The Dangers of Being Female

@HuffingtonPost

This month was big on bad news for women. First, a family in Canada was convicted for killing four female relatives, then a woman was allegedly strangled by her husband in Afghanistan, and then a high-profile charity in the United States decides to withdraw funds to screen women for breast cancer.

There are two things that struck me as noticeable about these events and their news coverage.

The first is that in all of these cases, different as they may be, women are being punished for being women. The Canada killings were allegedly motivated by the girls' dating and wearing girly clothes. The woman in Afghanistan was supposedly killed because she had given birth to three girls in a row. And it is hard to think of a gesture that more clearly targets women for just being women, in my opinion, than defunding screenings for breast cancer.

The second thing that is noticeable about coverage of these recent events is that many people have expressed their outrage over them, making me feel tentatively optimistic about the future for women's rights. With that in mind, I am hoping that more people will start caring -- and expressing outrage -- about these three very common ways in which women are being punished for being female.

Limited workplace support for pregnancy. Dina Bakst's recent piece in the New York Times put it succinctly: "few people realize that getting pregnant can mean losing your job." Several reports and books describe the devastating effects of limited or weak support for pregnancy on women's careers, health and finances. Contrary to what some might suggest, providing support for pregnant women and new mothers through flex-time, job-protection and paid parental leave is not just good for women: it is good for their families, their employers and ultimately society as a whole. Leaving that aside for a minute, though, regardless of the overall beneficial effects of better work-life policies, women should not be punished for the biological fact that they can get pregnant and men cannot.

Assumptions about female weakness. Despite the fact that many women are the sole or main providers for their families, and despite women's advances as middle managers, women continue to be underrepresented in top leadership roles: in 2010, only 2.8 percent of Fortune 500 companies were led by women. Research repeatedly points to assumptions about women's "nature" as key barriers to promotion: women aren't thought to be as assertive as men, and are seen to lack vision and strength. It is telling that many job adverts suggest that "qualified women" are encouraged to apply. Men, this seems to imply, are qualified just by being male.

Punitive laws related to women's sexuality. Societies have viewed and regulated women's sexuality differently than men's for as long back as we can dig up evidence about. The ancient Greek city-states, for example, expected Greek women to be chaste and demure, and punished or ridiculed those who were not. Today, laws to punish women for having sex with the wrong persons at the wrong time for the wrong reasons persist in almost all countries in the world, ranging from the criminalization of female adultery and of abortion over laws that punish drug use during pregnancy to social services provisions that punish poor unmarried women with more than one child. At the basis of all of these laws is one main thought: Women should not really want to have sex.

All of these three issues are intimately related to the anti-women news items of this month. As long as women are undervalued, expected to bear the entire price of reproduction, and at the same time required to be outwardly asexual, we will see more women and girls killed, maimed and their health needs discarded. Hopefully, we can continue to muster outrage and actually generate change.

New Pornography Regulations In LA: Are They Addressing the Right Problem?

@RHRealityCheck

On January 25, the mayor of Los Angeles signed regulation that requires the use of condoms by all performers in adult movies filmed within the city’s borders. The regulation conditions the issuance of film permits for adult movies on compliance with existing California worker safety rules, which already require barrier protection for workers exposed to blood and other potential contaminants (including semen). The ordinance spells out what these state safety rules mean in the context of the adult film industry, and requires producers to pay enough for film permits to finance workplace safety inspections.

Public health advocates have not surprisingly celebrated the regulation. Adult film producers have equally predictably been less enthusiastic, citing safe sex films as being less popular with viewers and actors alike, and threatening to move their filming elsewhere. This would not be too hard since the ordinance applies only to Los Angeles City and not to the broader Los Angeles County.

But there are other reasons the ordinance may not be as effective as one might hope.

The first is that fewer adult movies are filmed and produced professionally than was the case ten years ago. Over the past decade, free internet sites driven by home videos and other amateur content have taken over a growing slice of the porn image and film market. While it is clear that these sites are not posting free content for philanthropic reasons—indeed, online porn is said to be worth $5 billion a year—it is equally clear that the majority of US-produced porn content streamed online is not and will not be subject to filming permits.

As a corollary to this, the ordinance will not be very effective at influencing the overall depiction of sex in imagery and media. This outcome is all the more lamentable because encouraging condom use is so important. Let’s look at the facts.

