First, some recent posts at Our Bodies Our Blog:

Pink Ribbons, Inc. – A Closer Look at Breast Cancer Marketing – I’m really looking forward to seeing this film, especially after all the recent Komen/Planned Parenthood controversy. It’s going to show in several U.S. cities at various events this spring. Pink Ribbons, Inc. people, if you’re reading this, you totally want to hook me up with the showing at the Nashville Film Festival.

Christine also covered Komen and Planned Parenthood and stupid, sexist “barstool sports,” and Judy has something on Planned Parenthood and the Catholic bishops.

Finally, Good Vibrations selected Our Bodies Ourselves as one organization it’s supporting during February and March. If you buy something from their website or in stores, select OBOS during checkout to make a donation that goes entirely to the organization. Go on and buy yourself a Valentine’s present. Or, hey, buy me something, since I don’t otherwise have a tip jar.

Now, onto to other things:

Judy Stone has a great guest post at the Scientific American blogs, Molecules to Medicine: Plan B: The Tradition of Politics at the FDA. Stone ultimately looks at Kathleen Sebelius’s decision to override the FDA’s approval of over-the-counter access to Plan B, but also provides a review of past political decisions and appointees at the FDA, and U.S. government interference in sexual health care and information generally.

Soraya L. Chemaly has something at The Feminist Wire in response to that ridiculous recent piece in the New York Times about girls and “hysteria.”

Flanagan closes with the particularly ironic advice that what girls need is “protection from the most corrosive cultural forces that seek to exploit her when she is least able to resist.”…What girls really need is not to be characterized as inherently mad or inclined to the irrational.

Nick Baumann at Mother Jones writes about The Republican War on Contraception:

…in the past six months, social conservatives have widened their offensive, and their new target is clear: Not satisfied with making it harder to obtain legal abortions, they want to limit access to birth control, too.

I’m pretty sure a lot of women have seen this coming for a while.

I don’t agree with absolutely everything in Nicholas Kristoff’s NY Times piece, “Beyond Pelvic Politics,” but let me just highlight this:

A 2009 study looked at sexually active American women of modest means, ages 18 to 34, whose economic circumstances had deteriorated. Three-quarters said that they could not afford a baby then. Yet 30 percent had put off a gynecological or family-planning visit to save money. More horrifying, of those using the pill, one-quarter said that they economized by not taking it every day.

and this:

If we have to choose between bishops’ sensibilities and women’s health, our national priority must be the female half of our population.

Rachel Maddow has a piece on the birth control nonsense as well.

Nationally, Ohio Rep. Jim Jordan has introduced a national forced ultrasound bill, which I think I’ll start calling a “forced vaginal insertion of an object” bill. We should require all members of Congress to participate in a simulation display of a transvaginal ultrasound, although I’d be kind of afraid of their reactions.

A national forced 24-hour waiting period for abortion has also been introduced, this one by South Carolina’s Jeff Duncan.

Neither of these things is based on medical evidence; both are purely for the purpose of making it more difficult for women to obtain safe, legal, timely abortions. Dr. Jen Gunter talks about what happens to women exposed to inexpert abortion attempts when safe and legal isn’t an option.

And in Tennessee, Planned Parenthood has sued the state, which previously awarded the organization grants for STI and HIV prevention, but in December yanked the funding without providing an explanation, or an alternative route for those services. One of the affected Memphis sites was reportedly the only place around to get HIV testing done after daytime work hours. Pressed on the issue, Tennessee Governor Bill Haslam refused to provide any real explanation of the decision, saying, “The commissioner felt like there were other people who could provide that service just as well.” There was no explanation about why, if that were the case, those others didn’t get the grant during the competitive process last year, and as far as I know, none of those other “just as well” services have actually been awarded the funding.

Mary at Hoyden About Town has a cool post on soliciting research participants, with a lot of good points on what should be communicated to potential study participants and what researchers owe them for their participation.

And completely unrelated to anything, I cannot stop looking at these underwater dogs.

