Video: Can’t Catch a Break

My colleague Maureen Norton-Hawk and I recently had an opportunity to speak about our book Can’t Catch a Break: Gender, Jail, Drugs, and the the Limits of Personal Responsibility at a book launch at Suffolk University.

This link will take you to a four minute segment on our struggles to find an appropriate way to describe the criminalized and marginalized women whose stories we tell in Can’t Catch a Break. In this video we explain why we rejected “criminal” “homeless” and a few other descriptors, and why we decided to go simply with “women.”

This link will take you to the full forty-five minute video that includes a brief reading from the book and well as a few of our funny and not-so-funny experiences as researchers.

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Video: Alternatives to Incarceration

As awareness is growing of the costs (both financial and human) of mass incarceration, we’re hearing more about alternatives to incarceration. These alternatives include various sorts of electronic monitoring, intensive supervision, drug courts and mandated drug treatment.

While I am in favor of almost any plan that keeps non-violent people out of jails and prisons, I think it’s important to take a critical look at what is meant by “alternatives to incarceration” and how these actually play out given the broader contexts of dominant American ideas concerning crime, justice, gender and race. Do ATI really challenge the assumptions regarding who is ‘guilty’ and what it means to be ‘fixed’? Without fundamental changes in how we view human rights and relationships, ATI can too easily become a way to broaden the net of people caught in the correctional system.

This video clip by Meredith Berg includes some of my thoughts as well as comments by two proponents of ATI, one who works with a small not-for-proft organization and one who works in the correctional system.

You can read more about the thin line between ‘punishing’ and ‘treating’ here:
Incarceration by Any Other Name: A Return to the Cuckoo’s Nest?

Eulogy for Elizabeth

This was a hard week. Threatened with a 60 year prison sentence for firing a warning shot in the presence of her chronically abusive husband, Marissa Alexander agreed to a plea “bargain.” She’ll spend another 65 days in jail, on top of the 1,030 days she’s already been locked up.

Two days earlier, my friend Elizabeth was murdered by a man against whom she had taken out a restraining order. Francesca, a mutual friend, commented when she heard about Elizabeth: “The courts don’t realize that a piece of paper doesn’t save you. It’s exactly what it is — a piece of paper.”

Elizabeth (a pseudonym) was one a group of women I first met more than six years ago as part of a long-term project aimed at understanding the daily lives of Boston-area women who have been criminalized, marginalized and abused. Not always easy to be around, Elizabeth frequently wept from the pain in her life – the death of her sister and of her boyfriend, ten years of homelessness, numerous assaults, rape, struggles with alcohol and depression, a broken collarbone and shoulder that had not healed properly. But at unexpected moments she’d look up from her wad of tissues and, cracking a grin, poke fun at her own propensity to break into tears not only when sad but also when someone did something nice for her. Like buying her a cup of coffee. Or saying “Happy Birthday.” Or remembering that she once won a beauty contest. Or praising her generosity in sharing a cigarette or a dollar with someone who had even less than she had. Or giving her the mass transit pass to which she was entitled for participating in the project. “You are so nice to me and I don’t deserve it. I’m a whack job,” Elizabeth would tell me on a regular basis.

The last time we got together I gave her a copy of the book I wrote based on our project. She immediately identified herself in the pseudonymous “Elizabeth” and was absolutely thrilled that her story was being told. That day we talked at length about how happy she felt at having finally secured an apartment. She rarely went out, she told me, preferring to stay home and enjoy the quiet, privacy and safety that she had not known for ten years of staying in homeless shelters. And she most definitely wanted to stay away from “the only kind of men who would want to be involved with a woman like me;” that is, a woman with her history of mental health problems, homelessness and jail. She also was not interested in getting involved with her neighbors. “I’d rather stay to myself in my apartment. I am so grateful to God for my apartment.” Some weekdays she would go to lunch at a women’s soup kitchen and stay for arts and crafts or other activities. On Saturdays she would go to church and on Sunday she would watch church services on television. She had started seeing a therapist and they were working together on Elizabeth’s “coping skills” and on her “self-esteem issues”. I had to bite my tongue to refrain from telling her that I thought her coping skills were fabulous – I couldn’t have survived a decade on the streets, and that her “issues” struck me as more a matter of the low esteem in which others hold poor and homeless women than as a matter of her own self-esteem.

Elizabeth fully believed that “God gives you your own will to choose your own way.” She told me on more than one occasion that, “I don’t want to let Him down. I want to go to Heaven.”

And even as I am determined to give her in death the respect she rarely received in life, I struggle with letting her have the last word. The sociologist in me does not believe that Elizabeth was able to choose her own way. She certainly did not choose to be beaten to death on her own living room couch in the apartment she got to relish for so short a short time after a decade of homelessness. The feminist in me feels exasperation that a woman who has suffered rape, abuse and incarceration would continue to have such faith in Him. But as her friend, I have to believe that she has found her way to Heaven.

Elizabeth, may you rest in peace and may your memory be a blessing for us all.

 

Outcast Island

 

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October 9, 2014 marked the end of an era for Boston’s homeless, ill and marginalized residents when the sole bridge to Long Island was closed after a state inspection declared it too unstable for vehicles. One of several small islands (“Harbor Islands”) of the Massachusetts Bay, Long Island’s geographic separation from the mainland has made it a prime location for isolating social outcasts over the years. In 1882, the City of Boston purchased property on Long Island for an almshouse, a residence for unwed mothers, a chronic disease hospital, a nursing school and a “Home for the Indigent.” In subsequent decades, a treatment center for alcoholics was added. Recently, it’s the site of homeless shelters, Boston Public Health residential facilities and a variety of residential programs for “recovering” addicts and people involved with the Courts.

