Archive for the ‘Sex Education’ Category

November 15, 2010

What Does New Research on Adolescent Brain Development Tell Us About Designing Adolescent Reproductive Health Services?

by Karin Ringheim | Population Reference Bureau

A recent NPR story on the biological basis for the sometimes confrontational, erratic and seemingly irrational behavior of adolescents reminded me of my own experiences in raising adolescents (and gratitude that this particular stage of life is now behind me).

As Garrison Keillor recently reminded us, to be a parent is to live a life of constant silent prayer — prayer that everything will turn out all right. We know that adolescents don’t always exercise the best judgment, and now, at least, we have a better sense of why this is the case.

The Teen Brain – A Work In Progress

The physical evidence gathered from Magnetic Resonance Imaging (MRI), according to Harvard researchers Frances Jensen and David Urion, shows that the adolescent brain is only about 80 percent as developed as an adult brain.

In adolescence, the brain’s frontal lobe, responsible for such important functions as reasoning, planning and judgment, is not as well-connected to the rest of the brain by myelin, or “white matter,” as it is in an older individual. Because of the immaturity of their brains, adolescents are less capable than adults of rational thought processes.

White matter grows substantially over the course of adolescence, providing insulation that increasingly enables nerve signals to flow freely from one part of the brain to another. When the frontal lobe is fully connected to the rest of the brain, around age 25, the brain is more capable of “connecting the dots,” processing complex notions — such as that actions have consequences.

Brain development from age 5 to 20 / Source: Paul Thompson, professor of neurology, UCLA School of Medicine

Death and Disability Rates Double During Adolescence

If parents did not already intuit this, the difficulties that adolescents have in controlling their emotions and behaviors lead to a doubling in rates of death and disability during adolescence as compared to rates among younger children.

According to Ronald Dahl, Staunton Professor of Psychiatry and Pediatrics at the University of Pittsburgh Medical Center, increased risk-taking, sensation-seeking and reckless behavior lead adolescents to higher rates of traffic and other accidents, substance abuse, suicide, eating disorders, depression, violence and risky sexual behaviors.

Although Dahl does not promote a mechanistic view of biology as destiny, he does note that the life trajectories established in youth can have a major impact on later life, and it is best to alter these trajectories in a positive direction while one can.

Youth Reproductive Health: A Politically Charged Issue

Adolescents who become unintentionally pregnant or become infected with HIV are certainly in for a life-altering experience, and usually not one that will be advantageous.

For at least 15 years, reproductive health advocates have called for “youth friendly services” to enable youth who are, or intend to become sexually active, to obtain the information and services they need to remain healthy.

The concept of reproductive health services for adolescents has been, and remains politically controversial. In 2004, ideologues charged that the Global Health Conference [pdf], an international gathering of health professionals held annually in Washington D.C., would be a platform that year to advocate for youth reproductive health services, instigating a last-minute withdrawal of federal funding for the conference from the U.S. Department of Health and Human Services, the Centers for Disease Control (CDC) and the U.S. Agency for International Development (USAID).

While the conference proceeded with funding from other donors, the action had a chilling effect on some federal grantees, who swept their websites clean of any potentially damaging information. U.S. programs for youth in developing countries supported under the President’s Emergency Plan for AIDS Relief, PEPFAR, were firmly grounded in the “ABCs” — Abstain, Be faithful, use Condoms, even as domestic research showed that abstinence-only programs had no long-term health benefits.

Meanwhile, in some African countries, one in five young women is HIV positive and as many as one in two has been pregnant. In South Africa, 22 percent of young women attending antenatal care are both pregnant and HIV positive. These astounding statistics have largely been unmoved by the infusion of PEPFAR and other funding for proscriptive youth reproductive health information and services. And politically shaped policies in the United States help maintain pregnancy, birth and abortion rates among adolescents that are the highest in the developed world.

An Evidence-Based Practice

How should societies respond to the knowledge that adolescents may not be capable of obeying our pleas to “just say no,” “abstain until marriage,” or “always use a condom”?

Adolescents are capable of understanding, if not fully controlling, their own immature thought processes. They need realistic, truly “youth-friendly” tools and resources to help them make better decisions and remain healthy and safe.

If, based on brain research, adults come to view adolescence less as a period of self-centered disobedience and more as a period of innate vulnerability, we will do a better job of providing youth with comprehensive, compassionate services and education. We will do whatever we can to help them navigate this vulnerable period without becoming pregnant or HIV-positive, or undergoing an unsafely performed abortion, and if such outcomes occur, we will aim to minimize the harmful life-altering consequences.

Our obligation is to protect as best we can, those who by virtue of their not-fully-realized intellectual capacity, are less able than we previously assumed to look out for themselves.

Karin Ringheim, Ph.D., M.P.H., is a senior policy adviser at the Population Reference Bureau


April 30, 2010

Providing Sexual Health Info: Promotoras de la Salud Sexual Community Educators

View all Women’s Health Heroes. Voting closes May 14. Background info here.

Entrant: Emilia Gianfortoni
Nominee: Promotoras de la Salud Sexual Community Educators

The Latino community experiences vast sexual health disparities nationwide. Latinos disproportionately experience high rates of teen pregnancy and STIs compared to other ethnic groups. In Massachusetts, Latinas have a teen birth rate that is six times higher than non-Latinas.

The communities of Holyoke and Springfield experience the highest teen birth rates in the state, at 95.4 and 84.3 per 1,000, respectively, compared to 22 per 1,000 for the state as a whole.

As studies clearly show, teen pregnancy and birth rates are much related to high school drop out rates. Holyoke and Springfield are no exceptions with the two highest drop out rates for Latino teens in the state (34.9 and 33.3 per 1,000, respectively, compared to 22.8 in MA overall).

