Making Sexual Health a Part of the Health Discussion

Jamille Fields, Resident Blogger (’13, St Louis University School of Law)

The health care provider’s office is intended to be a confidential space for health discussions. It should be a place where all can discuss personal health issues as they arise, or practices to prevent health issues from arising. Conversations on sex and sexuality should be among these health discussions throughout youth. Education on sexuality has been shown to increase contraception use, reduce adolescent pregnancy rate, and reduce the risk of sexually transmitted diseases. But sadly, sexual health often is not discussed with youth in the provider’s office.

Earlier this year, the Journal of the American Medical Association published a study, documenting–perhaps for the first time–sexual health discussions occurring in physicians’ offices.  The study observed adolescent patients’ visits and found nearly one-third of physicians did not discuss sexual health. For those that did have sexual health discussions, the conversations lasted only 36 seconds. Now, count out 36 seconds and see how much of a “discussion” you can have.

In 36 seconds, one certainly cannot have a discussion that includes the full range of topics recommended. The American Academy of Pediatrics’ Bright Futures Guidelines for Health Supervisions of Infants, Children, and Adolescents recommends that sexuality education be provided from infancy to 21 years old. These recommendations include teaching the proper name of genitalia to young children. As children grow older, the discussions should include hygiene, privacy, and sexual development. By adolescence, these conversations should advance to counseling on contraceptives, HIV and STD prevention, and counseling against domestic violence. Notice, these conversations do not start in adolescence – the ground work should have been laid since infancy.

Failure to provide children and adolescents education on sexual health can also violate Medicaid and some Children’s Health Insurance Program (CHIP) rules. Specifically, the required benefit for those younger than 21 years old enrolled in Medicaid and some CHIPs includes medical screenings. And health education is a required component of each medical screen. This education must encourage a healthy lifestyle, be forward-looking and age-appropriate. As the Bright Futures recommendations indicate, age-appropriate health education must include sexuality education.

Unfortunately, children and adolescents are not receiving screenings as the law requires. A 2010 report from the Department of Health and Human Services notes that 76% of youth did not receive the required screening. And even when the screening did occur, it often failed to include any health education (over 20% screened did not receive any health education). So clearly changes must be made.

Thanks to the Affordable Care Act (ACA) sexuality education is also now a clear requirement for children and adolescents enrolled in Marketplace (Exchange) plans. The ACA requires most individual and group health plans to cover certain preventive services. One such service is sexuality education as Bright Futures recommends.

The explicit coverage requirements are an important first step to ensure that sexuality education and counseling are included in health care delivery. However, efforts should not stop there. Changes in the health care system must be made to ensure this actually occurs. To encourage these conversations, I offered recommendations in an issue brief and on a webinar LSRJ and American University hosted.

 

My Professor, the Genius

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

Probably by now, you’ve heard about the MacArthur Foundation Fellows, aka the Genius grant recipients.  If not, you can review the Geniuses here. In my last year of law school, I approached Professor Sarah Deer, who I knew would be teaching my feminist jurisprudence class in the spring semester, about a paper topic that would blend my interests: access to contraceptives and reducing the unintended pregnancy rate with some new element reflective of current needs that hopefully I’d be able to identify with her help. I knew full well she’d steer me in the direction of Native women and their access to emergency contraceptives—I just didn’t anticipate the overall effect it would have on me. Needless to say, from the first book she lent me to begin my research on emergency contraceptive access through Indian Health Services, I became completely invested in the project.

I had spent a lot of time researching emergency contraception access on a state level when I lived in Colorado, so I already knew many of the basics—it’s expensive, it’s often stored behind the counter (if it’s stocked at all), and there is a stigma associated with its acquisition, especially in small towns. I read all the books she loaned to me, dozens of scholarly articles she had collected over the years, and eventually finished a paper that not only am I happy to have researched and written for my own person growth, but in order to take a topic she wanted explored and produce something worth sharing.