According to reports in the Boston Globe, the decrepit state of the bridge was well-known to government officials. But it’s been years since the City or State has invested resources in replacing or fundamentally repairing the bridge to the metaphorical “nowhere” of shelters for the homeless and other social undesirables. Reachable only by limited shuttles, Long Island effectively served to keep homeless and sick people out of sight and out of mind for over a century.

Isolated from the mainland, people who stay at the various shelters cannot get to the Island before 2 PM or after 9 PM; once there, they cannot leave after the shuttles are finished running for the day; and (except on rare occasions such as blizzards) shelter residents must depart the Island no later than by the 9 AM mainland-bound shuttle.

Elizabeth, a woman who has navigated what she calls “the homeless life” for ten years explains, “Everyone knew the bridge was dangerous. I always went on the bus [that crosses the bridge to the shelter] with my heart in my throat and just prayed to God that we’d get across. But I had nowhere else to go.” Francesca, insecurely housed for nearly as long as Elizabeth, declares, “I hate that bridge. I always felt that if it went, I’m gonna be swimming with the fishes.”

The bridge’s closure has elicited far more attention than the on-going miseries of life on Long Island ever did. It’s been covered in Boston area newspapers and local television news shows. A public meeting held at the Blackstone Community Center in Boston’s South End was attended by more than 300 homeless people and supporters demanding solutions for the hundreds of people displaced by the Long Island closure. Many of these people are now sleeping on cots crammed into gymnasiums, cafeterias and other make-shift spaces. Others are sleeping on the streets.

With a few exceptions, public attention to the misery caused by the bridge’s closing ends with advocating for a speedy repair and a return to the status quo. But for the thousands of men and women who have traveled that bridge to nowhere, Long Island is far from an ideal solution to their struggles with housing, health and the correctional system.

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I first met Daisy in 2008 at a drop-in center for poor and homeless women who had few options for where to spend the day when the shelters are closed. An Asian woman in her fifties, Daisy began her Long Island sojourn ten years ago when her husband died. Mildly cognitively impaired since childhood, she was not able to support herself or pay rent after his death. She began drinking, suffered several assaults and robberies, and her health deteriorated.

A few years after I first met Daisy, she called to tell me that the Long Island staff had sent her to the hospital the previous night. “I felt depressed and couldn’t stop crying. I was talking to my boyfriend – he stays in the men’s dorm – and they said it was time I had to go to the women’s dorm. I was crying hard and couldn’t stop. I felt panic and cried for help. They called an ambulance and took me to the hospital.” I asked her what had set off her crying. “I can’t be with my boyfriend. I am anxious and want to sleep with him.” It slowly emerged during our conversation that she was worn out from sleeping in a room full of strangers, from eating food she neither liked nor chose, and from being separated from her sole source of emotional support.

At the Long Island shelters, like at shelters around the country, men and women are strictly segregated. While this policy serves to protect women from sexual abuse, it fails to respect the personhood of transgender and gender queer people, and it forces heterosexual individuals like Daisy to live as celibates. Is this a carryover from the days of monasticism? A punishment for the crime of homelessness? Are we afraid that homeless people will procreate, or that they’ll have fun? Many women in shelters have been victims of sexual abuse and intimate partner violence, but surely there are better ways of protecting women’s rights than by forbidding all heterosexual and hetero-amorous affection for people like Daisy who are in dire need of human warmth and support.

A few months later, Daisy’s depression escalated and she tried to commit suicide. After a stint in the hospital, she tried to go back to Long Island, but was barred from there because of the suicide. In the middle of the night, the shelter staff arranged a ride for her to go to Woods-Mullen Shelter (a less well furnished facility) with instructions to stay away from Long Island for at least a month. Having attained a new level of pariah-hood, Daisy was no longer welcomed even on the Island of Outcasts.

Most of the time, Daisy smiles and is agreeable to everything she is told, but when she’s pushed too far, she pushes back. As a consequence, she repeatedly has been barred from Long Island for fighting with other women (over use of the sinks or for making noise in her sleep) and for other infractions. She also has run into trouble with the police. Her most bizarre police encounter came when she was arrested for habitual littering at the shuttle bus stop. Not allowed to store her possessions at the shelter, she carried them with her as she walked through the streets of Boston each day. The shuttle drivers wouldn’t always let her bring all her bags onto the bus so she often left what looked like trash at the shuttle bus stop (where there was no trash can.) The police warned her to stay out of that area; she disobeyed because the shuttle was her only means of getting to the Island; they took her down to the station where they didn’t charge her, but kept her long enough to miss the last shuttle. She ended up spending the night on the street.

Today, after far too many years on the streets and in shelters, Daisy lives in a fairly stable situation in a rented room. When I called her up to ask her what she thought of the bridge closure, she simply laughed.

You can read more about Daisy in my new book Can’t Catch a Break: Gender, Jail, Drugs and the Limits of Personal Responsibility

This article was originally published by Truthout.

Why brain science won’t cure poverty

This article was first published by The Conversation.

Recently I’ve seen news reports with headlines like this one: “Can Brain Science Help Lift People Out Of Poverty?

This particular article described the near miraculous recovery of a woman who grew up surrounded by violence in the housing projects, became a “single mom on welfare” who wasted her money and damaged her health with a pack-a-day smoking habit, and was stuck in an abusive relationship. Then, with the help of “a novel program that uses the latest neuroscience research to help women dig themselves out of poverty” by making better choices, she quit smoking, got rid of the bad boyfriend, earned a business management degree and landed a job as an administrative assistant. It’s not the only article I’ve seen recently that is looking at brain science as a way to cure poverty.

