The Basic Problem is They Don’t Respect Our Agency

Whether it’s when we’re demanding our right to control our own bodies and fertility, including full abortion rights, or we’re asking those who proclaim themselves our allies to recognize how important it is they always recognize our rights, autonomy and agency without debate, it’s become clear that the problem we face is on a basic level, they don’t recognize that we are the sole owners of our bodies, our time, our energy and our feelings.

Now, those who claim they’re our allies and offer the most insipid & milquetoast kind of pro-choice attitudes insist they’re not like those bad people who’d force us to give birth against our will. They respect us and our choices. But must we always be so adversarial about it? So dogmatic? What’s so horrible about allowing debate or other viewpoints about abortion? It’s not as clear cut a secular advocacy issue as equal marriage rights, after all.

BULLSHIT.

Because every time they tell us we have to support and endorse movements that include and welcome those that devalue us, they are telling us we have to defend our most basic rights of self over and over again. It means that our supposed allies don’t respect our rights to own our time.

They are displaying the same toxic underlying male privilege assumptions they claim to denounce. They are saying with their actions that they do feel they or others are entitled to our time. And that our justifiably angry response to that imposition is wrong.

Let me be clear if you do not consistently support or respect the basic bodily rights and autonomy of people who can become pregnant, I don’t care if you are nominally pro-choice. You may think standard medical care like abortion care should be legal, but you haven’t shown you any respect for my agency. You have shown what you truly think is important, and it is you and your comfort above me and my actual life.

Do We Need Penicillin, Mr. Gohmert?

On Monday, Texas Representative Louie Gohmert made a deeply disingenuous argument to ensure that having sex remains as shameful and risky as possible to continue a long standing history of backing up religious hang-ups with healthy sexuality with intentionally created risk.

His statements on the conservative radio show, WallBuilders:

You don’t have to force this sexuality stuff into their life at such a point. It was never intended to be that way. They’ll find out soon enough. Mankind has existed for a pretty long time without anyone ever having to give a sex-ed lesson to anybody.

This got me thinking about all the things that humans have existed without for “a pretty long time” and which of these important modern developments Representative Gohmert thinks we don’t really need either. Of course, the obvious answer is that we’re only supposed to follow shitty antiquated levels of ignorance and suffering when it comes to the sex, but I’d really like to get him to own up to that.

Here’s is a extremely incomplete list just off the top of my head of things that humans as a species have done perfectly well without.

• antibiotics
• air conditioning
• glasses/contacts
• television
• safe potable water
• roads
• modern sanitation
• safe surgical procedures
• football
• guns
• computers
• injectable insulin
• cars
• airplanes
• boats
• painkillers
• blood transfusions
• washing machines
• restaurants
• radio
• deodorant
• CPR
• formalized education
• agriculture
• domesticated animals
• electricity
• representative government
• chemotherapy
• phones
• birth control
• movies
• pharmacology
• soap
• coffee
• refrigeration
• chocolate

Sorry they got caught?

UPDATE: Hospital Is Fucking Lying Their Asses Off, Plus Police Abuse, Homophobia, AIDS Hysteria

I have to say I was not surprised to hear that the hospital in the Kansas City area was lying. I was surprised just how blatantly they were lying because the truth is so much more sickening and horrible than I suspected. A new interview on AMERICAblog is just utterly horrifying and heartbreaking. Please read it.

Here are some highlights.

• Gorley’s husband, Allen Mansell, although in and out of consciousness, clearly expressed his wish that his husband stay & his brother leave. As Roger Gorley was physically hit & pulled by police, Mansell attempted to hold his husband’s hand to keep him from being removed.
• The “belligerent” conduct being referred to is the outraged reaction Gorley had when Mansell’s brother challenged the spouse’s right to make medical determinations under their power of attorney. Hospital staff, despite knowing better, sided with the brother, and insisted & facilitated a violent removal of his husband over the patient’s objections.
• Police were brutal, discriminatory, unnecessarily violent and utterly cruel.
  • In order to break his hold on the hospital bed & hand of his husband, police bashed at his wrists
  • When they knocked him to the ground, they dislodged his glasses & hearing aids and drew blood
• Massive homophobia and AIDS stigma and ignorance
  • One officer would not touch Gorley with his bare hands, even refusing to touch his own handcuffs (because they recuffed him three additional times) when they were handed back to him
  • All officers acted as if there was an AIDS concern obviously because Gorley was gay, and not because of any routine reason

When I first read this, I cried. I got weepy again writing this update. These assholes are not only liars, they are brazen asshole liars who treated a gay couple like dirt.

