As Senate Republicans continue to craft a healthcare bill behind closed doors, a Trump Administration’s reported plan would exempt many employers from including contraceptive coverage in health insurance plans. While the Administration has framed their executive order as a protection of “religious freedom,” it is just one part of a frightening new wave of policies that will particularly harm women.
According to the Congressional Budget Office, millions of Americans will lose health insurance under the American Health Care Act (AHCA), already passed by the Republican House of Representatives. Low- and moderate-income Americans will lose the most because the plan decreases insurance subsidies and will eventually eliminate the Medicaid expansion.
This is especially troubling for women. Consistently, year after year, American women earn less than men. And according to the Department of Labor, women are more likely than men to be among the working poor. At the same time, women use more medical services and spend more on health care than men. They make more visits each year to primary care physicians and are more likely to take at least one prescription drug on a daily basis.
Under the House version of the AHCA and the Trump Administration’s order, women’s access to care through their insurance will decline. The bill eliminates the Affordable Care Act’s requirements for insurance plans to cover “essential benefits” like birth control and maternity care. Worse yet, this move will reduce the largest health safety net for women in the country. The Republican House plan singles out Planned Parenthood, prohibiting federal funding for one year after the law goes into effect.
Reduced access to birth control will lead to more unwanted pregnancies. Yet under the Republican House bill, qualified health plans cannot include abortion coverage except for pregnancies that present life-threatening physical risks and pregnancies that resulted from rape or incest. Not only does this reduce access to a needed medical procedure, but it also leaves questions about how to determine if a pregnancy is life-threatening or how to confirm if it’s a result of rape or incest. And it could potentially force women to prove—to the satisfaction of an insurance company—that she indeed was raped. This would certainly delay performing the abortion. Delays, in turn, present health risks to women.
The Republican House bill does allow insurance to pay to treat “any infection, injury, disease or disorder that has been caused or exacerbated by the performance of an abortion.” But legal abortions performed by a qualified medical provider in a suitable medical setting are extremely safe. While it is unlikely that the House’s intent is to encourage illicit abortions, this provision seems to acknowledge that an increase in unsafe abortions may be a consequence of the policy.
The Administration’s order and the Republican House bill will have devastating effects for women’s health in the United States. Our maternal mortality rate is already the highest among all developed countries. And while this rate is decreasing in nearly every other nation, it continues to rise in the U.S. Our high maternal death rate is in part the result of unplanned pregnancies – more than half of all pregnancies in the U.S. – and a health system that makes accessing care difficult, especially for new mothers. The President’s order, together with Congress’s “repeal and replace” bill, will only lead to more tragedy. Now, the Senate has the chance to take out these harmful provisions and reaffirm the value of women’s health.
This post is part of a blog carnival. Mothers, activists, healthcare professionals and researchers around the world have come together to ask the UN Secretary General to recognize April 11 as the International Day for Maternal Health and Rights. Please join by using #IntlMHDay
Without rights to safety and bodily autonomy, women may be prevented from carrying and raising children whom they dearly wish to nurture.
Without laws guaranteeing women’s right to choose when or when not to be mothers, they may be forced to endure pregnancies that endanger their health and well-being.
Without rights to clean water and air, adequate nutrition and stable housing, women may enter pregnancy already in poor health. Women whose health is compromised are more likely to suffer miscarriages, complications during birth, low birth-weight babies, infections during the post-partum period, insufficient milk and heightened rates of maternal and child death.
Without rights to paid maternity leave women may not have the financial resources to properly nurse infants or allow their bodies to heal after childbirth. And without access to appropriate, respectful and high quality health care, mothers may become too weak, tired, discouraged or sick to advocate for their rights and for the rights of their children.
The U.S. Healthcare “Non”-system
Maternal health in the United States — to be blunt — is not good. The US ranks 61st in maternal health standards, by far the worst rank among all developed countries. And among 25 of the wealthiest capital cities surveyed around the world, Washington, D.C. has the highest infant mortality rate, with babies from the District’s poorest wards dying at much higher rates than the city’s already high average.
The United States lacks a system of universal health care access. Although the Affordable Care Act (Obamacare) has expanded Medicaid eligibility for women and men living in about half of the states, local governors and state legislatures in the other half of the country have refused federal money to expand Medicaid in their states. Especially in the states that did not expand Medicaid, women may find that they get healthcare coverage temporarily while they are pregnant. This means that women’s health may not be optimal going into the pregnancy; there may be delays in prenatal care because they cannot afford to pay for the doctor visit to “prove” pregnancy; or that their eligibility ends too soon after birth or miscarriage. This sort of policy conveys a clear message that women’s health is not important in and of itself, but only insofar as the woman’s body is a baby-carrier.