In Latin American countries and culture, health care is often provided in a more personal and informal way than in the United States. Promotoras offer customized health information from volunteers with first-hand knowledge of the communities they serve and the experiences they have that effect their health care knowledge and access.

Through a partnership with the Puerto Rican Cultural Center and Planned Parenthood League of Massachusetts, the Promotoras, or community health workers, in Springfield, Mass., have been providing sexual health education to their community in group and individual settings to raise awareness and increase access to sexual health information and services.

In just four short months, and with strong leadership and dedicated guidance from Iris Coralí, the Latino community health education coordinator from Planned Parenthood, the promotoras have connected with over 1,300 individuals in their community through charlas, health and community fairs, and family and friends. Each person they connect with receives accurate information about sexual health from someone they can identify with, along with answers to questions they may have and referrals to health services in their community. The promotoras include:

* Maribel Cabrera is 32 years old and was born and raised in Rio Piedras, Puerto Rico. She recently moved to the United States, to Springfield, and is studying English at the Massachusetts Career Development Institute. For Maribel, being a promotora means being a leader in her community and a confident advisor. As promotoras, she believes she can access and attain knowledge, information and resources to advise the Latino community. Maribel has two sons who are her main reason to keep moving forward.

* Paola Figueroa is 25 years old and was born and raised in Rio Piedras, Puerto Rico. She came to the United States to achieve some of her greatest drams, which included seeing snow and having a better life – both of which she has achieved. Paola is studying English at the Massachusetts Career Development Institute to be able to have a better job in the future. She loves being a promotora de salud sexual because she believes it is a very important topic for our children and their future and to be able to give advice to the community. As a promotora she has the skills to give correct information and be knowledgeable about the health services.  For Paola, being a promotora signifies the confidence in her community. She has a very intelligent 5-year-old daughter, Lenalisse, and a wonderful supportive husband.

* Jessica Rivera was born and raised in Arecibo, Puerto Rico and is 29 years old. She decided to come to the United States to find a better job and to give her sons a better future. Jessica has two sons who, along with her family, are her biggest love; they are 8 and 9 years old. She has a bachelors degree in Elementary English from Puerto Rico and is currently studying English at the Massachusetts Career Development Institute. Jessica likes to help other people, and to talk a lot. Being a promotora means she is an example for the community to give correctly information about sexual health and sexuality to help the community. Through her knowledge as a promotora she can help other people in need be able to have a healthy future.

* Sandy Soto was born in 1969 and raised in Puerto Plata, Dominican Republic. She completed her law degree from the Universidad Technologica de Santo Domingo and moved to the United States in 2006 after visiting a few times before. Sandy has always liked to work with people to help them and she believes that by being a promotora she can do that. Being a promotora means she can advise her community about how to protect their physical and mental health and how they can help their families. Sandy has three sons and one grandson.

So far, they have received very positive feedback, and it is clear many community members are appreciative of the information they are receiving.

A woman staying at a homeless shelter in West Springfield, where she lives with her two children, took a bus to the Center’s recent Three Kings Day Celebration. The woman was 35 years old and moved to Massachusetts from Puerto Rico six months ago after divorcing her husband and escaping domestic violence. As part of the process for signing up for toys at the Center, the woman attended a charla and filled out a subsequent evaluation. On the evaluation form, the woman mentioned having little knowledge of birth control options and STI prevention. She also listed that she had never had an annual gynecological exam.

After listening to the charla, the woman was very happy to have received such helpful information and commented that she felt many in the community could benefit from it. She also wrote that she would like to become a Promotora herself, and provided her contact information.


October 24, 2009

A “Real” Sex Ed Story: A Teenager Recalls Lessons From “Our Whole Lives”

by Meg Young
Our Bodies Ourselves intern

The Sexuality Information and Education Council of the United States (SEICUS) would like you to get REAL about sex education.

SEICUS has declared October “Sex Ed Month of Action,” and the organization is encouraging young people to raise awareness for the need for comprehensive sex ed — and specifically the Responsible Education About Life (REAL) Act [pdf].

Introduced by Sen. Frank Lautenberg (D-N.J.) and Rep. Barbara Lee (D-Calif.), the legislation (S.611, HR.1551) calls for a dedicated federal funding stream ($50 million) that would cover state grants for developing comprehensive sexuality education programs. A petition in support of the REAL Act is online at AmplifyYourVoice.org.

Reviewing these quick facts about the need for comprehensive sex education, I was reminded of my own “real” sex education.

Picture this: It’s Sunday morning, and I’m competing in a condom-stretching contest in the basement of a pre-school. Other kids are trying to blow up the largest condom-balloon, shoot a condom the farthest (rubber-band style), or beat my record of 24-inches for the condom-stretch (all the way from the floor to my hip). Four adults are recording scores and announcing winners. In the center of the room, next to a few condom-clad bananas, sits a box of donuts, a subtle bribe to get us out of bed so early on a weekend.

I was in eighth grade, and I was a reluctant student in Our Whole Lives.

Our Whole Lives (OWL), a sexuality education curriculum developed jointly by the Unitarian Universalist Association and the United Church of Christ, was first published in 1999, and subsequently updated in 2005. The class provides a comprehensive, interactive, unabashed look at sexuality, offering six sets of curricula for age groups spanning kindergarten to adulthood.

The “big curriculum” for seventh-to-ninth graders is predominantly offered outside of schools (I took OWL as part of Sunday school at my local UU church), and tends to take a more personal angle than classroom based sex-ed classes, offering time for discussion, games and unlimited questions.