[note: I modified the title after I realized a possible mis-reading of it]

Filed under: Abortion, Access, Rights, & Choice, Cancer, Contraception, Drugs, Government, HIV/AIDS, Infectious Diseases, Laws, Legislation, & Courts, News Round-Ups, Sex & Sex Education

[Originally posted at Our Bodies Our Blog. Speaking of, did you know the OBOS 40th anniversary edition book is one of Library Journal's Best Books for 2011 in the consumer health category?]

This week, Health and Human Services head Kathleen Sebelius interfered with the FDA’s decision that emergency contraception could safely be made available over the counter (OTC) without a prescription to women and girls of all ages.

The drug is already available without a prescription for women 17 and older, after years of political wrangling. Advocates have worked to ensure OTC access because emergency contraception is most effective when used as soon as possible, and time, distance, money, and privacy can be serious barriers to getting a prescription and obtaining the drug in time to prevent pregnancy.

The FDA’s Center for Drug Evaluation and Research (CDER) had completed a review of the issue and concluded that Plan B One-Step emergency contraception should be available OTC to younger women, which Commissioner Margaret Hamburg explains:

Based on the information submitted to the agency, CDER determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted diseases. Additionally, the data supported a finding that adolescent females could use Plan B One-Step properly without the intervention of a healthcare provider…CDER experts, including obstetrician/gynecologists and pediatricians, reviewed the totality of the data and agreed that it met the regulatory standard for a nonprescription drug and that Plan B One-Step should be approved for all females of child-bearing potential.

That’s when Sebelius stepped in and blocked the findings of CDER from taking effect. In her letter [PDF] overruling the FDA’s findings, Sebelius objected that “The label comprehension and actual use studies submitted to the FDA do not include data on all ages for which the drug would be approved and available over-the-counter.”

That data is not available for the vast majority of over-the-counter drugs on sale to all age groups without a prescription. Many OTC drugs (like acetominophen and aspirin) can have serious, even fatal, effects if taken inappropriately because of deliberate misuse or misunderstanding the label and instructions. You will not find data on safety and label comprehension for every possible age group for these medicines, yet they are readily available OTC in adult doses to consumers of any age.

Former FDA official Susan Wood – who resigned after a previous round of political interference in emergency contraception – agrees:

“They don’t do this for pain medication, headache medication, cold medication,” she said. “That’s not part of how we assess products. Are we going to go and now do this with all products, or are contraceptives once again being singled out for this special treatment and this extra standard when we’re talking about a very safe and very effective product that can really help women?”

Change.org has a petition up urging Sebelius not to let politics trump science, and objecting to the HHS leader’s focus on very young girls who may access the drug:

The fact that the HHS and the Secretary are focusing on this extremely young age group is bizarre. Less than 1% of 11 year olds are sexually active, where over half of adolescents have had sex before their 17th birthday.

This decision is illogical and unfounded. Physicians around the country agree that Plan B is incredibly safe and effective for all ages, helping to decrease the number of unintended pregnancies.

Further reading:
This NPR coverage provides a succinct timeline and political explanation of the controversy over accessibility of emergency contraception.

Statement from Physicians for Reproductive Choice and Health stating that the Obama administration’s “put[ting] politics before science and responsible health policy…is appalling.”

Heather Corinna at Scarleteen urges young people to speak up in protest of this action.

Jodi Jacobson at RH Reality Check, who reminds us that the previous administration wasn’t the only one playing political games with reproductive rights:

…no amount of proof it seems can make up for the fact that, despite all the evidence, even President Obama and Secretary Sebelius appear to think young women are too stupid to make their own decisions or that they are just chum to be thrown to the religious right in an election year. As the saying goes, with friends like these, who needs the far right?

Added: Email the White House directly.

.

Filed under: Access, Rights, & Choice, Adolescent Health, Contraception, Drugs, Ethics, Government, Women’s Health

In Memphis, TN, Title X family planning funds have been awarded to Christ Community Health Services, a religious health provider which has indicated that it may refuse to provide information, referrals, and some kinds of health care to Shelby County’s women.