Now, I am proud to say that she has molded and shaped my legal education, which I hope to maintain throughout my entire legal career. I would have been proud anyway, but she is an unstoppable force and her work has received (in my opinion) a fraction of the commendation it deserves. Because of her encouragement, insight, and guidance, I know the overall direction I want my career to go, I became a better feminist, and most importantly, I learned from her when to be angry, how to turn that anger into something productive, and when to accept people for who they are.

Regressive Voting Policies Emerging Across the Nation

Anne Keyworth, Resident Blogger (’16, North Carolina Central University)

There are few things more priceless in a democratic society than the notion that our vote is just as valuable and important as the next person’s.  My generation has grown up with a firm understanding of the fact that we have a right to vote, we should vote, and, depending on who we are, we may be encouraged to vote.  We have lived through some historic elections and have indeed witnessed the value each vote can have in battleground states.  For decades, there has been a consistent shift in voting laws and policies, making it easier and more convenient for voters to register and cast their ballot.  Many states now offer early voting and same day registration in an effort to increase voter participation.

But voting rights in many states are currently under attack, and in states like mine, it has become nothing less than a battle to protect every person’s vote.  Voter ID laws and placing limits on early voting are ways many states are working to make it more challenging for certain groups to exercise their right to vote.  Here in North Carolina, a destructive collection of changes to our voting laws were passed in 2013 in merely two days.  Prior to these changes, we had 17 days of early voting, same day registration, allowed for provisional ballots, allowed 17 year olds to register, and did not require a photo identification at the polls.  These are measures that North Carolinians have become accustomed to and that have been heavily relied upon in recent elections.  All of this changed last year and, if left in place, these limitations will have a profound impact on the outcome of our elections and therefore the composition of our state legislature, and potentially the control of the US Senate this year.  What limitations like this do is further marginalize communities of color and low income families, who are already underrepresented and who historically have had more difficulty securing their vote.

These changes are not unique to North Carolina.  They represent a major regression in what had long been a national trend of making voting more accessible, more convenient, and more reachable by more people.  If these efforts are not stopped, they will deeply compromise the integrity of the American political system and the notion that each citizen’s vote is as important as the next.  Entire groups of people will feel as though there are organized efforts to suppress their participation in our democratic process. In a system where our vote is our voice, this will send destructive and polarizing messages to a significant portion of our electorate.

The implications of this year’s election are far reaching, and that’s why I hope that groups like Law Students for Reproductive Justice can mobilize our peers and ensure that people understand and appreciate the value their vote has.  If we show up to the polls, we will show that we are here to fight back and win this battle to protect each person’s vote.

“Do you have a [female] condom?”

Rhiannon DiClemente (’16, Temple University Beasley School of Law)

In case you missed it, September 16 marked the third anniversary of Global Female Condom Day.  Two decades since its introduction, the female condom hasn’t quite lived up to its potential.  Today, less than two percent of all condoms distributed worldwide are female condoms.  When our LSRJ chapter asks local organizations to donate condoms, we are usually sent boxes full of male condoms.  On the rare chance that we do get sent a few token female condoms, they are often met with skepticism and laughter from the student body.

It’s true—the female condom is less intuitive and less familiar than the male condom.  Some may call it aesthetically unappealing and technically difficult to master, but we shouldn’t give up on the female condom just yet…

The female condom is the only woman-initiated technology that prevents both unintended pregnancy and sexually transmitted infections (STIs), making it an important tool in the fight against the spread of HIV.  Women now account for more than half of the world’s population living with HIV.  Worldwide, HIV and AIDS is the number one cause of death for women of reproductive age.  In Sub- Saharan Africa, 72% of new infections among young people age 15 to 24 are women.

Despite these facts, I can’t even give these female condoms away to fellow students.  Only 13% of people have heard of the female condom, and much fewer have ever used one.  However, organizations like PATH, a global health non-profit, are working to reinvent the female condom.  In 2012, the United Nations Population Fund released a new version of the female condom.  The Gates Foundation has also awarded grants for a “next-generation condom,” male or female, that would be easier and more pleasurable to use.  This is an important step.  Greater variety in female condoms can help increase the odds that women even choose to use, or at least try, any female condom at all.