The first sessions of the curriculum focus on building rapport between the instructors and the students, as well as creating a high level of comfort between the students themselves. One of my OWL classmates recently said: “Because of the intimate environment of OWL, it felt really awkward at times, but in the end was really effective in achieving its purpose… There was room for open discussion, and questions arose that never would have when surrounded by 22 random kids from school.”

This “intimate environment,” as well as the fact that, by virtue of being taught outside of the school system, OWL does not need to conform to any state or federally-imposed limitations, means that OWL can address sexuality education more broadly. Topics include everything from anatomy and physiology (I clearly remember being ejaculated on by a working model of a penis built by a class-mate), to gender roles in dating (we had a long argument about who should pay for dinner and a movie).

There was a whole session devoted to “love making,” and another devoted to masturbation. Trading colored m&ms taught us about the terrifying ease of spreading sexually transmitted diseases. We played with condoms, diaphragms, female condoms and spermicidal gels. We discussed our feelings about abortion at length. We spent three weeks discussing sexual orientation and gender identity. At an all-class sleepover, as part of our unit on responsible sexual behavior, we watched “American Pie.”

When I took OWL at age 14, issues like herpes, emergency contraception and “responsible sexual decisions” often seemed remote to the point of irrelevance, and I can’t deny that my high school health class served as somewhat of a necessary refresher. However, what I really absorbed from OWL at the time, and what I have carried with me ever since, is an outlook on sexuality that was strikingly absent from my sex-ed unit in health class: OWL taught me that sexuality is not something to be ashamed of, to be hidden or feared. It is something to be questioned and explored, respected and protected. It is nuanced and complex, and sometimes infuriatingly confusing.

Most of all, it is an essential part of the human experience that last from birth until death – Our Whole Lives.

So, am I bitter that I had to be up by 9 a.m. every Sunday for a year? Yes. I’m I glad my parent made me do it? Absolutely.

Meg Young recently graduated from high school in Middlebury, Vt., and will enroll at Tufts University in the fall of 2010 after taking a gap year.


October 2, 2009

Reading List: Crash Course in Sex Ed for Adults

girls_who_went_awayFollowing up on the battle over funding for comprehensive sex education, here’s a list of 40 books and articles about sexuality that are well worth a look at any age.

Compiled by Anna Clark, who blogs at Isak, these texts cover not only the basics, but the complex policies and politics surrounding birth control, gender, race, abortion, adoption and more. From the introduction:

If we can agree that few teens learn about sexuality in an accurate, age-appropriate, and comprehensive way, then where does that leave adults who came through the same school systems they did? Many of us are still full of questions that we aren’t quite sure how to articulate. Few can claim that they’ve figured sex — and its social influence — out.

If you want to graduate to the next level of sexual health, pleasure, and social awareness, now’s your chance. Get yourself schooled with a crash course in sex ed for adults. From orgasms to organs, from contraceptives to court decisions, look to the reading list below for the can’t-miss books and articles about sex.

There are a number of titles here that I’ve been meaning to read, including such recent releases as “The Girl Who Went Away: Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Roe v. Wade,” by Ann Fessler, and “The Means of Reproduction: Sex, Power, and the Future of the World,” by Michelle Goldberg. Any books on the list that you’d highly recommend, or other titles you would add?


October 1, 2009

Health Care Reform Update: Effort to Restrict Abortion Coverage Fails, Mixed Results on Abstinence Only Funding

The health care reform debate hasn’t been encouraging for reproductive health advocates, but on Wednesday the Senate Finance Committee pushed back against a Republican amendment designed to “doubly triply restrict abortion coverage in the bill,” as Rachel Maddow described it last night.

Republican Olympia Snowe of Maine joined almost all of the Democrats to defeat the amendment 13-10. Sen. Kent Conrad of North Dakota, a Democrat, voted for the restrictions along with the rest of the Republicans. Robert Pear of The New York Times explains the framework of the amendment:

The bill, written by the chairman of the Finance Committee, Senator Max Baucus, Democrat of Montana, says that no tax credits could be used to pay for abortions except as allowed in the latest appropriations for the Department of Health and Human Services — in case of rape or incest or if the life of a pregnant woman was in danger.

Under the bill, some health plans would cover abortion, and some would not. Private insurers that chose to cover abortion would be required to segregate money, taken from private premiums, to cover the procedure.

The amendment, offered Wednesday by Senator Orrin G. Hatch, Republican of Utah, would have gone much further. It said that no money provided under the legislation could be used to pay “any part of the costs of any health plan that includes coverage of abortion,” with a few limited exceptions. Under the proposal, insurers could have offered “a separate supplemental policy” to cover abortions. Such policies would have been financed “solely by supplemental premiums paid by individuals choosing to purchase the policy.”

Once again, Sen. Debbie Stabenow (D-Mich.), who demonstrated last week during a debate about pregnancy coverage that she is a no-nonsense force to be reckoned with, fired back against treating women as second-class citizens. She argued that the amendment goes far beyond existing law, which already prohibits spending federal dollars to pay for abortions for women on Medicaid, and it would restrict access to abortion for all women. Here’s my transcript of the video above:

In fact, with all respect to my friend, as a woman, I find it offensive that in [this amendment], any woman, any family purchasing through the exchange — if they did not receive any tax credit — would be prohibited from having the full range of health care options that they may need covered. This doesn’t just refer to the tax credits. As I read this: “prohibit private insurers operating through the exchange from offering coverage” — this is an unprecedented restriction on people who paid for their own health care insurance.

Then, when we look at the fact that this offers, that people could have a supplemental single-service rider, the assumption that somehow a woman or family would say, “You know, some day we may have an unintended pregnancy, so we’re going to get a separate rider. Or maybe my pregnancy is going to have a crisis — many, many crises — and so we’re going to try to find some other rider.”