The enchantment with neuroscience to explain social misery has spread among individuals and organizations with longstanding commitments to progressive social change. “What the new brain science says is that the stresses created by living in poverty often work against us, make it harder for our brains to find the best solutions to our problems. This is a part of the reason why poverty is so ‘sticky,’” explained Elisabeth Babcock, chief executive of the nonprofit Crittenton Women’s Union. Recent research from Princeton University has suggested that living in poverty can have an impact on concentration. Other research has found a similar correlation between poverty and neuroscience.

There is growing public discourse invoking neuroscience to re-emphasize that poverty really is bad, that bullying and abuse really hurt children, and that someone who has experienced rape or torture really is suffering. But uncritically invoking neuroscience is a risky proposition.

Proving the obvious

Studies showing that trauma and poverty change people’s brains can too easily be read as scientific proof that poor people (albeit through no fault of their own) have inferior brains or that women who have been raped are now brain-damaged. In light of the ongoing failures of the Veterans Administration to adequately serve our veterans, I am particularly concerned with statements like this on the US Department of Veterans Affairs website:

“Recent combat veterans with post-traumatic stress disorder have less volume in an area of the brain critical that is critical in fear and anxiety responses, say researchers with VA and Duke University. The scientists say their finding, published Nov. 1 in the Archives of General Psychiatry, is the first clear evidence that smaller amygdala volume is associated with PTSD, regardless of the severity of trauma. But there’s still a chicken-or-the-egg question: Is the physiological difference caused by a traumatic event, or does PTSD develop more readily in people who naturally have smaller amygdalas?”

In other words, is some sort of pre-existing neurological flaw the reason that some people suffer?

“Brain imaging is an extremely blunt tool quite incapable of determining if someone is traumatized or has some ‘poverty-stricken’ thought process, whatever that might be,” according to Tom Schwarz, Professor of Neurology and Neurobiology in the Department of Neurology at Harvard Medical School. “It only detects masses of activity by entire brain regions…. Those imaging methods are somewhat useful for neuroscientists if they tell us what part of the brain is engaged in a certain task, but only very partially because their resolution is so poor. Neurons that give rise to the sense of fear are mixed in and side by side with neurons that suppress anxiety and brain scans can’t tell them apart.”

At most, Schwarz explains, brain imaging can tell us “how;” it cannot tell us “why.”

Focusing on the neurological changes caused by poverty or violence bequeaths upon doctors and psychologists the power to decide what constitutes sufficient misery to entitle an individual to merit assistance. Right now, it seems the focus is shifting from the causes of suffering to the medicalized “proof” of suffering as the yardstick for determining who gets things such as reparations or refugee status.

Brain damage as evidence of trauma?

In settings where medical experts have a monopoly on determining and corroborating claims of abuse, what would happen when a brain scan doesn’t show the expected markers of trauma? Does that make the sufferer into a liar? Ineligible for asylum? Not entitled to veteran’s benefits? Does it make the testimony of a woman who was raped less credible in court?

In my own research with women who have been raped and abused I’ve witnessed reactions ranging from fear and insomnia (classic symptoms of post-traumatic stress disorder) to anger, self-blame or even a relatively blasé sense that this kind of thing happens all the time and you can’t let it destroy your life. Would these different sorts of personal reactions show up differently in the brain? Would the rape of a woman who was not traumatized not “count”?

The new neuroscience offers wonderful possibilities regarding Alzheimer’s disease, epilepsy, brain injuries and much more. In particular, the notion of neuroplasticity – the ability of the brain to “re-wire” – is one of the most exciting and optimistic implications of cutting-edge neuroscience research. But scientific knowledge always develops and is utilized within social contexts.

Holding the individual to blame

Social attitudes and policies regarding poor and marginalized Americans today are dominated by a culture that emphasizes individual rather than social pathology, and holds the individual accountable for the failings of the collective. That orientation is made clear in our national welfare policy – the “Personal Responsibility and Work Opportunity Act,” and in our world-leading rates of incarceration and use of psychiatric medication.

Within this climate, the notion that we can change or cure the brains of poor people so that they will no longer be poor assumes that if the individual just tries hard enough, in the right way, with the right mentoring, there really is a path out of poverty, abuse or prison. And it assumes that the current social landscape gives all people a fair shot at a decent life, that violence and deprivation are isolated incidents that took place in the past, and that it’s always possible to “move on”.

For more on this check out Anna North’s “Can Brain Science Be Dangerous” in the New York Times Op-Talk.

Paid Sick Leave: It’s More Than Just a Day Off

Photo by Cody Glenn, The Daily Journal

Francesca, a woman I have come to know during the past seven years, has tried hard to rebuild her life after fleeing an abusive marriage, overuse of pain medication, homelessness and a stint in prison. She popped into my mind this week when I read an article about Maria Fernandez who died of exhaustion. Working more than eighty hours a week at minimum wage jobs in fast food chains, she sat down in her car to take a nap between shifts. A gas container tipped over and Maria never woke up.