Kim (all names used in this post are pseudonyms), a young Illinois woman, worked hard to balance college and her job. Though she managed to support herself, she could not afford health insurance, “I also tried to apply to public aid for a medical card [Medicaid], but they were telling me I have to have a child. They said that’s what I need in order to get help through the system. They make me think that they’re stupid, because, I mean, you have people out here like me with no kids and trying to go to school and trying to do the right thing, and I think we should also be helped. I was like, ‘Child, are you serious?!’”
In quite a few states, the eligibility threshhold for Medicaid is more generous for children than for adults. In these states, babies and children may be are eligible for healthcare coverage even when their mothers are not.
Jamie, a married woman in her early thirties, was diagnosed with gestational diabetes during her first and only pregnancy. The Illinois doctor told her that gestational diabetes put her at risk of developing type 2 diabetes later on. Her son was born with special needs, so Jamie left her job to stay home and take care of him. She and her husband were able to arrange Medicaid coverage for their son, and her husband was covered through his job, but the household income was too high by a couple hundred dollars a month for Jamie to be eligible for Medicaid. However, their income was too low for them to afford to pay for her as a dependent on her husband’s insurance. Jamie did have a few good years during which she would get her blood sugar tested at free health fairs held at churches and parks. Today, she has full blown diabetes.
The absence of a comprehensive healthcare coverage system creates a dangerous roller coaster for women.
This often seems to happen in Mississippi, for Alisha’s tubes were tied shortly after she gave birth. The reason for this, Alisha explains, is that the doctor encouraged her to get her tubes tied while she was still entitled to Medicaid by virtue of the pregnancy. A few months later, when she began menstruating, she experienced profuse bleeding. By this time, however, her Medicaid eligibility was over and she was not able to afford a medical assessment or treatment. “It started with the heavy, heavy bleeding and the days lasted longer,” Alisa explains, “And then it started with it going longer and longer into periods being heavier and harder for me. Sometimes I just lie on the floor and push real hard until it’s time and then get up and get on the toilet and then the blood clot comes. So I have periods like that now.”
Mothering in the Shadow of the Correctional System
The health challenges faced by low and moderate income American women are exacerbated when they are caught in the correctional system. The United States has the highest incarceration rate in the world – and the gap between U.S. rates and those of the next most incarcerating countries are even higher for women than for men.
At this time, more than one million women are under the control of the United States correctional system. Most of these women are mothers of minor children and the majority of these mothers lived with their children before entering jail or prison.
According to the Center for Investigative Reporting, doctors sterilized as many as 148 women inmates in California prisons during the five-year period from 2006 to 2010. Women can be shackled during labor or delivery in most U.S. states. Incarcerated women struggle to obtain routine prenatal services, and the majority of newborns are separated from their incarcerated mothers immediately following birth.
Kristin from Massachusetts went to prison for the first and only time in her life immediately after giving birth to her second child. (The state kindly allowed her to wait to start her sentence until the baby was born.) At her request, her married brother and his wife took custody of her eight year old son and her newborn baby. Shortly afterwards, the brother and his wife found it difficult to cope with behavioral problems the older boy began to exhibit when his mother was taken away. At Kristin’s initiative, the department of Social Service (DSS) placed him with foster parents who seemed well able to care for the boy. A year later her son was placed with a single man in his forties who has asked to adopt the boy. Kristin is suspicious of his motives in wanting to adopt a ten year old with special needs and cannot understand why the Court feels that he is a preferable parent to her – even after she finished serving her sentence for a non-violent crime. There is no record, evidence or even accusation that she ever abused or neglected her children, and the boy desperately wants to come home with his mother.
With all of this going on, Kristin found out that she was pregnant. This was an unplanned pregnancy, for at 41 years of age she thought that her childbearing years were over.
By the time, Kristin was able to see a doctor, who showed her ultrasound images of the fetus, SHE felt that she could not have an abortion. The various lawyers and social workers involved in her custody cases are outraged at her decision to continue the pregnancy, seeing it as “irresponsible”. Caseworkers have threatened that by going through with this pregnancy rather than having an abortion, she will “lose any chance” of regaining custody of her other children.
Kristin’s loss is not a rare event. Across the country in Idaho, a friend watched Child Protective Services rip a baby from the arms of a woman who had just given birth. This woman’s child was taken from her because her drug use was seen as a danger to her children. “She asked for help,” her friend explains, “She failed her drug first test, but passed every one since. She is clean and committed to staying that way.” To make matters worse, CPS deemed the woman’s family members as unacceptable to take the child because they do not live in the same state. She has no money for a decent attorney and is looking at a hard road ahead. “Today I will watch them rip her three year old son from her arms too,” her friend says, “The baby was born with no drugs in the system. A perfect healthy 7 pound 3 ounces bundle of love. I’m sad and mad today.”