In my judgment, I don’t even know how that would work. In the few states that have tried to do that, there’s no evidence that even those kinds of riders are available.

It’s remarkable that discussions about abortion conveniently leave out that it is a legal, medical procedure. Or that one in three women will have had an abortion by age 45. Or that three-fourths of women who obtain an abortion say they cannot afford to have a child. Or — as we saw in the weeks after the murder of Dr. George Tiller, when women stepped forward to reveal their stories — the decision is sometimes heartbreakingly, medically necessary.

We’re not the only ones frustrated by the way abortion has turned into a wedge issue for health care reform.

“In a rational system of medical care, there would be virtually no restrictions on financing abortions,” reads an editorial published in today’s New York Times. ”But abortion is not a rational issue, and opponents have succeeded in broadly denying the use of federal dollars to pay for them, except in the case of pregnancies that result from rape or incest or that endanger a woman’s life.”

“There should be no restrictions on abortion coverage in the exchanges,” the editorial concludes. “Health care reformers should not retreat on this issue, but we recognize that principle is often sacrificed in Congressional bargaining. Democrats who support the compromise must find a way to prevent it from being used later to go after other tax subsidies and thus further deny Americans’ rights to make their own health-care decisions.”

Hatch put forth a second amendment to strengthen existing “conscience clause” laws protecting healthcare workers from performing abortions or other services to which they have moral or ethical objections. It also failed on the same on the same 10-13 margin; Snowe voted with the Democrats, and Conrad with the Republicans.

Funding for Abstinence Only Education

On Tuesday night, the committee approved a comprehensive sex education funding stream, the Personal Responsibility Education for Adulthood Training. That amendment, proposed by Baucus, provides $75 million for states, according to the Sexuality Information and Education Council of the United States (SIECUS), “$50 million of which would be geared to evidence-based, medically accurate, age-appropriate programs to educate adolescents about both abstinence and contraception in order to prevent unintended teen pregnancy and sexually transmitted infections, including HIV/AIDS. The remaining funds would be for innovative programs as well as research and evaluation.”

Snowe joined all Democrats in passing the amendment; the vote was 14–9.

Yet on the same night, the committee voted for an amendment introduced by Hatch to restore federal funding for abstinence-only education — “better known,” said Maddow, “as the best teen pregnancy and STD delivery system politicians have ever devised.”

Democrats Conrad and Blanche Lincoln of Arkansas joined all 10 Republicans on the Finance Committee to vote in favor of adding $50 million-a-year funding for the Title V abstinence-only program to the health care bill, despite the fact that President Obama’s 2010 budget eliminated funding for abstinence-only education programs — because they simply don’t work.

Even Texas got the message. The state that ranks first in spending on sexual abstinence has the third-highest teen birth rate in the country and the highest percentage of teen mothers giving birth more than once. As the Austin American-Statesman reported on Sunday, some school districts are giving up the abstinence-only model and adopting a more comprehensive sex education curriculum, also called “abstinence-plus.”

Both amendments still have to pass the full House and Senate, so it’s anyone guess where the dollars will fall, but SEICUS is optimistic that legislators will wake up and reject the abstinence-only funding.

“This amendment takes a giant step backward by restoring funding for the failed and discredited abstinence-only-until-marriage program for the states,” said William Smith, vice president for public policy at SEICUS. “However, because this program so clearly doesn’t work and half the states don’t even participate, we are confident it will be stripped from the final bill and ask Congressional leaders and the White House to ensure this happens.”


June 16, 2009

Juno’s Alternative Reality: MTV’s “16 & Pregnant”

16_and_pregnantMTV’s new documentary series “16 & Pregnant” makes its debut Thursday, June 18, at 10 p.m. (EST).  The episodes are also available online.

I watched some of episode one; Maci, the mom shown here with her boyfriend, Ryan, and their son, Bentley, is amazing. She basically gives up everything to take on this new responsibility, with little help from Ryan. I was a bit surprised, though, to read her update describing her life now in far more upbeat terms. I’m thrilled for her, of course, but I do wonder if some teenage viewers will be conflicted.

Baltimore Sun critic David Zurawik highly recommends the series and praises the realism: “Parents who don’t go out of their way to see or record this six-week series of profiles of pregnant teenagers are making a big mistake. If you have no other involvement in your kids’ media lives, make them see this.”

Plus: When it comes to sex-ed, who’s the voice of reason?


April 14, 2009

The Sex Talk – With a Focus on Respect

Do boys and girls need to be taught different lessons, particularly about sex? Pediatrician Perri Klass talks to other doctors about the lessons they share with their patients about sex and respect for their partners.

Her conclusion:

As a pediatrician with two sons and a daughter, I acknowledge the need to emphasize manners and respect as boys maneuver into adolescence and adulthood, and to help them understand the implications and obligations of their increasing size and strength. And I acknowledge that for their own protection, boys need to understand that there are people — male and female — who will see them as potential predators, and judge them automatically at fault in any ambiguous situation.

But I am enough of an old-fashioned feminist to want to teach daughters the same fundamental lessons I teach sons: err on the side of respect and good manners; understand that confusion, doubt and ambiguity abound, especially when you are young; never take advantage of someone else’s uncertainty; and, just as important, remember that adolescence should be a time of fun, affection, growth and discovery.

It’s too bad that one side of teaching our children about sex and relationships means reminding them that there are bad people in the world; stay away from them, stay safe, speak up if someone hurts you or pushes you. But everyone needs that information, and that promise of adult support. We have to get that message across without defining some of our children as obvious perpetrators and others as obvious victims, because that insults everyone.