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Today we’ve learned about a man in Lee’s Summit, MO who was removed from his hospitalized husband’s bedside, handcuffed, escorted off the property and arrested because he refused to leave. There have been some conflicting reports about a restraining order*, but that much of it has not been disputed by anyone.

Since this morning, the local Fox affiliate (the ultimate first source on all the pieces I’ve seen written) has put up an update that Roger Gorley is now free to visit his husband again, but there is no detail or explanation of how & when this development occurred.

It definitely was not there when the Change.org petition to have the hospital stripped of its Medicare and Medicaid access was started. So the cynic in me is wondering whether they actually realized they did a bad thing or whether they just want people to shut up about it so they stop looking bad.

Hospital statements have been cagey about the details of how & why Gorley was removed and frankly what is reported as part of a statement to the police is in direct contradiction to how he describes what happened. What I think explains the difference is that the hospital staff probably has different rules for family and non-family visitors of patients.

According to Roger Gorley, he arrived at the hospital and found that his husband’s family was already present in the hotel room, and it was one of them that told him to leave, even though he and Allen have been in civil union for years and Gorley has power of attorney for medical issues. (What’s more, apparently that power of attorney is on file and Allen has received treatment at this facility previously so there can be no reasonable claim of ignorance one the part of hospital staff.)

The local news report says that hospital staff asked Gorley to leave because they “did not want to have any visitors to Allen’s room.” To be frank, I do not believe the hospital here and this is why:

• No mention of Allen’s family in any statements about visitors
• Allen has previously been treated here without any problems of visitation for Gorley & Allen

So yeah, I think they’re trying to cover their asses here. Especially because they keep claiming they’re totally respectful of same-sex couples and the only problem was that Gorley was “belligerent,” “disruptive” and physically resisted being removed. I won’t believe them until they answer one key question: Why was it necessary to remove a spouse from a patients’ room?

Because I do not blame Gorley one bit for causing a scene when he was told to leave by his spouse’s family. I would be belligerent and disruptive too.

I don’t think this is just some misunderstanding. I think the hospital was sorry they got caught so publicly & are covering themselves to make it go away.

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*The local affiliate may have updated the story to remove reporting about issuing a restraining order, because I have seen sources linking that site as the source of a restraining order filing. The most recent public statement by the hospital was on their Facebook page claiming they never asked for or issued a restraining order.

The Other Side of Medical Homophobia

I have had enough experience in hearing about how LGBT patients are mishandled, dismissed and minimized in medical situations that I expect a certain amount of entrenched homophobia and transphobia (especially transphobia) from medical staff.  It had never occurred to me to consider that the same unpredictable field of hostility would also affect those in training and employment as well.  Yet another example of my privilege showing, I suppose; I’m glad that others are there to help me educate myself, like when Queereka linked to a New York Times article discussing homophobia and doctors.

I feel blind and honestly a bit stupid not to have considered the impact on medical students and graduates facing this kind of bullshit.

Most poignant, however, is what happens to Dr. Schuster toward the end of medical school. A powerful figure in the specialty he hopes to pursue quickly becomes a father figure, doling out advice to the young man and volunteering to write glowing recommendation letters for residency training programs. One day, Dr. Schuster decides to reveal to his mentor that he is gay. “I felt I had to,” he recalls. Residencies wanted leaders, and his most important experiences as a leader to date had been with a gay group. Moreover, he writes, “I didn’t want him to hear from someone else and think I didn’t trust him.”

His mentor’s reaction is silence. And a few months later, with only weeks to go before the deadline for submitting residency applications, he tells Dr. Schuster he will no longer write a letter of support.

“I felt blindsided; and there were no policies, no grievance boards and no mechanisms in place to protect us,” Dr. Schuster said when I spoke to him last week. There is no anger in his voice when he talks about his experiences. “It wasn’t just me, nor was it just the places where I was learning and working. There were a lot of doctors who had the same experiences as I did all over the country.”