But putting more female condoms on the shelves is not enough.  Advocates need to create education campaigns at the local, national, and global levels on the benefits of female condoms, including the fact that they give women the power to control safe-sex negotiation.

As an LSRJ chapter leader, I hope to start a larger conversation about the benefits, and shortcomings, of the female condom.  I want to encourage women, including myself, to at least try one before we form an opinion about it.  I want men to be involved in this discussion as well; there is no reason a man shouldn’t introduce a female condom to his partner.  Normalizing female condoms in a conversation about pleasurable and safe sex is an important first step.  With informed feedback, the unattractive, clumsy female condom can only get better.

Condom Dispensers are Rad, Cool Things

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

I lead the chapter of Law Students for Reproductive Justice at Michigan State University College of Law. Whenever we get a chance, we hand out free condoms at the school.

Valentine’s Day? Condoms.

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Halloween? Condoms.

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Student organization fair? Condoms. I can’t tell you the joy I get from pressing a condom into the hand of a 1L who wandered up wondering what reproductive justice is.

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Last year, our then-chapter-president was visiting University of Minnesota Law School and realized that their LSRJ chapter (HOLLA!) was distributing condoms in a way we weren’t: WALLS.

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Our e-board talked it over and decided that we most definitely wanted to see a condom dispenser go up at our school. This June, we got word from the administration that we’d be getting a bulletin board at the school to post news about upcoming meetings and other information about our organization. Just look how fabulous it is.

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The timing couldn’t have been better; the board seemed like a perfect home for our condom dispenser. We expected that approval from the administration would come at a glacial pace, so we put in a request right then to purchase a dispenser and mount it on our board. I have to say, I was pretty surprised when we got word that the plan could proceed as long as it was ‘accompanied by a tasteful message explaining our support for the dispenser.’ Our school’s administration is awesome, but if you have experience trying to integrate reproductive justice, sex education, or sex positive programming into an environment that isn’t built around that ideology (read: law school), you know that asking for something like this can feel like asking the conservative wing of the Supreme Court for a condom.

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We’ve picked out a dispenser that we like. You can check it out here. I’d be lying if I said I wasn’t amused that they’re “made from the same material used in police riot vehicles .”

Our next step is funding. I just submitted our funding request to the Student Bar Association at MSU Law, which feels more like asking Justice Kennedy for a condom- wish us luck!

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Update: Michigan State’s LSRJ chapter has successfully installed a condom dispenser:

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You can purchase your own dispenser here. (It’s actually a lens wipe dispenser, but it gets the job done!) Go Michigan State LSRJ!

Oral Contraceptives and Why We Shouldn’t Count Out Over-The-Counter

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

Recently, some Republican candidates have entered the spotlight for doing a 180 on issues of contraceptive access. Take Congressman Cory Gardner (R-Col.) for example.  Gardner has a sinister record when it comes to matters of reproductive justice.  However, in a recent op-ed, Gardner argued for over-the-counter availability of oral contraceptives.

Practically overnight, leery reproductive justice advocates leapt to attack this position, denouncing it as an insidious political tactic to ultimately decrease access to oral contraceptives.  The logic goes like this: oral contraceptives are widely available without a copay under the Affordable Care Act, but would be costly (as much as $600 a year) OTC.  Women who had previously been able to access oral contraceptives thanks to the ACA would be squeezed out due to the price.

I have to say, although I am against most of Gardner’s positions on reproductive justice, this one might not be as bad as we’ve made it out to be.  In countries where oral contraceptives are sold, most already offer them OTC.  Even Planned Parenthood advocates for OTC oral contraception in the United States.  And I have to wonder – when drugs have gone OTC in the past, there have still been prescription-only versions.  Wouldn’t this be the case with birth control as well?

Even though it comes from someone with history of deplorable stances on reproductive justice, maybe we shouldn’t be so quick to denigrate this one.