March 23, 2009

Political Diagnosis: The New Sisterhood in Washington; Lawmakers Get REAL on Sex Education; Panel to Advise on Comparative Effectiveness Research …

The New Sisterhood: Krissah Thompson of the Washington Post writes about the ascent of black women in the new Obama administration: “The ‘Obama women’ — as African American women who’ve taken big jobs in his administration have been nicknamed — mark another step in the long journey of black women from outsiders to gatekeepers in political Washington. They have quietly entered their jobs with little attention paid to the fact that they are the largest contingent of high-ranking black women to work for a president.”

Time, Again, to Get REAL: Sen. Frank Lautenberg (D-N.J.) and Rep. Barbara Lee (D-CA) this week introduced a bill called the Responsible Education about Life (REAL) Act that would authorize funding  for comprehensive and medically accurate sex education. Believe it or not, federal funding is only available now for abstinence-only-until-marriage programs. And we know how well that’s been working.

Spending Strategy Advisers Named: The U.S. Health and Human Services Department on Thursday named a panel of 15 government experts to advise the government on how to spend the $1.1 billion on determining which medical treatments work best. The money was set aside in the stimulus bill.  Rachel has more on comparative effectiveness research, a new focus of the Obama administration.

Plus: HHS announced Dr. David Blumenthal, a former Harvard Medical School professor and political adviser on health care issues, as the  national coordinator for health information technology. In this new role, Blumenthal “will lead the implementation of a nationwide interoperable, privacy-protected health information technology infrastructure as called for in the American Recovery and Reinvestment Act,” according to the release.

A Reason to Fast Track Coverage: “Health care is one of the few relatively healthy parts of our unhealthy economy right now,” writes Drew Altman, Kaiser Family Foundation president and CEO.

“Since January 2008, the economy has lost 4.3 million non-farm jobs. Virtually all major industries have shed jobs. What went up? Well, mining and logging companies added modestly to their payrolls. Government and education employment is up somewhat, along with social assistance (not too surprising given our economic circumstances). But where did employment go up the most since January of last year? You guessed it: Health care, which added 383,200 jobs.” Read on.

Small Business Takes on Reform: The National Small Business Association today launched a new website, Health Reform Today, advocating for a federally defined benefits package, subsidies for low-income individuals and tax incentives.

White House Forum in Iowa: The third Regional White House Forum on Health Reform takes place today in Des Moines, Iowa. Nancy-Ann DeParle, director of the White House Office on Health Reform, will represent the administration. The Des Moines Register website will carry the event live at 10 a.m.


March 9, 2009

Double Dose: Where’s the Media Coverage of Breast Cancer and Environmental Causes?; New Report on Sex Education in Florida; Gender Neutral Prounouns; Domestic Violence and Technology …

Overlooking Evidence: “When it comes to breast cancer, why is it so hard to get the most influential media to pay attention to the possibility that, in addition to better-understood risks, unnatural substances entering women’s bodies might also be a factor?” That’s the million-dollar question in this Fair! analysis on the surprising dearth of news coverage on environmental hazards and breast cancer. An excellent report by Miranda Spencer.

Skimping on Care: More than a third of people surveyed have skipped medical check-ups or dental visits over the past year due to concern over health care costs, and 27 percent have put off getting needed health care, according to the Kaiser Family Foundation’s first health care tracking poll of 2009.

Supreme Court: No Legal Shield in Drug Labeling: The Supreme Court on Wednesday ruled that people injured by drugs can sue the drug manufacturer in state courts, even if the drugs were approved by the Food and Drug Administration.

“The ruling could have significant implications beyond drug manufacturing,” writes Adam Liptak at The New York Times. “Many companies have sought tighter federal regulation in recent years in part to shield themselves from litigation.”

The case involved a Vermont woman, a musician, whose arm had to be amputated following an injection of the anti-nausea drug Phenergan. Levine sued the drug maker Wyeth because Wyeth had not changed the label indicating that one method of administering the drug had a small risk of error which caused irreversible gangrene. Nina Totenberg did a good report on the ruling. The NPR link also includes excerpts from the oral arguments heard last November.

Sunshine State Keeps Teens in the Dark: The Healthy Teens Campaign of Florida and the Sexuality Information and Education Council of the United States (SIECUS) have released a report on failed abstinence-only sex education programs in Florida’s public schools: “Sex Education in the Sunshine State: How Abstinence-Only-Until-Marriage Programs Are Keeping Florida’s Youth in the Dark” (pdf).

“[O]ur research has exposed both the state’s appalling indicators of poor outcomes for young people and the equally appalling nature of how abstinence-only-until-marriage programs have become pervasive throughout the state,” writes Adrienne Kimmell at RH Reality Check.

Him/Her/They: Elizabeth Landau at CNN reports on the history of the search for gender-neutral pronouns, an issue that has recently been taken up on Twitter. An interesting story.

On the Issues: Good reads in the On the Issues Magazine cafe, including Diana Whitten‘s look at Women on Waves, a Dutch organization that provides on-ship abortions in international waters for women from countries where it is illegal. Women on Waves recently won an important victory in the European Court of Human Rights. And don’t forget to check out the winter issue, which features stories on topics from ratifying CEDAW to Second Life.

Moving Reproductive Services Off-Site (Six Feet Away): From Women’s eNews: For more than a decade, a hospital merger in New York state was held up by abortion politics. Last week, community activists gathered for a ribbon-cutting ceremony marking their hard-fought compromise. Rebecca Harshbarger reports.

Plus: Emily Douglas points to this Albany Times Union op-ed on the implications of a possible merger between two secular hospitals and one religious hospital in Rensselaer County, New York. The merger raises questions about reproductive health care for patients and employee health insurance benefits, since Catholic directives prohibit coverage for contraception.