I share both the sadness and the anger. If there were any evidence that removing children from mothers like Kristin actually benefited children or mothers, I might feel differently. But children put into state foster care systems tend not to do well: they typically move from placement to placement, each time switching schools, doctors and caregivers. They are more likely than other American children to be overmedicated with cocktails of psychotropic prescription medication. And while some mothers may respond by trying as hard as they can to stay off drugs and to jump through every hoop demanded by every caseworker and judge involved in the case, some mothers become so despondent that, as one mother who lost her children told me, “After that happened I just gave up. When I had my kids, I admit, I sometimes used [drugs] but I always kept it under control – just small amounts on a Friday night, never in front of them, never got so high that I didn’t take care of them. But once they were gone I was off and running. There was no reason to try [to refrain from drug use] anymore. I stopped taking care of myself. I never cried so much in my life.”
While the brief stories presented in this post have to do with women whose mothering experiences are particularly harsh, once we understand the political, legal and economic contexts of mothering in the United States, we understand that these personal experiences are shaped by the same social forces that shape maternal health for all women.
Around the world maternal health is constrained and encouraged by both formal and informal social institutions. In the United States, mothering increasingly has become a matter of legislative policy and judicial control. The lack of universal healthcare coverage, narrowly limited coverage for pregnant women, abortion restrictions, mass incarceration, prosecution of women for prenatal harm, removal of children from mothers who use drugs, welfare (TANF) limitations on childbearing, and the authority of family courts in child custody decisions are manifestations of a broad cultural consensus that the State has legitimate powers to decide what constitutes maternal health, who is entitled to health-enhancing conditions and services, and who counts as a good enough mother.
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Forward this post to everyone you know.
Click here to learn more about how to get involved in the movement to urge the UN to declare April 11 as International Day for Maternal Health and Rights.
If you live in Massachusetts, let your legislators know that you SUPPORT HB 1382: An Act to Provide Community-based Sentencing Alternatives to for Primary Caregivers of Dependent Children Convicted of Non-violent Offenses. If you live in other states or countries, find out about — or initiate — similar legislative efforts.
The emergence and spread of the Zika virus is worrisome on many levels: the impact of global warming on the spread of infectious and mosquito-borne diseases (see “Getting Dumped On: Snowmaggedon, Women’s Health and Human Rights“); indiscriminate aerial spraying of poisonous chemicals — especially in poor regions — whether well-intended or not; and the reality that the poorest families in Brazil and other countries disproportionately bear the burdens of global warming and are disproportionately exposed to Zika virus due to living in crowded neighborhoods, reliance on public water pumps that often are surrounded by pools of standing water, and lack of adequate public health resources.
A related set of worries are products of structural gender inequalities: prohibitions on abortion in countries and US states at the same time as women are being warned not to become pregnant because of the presence of the Zika virus (see “Pregnant Bodies as Public Property“); the power of ‘rape cultures’ in which women may not be able to control access to their own sexuality and fertility (see “Fighting Rape Culture: Real Tips“); and a problematic history of public responses to viruses (such as HIV-AIDS) that may be spread through sexual contact, especially when the virus initially impacts disenfranchised or stigmatized groups.
In addition to alarm regarding the vectors of spread of the virus, there is cause for concern for the well-being of families affected by Zika virus. Here in the United States, Zika virus-bearing mosquitoes have shown up in Florida and other southern US states where many people are unable to access appropriate medical care because their state governments have refused to expand Medicaid under the Affordable Care Act (see “The State(s) of the Affordable Care Act“). Shocked and saddened by the pictures we are seeing in the press of babies born with microcephaly, the US’s continued refusal to sign the International Convention on the Rights of Peoples with Disabilities (see “Disabled Rights“) seems particularly indefensible at this time.
In light of the recent outbreak of the Zika virus in Latin America and the Caribbean, the Women’s Global Network for Reproductive Rights (WGNRR) and the Latin American and Caribbean Women’s Health Network (LACWHN) join the voices of our feminist and women’s rights partners in admonishing regional governments’ limited public health advisories for women. In particular we denounce the calls of countries such as Colombia, Jamaica, Ecuador, and El Salvador, advising women to delay pregnancy until the virus is eradicated, and particularly the call of El Salvador for women to avoid becoming pregnant for a full two years.
Governments must recognize that when combatting the Zika virus, any public health strategy that does not have human rights, including sexual and reproductive health and rights (SRHR) at its core, will be limited in its impact and sustainability, while also creating massive grounds for human rights violations.