Fact number one: young people in the United States act particularly clueless about the cause-and-effect links between unprotected sex, the spread of sexually transmitted infections (STIs), and unplanned pregnancies. In the United States, about half of the 19 million individuals newly diagnosed with an STI every year are between 15 and 24 years old. In addition, about 800,000 girls and young women between 15 and 19 years old get pregnant every year, mostly unplanned. Only about 60 percent of sexually active high school students say they used a condom during their last sexual encounter.

Fact number two: frighteningly few teenagers and pre-teens in the United States receive effective information and guidance about sex, despite the fact that 9 out of 10 kids in public secondary schools will receive some form of sex education at least once during their time from 7th to 12th grade. This is partially due to the fact that the federal government has invested several billion dollars in abstinence-only programs since 1997, including $5 million in the 2012 federal appropriations bill alone. Abstinence-only sex education teaches sexual abstinence until marriage as the only viable option for teenagers to avoid STIs and pregnancy. Under this logic, condoms are not only ineffective but also immoral because they “make” teenagers have sex. (Study after study has proven abstinence-only sex education to be ineffective at best and harmful at worst).

Fact number three: the internet is where kids go for the information they feel they need, including about sex. Successive Youth Internet Safety Surveys have shown that children between 10 and 17 years old are increasingly exposed to sexual content on the web, and, in fact, that to a growing extent they seek this content out. This is not surprising. Teenagers will always be curious about sex, and the availability of internet viewing on portable computers and other mobile devices such as MP3 players makes it easier for them to seek out sexual content in privacy.

The scary bit is that those children and adolescents who depend on the internet for information about sex—that is, those who do not receive effective sex education at school or at home—are more likely to be influenced by what they see. Already a desk study commissioned by the US Department of Health and Human Services notes that the general effects of pornography on the viewer include more permissive sexual attitudes, including a heightened tolerance for unprotected sex.

Which brings us back to condom use in pornographic movies and imagery. We cannot really prevent children from seeking out or inadvertently being exposed to explicitly sexual content online, including from porn sites. And we cannot mandate parental support for comprehensive sex education or even just an understanding attitude towards sex. As a result, if most online porn content depicts unsafe sex as the norm, a scarily large proportion of teenagers will see it as such.

We are not, however, as powerless as the Los Angeles City ordinance. We can think of creative ways to support adult content that features safe sex—for example, government-sponsored awareness campaigns or guidelines for amateur porn, potentially supported by financial incentives. And, by mandating comprehensive age-appropriate sex education in all schools, we can make sure that no teenager will have to depend on the internet for information on sex.

The complacency over unsafe abortions must end

@guardian

The results of the latest study on global abortion are no surprise – the shock is policy-makers have ignored such data for decades

The astounding thing about the global abortion debate is not that some people have deeply held views about what a pregnancy is and when a human existence begins. After all, both of these questions are closely related to that most ubiquitous of philosophical questions: what is the meaning of life? The astounding thing is that policy-makers continue to ignore carefully amassed information about the actual outcome of programmes and laws related to sexuality and reproduction.

In that context, one could only wish that the latest figures on induced abortion rates and unsafe abortion came as more of a surprise. The analysis, carried out by the US-based Guttmacher Institute and published in the Lancet, has two main conclusions: first, when governments fail to provide contraception for those who want it, abortion figures stay the same; and second, where abortion is illegal the procedure is predominantly unsafe. The foreseeable consequence – continued high levels of maternal mortality – also plays out in the data.

None of this is new or surprising, and we have, as one health advocate pointedly noted, known it for decades. The aggregate data, however, hides additional details the discerning policy-maker should take into account.

First, overall abortion and fertility rates present the consolidated result of millions of very personal decisions.

It is not an accident that abortion rates are higher and procedures more unsafe in poorer countries generally, and for poorer women everywhere. Because even though decisions about abortion are personal, the context in which they are made is not. In this sense, the frequency with which women and girls need abortions and the conditions in which they feel compelled to access the procedure is in many cases an expression of exclusion, stigma and discrimination.

This is most clearly illustrated by the seeming anomalies in the Guttmacher study. Take a country like India. Abortion is generally legal, and modern contraceptive methods are, in theory, available. Even so, the study found that two thirds of the 6.5m induced abortions that occurred annually in India were unsafe. The reason for this is the combination of available health infrastructure, poverty, moral condemnation of sex outside marriage and severe gender inequities in the labour market. This is the context in which the women and girls make their decisions. Those who are most likely to need an abortion – young or unmarried women, those pursuing education or those engaged in subsistence farming – either cannot afford a legal procedure or fear the stigma attached to going to a recognised clinic for care. As a result, they end up having unsafe abortions, not because the government doesn't allow legal care, but because it does not enable women to effectively access it.