With a prison record, Francesca can barely find one job, let alone the four that Maria juggled. But she certainly understands what Maria was going through at Dunkin Donuts. A couple of years ago Francesca was hired at a Boston-area Dunkin Donuts where she worked erratic, long shifts at the whim of the manager. She rarely knew ahead of time when she’d be called into work, or for how many hours. After a few weeks she found herself in pain — bone spurs in her foot had been exacerbated by the long hours standing on her feet. Her manager told her that if she took off time or reduced her shifts he would let her go. Fortunate to be a recipient of Massachusetts’ generous health insurance coverage, she went to her doctor who gave her an orthopedic boot to wear at work. Unfortunately, the boot caused her to trip at work and she was fired on the spot.

Paid Sick Leave

In a mid-term election cycle that resulted in few reasons for young, sick, poor or vulnerable Americans to look forward to positive changes in their circumstances, there was at least one bright light. Massachusetts voters (yes, the same folks who voted in Republican Charlie Baker for governor) approved a ballot measure in support of the country’s most robust requirements for providing paid sick leave to workers. The new Massachusetts law entitles people to earn up to 40 hours of paid sick time each year if they work for businesses with 11 or more employees; staff at smaller companies would earn 40 hours of annual unpaid sick time. Sick leave could also be used to care for a sick child, spouse, or parent.

With that vote, Massachusetts joins two other states (California and Connecticut) and about a dozen municipalities. Paid sick time questions were also on the ballot in three cities in this election, and passed in all three.

It’s not hard to argue that paid sick leave is good for everyone, not just for Francesca or Maria. For parents, it means being able to take off from work to care for sick children. For consumers, it means less likelihood that the people serving your meal, ringing up your groceries or checking you in at the doctors’ office will spread germs by coming into work sick. It also means less likelihood that someone doped up on Nyquil will be at the wheel of a car or truck. Or that construction workers, bank tellers and security guards will make the kinds of illness-induced errors that can lead to roofs collapsing, money going astray, or weapons making it into public institutions. But it doesn’t end there. Paid sick leave is also good for employers: Productivity and profitability go down when workers are forced to come to work when they are sick. One study on the impact of illness on productivity estimates that businesses lose twice as much money to workers who show up at work while sick then when workers stay home due to an illness.

Tip of the Iceberg

But there are more macro reasons that the four sick leave ballot votes are a cause for elation. On a deep level, paid sick leave pushes back against a corporate culture in which workers, and especially low-wage workers, increasingly are treated as replaceable cogs in the money-making wheel.

In the best of all possible worlds (actually, in the world that the labor movements of the early twentieth century fought hard to create), employers and employees would collaborate in creating a safe working environment, a first rate product, and profits for the company and livable wages and solid benefits for the employees. In that world, the health and safety of the employee would be seen as serving not only the moral but also the financial good of the employer. Employers would understand that they could not prosper without the dedicated services of their employees. They would nurture that dedication through an occupational culture of respect and fairness, and they would do everything in their power to hold onto their employees’ services. These employers would know that it is in everyone’s interest to ensure that the workplace environment minimizes the risk of injury and thus minimizes lost workdays, and that in the case of accidents or illness employees receive the best possible medical treatment so that their return to work is expedited. These employers would also respect that their workers have lives outside of the factory or store or restaurant or office. They would understand that workers, like themselves, are also human beings living in the frail bodies. And workers, like employers, are embedded in the family and social networks of mutual obligation that provide the truest safety net when we – as all humans do – are born, give birth, become ill, age and die.

This scenario is rooted in an idealized business ethos of respect that recognizes the mutual dependency between owners and workers, and it is actualized through specific health and safety programs that employers support on both moral and business principles. Employers know that it is economically inefficient to deal with frequent turnover in their workforce so they want employees to work for them for a good long time, to improve their job skills, and to develop company loyalty. To some extent, it is irrelevant whether this goal is driven by pure altruism, by the profit motive, or by a combination of the two. Whatever the motive, in our ideal world, it wouldn’t be such a bad idea to link health care to employment or for workers to depend upon their employers to compensate them for work related injuries.

Unfortunately for American workers, however, that ideal world does not exist (at least, not outside of occasional nostalgic TV sitcoms). The current American work world is highly mobile and transient; many of the largest employers in, for example, the fast food industry, seek ways to structure employment so that workers are easily interchangeable; multi-national conglomerates neither feel loyalty towards their employees nor expect their employees to feel loyalty towards them; small businesses go under faster than they get started; and manufacturing and other business associations spend billions of dollars lobbying Congress and state legislatures to limit laws requiring and enforcing workplace safety standards.

In the real world, employees and employers often experience their relationship as more adversarial than cooperative. Rather than collaborate on a mutually beneficial social contract that balances the well being of workers with profits and productivity, employers increasingly have chosen to pursue immediate profits. Employers frequently view living wages, strong worker benefits, and safe working conditions as coming at the expense of profits. Investing in the health of employees often is seen as superfluous in an economic climate in which the growing caste of the working poor can be hired on a temporary or contingent basis, and in which plants and factories can be moved to South America or Asia — places where employers need not bother with things like paid sick leave, health insurance or worker’s compensation, labor unions, environmental regulations, or child labor laws.

What’s Next?

Successfully passing paid sick leave ballot questions in a few states and cities cannot reverse decades of policies that created the work environments in which Francesca and Maria live, and die. But it is a meaningful move pragmatically for hundreds of thousands of people, and a meaningful move symbolically in terms of collective recognition of basic human rights of workers.

So, as I write this I can, for a few minutes at least, feel a bit better about the 2014 mid-term elections. That is, until I remember that Republican leaders have made clear that one of their highest priorities will be the repeal of Obamacare, which while far too watered down for my own tastes, does require employers of large companies to offer health insurance to their employees.