As a region, Latin America and the Caribbean is characterized by: high rates of unplanned pregnancy, where upwards of 56% of pregnancies are unintended; high levels of sexual violence; limited access to contraceptives and sexual and reproductive health services; and restrictive laws on abortion, where in some cases such as El Salvador, abortion is prohibited under any circumstances and women are routinely persecuted and even criminalized on suspicion of having abortion. Moreover, women who are young, from remote or low-income communities, and/or living in other vulnerable situations, disproportionately face multiple barriers when it comes to exercising meaningful decision-making power and control over their sexual and reproductive lives. In such a context, calls for women to simply delay or avoid pregnancy are not only unrealistic but irresponsible and negligent.
The rapid spread of the Zika virus and its strong association with marked increases in microcephaly and other neurological abnormalities is in many ways new terrain, with new elements continually coming to light, demonstrating a clear need for more research. This uncertainty makes it all the more imperative for governments to undertake from the beginning a holistic, sustainable, and rights-based approach to eradicating the virus and mitigating its effects. Anything less is careless and counter to governments’ human rights commitments under regional and international human rights law.
We thus urge the governments of affected countries both in Latin America and the Caribbean as well as other regions worldwide to undertake a rights-based, reproductive justice, and sustainable development approach towards the Zika virus and any other emerging health issue. Such an approach must be holistic, while recognizing gender equality and women and girls’ empowerment as a cross-cutting priority, in keeping with governments’ agreements and commitments under the 2030 Agenda.
In practice, this approach to combatting the Zika virus must include:
Ensuring universal access to a full range of high-quality, voluntary, and user-friendly contraceptive methods, including barrier methods such as female and male condoms, and emergency contraception, as well as comprehensive SRH information and services, including antenatal services to enable early detection of microcephaly.
Targeting both men and women in public health awareness campaigns, especially in light of recent evidence that Zika may be sexually transmitted, recognizing that the responsibility for safer sex methods falls on both men and women and cannot be shouldered by women alone.
Decriminalizing abortion, and removing all legal and implementation barriers to expand and ensure access to safe, comprehensive, free and high-quality procedures for pregnancy termination, free of requirements for marital or parental consent. As has been flagged by partners, in the context of the many uncertainties and increasing public fears surrounding the Zika virus, calling on women to simply not become pregnant when access to safe abortion is limited or even completely criminalized will inevitably risk driving up rates of unsafe abortion, and ensuing maternal mortality and morbidity. Moreover, restrictive and punitive abortion laws that force a woman to carry an unwanted pregnancy violate women’s right to be free from inhuman and cruel treatment, as noted by Human Rights Bodies.
Supporting pregnant women in Zika-affected countries who decide to remain pregnant to be able to carry the pregnancy safely to term, including access to comprehensive pregnancy, safe delivery, pre- and post-partum care and neo-natal care services; as well as the provision of special needs therapy, health and educational services as needed for children with microcephaly.
Systemic policy and programme changes that account for the intersections between climate change and SRHR.
Immediate implementation of related recommendations under the Montevideo Consensus as well as targets under the Sustainable Development Goals of the 2030 Agenda, particularly those related to health and gender equality, in order undertake effective and holistic protection measures and help curb the spread of the virus.
Within the next months, Massachusetts’ legislators are expected to consider an amendment mandating that “Strip searches of inmates, including the videotaping thereof, shall not be conducted by or in the immediate vicinity of a correction officer or other employee of the opposite sex, except under an emergency or otherwise urgent situation.” Massachusetts Bill H.3444, An Act relative to searches of female inmates, comes in the wake of a successful lawsuit filed in 2011 against Sheriff Michael J. Ashe and Assistant Superintendent Patricia Murphy of the Western Massachusetts Regional Correctional Center in Chicopee. This lawsuit was filed on behalf of Debra Baggett and 178 former and current women detainees at the Chicopee Jail. As Jean Troustine explains, the defendants brought evidence showing that over a period of less than two years 273 strip searches had been videotaped, all of women, mostly by men who supposedly did not look.
The proposed law is certainly a step in the right direction. However, allowing the presence of an officer or employee of the opposite sex under an (undefined) “emergency or otherwise urgent situation” leaves the door open for subjective assessments of “emergencies” (for example, the inmate appears upset – a reaction that I’d expect to be fairly common when faced with a strip search) or bureaucratically based “urgencies” (for example, no officers of the matching gender happen to be available.)
Strip searches ostensibly are carried out in order to prevent contraband from entering prisons, yet reports cast serious doubts on the effectiveness of strip searches in that matter. In fact, evidence indicates that the majority of contraband is brought into prisons by prison employees rather than by inmates. Even if a strip search uncovers a bag of heroin or cocaine hidden on the body, that bag is likely to be a drop in the bucket against the background of the larger market of drugs smuggled in by employees. In other words, even if strip searches could be justified in terms of uncovering contraband (which, in fact, strip searches rarely uncover), to the extent that I have been able to see hard data on the matter, the amount of the uncovered contraband cannot justify this practice. In fact, no one really knows how effective strip searches are at keeping contraband out of prisons which is why I urge the Commonwealth of Massachusetts (and the rest of the country, for that matter) to document every strip search: the specific reason for conducting it and what exactly – if anything – the search uncovered.