Second, the 70,000 women who die annually as a result of unsafe abortion didn't just die because abortion was illegal in the country they live in. They died because their lives were seen as dispensable by those in charge. Maternal mortality caused by unsafe abortion is, in fact, entirely resource-specific. This is the very reason policy-makers can and do continue to ignore facts: the only women who die as a result of restrictive abortion laws are poor. Case in point: Mississippi, the US state with the highest poverty rate, also has incredibly restrictive abortion access and – not surprisingly – soaring levels of maternal mortality.

Finally, the study hides massive levels of complacency (or resignation), even among those of us who care. How is it that we don't ask for more informed positions from our policy-makers? Regardless of whether we identify as pro-choice or pro-life, or neither, we should all require some sort of plausible explanation for why the suggested solutions actually would generate the change we want. In this sense, if a key goal is lowering the number of abortions, we should not accept policies that police women's sexuality based on particular conceptions of morality.

In fact, we should accept nothing less than what the data for decades has shown to be effective: a policy package of comprehensive sexual and reproductive healthcare, including support for parenting, gender equality and poverty reduction.

The Problematic Framing of Abortion as an Issue of Privacy

@RHRealityCheck

Over the past months, candidates for the Republican nomination for president have fallen over each other to declare their opposition to abortion rights. Research indicates that they needn't bother: states are quite capable of restricting women's access to abortion without help from the federal government. In fact, 2011 was a record year for the passage of state provisions to limit abortion access since 2003.

The success of state legislatures in restricting women’s right to choose is surprising given the fact that, when asked, slightly more Americans consider themselves “pro-choice” than those who say they are “pro-life.” But one key reason might be that the fight over abortion in the United States historically has been framed as an issue of privacy. And the right to privacy offers poor protection for what is also an issue of life, health, and—above all—discrimination.

In this sense, the opinions issued by the US Supreme Court in abortion-related cases can in some ways be seen as indicative of what is happening across the country. In the earlier cases the Court established a balance between women’s autonomy and the government’s legitimate interest in the protection of growing fetal life. This balance was successively undermined over time, culminating with the Court, in 2007, declaring it constitutional to criminalize a specific abortion procedure even for women for whom this procedure is the least likely to jeopardize their health.

To reach this conclusion, the Court explicitly placed moral concerns over a narrowly constructed right to privacy. Justice Ginsberg alone dissented, noting that the mandate of the Court was to protect the rights of all, not the morals of some. But, on the face of it, such weighting is not an entirely unreasonable conclusion. After all, universal morality would appear to be a broader and more applicable common good than guaranteeing the right of a handful of women to a specific medical procedure because of concern for their private lives.

Or not.

Because what is at stake is not just, as Justice Ginsberg also noted, some generalized notion of privacy but rather women’s ability to realize their full potential. Or, put differently, when a government unduly limits access to a medical procedure only women need, it not only infringes their privacy, it engages in blatant discrimination.

Discrimination, as it happens, is also a better rallying cry for activism. It is noteworthy that while states have imposed many abortion restrictions over these past years, the push for marriage equality (also a pet peeve of Republican candidates) is gaining momentum. True, a majority of states still have legal or constitutional provisions on the books defining marriage as between one man and one woman. But more and more states are passing laws to allow same-sex partners equitable partnership rights in circumvention of those provisions. Perhaps more to the point, the push for marriage as a matter of equality rather than a private concern for those living in same-sex couples has led to broad support for general reform. An April 2011 CNN national opinion poll found majority support for same-sex marriage.

What is striking in comparing these two issues is that abortion access is more directly relevant to a larger number of people in the United States than sex-same marriage is. More than half of American women will experience an unintended pregnancy and 30 percent will have had at least one abortion by age 45. In comparison, little under 4 percent of the American population identifies as gay, lesbian, bisexual or transgender, of whom presumably only a proportion will want to settle in a same-sex marriage.

The broad support for marriage equality is certainly a testament to the organizing power of the LGBTI movement. It is also a reflection of more motivating messaging: same-sex marriage is an issue of equality that affects us all—an early court decision in Vermont on same-sex partnership rightly referred to “our common humanity” as the central point.