Title X funds have historically gone to Planned Parenthood in Memphis; the move to give the funds to an anti-choice organization is part of nationwide efforts to defund Planned Parenthood because PP provides abortions. Existing laws already clearly prohibit Title X or other federal funds from being used for abortion services – the money goes to provide necessary services like contraception and cancer screenings.

Reports indicate that Christ Community has no intention of providing referrals to women who choose to have abortions, whether that is for personal or medical reasons. From a report by a Memphis newspaper (emphasis added):

[Christ Community CEO] Waller initially said the clinic refers patients to abortion providers if they request it, but he and Dr. Rick Donlon, a founding physician at the clinic, later called the newspaper to change that statement.

“We really try to provide women with other options and make sure they have those possibilities. And if they at the end still want a pregnancy termination, we know they know where to go,” Donlon said.

“They know where to go.” That doesn’t exactly sound like a professional provider of medical services to me. The clinic leaders obviously made a point of contacting the newspaper to make sure it was clear that they would *not* provide referrals, demonstrating a clear intent to put religious belief ahead of the medical care of women who may consider or require abortions.

Christ Community has also said it will not provide emergency contraception, only doing so through a third party. No details are available about how this will happen in practice, and how much additional time, travel and cost women may be subjected to in order to access this legal, previously available, and non-abortifacent medical care. This change clearly creates an additional burden for women seeking emergency contraception, and the women of Memphis currently have no guarantees that the third party provision will happen in a timely way, while timely administration of emergency contraception drugs is absolutely crucial for them to work.

I have not seen this discussed elsewhere, but it is also not readily apparent to me whether Christ Community would or could ever decide that any other forms of birth control are off-limits because of purely theoretical possibilities of preventing fertilized egg implantation. If we’re already providing the Title X money to a provider who can pick and choose services because of religious beliefs, I don’t see that refusing other forms of contraception is completely out of the question.

The organization also is reportedly working to install “crisis pregnancy centers” at its locations; these centers are well known for providing false and misleading information about abortion and exist to convince women not to choose abortion. Title X rules require “nondirective” counseling about abortion, and Planned Parenthood and other reputable providers who do provide abortions (using other, non-federal money) have processes and counselors in place to check whether women are certain of their decisions without pushing them in either direction.

Given the interest in installing deliberately biased in-house counseling and the stated intention to refuse to refer women out to other providers for abortion, it seems unlikely that Christ Community will be able to or has any intention of meeting the rules requiring factual, nondirective counseling. Women who cannot afford to access family planning care elsewhere will be subjected to a provider who clearly wishes to influence women’s choices, rather than providers who are committed to medical accuracy and offer women a full range of choices, supporting their right to individual decision-making about their bodies.

One woman reports that “Christ Community provides high-quality medical services, but that they sometimes come with a ‘sermon.’” She says she was told by a Christ Community provider, “If only my relationships with people and God were right, I would have fewer health problems.”

You have got to be f***ing kidding me.

In addition to these concerns, there may be other issues with Christ Community’s administration of the Title X funds. I’m not personally familiar with CCHS’s existing health clinics and services on the ground. A Memphis local informed me Christ Community does not take appointments – patients must show up first thing in the morning and wait to be seen, and may even have to come back the next day if too many people show up. This is obviously not a good model for providing family planning services, especially when emergency contraception or other urgent services are needed or when women must take time off from jobs, school, or childcare in order to wait around for care. Although the organization’s website does have an “appointment line,” it indicates that this is to find out which clinics provide which services; I’d like to hear from others about whether this matches their experience at Christ Community clinics.

Another serious concern is that Christ Community’s proposal to provide these services clearly indicated that they would provide less care to fewer women than would Planned Parenthood. Steve Ross, of Memphis and blogging at Vibinc, has an excellent series chronicling the whole debacle, from the Tennessee state government pressuring the Memphis health department to take the funds despite their lack of capacity for family planning through to the current funding of Christ Community (parts 1, 2, 3, and 4). In part 2, he lays out the numbers and apparent relative deficiencies of the Christ Community proposal, including their lower numbers for proposed services and inconsistencies in how the proposals from Christ Community and Planned Parenthood were scored by local officials.