National studies have found that strip searches often are conducted to establish power more than for real expectations of finding contraband . According to Deborah L. Macgregor, in an article published in the Columbia Journal of Law and Social Problems, women are particularly targeted for these displays of power. It is not uncommon for prison guards to use children as pawns to coerce women to participate in a strip search. For example, women may be threatened with not being permitted to see their children if they fail to cooperate. “Prison and police officers are vested with the power and responsibility to do acts which, if done outside of work hours, would be crimes of sexual assault. If a person does not ‘consent’ to being stripped naked by these officers, force can lawfully be used to do it,” according to Amanda George in the Australian Institute of Criminology. George cites women’s accounts of strip searches: “We are strip searched after every visit. We are naked, told to bend over, touch our toes, spread our cheeks. If we’ve got our period we have to take the tampon out in front of them. It’s degrading and humiliating. When we do urines it’s even worse, we piss in a bottle in front of them. If we can’t or won’t we lose visits for three weeks.”
Justice Marshall has described a strip search as “one of the most grievous offenses against personal dignity and common decency.” These searches create “feelings of ‘deep degradation and terror'” and instill psychological reactions that “can be likened to those of rape victims.” The punitive nature of strip-searching is particularly egregious in light of the fact that approximately one third of women incarcerated in Massachusetts have not been convicted of a crime. Rather, they are in jail or prison awaiting trial, typically because they are not able to pay relatively small sums of bail money.
The coercive nature of prison exacerbates the humiliation of strip searches. An estimated 70% of women drawn into the correctional system have experienced physical or sexual violence, and in many cases that includes childhood sexual abuse. Prison procedures requiring the removal of clothing and intimate touching of an inmate’s body are especially traumatizing for women who have suffered abuse in the past.Responses to perceived threats can include alienation, withdrawal, fighting back, extreme outbursts, worsening of psychiatric symptoms or physical health problems, self-injury or suicide attempts, and increased substance use. In the prison context, these behaviors can lead to further punishment, including solitary confinement, and can easily be construed as an “emergency” meriting the presence of opposite sex officers at the strip search.
According to testimony provided by Carmen Guhn-Knight (August 7, 2015) based on interviews with sixty women who were videotaped while undergoing strip searches at the Chicopee Jail in western Massachusetts, “Women with histories of sexual abuse told me of their heightened sensitivity to having their naked bodies video-recorded. They said they returned to their communities re-traumatized, and in some cases with PTSD due to being recorded during strip searches.” Guhn-Knight shares some of the reactions she heard from these women: “Do we have to have the videotape? I don’t want to be videotaped naked. I don’t want to be filmed naked… I don’t want the camera on me.” “Is this going to end up on YouTube? … I’m being filmed while everything’s off? I’m naked being filmed.” “I’m not going to get stripped in front of a camera, that’s pornography.” “[You] take someone’s dignity and then do it again with a camera.” According to Guhn-Knight, “Despite their complaints, these women had no choice in the matter; they eventually removed their clothing themselves or were restrained while an officer removed their clothing.”
While the proposed amendment addresses the gender of the person holding the camera, it does not address the broader problem of video-taping strip searches overall. The taping of strip-searches is ostensibly for the protection of the prisoner; that is, having a record may prevent or at least document abuse during the search. However, the preservation of the tapes opens the door for grievous violations of privacy. In a country in which viewing on-line pornography is widespread (and sometimes unavoidable when unrequested porn sites pop up on screens), women inmates have good reason to fear that the tapes of strip searches may be misused for pornographic entertainment. Doubling down on the harm of the practice of videotaping strip searches, research shows that men who watch pornography are more likely to voice attitudes supporting violence against women and to display dominance and aggression (including choking, gagging and insulting name-calling) toward women while engaging in sexual activity.
Based on my reading of the scholarly literature as well as on my own research with formerly incarcerated women, I believe that the proposed amendment does not go far enough to protect women or men from the pain, humiliation and human rights violations associated with strip searches. I suggest that the law be amended to (1) disallow routine strip searches (2) permit strip searches only in situations when there is clearly defined and documented reason to suspect that the inmate is hiding contraband on his or her body (3) clearly inform all prison staff that strip searches may not be used as a form of punishment or discipline, and institute sanctions against staff who order or participate in strip searches in other than situations where there is clearly defined and documented reason for the search (4) disallow all strip searches by opposite sex officers and employees (5) cease video-taping of strip searches (6) immediately discard all existing video-tapes of strip searches.