You can read more about these issues in Uninsured in America: Life and Death in the Land of Opportunity by Susan Sered and Rushika Fernandopulle.

Sex, Gender and Informed Consent

A shorter (and much pithier) version of this essay was published today in the Washington Post.

California’s SB967 – better known as the “yes means yes” law – clarifies the contours of sexual consent. For universities to receive state funds, they must now employ an “affirmative consent standard.” That means that both parties must actively, consciously and voluntarily agree to engage in sexual activity.

“Yes means yes” addresses both the high rate and the particular nature of sexual assaults on college campuses. According to studies one in five college women have been sexually assaulted. College victims are especially likely to be raped by someone they know and / or while incapacitated by drugs or alcohol. And they are less likely than women in the general population to define their experience of sexual assault as “rape” or to report assaults to law enforcement authorities. Because most campus rapes are not carried out by self-conscious criminals who set out to commit sexual assaults, SB967 makes use of the opportunities offered by a college setting to reduce sexual violence through education rather than solely through punitive actions.

Critics have argued that this measure will be impossible to implement on the grounds that “consent” is too difficult to gauge, that it constitutes government intrusions into the privacy of one’s bedroom, that it unconstitutionally presumes guilt, and (I assume mockingly) that it will require all men to tape video cameras to their genitals in order to prove that women continue to consent throughout the entire sexual encounter.

Concerns regarding the nature and feasibility of consent are not new, and fortunately for California and other states considering similar laws, these concerns have been thoroughly and successfully addressed in other settings. As the former Chair of the Institutional Review Board (the body that reviews the ethics of research involving human subjects) at Suffolk University, I have seen how well-developed, refined and extensively evaluated protocols for informed consent in human subjects research contain real protections for vulnerable populations as well as the flexibility to allow research to thrive.

Clearly, there are differences between research and party settings in terms of the business-like atmosphere of research interactions versus the recreational atmosphere of college interactions, the clarity with which the roles of researcher and subject versus the roles of college class mates are defined, and the amount of planning that goes into research versus a party.

But there are significant similarities as well. In both settings everyone involved may assume that all parties to the interaction have everyone’s best interests at heart and that there are no or minimal risks to participation. It is these kinds of assumptions — both by researchers and by subjects — that led to tragedies such as the Tuskegee syphilis experiment in which rural African American men were given free meals (and burials) for participating in the study, but were neither told that they were infected with nor were they treated for syphilis and to the need for subsequent restrictions on human subjects’ research.

Protocols for protecting human subjects recognize the power differentials inherent in the relationship between researchers (in possession of knowledge, institutional backing, monetary resources and access to goods and services such as new medical treatments) and human subjects. Gendered interactions similarly are inherently unequal given the greater incomes, financial assets, political power, physical size and strength of men, as well as the far greater likelihood that women (nearly one in five) have been raped at some time in their lives.

If regulations, whether for human subjects’ research or for sexual consent, at times seem tedious, we acknowledge that past injustices and current inequalities legitimately demand heightened scrupulousness in ensuring true, informed consent. Informed consent does not mean reading off a list of bureaucratic legalese. To the contrary, it entails authentic conversation regarding the roles of all participants.

How would this play out in a college setting?

Just as a researcher cannot acquire informed consent from a comatose or cognitively impaired subject, “yes means yes” requires that all parties to a sexual encounter are conscious and sufficiently sober to give meaningful consent. Consent does not necessarily need to be verbal – it can be indicated by a vigorous nod of the head or by moving in closer to the partner to the interaction. But it can never be assumed simply by the absence of aggressive resistance.

Along the same lines, it is the responsibility of the researcher to share with potential subjects all information needed to make an informed decision, and to clarify that the subject heard and understood that information. In terms of “yes means yes,” this principle translates into the responsibility of potential sexual partners to disclose information such as HIV status, the existence of other committed relationships, or actual motivations behind the encounter (for instance, whether the encounter is part of a fraternity initiation ritual).

Researchers are required to present potential subjects with a real choice regarding participation; we are not permitted to offer substantial monetary incentives and we are not allowed to withhold access to services or resources for those who do not wish to participate. The responsibility of researchers to refrain from badgering, tricking, or threatening subjects or potential subjects directly translates to the college setting where potential sexual partners should be trained to avoid pressure such as “If you don’t have sex with me I’ll tell people you’re a frigid bitch and you’ll never be invited to another party” or trickery such as inviting a first year student to a “cool” frat party with the intention of plying her with alcohol and manipulating her into a sexual encounter.

Particularly relevant to colleges, researchers are required to inform and remind human subjects that they may leave the study – with no negative repercussions and no need to justify or explain their decision – whenever they wish. In terms of SB967, a kiss really can just be a kiss and both parties to the kiss can walk away without threatening or humiliating accusations of “leading me on.”

In human subjects’ research, as in sexual encounters, no law will change the behavior of those few individuals truly intent on hurting others. While the initial push for human subject’s research regulation came about in response to the horrific Nazi medical experimentation on powerless victims, I don’t believe that the best ethics board in the world could have stopped Nazi doctor Josef Mengele.

Along the same lines, I do not believe that SB967 will stop a perpetrator who consciously sets out to assault a fellow college student. It will, however, educate the many men who do not wish to be abusers on how to assess their own behavior and interactions. It will empower the many women who are not sure whether they really can say “no,” or if the unwanted sexual encounter really was “rape” to report and confront harmful actions and policies. And it will obligate colleges to provide compulsory and meaningful training in gender equity to women and men.

