rape: A Brutal Assault and Struggle for Justice at UVA,” originally published November 19, 2014. The piece unleashed a maelstrom of criticism levied at college administrations, and followed up other efforts to tighten sexual assault policies on campuses across the United States. However, the magazine faced similar criticisms as to its reporting of the central incident, with many challenging key factual assertions to the story underpinning the entire investigation. These criticisms came to fruition with the investigation and the magazine’s retraction of the article.

The central findings of the CJR’s report concentrate on the magazine’s failure to utilize basic journalism techniques, placing the blame squarely on a publication that should have known better. Rolling Stone likely did not set out on this trajectory with anything but good intentions, but good intentions is what is leftover regardless. Indeed, CJR reported that “[it] had hoped their investigation would sound an alarm about campus sexual assault and would challenge Virginia and other universities to do better. Instead, the magazine’s failure may have spread the idea that many women invent rape allegations.” (See the complete investigation at the above link). What started as an attempt to expose assaults and fight for survivors instead left those survivors even more exposed while Rolling Stone swallowed its good intentions – sacrificing more than journalistic integrity in the process.

Consistently through the investigation, Rolling Stone stated it tried to honor its source and grant her credibility, traipsing over tried-and-true investigative methods. However, handling survivors with kid gloves is neither respectful nor helpful; rather it diminishes the survivor’s autonomy and patronizes her or him. The paradox here reveals the underlying anxiety in dealing with sexual assault; we as a society are still uncomfortable with the fact that sexual assault is everywhere.

The magazine’s reliance on Jackie as its single source finally underscores the continuing need to sensationalize these assaults. In its own follow-up, the New York Times reported “the magazine was drawn toward the most extreme story of a campus rape it could find.” (Find this interview here). Though there were other stories to tell, Rolling Stone’s focus sensationalized the crime and ignored the reality that rape occurs when consent is disregarded or dishonored.

In its reporting, the CJR carefully placed the blame where deserved, and highlighted successful efforts in reporting on rape; it is these efforts which should be focused on going forward. The failure of Rolling Stone to heed these suggestions should stand as a failure of investigative reporting, rather than an excuse to blame survivors and perpetuate sexual assault.

[For more articles covering this story see: Maya Dusenberry @; Anna Merlan @ Jezebel; Sandy Hausman @ NPR; Michelle Goldberg @ The Nation ]

Carl Djerassi: A Legacy that Lives On

SJ Chapman, Resident Blogger (’12, Northwestern University Law School)

Carl Djerassi, who created the key ingredient in oral contraception, died on January 30.  The legacy he left behind was invaluable: a safe way for women take control of their reproductive lives.  Djerassi’s death spurred Megan Gibson to write a stunning article for Time on the history of birth control.  Gibson writes about epochs I can’t fathom – before birth control was available… before people even knew what it was.

Gibson writes, “For as long as men and women have been making babies, they’ve been trying not to,” quoting The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution.  Experimenting with contraception goes back to at least 3000 BC, where condoms appear in legends of King Minos of Crete.

Women began using methods for birth control that ranged from silly to lethal.  Women held their breath during sex, tied weasel testicles around their thighs, inserted crocodile dung into their vaginas, drank lead, drank mercury, or douched with Lysol.  Women used IUD precursors made of precious metals or glass, risking serious injury or infection.

Nearly 5000 years passed between 3000 BC and 1838, when vulcanized rubber led to the invention of rubber condoms, cervical caps and diaphragms.
Then, in the 1950s, Carl Djerassi led a team of scientists to develop a progesterone pill to block ovulation.  His synthesis led to the invention of the birth control pill, released in 1960.  By 1965, more than 6 million American women were on the pill.

During the 1960s, the battle against laws and stigma raged as women fought to gain access to the pill.  Finally in 1972 the Supreme Court ruled that the pill was legal for all women to use.  Today, more than 100 million women use the pill around the world, and it’s free to Americans under the Affordable Care Act.

Because of the pill, we live in an age when women can confidently and safely take control over their reproductive lives.  Not that there aren’t better methods waiting for us in the future. (Oh how I welcome the day when an LSRJ blogger writes “women used to resort to inane methods of birth control, like taking pills at regular 24 hour intervals to hormonally alter their bodies”).  But until that future arrives, I’ll be eternally grateful for Carl Djerassi’s contribution to reproductive justice.  And I’ll always be saddened by his passing.

Introducing the Denver Principles… to a New Generation

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

Preventing HIV and increasing access to care for people living with HIV/AIDS have long been interests of mine and is currently a part of my work portfolio. But, it was not until recently that I was introduced to the Denver Principles, which were outlined by a group of people living with AIDS in 1983–two years after the first instance of AIDS was reported. These principles changed the health care landscape for people living with HIV. I imagine other RJ advocates have not been introduced so I decided to pay it forward here.


I do not know if those who developed the Principles had the RJ framework in mind, but the principles are so RJ (or “Hella RJ” as LSRJ swag reads). Fear and discrimination of and against people living with HIV is still present, and it was even more blatant over thirty years ago. It was at this time that a group of fearless advocates stood at a gay and lesbian health conference to declare: “We condemn attempts to label us as ‘victims,’ a term which implies defeat and we are only occasionally ‘patients,’ a term which implies passivity, helplessness, and dependence upon the care of others. We are ‘People with AIDS.’” I imagine here the speaker dropped the mic and the crowd cheered. But, this powerful opening statement is only beginning of the Denver Principles.


The Principles are outlined into three different categories: (1) Recommendations for all People (aka the recommendations to be a decent human being), such as being a good ally for people living with HIV/AIDS when others attempt to separate them from their communities. (2) Recommendations for People with AIDS includes guidance for them to plan their own policy agenda. (3) The Rights of People with AIDS is where we, as lawyers, have a role to play, so I have outlined them here:


Principle 1: “To [have] as full and satisfying sexual and emotional lives as anyone else.”

This overarching guiding principle should govern the work we do as reproductive justice lawyers, whether or not we are specifically working on HIV/AIDS related care.


Principle 2: “To quality medical treatment and quality social service provision without discrimination of any form including sexual orientation, gender, diagnosis, economic status or race.”

The Affordable Care Act § 1557(enacted 27 years after the Principles) explicitly prohibits discrimination based on race, color, national origin, sex, age, or disability in health care delivery. This is an important tool that legal advocates can use to combat discrimination against people living with HIV. Here, at the National Health Law Program, we have filed a complaint against insurance companies for charging the highest level of cost-sharing for HIV/AIDS related drugs. We believe this is discrimination against people living with HIV/AIDS.


Principle 3: “To full explanations of all medical procedures and risks, to choose or refuse their treatment modalities, to refuse to participate in research without jeopardizing their treatment and to make informed decisions about their lives.”

This speaks to informed consent. Every person, including people living with HIV/AIDS, has a right to be fully informed of and to affirmatively consent to any health care procedures or research performed. This means ensuring the individual is made aware of all risks and consequences in a language and manner that ensures the person can make a voluntary choice whether to engage in the research or procedure. In general, it is important for lawyers to monitor language access and cultural competency in health care delivery.

Principle 4: “To privacy, to confidentiality of medical records, to human respect and to choose who their significant others are.”

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law designed to protect the confidentiality and security of health information. In addition, states have varying laws related to confidentiality, particularly as it relates to youth. Issues of confidentiality are particularly important for people living with HIV/AIDS given the discrimination this community often encounters once their HIV status is learned. Legal advocates have a role to play in ensuring the enforcement and improving of these laws.

Principle 5: “To die – and to LIVE – in dignity.”

Enough Said.