Nearly a year after she was murdered by a man against whom she had taken out a restraining order, the newspapers have uncovered a bit more of what happened.
The day before she was murdered she called the police with a request that they get her former boyfriend out of her apartment. She told them she had taken out a restraining order against him. According to the press, “When the two officers arrived, they failed to make the simple computer check that would have confirmed the restraining order she told them she had against him, and should have led to his arrest. They took [him] to a detox facility instead.” He came back the next day (allegedly) and battered her to death.
I can’t know what was going through the minds of the officers when they ignored Elizabeth’s plea for help, when they chose not to believe that she had filed a restraining order against the man she wanted out of her apartment. I can only guess that in their minds she was one more drunk, one more loser, one more woman who doesn’t deserve respect because she has been homeless or incarcerated.
While the Boston police may have invested a great deal of time and effort into educating officers about intimate partner violence, they certainly dropped the ball this time. “Police records show [one of the two responding officers] has had 22 internal and citizen complaints filed against him for use of force, disrespectful treatment, and conduct unbecoming. … [The other officer] has three complaints on his record. … He was the subject of a 2006 lawsuit after he led a car chase that left a 15-year-old boy dead in Roslindale.” Yet according to the Patrolmen’s Association attorney, they are “outstanding officers” who, when responding to Elizabeth’s call, did “the best they could in this situation.”
I could be snarky and say that I’d hate to see the worst they could do in this situation. On second thought, that’s not being snarky – it’s simply stating the truth.
Elizabeth – I still have your picture on my desk. I still hear your classic Boston-accent voice telling me — less than a month before you were murdered in your apartment — how grateful you were for finally having a home after two decades of shelters and the streets. I don’t believe in an eye for an eye, that’s not the kind of justice I’ll seek for you. But I will seek justice.
I thought we’d reached the apex of disgusting with the pink handcuffs for “arresting breast cancer” and the pink drill bit used by a fracking company “doing its bit” for the cure. But I guess there always are new levels of gross. (Photo courtesy of Barak Sered, aka my son)
(Thank you to Lois Ahrens for bringing the pink handcuffs to my attention.)
Each October, as national breast cancer month rolls around, I find myself fluctuating between pink-nausea and pink-rage. The pink ribbon extravaganza, a month-long consumer fest that turns women’s suffering into cold hard cash makes the absence of a national commitment to identifying and eliminating the environmental causes of breast cancer seem that much worse. The sanitized cuteness of pink-ribboned teddy bears makes the slash and burn treatments of the bio-medical cancer industry feel all the more painful. And the pink-painted messages praising “strength” and “optimism” reinforce the “holistic sickening” at the core of many of the complimentary and alternative healing modalities that “explain” breast cancer in terms of poor lifestyle choices, suppressed anger, or denial of one’s true femininity.
This year I’ve collected a few of the new (or at least new to me) egregious efforts to commodify, to normalize, to exploit — and to “cutefy” — breast cancer. Click here and here for more serious analyses. And as always, to learn more about “pinkwashing” and to support the work of Breast Cancer Action, click here.
As you can see in the feature photo, the pinkwashing Olympics have their new champion: the police department of Greenfield, Massachusetts announced on Facebook that for the month of October, they’ll be using pink handcuffs. Officers will also sport pins reading “Arrest Breast Cancer.” Because there’s no problem you can’t solve that way.
October is National Breast Cancer Awareness month. While most people are aware of breast cancer, many forget to take the steps to have a plan to detect the disease in its early stages and encourage others to do the same.
Many of our community members, including some of our own friends and family members, have been affected by breast or other types of cancer.
Officers of the Greenfield Police Department have “gone pink” in order to raise awareness for the disease! All of our officers have changed their collar pins, which were blue and white state seals to pink and white pins which states “ARREST BREAST CANCER – UNLOCK THE CURE” surrounding a pink ribbon and a pair of handcuffs. Some of our officers have even replaced their on duty silver handcuffs with pink ones and will be using them during the course of their work day.
Help us ARREST BREAST CANCER by spreading the word and by making your own early detection plan.
Remember: when placing a suspect in a light chokehold or frisking them against a vehicle, always ask if they’ve performed a monthly breast self-exam. There’s no awareness like the kind that takes hold in the back of a squad car.
In this era of stop and frisk, rising rates of incarceration among women and continued sexual abuse of women in prison it’s hard to get excited about a pink police car. “In 2006, a Department of Justice (DOJ) study found that women in prison are at significantly greater risk for cancer than their male counterparts. Out of every 10,000 incarcerated women, 831 had cancer, compared to 108 per 10,000 men.” According to the Department of Justice there are over 1,000 incarcerated women who either have or have had breast cancer. To learn more about the suffering of “breast cancer behind bars” click here.