In Part 3, Steve points to the questions asked by the potential providers – Christ Community, Planned Parenthood, and a third non-religious applicant. Although they are unattributed, we can only assume that the following questions were asked by Christ Community, the only applicant with an explicit religious mission and on the record about refusing services because of beliefs. I think these are very telling about the intentions of the leadership of the organization that asked these questions, and how they plan to approach women’s health:

In providing information about pregnancy termination, is it sufficient to have the referral information in writing? [My interpretation: In other words, do we even have to bother to actually have a conversation with women about this?]

If the information about pregnancy termination is provided, is the contractor allowed to indicate in wiriting (NOT coerce) – on a referral sheet or in the office that it does not provide that service because of its beliefs.

If a contraceptive method is not provided on site by a provider because of the provider’s ethical beliefs, can the provider refer the client to another Title X provider who offers this method? If so, does the referring provider have to pay for the service?

The answers to these questions explicitly state that emergency contraception must be provided, the organization cannot choose not to provide forms of contraception because of its beliefs, and they are not allowed to talk about refusing abortion and referrals because of beliefs. Yet everything we’ve heard – as mentioned above – indicates that Christ Community plans to do exactly that.

As Steve writes:

To be honest, these three questions left me flabbergasted. Certainly individuals and associations of people are allowed to hold their own beliefs. Certainly, different physicians and networks of physicians have different preferred treatment plans. There’s plenty of room for this diversity out there in the private sector. However, when you choose to enter the public sector by seeking a contract for public dollars, you are bound by the requirements those public dollars place on you. If those requirements are unpalatable to you, then perhaps you shouldn’t seek them.

Honestly, I’m sure this whole thing will end in lawsuits, and I wouldn’t be unhappy if HHS would intervene. In the meantime, poor women suffer.

I will leave you with this excellent rant from Sig at DowntownMemphisBlog:

Public policy needs to be based on reason and fact, not feelings and faith. Abortion is a legal medical procedure. Any organization that aspires to hold a government contract in the area of family planning needs to present all options and perform all medical procedures, not just the ones it agrees with or likes. Not just the ones that make them feel warm and fuzzy inside. Not just the ones that fit into the narrow world view defined by their archaic religious beliefs.

See also: Aunt B

Filed under: Access, Rights, & Choice, Contraception, Ethics, Government, Women’s Health

I haven’t done one of these in a while, having been distracted by the heat, the carless situation, dad’s cancer, mom’s hip replacement re-replacement, work, leveling my first character in Warcraft (now a level 71 undead frost mage – I don’t want to duel you!), and life in general. Tonight, though, I’m at my parents’ house (sitting with mom after said re-replacement), in a town with <30 thousand people that gets really, truly dark at night, World of Warcraft won't run on this computer, and I think I've reached the end of the internet. Might as well do something.

The FDA has issued a warning not to use emergency contraception labeled as Evital. The agency says,

These products may be counterfeit versions of the “morning after pill” and may not be safe or effective in preventing pregnancy. Evital has not been approved by the FDA for use in the United States. This potentially ineffective and suspect counterfeit emergency birth control may also be in distribution in some Hispanic communities in the United States.

The FDA announcement linked above has an image of the packaging for the drug in question and further details.

The FDA is also proposing guidelines for mobile medical apps (like you use on a smart phone). I haven’t fully parsed the implications of the proposal yet, but public comment is being accepted through October 19.

CNN has a piece on breast ironing in Cameroon. This is not a custom I know much about, and I’m always hesitant to jump in where I know so little, but I feel comfortable saying that this must be a painful procedure that doesn’t achieve the apparently desired goal of preventing sex ad pregnancy.

The New York Times talks about Title IX, the law requiring that women and girls have equal access to participation in school sports, focusing on a lack of investigation and enforcement when schools are thought to not be following the law.