Politician Advocates Birth Control for Welfare Recipients

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

Stories depicting the regulation and subsequent criminalization of the poor are far too common, almost mundane, in a country that espouses the virtues of democracy and asserts constitutional rights in the drop of a hat. However, the recent kerfuffle in Arizona points to something even more sinister baked into America’s apple pie coating. Earlier this week, the state’s GOP vice president (rightfully) resigned his post after advocating for sterilization of the state’s Medicaid recipients. This cracker-jack reasoning was punctuated with the statement: “. . . if you want to (reproduce) or use drugs or alcohol, then get a job.” (Full story here). The debate over drug testing for government aid recipients has been dissected ad nauseum, and fortunately been struck down in the courts. (For a review of this issue, see The Huffington Post’s collection).

But this latest call for sterilization should cause hesitation in even the most conservative thinkers. In a political climate that still hotly debates abortion even 40 years following Roe v. Wade, these statements point to a dissonance in the reproductive debate. Certainly there is a difference between birth control and abortion, however the point remains centered over the control one has over his or her reproductive future. Individuals, by virtue of being human, claim the right to exercise complete autonomy over their reproductive choices; this right is not premised on his or her financial situation or employment status. Regulating the reproductive choices of an individual based upon his or her Medicaid status demonstrates that such individual should be disallowed of this inherent human right because he or she is in fact less than human. No person or entity should breach another’s bodily integrity, nor advocate for rules that do so. For once and for all, get the government out of these intimate decisions and focused on topics it should be discussing. I have a list.

Introducing our 2014-2015 Resident Bloggers!

We are so excited to introduce our seven resident bloggers — each of whom will bring their perspective to a host of reproductive justice issues each month. If you are interested in blogging for LSRJ, please send us an email at communications@lsrj.org.

SJ ChapmanSJ Chapman is an associate at Bielski Law Office, Ltd. in Chicago, IL.  She is a graduate of UNC Chapel Hill and Northwestern Law School.  At Northwestern, SJ served as Co-President of the Human Rights Project and Secretary of LSRJ.  SJ studies and writes in the field of critical familism and international adoption.  You can read more at her home blog adoptanewwayofthinking.com, or contact her directly at sjbchapman@gmail.com

 

 

Anne KeyworthAnne Keyworth is a 2L at North Carolina Central University and ultimately hopes to do legal and policy work in reproductive rights. She has been a longtime advocate of reproductive justice and currently facilitates a women’s group in Cary, NC that focuses on inspiring, educating, and engaging people to invest in programs that make a meaningful difference for women and girls. Being from North Carolina – a state that is currently a battleground for reproductive rights – Anne believes that groups like LSRJ will help foster and prepare the next generation of reproductive justice advocates in working towards a more safe, just, and healthy society. Her campus LSRJ chapter is just getting started at NCCU this year and Anne is excited about engaging people on her campus. Her main interests include reproductive justice in the criminal justice system and in prisons, abortion access, and the impacts of healthcare legislation and litigation on low income women.

Amy Krupinski is currently a law clerk for a Minnesota district court judge. She graduated from William Mitchell College of Law with a J.D. in May 2014. During law school, Amy was a law clerk for a solo practitioner working in the products liability field, and a law clerk for the Public Health Law Center in St. Paul, MN, where she did research on tobacco legislation. During law school, Amy was an active member and co-president of Law Students for Reproductive Justice. Prior to law school, Amy lived in Denver, CO, where she was the Public Education and Research Associate for NARAL Pro-Choice Colorado for four years. During that time she worked on the Prevention First social marketing campaign aimed to increase contraceptive use among women in their 20’s. Prior to that, Amy attended the University of Wisconsin-Madison where she earned her B.A. in Political Science with certificates in Global Cultures and European Studies. While at UW-Madison, Amy was a summer intern for NARAL Pro-Choice Wisconsin where she was the grassroots organizer.