In Translation: Over at Sociological Images, a blog sponsored by the American Sociological Association, there’s been some debate over the English and Spanish versions of a pamphlet for pregnant women offered by Kaiser Permanente. Kaiser provides a response.

The Economic Future and Women’s Roles: The Chicago Foundation for Women looks at how the stimulus package affects women’s economic security.

Teaching Domestic Violence Victims Safe Use of Technology: Via this press release, I learned about a Washington state program designed to help victims of domestic violence by increasing their knowledge of how to use technology safely.

“Domestic violence is built around control, not anger, and an abusive partner often limits a woman’s access to information and support. Monitoring computer activity is one of many ways to control a spouse,” said Jerry Finn, a University of Washington Tacoma professor of social work who also evaluates the effectiveness of human services programs.

The training covers how to prevent such things as identity theft; concealing browser history; how to be safe in a chat room; how to set up an e-mail account without using a real name; and how to prevent being followed with a GPS device. What a smart idea.

Welcome Particle, Wave, Astarte and …: To apologize for the late Double Dose, I offer some cute overload, via feminist poet and performance artist Diana Tigerlily, who also raises goats.

Meet the newest ones — five in all, if my counting is correct. Makes me think two dogs and two cats may not be enough : )


February 20, 2009

Political Diagnosis: Kansas Governor is HHS Frontrunner; Stimulus Bill Includes Money for Treatment Comparisons; What’s Holding Up Reversal on Stem Cells? …

Obama Closer to Nominating HHS Secretary: Kansas Gov. Kathleen Sebelius appears to be President Obama’s leading choice for secretary of Health and Human Services. In a front-page story on Thursday, Peter Baker and Rober Pear of The New York Times write:

With his economic recovery plan signed into law, Mr. Obama plans to turn his attention more to health care next week with a fiscal blueprint that will begin to advance his ideas about covering the uninsured, advisers said. He may also make health care a theme of his prime-time address to a joint session of Congress on Tuesday night, they said.

It remained unclear whether the White House would finish vetting Ms. Sebelius in time to nominate her by next week. Advisers described her as “the leading candidate,” although they said other names were still in discussion and emphasized that no final decision had been made.

We previously noted Sebelius’ frontrunner status, along with other names reportedly under discussion. The Washington Post’s Al Kamen this week mentioned another would-be contender: “Obama transition chief John D. Podesta, whose name has been out there as perhaps most ready to handle the difficult job, has told co-workers and friends that he’s staying put at his think tank, the Center for American Progress. But he’s been observing that perhaps Bill Novelli, the outgoing head of AARP, the seniors lobby, might be a possible candidate.”

The More Things Change …: In that same column, Kamen notes that Obama’s first 56 selections for Senate-confirmed jobs reflect, well, the status quo — white men still rule, though they’re not quite the majority. At this early stage, 32 percent of the appointees are women.

By way of comparison on a few of these statistics, 39 of Bill Clinton‘s first 48 nominees (81 percent) were white and seven (15 percent) were African American; 75 percent were men. Of George W. Bush‘s 28 first nominees, 22 were white (79 percent) and only 14 percent were women, according to data compiled by the Presidential Transition Project at New York University’s Wagner School of Public Service.

It should be noted that this snapshot is of the Cabinet and topmost officials in the new administration and may change significantly over time. For example, the average age could be expected to drop a bit as lower-level positions — assistant secretaries and such — get filled, probably with a younger cohort of appointees.

Obama Signs Stimulus Bill: President Obama on Tuesday signed into law the $787-billion economic stimulus bill. Ann at Feministing looks at who’s getting stimulated — or, to be more specific, how will the law expand job opportunities for women?

Over at The New York Times, Robert Pear reports that the bill provides “substantial amounts of money for the federal government to compare the effectiveness of different treatments for the same illness.”

Under the legislation, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and other ways of treating specific conditions. The bill creates a council of up to 15 federal employees to coordinate the research and to advise President Obama and Congress on how to spend the money.

The program responds to a growing concern that doctors have little or no solid evidence of the value of many treatments. Supporters of the research hope it will eventually save money by discouraging the use of costly, ineffective treatments.

Meanwhile, NPR reports on a new study that shows even head-to-head comparisons don’t provide easy answers.

Scientists Await Action on Stem Cells: Sure the economy has demanded a lot of attention, but some scientists are wondering when Obama is going to lift restrictions on stem cell research.

“Everyone is waiting with bated breath,” George Daley, a leading stem cell scientist at Children’s Hospital in Boston. tells the Washington Post. “We’re all waiting to breathe a huge sigh of relief.”

Know How to Fix Health Care?: If you have a plan — and if you’re an undergraduate or graduate student — Kaiser Family Foundation wants to hear from you. Below is your essay assignment — and unlike the last paper you wrote, this one could net you $1,000:

President Obama has stated that reforming the health care system is one of his top priorities, and there is broad interest from policymakers and the public in making a change. During the campaign, he outlined a framework for reforming health care. The essay should cover: what elements of his plan should be prioritized given the current economic crisis, what elements are most likely to garner support and which ones will be most challenging and why?

Action Alert
* Ask Obama to End Abstinence-Only Funding
President Obama is putting together his proposed budget for 2010, and as he has assured the nation, he will be on the lookout for failed programs that deserve to be eliminated. We have an easy cut to suggest: End federal funding for the failed abstinence-only-until-marriage experiment.
Email the White House (Chicago Foundation for Women)


February 19, 2009

Show Your Love for Sex Ed & Scarleteen

Those of us beyond our teenage and young adult years can only wish that Scarleteen.com — a website that delivers progressive, inclusive and accurate information about sex and sexuality — existed when we were growing up.