In human subjects’ research the bottom line is that we educate researchers to make honest and intelligent efforts not to exploit or cause harm to others, and we acknowledge that in the heat of the moment (yes, researchers do get passionate) we might be tempted to use our status or power to coercively. As a community of well-intentioned scholars, we welcome the guidance on how to minimize the risk of doing so. In that light, it’s hard to see why there has been so much opposition to “yes means yes.”

Read more here on why “yes means yes” is good for women and men.

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Pink Ribbon Extravaganza

A newer version of this post (with more great photos) can be read here.

It’s October – the leaves are turning yellow, porch ornaments are coming up pumpkin orange, the first frost is sparkling silver, and everywhere I turn the sight of pink ribbons assaults my eyes and affronts my sensibilities. The annual pink ribbon extravaganza, surely one of the most successful marketing campaigns in history, has millions of Americans walking, running, racing and selling merchandise “for the cure.” Having spent the first half of my career studying religious rituals, I can’t help but think that many of the ribbon bearers see their little scraps of pink as an amulet or a charm, a means of warding off an enemy over whom one feels impotent. If we just wear or sell enough pink ribbons during the month of October, we hope or we bargain with the cancer gods, then maybe we’ll be safe from breast cancer for the coming year.

10well_ribbon-blogSpanMaybe I’m a cynic, or an agnostic, but as a means of averting breast cancer I’d rather put my money on cleaning up toxic chemicals from the environment than on adding a bunch of pink ribbons to our November trash piles or on painting pink ribbons on football fields while the NFL allows known rapists and batterers to play in the league.

Winners and Losers

When my mother became ill with and eventually died of breast cancer in 1971, no one talked about it – not even her close friends were present to offer aid or comfort. Yet, today, as we paint the town pink, I am concerned that we have come to see breast cancer as a relatively normal part of the female life course: puberty, pregnancy and childbirth, followed by menopause and breast cancer. Pushing against this cultural tide, I feel a need to yell: Breast cancer is not normal; nor is it pinkly feminine or cute. The rise in rates of breast cancer over the past century is a palpable sign that something is wrong with our world.

America loves winners, and we have come to regard women who are diagnosed with but do not die from breast cancer as heroic battlers. Those women who die are hidden, lying somewhere outside of the victory circle, “victims” in a culture that at best pities and at worst blames victims for their own misfortunes. It feels absurd to have to say this, but it needs to be said: Breast cancer can’t be cured by the optimism or will power or athleticism or fighting spirits or strength of character of women who are afflicted with the disease. Breast cancer should not be treated as a challenge or as a measure of one’s moral fiber.

And it should never, ever be treated as a commodity.

Big Bucks

Gayle A. Sulik draws attention to some disturbing implications of the ubiquitous pink ribbon. First, pink ribbon marketing, like all “cause marketing,” primarily benefits the company, not the charity or cause. Second, as a result of cause marketing, people actually give less to charities. And third, pink ribbon and other cause marketing can mask conflicts of interest, like when companies promote the idea of cancer research but also manufacture, disseminate, or sell products that contain toxic or carcinogenic ingredients.

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Over the past few years the failure of the pink ribbon movement was brought home to many of us when the Susan G. Komen for the Cure foundation, the most visible promoter of pink racing for the cure, announced that it would no longer fund breast cancer screenings at Planned Parenthood, the health care home for millions of young and low-wage women. This decision, believed to reflect the Komen’s Foundations’ capitulation to anti-choice advocates, was reversed when donations to the organization plummeted in response.

 

Where is the Evidence?

Victory laps in races for the cure, together with the ubiquitous pink ribbons, may lead people to believe that far greater strides have been made in preventing and treating breast cancer than have actually been made. In a 2014 article published in the New England Journal of Medicine, Nikola Biller-Andorno, M.D., Ph.D. and Peter Jüni, M.D. report that data show no evidence that routine mammography screening of women at average risk saves lives. A high-quality study made public by the Swiss Medical Board, “acknowledged that systematic mammography screening might prevent about one death attributed to breast cancer for every 1000 women screened, even though there was no evidence to suggest that overall mortality was affected.”

The NEJM article also cites research showing that many American women overestimate their personal risk of breast cancer and the benefits of mammograms. In a study of U.S. women’s perceptions, “717 of 1003 women (71.5%) said they believed that mammography reduced the risk of breast-cancer deaths by at least half.” Exacerbating the dangers, as a major Canadian study discovered, 21.9% of breast cancers found through mammography screening represented over-diagnoses. In other words, thousands of women each year undergo surgery, radiation and chemotherapy for non-life threatening cancers.

Breast Cancer Action, a national non-profit organization calling for transparency in breast cancer research, treatment and education, has these harsh words to say: “While corporations [such as manufacturers of mammography equipment] have made billions off the disease, progress in breast cancer treatment, prevention, survival, and inequities has not been forthcoming. Three million women in the U.S. are living with breast cancer. Up to one-third of all breast cancers will metastasize, even when found in the early stages. Black women are still 40% more likely to die of breast cancer than white women. And each year, 40,000 women die of breast cancer.”

We Can Do Better

PieChartWhile spending on breast cancer detection and treatment continues to increase, funding for prevention – for learning about the causes of breast cancer – is far less marketable. This year, in my home state, the Massachusetts legislature failed to fund research on potential carcinogenic impacts of chemical exposure despite clear findings that there are specific communities in Massachusetts with particularly high rates of breast cancer. According to reports, “The Massachusetts Senate [2015] budget … did not include a $500,000 request to fund water quality and public health research by Silent Spring Institute.  The Massachusetts Breast Cancer Coalition requested this funding on behalf of its sister organization, Silent Spring Institute to study exposure to toxic chemicals in drinking water and homes in Central Massachusetts and on Cape Cod. Earlier this month, the House of Representatives failed to approve funding for Silent Spring Institute in the FY 2015 House budget. This is the second year in a row that budget requests for important water quality research in both the House and Senate have been excluded.”