The NY Times piece links to American Pediatrics’ reprinted remarks of Dr. Mark Schuster to the Children’s Hospital Boston GLBT & Friends Celebration in June 2010.  What he has to say is important.

Around the same time, a Harvard physician I later met was just coming out. He was spotted at a social event with someone his hospital’s Chairman of the Board suspected was gay. The Chairman reported to the hospital that he thought the physician was gay too and said that people like that should not be allowed to work there.

Seriously, this kind of shit is terrifying; how entrenched are these attitudes among senior administrators deciding the careers and livelihoods of doctors?

There was a junior faculty member at Beth Israel Hospital who was out and actually willing to talk with gay students. When I made my pilgrimage to meet her, even she advised me to remain closeted until after I got my first semester grades. She explained that the school would want to kick me out if they learned I was gay, and they could use poor grades as an excuse.

That’s not to say that there was silence about gay people. We did learn about them in an elective course on “special” populations. One week we learned about prostitution; another, about drug addicts. In between, we learned about homosexuals. A real live one showed up to tell us what it was like.

Sorry, I just can’t get over the idea that in between talking about drug addicts and sex workers, a “real live one” showed up to talk about what his life is like.  Are you fucking kidding me?  Of course, this is in the same program where students were advised to stay in the closet to avoid being punished academically.  And his experiences with administrative discrimination were not limited to just this one institution.

During medical school, I was on the admissions committee. Two people interviewed each applicant and then presented to the rest of the committee. There was an applicant who was outstanding in every category; I gave him a 10 out of 10. The other committee member who interviewed him, a doctor at Children’s, gave him the worst score we’d seen. His record at one of the top schools in the country meant that he would have had to have confessed to murder, or worse, preferring Yale to Harvard, to get such a low score. We waited to hear the explanation. He said that he just didn’t feel “comfortable” with the applicant. The committee was baffled. I wasn’t, because I had met the applicant. He was a man who was effeminate. I didn’t know if he was gay, but I did know that he was someone who was likely to have been called names or to have been roughed up because people thought he was.

It’s not surprising what this sort of medical educational system would do terrible damage to the attitudes of peers and classmates.

I came out to classmates I felt close to. They were mostly supportive. One time I was talking with a classmate about a guy who had asked me out on a date. She confessed that she had thought that being gay  meant simply that men had sex with men; it had never occurred to her that they might actually go to a movie or fall in love. Her honesty gave me a window into what many peers believed, as I would learn repeatedly over the years when people let down their guard.

This makes me want to cry.  So much for the idea that pathologizing homosexuality was on its way out when it was removed from the DSM in 1973.  And we’re still dealing with the sort of misinformation and bigotry that says gay men can’t and won’t commit to another partner, that they’re just sex obsessed and diseased.

I feel like a fool for thinking this sort of thing was mostly a problem for patients.  I can think of multiple instances where and OB/GYN found a (in my case) mistake on my office paperwork where I accidentally checked “same-sex” rather than “opposite-sex” on the portion asking about my sexual activity.  The doctor each time asked if it was a mistake, because although it’s on her form, no one is actually gay or bi, right?

That’s the kind of bullshit I expect when talking about medicine’s homophobia (and elephantine transphobia) problems.  I’ll know to be more careful in the future, because why look, straight privilege, it looks like that’s where you were hiding all along.

An Acorn is Not a Tree, An Embryo Isn’t a Person and Miscarriage Isn’t Murder

Lost in the emotionally charged atmosphere of reproductive rights is the fact that unlike nearly any other discussion about legal rights and freedoms, abortion rights reflect one of the few instances where we deal with a zero sum game.  You cannot grant potential humans rights without taking them away from living, breathing women.

When you acknowledge this basic fact, personhood legislation becomes more than simply political disagreement, it becomes a public debate on how much we as a society value (or don’t value) women.

Tennessee’s legislature has made sure that it has joined company with other states that show that they clearly believe: that bitches ain’t shit.

Like bills that have been proposed or even passed in other states, the original idea that made these sorts of laws palatable is that they purport to protect pregnant women.  The idea of protecting women by adding an additional penalty for attacking or killing pregnant women to existing law seems on the most shallow examination to be a positive step.  Pregnant women are statistically more vulnerable to domestic violence, and so the basic idea seems to hold water.