Pinkwashing has also expanded in the usual commercial way:
Just what every woman needs to stay healthy: Pink stilettos. Perhaps the message is: Don’t worry about dying of breast cancer when you can kill yourself running for the train in pretty pink shoes.
This year the Hard Rock Hotels are offering “Pink Rooms” with pink bed sheets and an option to purchase pink bathrobes. The activists among us will be relieved to know that we can stop organizing, lobbying, researching and lecturing. All we need to do to eliminate breast cancer is “Get into bed” and “relax for the cause.” And in case you’re more of a “party for the cause” than a “relax for the cause” kind of gal, Hard Rock Hotels have you covered as well. Who knew that pink margaritas prevent (or is it cure?) breast cancer?
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. I’ve recently seen dry cleaning companies jumping on the Pinktober bandwagon:
What this and similar ads leave out is that PERC, the solvent used in most dry-cleaning, is a known carcinogen.
And finally, to take away the sour tastes in our mouths (whether caused by chemo or by pinkwashing): Nothing promotes the health and wellness of women quite like sugar filled candies with cute little pink ribbons all over them.
We Can Do Better
While 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. In past years 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.
As for me, I’ll skip the pink bathrobes, candy, nail polish and (hopefully) police cars, and spend my money on real research into breast cancer prevention. For more on the Silent Spring Institute click here.
Thank you to Robin Yang and Ashely Rose Difraia for help with this post.
The Jewish holiday of Purim starts this evening and continues throughout the day tomorrow. Something of a cross between Halloween and Carnival (though more toned down than either), Purim is one day in the year in which Jewish children and adults are encouraged to wear costumes. While I’m sure there will be a few fabulously funny and innovative outfits at my synagogue tonight, I know – even before seeing them – that most of the little girls will be dressed as princesses or brides while quite a few of the adult men will be dressed as women. Coming on the heels of Mardi Gras, Purim has me thinking about why so many cultures feature costuming practices that draw attention to gender.
To begin with, it’s useful to make some sort of distinction between clothing and costuming, though these categories certainly overlap. When I dress up in a tailored blazer to go to court I feel that I’m putting on a costume although that blazer was purchased at Macys – not at a costume store, and similar blazers are fairly standard items in the wardrobes of professional women today. Yet I do see something of a difference between clothing that is mostly functional (we wear it to keep warm, protect our skin from the sun, keep our bodies clean or dry, avoid being arrested for indecent exposure, or warding off unwanted interpersonal contact) and costumes that we intentionally don for their symbolic value with the conscious intention of drawing attention, reactions and interpretations.
Like all symbols, costumes are multivocal or multivalent, suggesting multiple meanings to the dresser, the wearer, and the viewers.
As a Jewish American mother, for many years I served double duty as a dresser for Purim and for Halloween. At first I consistently dressed my babies and toddlers in gender neutral “cute” outfits. At an age in which they were too young to notice or care I pushed back against gender stereotypes but embraced age stereotypes (cuteness) by dressing them as un-sexed teddy bears, bunny rabbits, and that ultimate cross-cultural costume: the Purim pumpkin.
As soon as they were old enough to care, my children demanded gendered costumes. My daughter, like all of her friends, dressed as a princess, a fairy or the Biblical Queen Esther (happily for my wallet, these are basically interchangeable costumes) for nearly a decade. Her costumes challenged age norms (she dressed as a young woman, not a little girl) but magnified gender with make-up, jewelry and long skirts that made running and climbing impossible.
My sons went through a brief cowboy, policeman and soldier stage (they later told me that they didn’t care about the costumes but they wanted the guns that we normally did not permit in our pacifist household.) But for most of their childhood and early teen years they wanted to dress as a hyper-masculine super-hero.
Not just any super-hero. My eldest son in particular would begin planning his Purim costume a good four months in advance. Over that time he’d consider, play around with and even stress over whether he would be Superman or Spiderman. Perhaps the tenth time he woke me up at night to talk about the heavy decision weighing on his heart I realized what was going on in his mind: He cared so much about his costume because the decision of being Superman or Spiderman really was about being Superman or Spiderman – a decision of existential importance. Would he be able to climb the outsides of buildings or would he be able to fly? My son helped me see a deeper cultural truth: Costumes are transformative. For that reason many religious traditions use costuming and masks for ritualized existential transformations in which the costume wearer becomes – embodies or is possessed by — the god or the spirit.