Rhiannon DiClementeRhiannon DiClemente is a 2L at Temple University Beasley School of Law in Philadelphia. As a Temple Law and Public Policy Scholar, she has written and presented on the intersection of global LGBT rights promotion and sexual and reproductive health within U.S. foreign development work. During her 1L summer, she worked to promote global sexual and reproductive health and rights through U.S. foreign assistance reform as a legal intern at the Center for Health and Gender Equity (CHANGE). At Temple Law, Rhiannon is a staff editor of Temple Law Review, Chair of Temple Law Students for Reproductive Justice and Co-chair of Temple’s National Lawyers Guild chapter. Ms. DiClemente graduated from The George Washington University with a B.A. in International Development and Latin American Studies in 2011. Rhiannon likes the beach, red wine, and aged Gouda.

Emily GillinghamEmily Gillingham is a 3L at Michigan State University College of Law, and the president of her school’s chapter of LSRJ. She received her bachelor’s degree in Political Science and Women’s & Gender Studies from Eastern Michigan University. She has been lucky enough during law school to work as a research assistant for Professor Hannah Brenner, whose work focuses on issues of gender and the law; advocate for women while interning at the PPO project of the Women’s Law Center of Maryland; and volunteer at End Violent Encounters, Inc., a women’s shelter in her area. Her areas of interest are employment law, family law, reproductive rights, and sex workers’ rights. She can be reached at emgillingham@gmail.com.

Elise ForemanElise Foreman is originally from Denver, Colorado but moved to the South to pursue a career in international advocacy and human rights law. Elise is interested in how the law may be used to further social justice and create a more equitable society for everyone. If she is not studying or whipping herself into a passionate frenzy over the latest piece of news, she can be found drinking wine or playing rugby.

 

jamille fieldsJamille Fields is a fellow in the Reproductive Justice Fellowship Program, which aims to enhance the capacity of organizations working to influence law and policy as it relates to reproductive justice and to build a pipeline for future reproductive justice lawyers by placing stellar young attorneys with Washington, D.C. nonprofit organizations. While in law school, Jamille was a summer associate in NHeLP’s North Carolina office, where she worked on issues related to Medicaid and helped conduct a 50-state health policy survey. Jamille also worked as a summer associate in the office of the Missouri Attorney General, interned in the Washington, D.C. office of Families USA, and served as a judicial extern to Judge Paula Bryant on the 22nd Judicial Circuit Court. Before law school, Jamille’s work focused on public policy and communications. She worked as a communications coordinator on Robin Carnahan’s Missouri Secretary of State Campaign, and interned in the offices of the Missouri Secretary of State, the Congressional Black Caucus, and then-Senator Barack Obama. Jamille received her J.D. and Master of Public Health degrees from St. Louis University’s Schools of Law and of Public Health in 2013. She received her bachelor’s degree in journalism from the University of Missouri at Columbia. She is the recipient of a number of scholarships, and was one of the top three national finalists in the White House Policy Challenge. Now that Jamille is done with school, she is looking to return to old hobbies of reading non-educational books, learning to cook foods from around the world, and adding new hobbies.

 

Top 5 Tips I’d Give My First-Year Self

Sasha Young, LSRJ Summer Intern (’16 Northwestern University School of Law)

This time last year I was reading a million “Top 10 Tips for 1Ls” lists and feeling like most of them were generic and aimed at the masses. So instead of speaking to all 1Ls, I’m going to speak to myself as a 1L. After making it through that experience, here are my top 5 tips for myself this time last year. Here are the honest things I would tell myself, a racial minority from a lower socioeconomic background at a T14 school, who was interested in social justice and not the pipeline to big law.

  1. Don’t talk to the white people about racial stuff. I didn’t come in to school very fixated on race, and I had no idea how much racial tension I’d encounter. I’m not saying that white people won’t understand or be sympathetic. But racism in law school can be very smartly hidden and excused by “logic” and especially competition. You never know who thinks that you’re just there because of affirmative action and not because you “earned” it. Save yourself the distress, and go talk to the diversity counselor or a professor that teaches something like “race and the criminal justice system.” 