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Today, when I walked past the Massachusetts State House on my way to work and saw pink ribbons everywhere, women’s health pioneer Barbara Ehrenreich’s words came to mind. Writing about her own experiences with breast cancer, Ehrenreich wrote, “What sustained me through the ‘treatments’ is a purifying rage, a resolve, framed in the sleepless nights of chemotherapy, to see the last polluter, along with say, the last smug health insurance operator, strangled with the last pink ribbon.”

In honor and memory of my mother, Bernice C. Starr, let me say “Amen.”

 

Updates on the Women of Can’t Catch a Break

The publication of Can’t Catch a Break is not the end of the stories of the women whose life experiences are described in the book. We continue to spend time with some of the women and as we do we learn more about their lives – both the challenges they face and the strategies they use to address those challenges. It is important for us to convey to readers that these women are not “objects of inquiry” but real human beings who, like all of us, change their attitudes and their circumstances over periods of years, months and even days.

This page is a “Reader’s Guide to Updates” on the women whom you have come to know through the book. In some instances we’ve written full-fledged blog entries about issues that their experiences illuminate. In other cases we’ve simply added a few sentences under their names. All names are pseudonyms.

Please check back – we will continue to update this page!

Andrea: Andrea is settled in a studio apartment, but – much to her annoyance — her boyfriend has moved in with her. According to Andrea he is “too proud” to sign up for housing or food stamps.

Ashley: Ashley has a steady job (though she is underpaid and overworked), a nice apartment, and a lovely boyfriend. Unfortunately she was hit by a car about a year ago and is still struggling with severe back pain, as well as with doctors who too liberally prescribe pain meds for her.

Carly: Carly has lost a great deal of weight, remains involved in her church, and still cannot land a job.

Elizabeth: After ten years, Elizabeth finally has her own apartment. She feels safe for the first time in years and is trying to put her life back together. Sadly, her father passed away this year. Her brother, her closest living relative, seems to have inherited her father’s property and he has taken out a restraining order against Elizabeth. Caste Away: Mass Incarceration and the Hardening of Economic Inequality

November 2014: Elizabeth was beaten to death, on her own living room couch, by a man against whom she had taken out a restraining order. The man who killed her currently is being held on $500,000 bail.

Francesca: Over the past two years Francesca has moved in with and away from Joey several times. She returns because she needs a place to live. She leaves because Joey is verbally abusive. She remains deeply involved with her sons and her granddaughters, and posts frequent pictures of her granddaughters playing with her and their fathers. Yesterday (October 2014) I met Francesca at her new place: a one bedroom apartment she is sharing with her man [not Joey!], a friend’s daughter and the daughter’s girlfriend, and a another young woman. She is thrilled that her name is on the lease so she is not at the whim of the official tenants, but the place is really, really crowded. But the bigger news (for me!) is that I had the honor of sitting with her while she read the Introduction and Chapter 1 of Can’t Catch a Break. She is the “star” of both of these sections — and she LOVES the book and told me that “you got it.” She laughed at the changes I made to her name and certain identifying characteristics (for the sake of preserving her anonymity in the book) reminded me that we’re planning to write something together on the absurdity of young women straight out of college who work for Children’s Services being able to tell experienced moms like her what they have to do. For Francesca, reading the book was a bit of a walk down memory lane. For me, seeing and hearing her reactions are the most important validation of my work that I could ever hope to get.  White Women, Opiates and Prison

Ginger: Ginger’s beloved mother passed away several months ago. As soon as her outstanding court case is settled (see The New Price of Freedom: $40 (Bail Blog #2) | The Courtroom was a Circus: Bail Blog #3 – $190 and Counting) she will move out of state to live with her brother, his wife and their toddler.

Gloria: Sex, race and prison’s violent double standard: Incarcerating men hurts women, too

Isabella: Isabella is happily married to the man with whom she became involved after she left Reese. They are both on methadone maintenance and out of jail. Neither has a job.

Joy: Joy continues to cycle through jail, detox, psychiatric wards and the streets. She recently told me that she doesn’t expect that she’ll survive much longer. Guilty Until Proven Innocent | Suicide is Painful  | Suicide is Painful, Update

Junie: Junie’s health has severely deteriorated. The last time I saw her she was in respite care. I have not been able to contact her for several months.

Kahtia: On the outside, things look great. She and Enrique are still together, they have their own apartment, and the children are holding their own. On the inside, things are not so good. She has been severely depressed and anxious, and feels that “my life is falling apart.” Over the past year she has had half a dozen health emergencies. Today she told me that the doctor is sending her for a CT scan because “I can’t remember anything, where I put things. I can’t find my medicine. I can’t find my daughter’s shoes in the morning and so she’s late for school. She’s in the best school around here and I’m afraid they won’t let her stay in this school.”

Megan: Megan has been in and out of jail and the hospital. She is no longer able to care for her children.

Melanie: Civil Commitment: If You Build It They Will Come

Tonya: Sex, race and prison’s violent double standard: Incarcerating men hurts women, too

Vanessa: I speak to her on the phone but haven’t seen her for a while. She was living in a rooming house but her room was infested with bugs. She had to throw away all of her clothes and furniture when she moved to another rooming house.