Once boys reach their later teens and adulthood and (assumedly) become too sophisticated to think that they truly will be transformed by their costumes, many turn to dressing up as women. Blonde wigs, high heels and mini-skirts are sure-fire recipes for getting a laugh at Purim, Halloween and Carnival masquerades. (Of course, cross-dressing limited to the privacy of one’s own bedroom is likely to be interpreted as pathological or at least bizarre.) At these same events it is rare to see adult women wearing “men” costumes. A woman can masquerade as a particular male profession or identity (fireman, Elvis) but dressing in “men’s” clothes simply means wearing normative clothing in a culture in which male is normative and female is “special” or “other”. Masculinity lacks much of the ‘artifactuality of the feminine’. In fact, a woman wearing generic men’s garments (slacks, button down shirt) at a Purim or Halloween party would likely be asked why she isn’t wearing a costume! This is what Peter Tokofsky calls the ‘asymmetry of cross-dressing’.
Costumes conceal identities and free us to do things we wouldn’t normally do (for example, flirt, get drunk) AND free other people to do things TO the costumed one (I think here of the behavior of “straight” men at a drag show). Embracing that sort of freedom, many cultures practice what anthropologists call rituals of reversal; that is, rites in which, for a prescribed amount of time, social roles and norms are turned topsy-turvy. Classic anthropological wisdom goes like this: In repressive and strictly hierarchical cultures tensions build up. Rites of reversal are an opportunity for everyone to blow off steam for a few hours or days at the end of which most people will feel relieved to go back to the ‘natural’ social order. In her work on Mardi Gras, Carolyn Ware argues that “when men dress up as women they reaffirm masculinity by ridiculing the feminine and therefore ratify the social order.” Chaos is fun for a little while, but few of us want to live out our whole lives in a drunken Mardi Gras parade.
Costumes can elevate (as in the case of the Superman costume) but they also can degrade. A number of years ago an anthropologist colleague in Israel observed the Purim costumes of ultra-orthodox Jews whose religious beliefs demand extensive gender segregation and limit leadership roles to men. In the ultra-orthodox neighborhood of Mea Shearim she noticed a pattern of men dressing as women and women and girls dressing as inanimate objects. In this scene, unlike in the Superman scenario, costumes moved people down an existential level.
For some of these ultra-orthodox girls the cumbersome de-humanizing Purim costumes were good practice for wedding costumes that, for some groups, include a long opaque veil wrapped around the bride’s head hiding her face from the audience, covering her eyes and making her dependent on others to lead her around. I see much the same process of existential transformation in the extreme coverage of women’s bodies and faces demanded by ISIS and other extremist and ultraconservative religious groups: Full body and face coverings erase markers of individuality, turning the wearer of the costume into a symbol to be “read” by others (for modesty, piety and moral status) every moment of every day in every setting and situation.
A Guest Post by Amy Agigian, Founding Director of the Center for Women’s Health and Human Rights at Suffolk University
Greetings from Boston, where we are currently experiencing Snowmageddon 2015. We’ve had four storms, accumulating over seven feet of snow, in less than three weeks, making this the snowiest month in Boston’s long recorded history.
But what does our unparalleled snowfall have to do with women’s health and human rights? First, the health effects of extreme temperatures hit those with fewest resources–money, housing, safety, good health–hardest. It makes sense if you think about it: if you’re already sick, or living in a violent home or neighborhood, added difficulty getting around is much more serious than for healthy people who are safe at home. If you are homeless or have precarious housing, finding shelter and keeping track of your possessions is that much harder in the brutal cold. The lower your income, the more you will likely depend on massively-disrupted public transportation. And obviously, if you have little money, you can least afford to miss days of work when businesses shut down during blizzards. People caring for children and other dependents also struggle with the dearth of passable sidewalks, breakdowns in public transportation, inability to rely on the timely arrival of caregivers, and simply being stuck in the house day after day.
In addition to these immediate burdens, this historic weather has longer-term implications. Counterintuitively, Boston’s “extreme weather events” are likely part and parcel of global climate change. Global warming leads to more severe snow and rain storms, as well as heat waves, droughts and wildfires. Instead of this month being a freak outlier, we are likely to suffer more, and worse, extreme weather events as climate change intensifies.
All over the world, women bear the worst brunt of a degraded environment. As UNFPA explains, women are disproportionately affected by global environmental hazards. Women are the majority of those who stretch the family budget when income is disrupted, take care of family members when they can’t afford or access formal healthcare, and walk farther to gather and carry water or firewood. All over the world, women’s resources and health are taxed by such burdens. These hardships exacerbate violations of human rights including the rights to health, an adequate standard of living, and gender equality.
It follows, then, that women must be central to finding both short and long-term solutions to these problems. Women bring critical perspectives, insights, and priorities to discussions of extreme weather. Women’s health and human rights should be put at the center of all policy discussions and funding decisions, at every stage of planning and implementation of solutions. Snowmageddon 2015 has brought much of New England to a grinding halt. Centering women’s health and human rights can help it from becoming the new normal.
Click here to read about the Center for Women’s Health and Human Rights.
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.