By contrast, through keeping its main focus on privacy the movement for abortion access is hamstringed: it divorces profoundly private decisions from general support for parenting, women’s equality, and access to comprehensive health care. Partially because of this, many women and girls who need abortions feel they are alone in battling the restrictions that apply to their situation, be it mandatory waiting periods, the additional cost of medically unnecessary sonograms, or the ban of the abortion procedure that best serves their health.

Governments absolutely have an interest in and right to regulate the provision of and access to medical services, including abortion. But the regulation cannot be based on the personal morals of the legislator or on a poorly veiled intention to eliminate needed health care options for just some people—in this case women.

Or, as Justice Ginsberg noted: “Our obligation is to define the liberty of all, not to mandate our own moral code.” Privacy does not adequately express that sentiment. It also does not adequately express the fact that abortion is a medical intervention three out of ten women in the United States will have needed by the time they are 45. Imposing undue burdens on access is an affront to us all.

UN Special Rapporteur: Abortion Restrictions Don't Work

@RHRealityCheck

Restrictions on abortions just don’t work in that they don’t result in the desired outcome.  This is the predictable, yet bold, conclusion of a report to be presented at the United Nations on Monday, October 24th by Anand Grover, a UN-appointed independent expert on health.  The report, which is part of an annual report-back from various human rights experts to the United Nations’ General Assembly, consolidates years of legal analysis and empirical evidence from other experts and concludes that abortion restrictions are unworkable and damaging to women’s health. Instead, the report advocates access to full, accurate, and complete sex education and information about contraception, as well as to all forms of modern contraception, because these services and state support for women’s equality actually do work to reduce the need for abortions.

Abortion restrictions are generally justified by reference to a desire to lower the number of terminations, be it by limiting access to abortion for all women, as in Chile, El Salvador, and Nicaragua, or just for the “undeserving,” as in most of the rest of the Americas including the United States. Some explicitly prefer pregnant women to die rather than having access to a life-saving abortion, but most refer to some sort of makeshift hierarchy of morals. 

“Most people, of course, should have access free of charge,” a high school friend from Denmark told me the other day. “But women who just keep having abortions: there really should be some sort of punishment for them.”

I have heard this sentiment echoed so many times.  “Seriously, I believe in access to abortion,” a young Mexican friend told me. “But really women need to show a minimum of responsibility.” This friend had, in the course of the same conversation, told me he recently had a condom break during intercourse.  When asked if he believed the woman in that case, if she were to become pregnant, had shown the requisite minimum of responsibility he was confused and horrified.  Of course she should have access to an abortion.  At least they had tried. 

These considerations about who, if anyone, deserves access to abortion are often at the core of public debate on the issue.  All but the most radical anti-choice activists would say that pregnant rape victims should have access, as well as those whose lives or health are threatened by the pregnancy.  This distinction between the vulnerable madonnas and the physically healthy sluts is, in fact, the bright line in determining public funding for abortion services in the United States today.

The truth of the matter is that abortion restrictions in law and policy have little if anything to do with how women and girls deal with their pregnancies.  Of the hundreds of women I have spoken to about their abortions, none mentioned the law as a deciding factor in whether or not to continue an unwanted or unhealthy pregnancy. Sure, the criminalization of abortion might be an impediment to getting a safe and timely abortion, but never a real barrier to getting one at all.

In fact, the only two questions policy-makers can helpfully ask themselves about their approach to abortion are 1) is it workable; and 2) does it actually work.

Most policies that allow only partial access to abortion for the “deserving” women are not all that workable. You need a process for determining the validity of rape claims, for example, and a solid definition of just how unhealthy a pregnancy needs to be to be unhealthy enough for the woman to be entitled to care.  In Ireland, where abortion is only theoretically legal for women who will die as a result of their pregnancy, a doctor asked me in visible distress: “How terminal does she have to be?  Can I help her if she has a 51 percent chance of dying, or does it have to be more?”

The notion proposed by my Danish friend—that irresponsible women who just have one abortion after another need to be punished—is equally unworkable.  How do you determine responsibility? And how many abortions are too many?  And what would be an appropriate punishment?  Carrying the pregnancy to term?  For many, the key moral question in the abortion debate is whether women who want their pregnancies terminated actually care.  But any policy based on a value-judgement on that count raises more ethical questions than it solves.  It is not workable.

Spread the word: abortion restrictions just don’t work.