Washington became the first state to specifically provide for offspring from donated eggs and sperm to access the donors’ medical history and names once the offspring turn 18. This is an issue I’ve written a tiny bit about at Our Bodies Our Blog.

Shockingly, Bill O’Reilly is kind of an uninformed jerk about unintentional pregnancy and birth control. The professional blowhard stated that “Many women who get pregnant are blasted out of their minds when they have sex and are not going to use birth control anyway.” Right. Half of all pregnancies in this country are unplanned, and it’s obviously just because women are too drunk and high to use contraception. A lot of attention has been paid to this comment, but O’Reilly also stated in the same segment that HHS should pay for “everybody’s birth control, all the women in the world, or here in the United States, or maybe both.” Yeah, we’re going to pay for birth control for *all the women in the world* – even those women in the many countries with lower rates of teen and unplanned pregnancy. Sure, that seems likely and logical and fact-based, doesn’t it? *headdesk* Media Matters has more, including response from the National Women’s Law Center.

C-section rates apparently hit an all-time U.S. high of 34%. I feel like “new high” is the news we get every year now on c-sections.

Al Jazeera English has a short piece on the ethics of clinical pharmaceutical research in India, where research participants may not clinically benefit from drugs being tested and may be vulnerable to exploitation.

Max Barry has a nice piece about gender through the lens of how we gender animals and the gender of Smurfs.

Kari Paul at the Ms. Blog explores the topic of sexual assault on campuses and the lack of arrests or serious addressing of this problem.

Connecticut added gender identity and expression to the state’s anti-discrimination laws. Good job, Connecticut!

Anita Sarkeesian talks about the “mystical pregnancy trope,” especially in sci fi/fantasy, in which women are used for their reproductive capacity and often forcibly impregnated. I hadn’t really noticed it as much as I should, maybe you haven’t either – check out the video (via Sociological Images).

Hey, it’s World Breastfeeding Week.

Honestly, I can watch True Blood as a bit of fluff and as somebody who likes to see on-screen adaptations of books. There are a lot of problems with it. Watching tonight’s episode, I really wondered how many gratuitous rape scenes one show can possibly have, especially after Alan Ball’s comment on the serial rape of Jason that he’s basically getting what he deserved for his sexual history. Feminist Frequency also has some TB commentary and links to more.

Relatedly but not surprisingly, the blogger at The Frisky wrote critically today about how True Blood handles rape, and the very first comment is of the “relax/don’t watch then” variety. Don’t worry your pretty little head! *predictable-but-disappointing-argh*

I’m proud of our Nashville students who came out to protest stupid, offensive, and mean “don’t say gay” legislation in Tennessee.

Apparently one place in Minnesota has similar “don’t say gay” rules in its schools; CNN covered the issue and the National Center for Lesbian Rights has a letter you can sign onto to express your support for students in the affected school district who are trying to change the policy.

The CDC is talking about antibiotic-resistant gonorrhea.

Somebody threw a Molotov cocktail into a Planned Parenthood of North Texas clinic. The clinic provides health care, including birth control and screenings, but doesn’t even provide abortions. Alex Pareene at Salon’s War Room points out that nobody seems to care about this form of domestic terrorism.

Last but not least, everybody wish Hilary luck on her last board exam and subsequent residency application process.

1) It’s the attack kitty edition because, in noting on Facebook that I am away from home, I told the Internet not to get any ideas – the house is guarded by the spouse, attack kitties, and weirdly commandable suits of armor.
2) Yes, I suspect there are some conversations we could have about gender and Warcraft. If you want to talk about that, we can do so in the comments.

Filed under: Abortion, Abuse, Rape, & Safety, Access, Rights, & Choice, Birth, Breastfeeding, Contraception, Drugs, Ethics, Events & Observances, Global Issues, Government, Infectious Diseases, Laws, Legislation, & Courts, Miscellaneous, News Round-Ups, Pregnancy, Products, Technology, & Devices