But we can do something to help ensure today’s teens have access to this information — and more — at no cost.

A donor to Scarleteen has agreed to match donations made through March 15. And now that Scarleteen is affiliated with the Center for Sex and Culture in San Francisco, it has nonprofit 501c(3) status, which means donations are tax-deductible. Read all about it here and make a donation.

Heather Corrina launched Scarleteen back in 1998. It currently has about 20 active volunteers and is one of the top-ranked sites for young adult sexuality education. Despite its popularity, Scarleteen averages just one donation per every 500,000 users. That’s because most of the website’s visitors either do not have their own income or do not have access or permission to use credit cards or checks to make donations. So it’s up to us older folks to step up.

With more funding, writes Corrina, Scarleteen could do so much more:

  • Creating and distributing outreach print materials for schools, clinics and community groups, based on content like our popular Sex Readiness Checklist, our anatomy articles, and our pieces on abuse, gender identity and sexual orientation.
  • Providing our volunteer staff extra training. In the next year, we’d like to get a few of our staff trained or certified in either or both pregnancy options counseling and/or basic sex education.
  • Stipends for some of our volunteer writers and columnists, which will both sustain a quality of content and allow us to keep up with the frequency of updates we have had in the last year. Paying writers also can nurture a greater diversity of voice and content.
  • Maintaining a part-time freelance developer to help us best manage and maintain the site for optimum useability.
  • A part-time, in-person assistant for myself as director.

Plus: There is a way for young people to make a difference through Scarleteen’s new campaign, Do You Give a Buck About Sex Education? Yep. Just a buck or two, sent by mail, would be most appreciated.

Either way you can help out, this is a sex education campaign that we happily support.


February 17, 2009

Survey on Reproductive Health Agenda

When it comes to the politics of women’s health, there’s more common ground than might be expected, according to a new national opinion survey sponsored by the National Women’s Law Center and the YWCA USA.

“The survey of 1,000 Republican and Independent voters conducted by Public Strategies, Inc. found that Republicans, and to an even greater degree Independents, support a range of legislative proposals to make contraception more affordable and accessible,” according to the release. Among the findings:

  • Nearly three-quarters (72%) of Republicans and Independents favor legislation that would make it easier for people at all income levels to obtain contraception, and 70 percent favor legislation that would help make birth control more affordable. More than 60 percent of fundamentalist/evangelical Protestants favor these proposals.
  • Only 2 percent of Republicans and Independents would like to see government restrict access to contraception. A majority (64%) would like to see government provide more information about contraception, and 33 percent would prefer that the government play no role.
  • A strong majority of Independents (67%) and nearly half of Republicans (49%) have a favorable opinion of emergency contraception.

View more of the survey concerning attitudes toward sex education, pharmacy refusals and abortion.

I haven’t seen the questions, but I was a bit surprised to read that “only 8 percent of Republicans and Independents think the government should support abstinence-only education.” The percentage of Independents and Republicans who support comprehensive sex education programs was a less enthusiastic 76 percent and 62 percent, respectively, but those numbers are still higher than I would have guessed.

Plus: Abstinence-only education programs were funded to the tune of $175 million per year under the Bush administration. Has its golden age come to end? The Economist ponders the fate of abstinence-only education under a new administration and Congress.


February 9, 2009

A History of Menstrual Activism

A recent issue of the journal Health Care for Women International includes the article “From Convenience to Hazard: A Short History of the Emergence of the Menstrual Activism Movement, 1971-1992,” a succinct and fascinating history from author Chris Bobel. This article is well worth a read if you can get your hands on a copy (the link above is to the abstract only). The article highlights “Our Bodies, Ourselves” and the ways in which our classic book addressed menstruation and menstrual products over the years and editions.

Bobel notes milestones in the history of menstrual activism, including growing concerns about menstrual products and changing attitudes and growing discussion about menstruation in the 1970s, concerns about toxic shock syndrome and the FDA’s inaction in the 1980s, and growing concern about toxins and interest in alternative products in the early 1990s.

Regarding past editions of “Our Bodies, Ourselves,” Bobel notes that the topic was addressed briefly in the 1970 OBOS precursor “Women & Their Bodies,” but had “its own four-and-a-half-page subsection in Chapter Two” by the 1973 edition. By 1979, the text “suggest[ed] that conventional products were not for everyone,” but Bobel wonders why “the introductory passage acknowledging cultural and historical differences in the ways women absorb their flow also was deleted.”

Bobel observes that strong language about toxic shock syndrome and the lack of uniform absorbency standards from the FDA made it into the 1984 edition, as did the problems of menstrual products for women using wheelchairs. By “The New Our Bodies, Ourselves” in 1992, the text included “an expanded discussion of menstrual products by including still more alternative options and introducing the potential health hazards associated with the industry’s standard chlorine bleaching process.”

If this topic is of interest to you, Bobel also has a book coming out soon which will elaborate on the themes of the article entitled “When the Private Becomes Public: Menstruation, Resistance and ‘Doing Feminism’ in the Third Wave” — we’ll try to review it when it becomes available!


February 5, 2009

Yes Means Yes: Q&A With Lisa Jervis & Brad Perry

Today we’re pleased to present an interview with two outstanding contributors to “Yes Means Yes: Visions of Female Sexual Power & A World Without Rape,” a collection of essays recently published by Seal Press.

Lisa Jervis, the founding editor and publisher of Bitch magazine, and Brad Perry, sexual violence prevention coordinator at the Virginia Sexual and Domestic Violence Action Alliance, take on popular perceptions of rape and what needs to be done to transform regressive attitudes toward sexual violence — in both the media and among young men.