Yes Means Yes: Kudos to California

Ono-Yes

Yoko Ono

Kudos to California

California’s Governor Jerry Brown, on September 28, 2014, signed into law a bill making California the first state in the nation to require universities receiving state funds to use an “affirmative consent standard” for determining whether consent was given by both parties to sexual activity. SB967 represents a paradigm shift from women as victims and potential victims whom we need to encourage to shout “no” a bit louder, to women as agents who have the positive right to engage or refrain from engaging in sexual relations when and with whom and under circumstances of their choosing.

Schools and colleges have been trying to convey the message that “no means no” for at least two decades, yet according to recent data about 20% of women are sexually assaulted in college. In other words, “just say no” hasn’t worked any better in preventing sexual violence than it did in the utterly failed war on drugs. Designed to address high incidences and less-than-stellar responses to rape, sexual harassment and stalking on college campuses, SB967 removes the onus from potential victims to unequivocally convey and prove refusal or resistance (“no”) and places the onus on potential perpetrators to ensure active consent (“yes”).

“Affirmative consent,” according to the bill, “means affirmative, conscious, and voluntary agreement to engage in sexual activity. It is the responsibility of each person involved in the sexual activity to ensure that he or she has the affirmative consent of the other or others to engage in the sexual activity. Lack of protest or resistance does not mean consent, nor does silence mean consent.” The bill further clarifies that “it shall not be a valid excuse that the accused believed that the complainant affirmatively consented to the sexual activity if the accused knew or reasonably should have known that the complainant was unable to consent to the sexual activity.”

The Problem with the Status Quo

“No means no” has been the dominant anti-rape paradigm in the United States for the past several decades. One unfortunate consequence of the “no” paradigm is the responsibility it places on women who have been assaulted to prove that they really did say “no.” But even in the wake of the Violence Against Women Act, the majority of rapists are not arrested; only an estimated 5% of rapists are convicted; and an estimated 3% spend any time in jail.

Rape remains one of the few crimes in which the victim is scrutinized for ulterior motives, false accusations and moral deviance. Despite rape shield laws designed to protect women from verbal assaults by defense lawyers at rape trials, victims can be asked about their social and sexual history when these issues are ruled relevant to determining consent. Victims least likely to see offenders convicted are older, poorer, deemed promiscuous or prostitutes, have a psychiatric or drug abuse history or criminal record, didn’t overtly resist or were acquainted with the offender, or had a history of previous rape or abuse.

Joy, one of the Boston area women whom I have come to know through my work with criminalized women, explained to me that when she went to court to testify against a man who violently and brutally raped her, she assumed that the evidence against the perpetrator was very strong: DNA evidence had led to his arrest originally – his DNA was found on the police computer system; police offers and crime scene officers testified; other witnesses from her apartment building testified; the nurse who examined her in the emergency room testified. However, he was found not guilty. “The last three questions the defense attorney asked me are: Isn’t it true that you were in prison? Isn’t it true that you are an addict? Isn’t it true that you used to work in prostitution?” In other words, her “no” didn’t count.

Joy’s experience represents a broad trend: In this era of DNA testing, consent is the primary defense used in rape cases. Coming at this time, California’s affirmative consent standard is a critical step in diverting attention away from the behavior, clothes, personality, drug use, criminal record or degree of resistance by women who have been raped and placing it where it belongs – on the actions of the perpetrator.

The Need for a New Model

California’s new “yes means yes” law has been critiqued as impossible to implement on the grounds that “consent” is too difficult to assess. I disagree. As the former Chair of the Institutional Review Board (the body that reviews the ethics of research involving human subjects) at Suffolk University, I suggest that the State of California turn to the well-developed, refined and extensively evaluated protocols for informed consent in human subjects research as a model for interpretation and implementation of affirmative consent in sexual activity.

Protocols for protecting human subjects acknowledge the power differentials inherent in the relationship between researchers (in possession of knowledge, institutional backing, monetary resources and access to goods and services such as new medical treatments) and human subjects. The structural imbalance of power in the relationship between researcher and subject demands that researchers are pro-active and clear in facilitating the informed consent or refusal of each human subject. Consent cannot be assumed, silence does not mean “yes,” and it is the responsibility of the researcher to present potential subjects with a real and meaningful choice regarding participation in the research, to refrain from offering inappropriate financial incentives, and to avoid any hint of threatening negative repercussions for refusal to participate. The process of asking for and receiving informed consent includes: (1) disclosing to potential research subjects information needed to make an informed decision; (2) facilitating the understanding of what has been disclosed; and (3) positively promoting the voluntariness of the decision about whether or not to participate in the research.

The language and the technicalities (such as written proof of consent) used in human subjects’ research would need to be revised to meet the needs of ensuring consensual sexual activity, but the model makes a great deal of sense. Like research interactions, gendered interactions are inherently unequal given the greater incomes, financial assets, political power and physical size and strength of men as a group vis-à-vis women as a group, and the far greater likelihood that women (nearly one in five) than men (one in 71) has been raped at some time in their lives. Clearly spelling out the responsibilities of those in positions of dominance will in the long run facilitate positive interactions despite power differentials. And clearly spelling out the rights of those in subordinate positions will, I believe, contribute to more equality in all spheres of life.

You can read more on Yes Means Yes here.

You can read more about Joy here: Guilty Until Proven Innocent | Suicide is Painful  | Suicide is Painful, Update

You can read further analyses of rape culture here: Ray Rice and Cultures of Violence /Fighting Rape Culture: Real Tips