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  1. It’s not your responsibility to educate anyone else. For every person who tells you that they “wouldn’t want to be embarrassed to not have earned their spot,” there will be a very well-intentioned White Savior randomly telling you, “It’s so great that you [people] are here.” You’re not there to provide the “minority perspective,” or to teach the rest of the student body about racism. You’re not there to “create a diverse educational experience” for the kids who only have only ever been around people like them. You’re there to learn contracts.brb-saving-africa
  1. Get your tools ready, ya trailblazer. The machine is not-so-gently pushing you through the big law pipeline. So if that’s not part or all of your plan, you’re going to have to figure it out yourself. Surely there are schools out there that support public-interest folks better than others, but you should still talk to everyone. Find as many options as you can. Google. PSJD. Look up attorneys who do what you want to do, and see what steps they took.
  1. Don’t knock it. I know you’re suuuuure that you’re not interested in big law. But trust me; you don’t want to close any doors just yet. A happy work life isn’t just about your substantive work; your work environment is equally (if not more) important. Plus, big law opens some doors in the public interest world, just like it closes others. I had many attorneys tell me that their organizations looked skeptically at candidates who came from big law. Other attorneys told me their organizations like candidates with some big law background because they are well-trained. You’re just going to have to figure out your own path.
  1. If you want to leave, that’s ok. It’s too much time, energy, and money to spend on something you hate. If you want to take a year off, go between 1L and 2L (but ask about 2L OCI eligibility first). If you decide you don’t want to be a lawyer, you’ll find a way to pay off that year of loans. You are not stuck, and if you think you are, you’ll only hate it more. This is still your life; it doesn’t start later.2qklzz4

Good luck, 1L self. Remember, you’re the shit and don’t let anyone tell you different.

Kids Will Be Kids, or Why We Should Stop Forcing Gender On Our Children

Grace Ramsay, LSRJ Summer Reproductive Rights Activist Service Corps (RRASC) Intern (’16, Smith College)

I spent the past weekend at a family friend’s in northern California, with no internet/phone access, and around 40 children ages 5 months – 10 years.  To many — myself included — this sounds like a nightmare.  I have never considered myself a “kid person,” and tend to feel uncomfortable when interacting with children.  My friends always seemed much more natural than I did when communicating with toddlers and pre-schoolers.  I didn’t understand how you could relate to someone whose age was yours divided by four.  So I was completely taken by surprise when I started forming relationships with several of the younger children over the weekend.  Boys and girls alike wanted to hold my hand, to run around together, and to tickle me to death.  Maybe it was because the parents at this weekend are fairly progressive, but I noticed right away that both sons and daughters were held to the same social expectations.  One moment in particular struck me: I was talking to a boy and a girl, and the boy kept interrupting her.  She turned to him, said “Excuse me!” and finished her sentence.  She didn’t let him cut her off again.  During my stay at The Land (the official name of the house upstate), I watched kids of every gender get dirty playing outside, decorate papier mache  bunnies, and sing along to folk music.

It’s no secret that gender socialization exists, and it starts right from when the doctor proclaims, “It’s a girl!”  The gender binary is coded for far more than difference in “biological sex,” a term debated today.  Girls and boys are expected to talk, dress, and play differently.  Gender differences are exaggerated to the point that activities are often gendered — girls get to play dress up, boys get to run around outside.  The socialization of boyhood and girlhood forces children into very distinct pink /blue boxes, leaving little room for gender expression outside of their assigned identity.  This limits cis boys and girls to either “girly” or “boyish” expressions, and completely disregards trans children’s possibility of living authentically.

Fighting gender socialization is a reproductive justice issue.  The right to parent with dignity goes both ways; children deserve to self-express in ways that make them feel comfortable and safe.  Returning to San Francisco after the weekend away, I was bombarded with gendered ads for young people.  Maybe a world without gendering childhood is only possible during a hippie retreat.  But from now on, I’ll keep on helping little kids play however they’d like.