In “An Old Enemy in a New Outfit: How Date Rape Became Gray Rape and Why it Matters,” Jervis deconstructs the latest blame-the-victim terminology. Perry’s essay, “Hooking Up With Healthy Sexuality: The Lessons Boys Learn (and Don’t Learn) About Sexuality, and Why a Sex-Positive Rape Prevention Program Can Benefit Everyone Involved,” revisits advice Perry received as a teenager and the more enlightened strategies he has encountered in his work.

Ultimately, they grapple with how to create an atmosphere for a healthy and empowering sexual experience for both women and men.

Please add your thoughts on the discussion, or your questions for Lisa or Brad, in the comments. And don’t miss the next stop on the “Yes Means Yes” virtual book tour: a live chat on Feb. 9 at Shakesville with co-editor Jaclyn Friedman.

Our Bodies, Our Blog: What is the allure of so-called “gray rape” for anti-feminists? How does it help serve a conservative agenda?

Lisa Jervis: The construct of gray rape does two things: it minimizes rape, seeks to make it seem like less of a big deal — if it was a “gray area,” can it really be that bad? — and it also justifies victim-blaming and its close friend, slut-shaming. This actually serves anti-feminists in two really different ways, though they’re both pretty much classics of sexism and misogyny.

The minimizing encourages an attitude of, “What are all those angry women complaining about now?”; and almost every feminist issue has been minimized at some point over the history of the struggle for gender equality.

The victim-blaming part is even more disturbing, as it updates and revitalizes one of the biggest obstacles to transforming rape culture. And it’s particularly insidious because of how it cultivates self-doubt and self-blame even more than previous victim-blaming discourses have. And, especially when paired with slut-shaming — which makes women and girls feel bad about the existence of a strong sex drive and any entitlement they might feel to (gasp!) satisfy their desires — it serves as an attempt to keep a tight cultural lid on women’s sexuality. It’s an updated and vastly more complex version of “good girls don’t.”

OBOB: Brad, how has the notion of “gray rape” complicated your teachings?

Brad Perry: In my experience, the attitude about acquaintance rape (which is what the term “gray rape” is usually referring to) amongst most policy makers, many students, and a good chunk of the general public has not changed drastically since it first entered the public’s awareness 20 years ago. There has been some progress in getting people to understand that usurping another person’s sexual autonomy is rape under any circumstances, but old mindsets die hard.

In that context, the gray rape thing just seems like more of the same but with a new name — as Lisa eloquently discusses in her essay. The only way my work has been complicated by the notion of “gray rape” is that now people have a convenient label. I don’t think it’s necessarily changed many people’s minds on whether or not to take acquaintance rape seriously — the people who are going to deny it are usually going to find a reason to do so until something happens to change their mind — but it has given those folks some hip new contemporary language to dismiss acquaintance rape.

We’re a country found by patriarchal religious fanatics who were (among other things) obsessed with denying human sexuality, so it’s not at all surprising to me that we keep revisiting the issue of social control over women’s sexualities. That’s not too say I think we should throw our hands up and say, “Oh, well” — in order to remember how much history we have to overcome so that we don’t lose our minds trying to make progress.

Read the rest of this entry »


January 26, 2009

Expanding the Female Condom Market

Guest post by Audacia Ray, International Women’s Health Coalition

Demand for newer and better devices that protect against pregnancy and sexually transmitted infections is constant — partly due to the fact that the process of development, testing and approval takes forever, and partly because what’s on the market often leaves something to be desired.

The polyurethane female condom (FC) has been available for 15 years now, and it’s gotten a lot of mixed reviews. It is the only barrier method available that is designed for female initiation, but it’s three times as expensive as a male condom, unwieldy, and can squeak during use (not sexy). Male condoms, of course, have their imperfections; loss of sensation and ill-fit are chief among the complaints.

This past December, the new and improved FC2 was recommended to the FDA for approval (see OBOB post). It should be on the market in the United States within the next year. The FC2 is made of a latex alternative, which is by all accounts a thinner, quieter, lower-cost material than polyurethane.

However, there are also other prototypes out there that are being actively tested and promoted outside of the United States, especially in Africa. In early December Jen Wilen, a program officer for Francophone Africa at the International Women’s Health Coalition (IWHC), ventured to the 15th International Conference on AIDS and STIs in Africa (ICASA) in Dakar, Senegal, where she got to check out two different prototypes for new female condoms.

One of these new condoms is the VA w.o.w. Condom Feminine (pictured left), a latex female condom made by the same company that produces the popular Inspiral male condom, which is extra roomy around the glans of the penis to increase male pleasure.

The most striking feature of the w.o.w. (worn-of-woman) FC is that it has a soft sponge where FC and FC2 has an internal ring. The sponge acts as an anchor to hold the female condom in place. The w.o.w has been available in Southern Africa since 2004 and is also available in the UK.

The second female condom (pictured right) was designed by a Seattle-based company called PATH, which has a contract to move forward with making the device available in China by 2010.

This FC is made of nitrile and has something of a parachute effect — its applicator capsule dissolves once it is inside the vagina and the FC expands to its full size.

This particular version is being tested through Family Health International — the packaging warns that it is “limited by law to investigational use only. This product may fail during use and must not be relied upon for contraception or sexually transmitted disease prevention.”

One of IWHC’s partners, Society for Women Against AIDS in Africa, Cameroun Chapter (SWAAC), has been a major advocate for the female condom. They regularly host sexuality education sessions — some in very public places (see below and here) — that teach women and men about how to use the female condom.

Audacia Ray is program officer for online communications and campaigns at the International Women’s Health Coalition.