But the difference comes in how the laws are constructed; when an criminal prosecution includes an aggravating factor (e.g. hate crime), that modifies an existing crime.  These laws create a new crime against a victim that should never be recognized under the law.  It’s absolute essential to recognize it’s not about protecting pregnant women from attack (which is obviously already illegal), it’s about prosecuting someone for the death of a person that doesn’t even fucking exist yet.  These sorts of laws have been used to constrain the rights of pregnant women in totally unethical ways.  I’ve already talked about the sorts of bills that only deal with assaulting or killing a pregnant woman here, but the bill the Tennessee legislature has passed is something more harmful.

While these bills normally simply blur the line between abortion and homicide, the change to Tennessee’s law very clearly attempts to advance a legal justification of a zygote as a person under the law.  The previous statutes specifically require a “viable fetus” whereas this bill allows for criminal prosecution for anyone causing the death of “a human embryo or fetus at any stage of gestation in utero.”

It becomes abundantly clear that conservative lawmakers are trying to get the law to recognize eggs as people; here is a quote from Republican Representative Matthew Hill:

This deals with criminal behavior, by people who have harmed not one but two Tennesseans

I don’t think we need any more proof that we’re looking at another embryos are people bill here.

Ignore the Pity Party Behind the Curtain

I didn’t think I’d be where I am about now, feeling sad, frustrated, helpless and depressed.  For the last month (at least) I’ve been feeling happy and fairly optimistic, and I had all these grand plans for the week following my birthday that involved food I didn’t have to cook, drinking and games with friends (and also after Sundance since lots of people I know are busy then).  Now I’m cancelling everything except dinner with my parents because I don’t feel like I could fake my way through the happy face I’d have to put on.

I’ve been meaning to find a new psychiatrist for a while because I’m sick of having untreated ADD, but now I’m thinking that I need to find one to help me sort out some emotional shit that has knocked me on my ass.  There’s just one problem: I have no idea where to start eliminating therapists who will treat my atheism as a reason for unhappiness and depression when nothing could be farther from the truth.

So I’m starting out a search to try to figure out who will be dispassionately helpful, who will subtly pathologize my worldview and who will blatantly tell me that I would be happier if I found God.  Fun!

“The deaths stopped overnight in 1973.”

The thing that bothers me most about people who want to overturn Roe v. Wade is the self-deception they practice about what the actual effect of doing so would be.  People either don’t care or are simply too young to know what horrors we would be returning women’s care to if we were to again outlaw abortion.  Like Griswold v. Connecticut or  Eisenstadt v. Baird, many people simply grew up taking access and legality for granted.  Sometimes it seems as if people believe that abortion did not exist in any meaningful form before SCOTUS decided in favor of Roe in 1973, because we don’t teach the grisly details of the illegal abortion era in history courses.

Being pro-choice, despite the demonization by conservatives and the modern Republican party, simply means that we will fight tooth and nail for the legal choice.  We fight because our system of sex education and reproductive self-determinance is imperfect enough that we still have women with unwanted pregnancies.  We fight because pregnancy is not always safe.  We fight because no one should have to carry a non-viable fetus to term.  And we fight because the alternative is too terrible to think about.

We don’t want people to have abortions who do not want them. What could be any clearer about being pro-choice?

Yet the trend of nibbling away at Roe has in the last year given way to states and even the U.S. House of Representatives trying to take giant bites away or doing away with access altogether.

We are seeing a war on women’s freedoms becoming increasingly acceptable in public discourse.  Our president, a Democrat, supported the Human Health and Services decision to overrule the FDA in ensuring access to Plan B over the counter because he was too concerned by the prospect of his daughters getting access to understand the importance of immediate access.  I confess I was and am horrified by the kind of parent who would rather have a pregnant twelve-year-old than allow that girl access to drugs that would prevent pregnancy.  Because any twelve-year-old who needs access to Plan B is a girl who has been raped*.  Why compound the evil of having a twelve-year-old suffer an unwanted pregnancy with all its dangers for developing bodies by preventing timely access to Plan B through prescription requirements?

Personhood amendments are no longer advocated only by the fringe, but are endorsed by mainstream politicians.  There is no greater social dialogue discussing that these would ban all abortion (including cases such as ectopic pregnancy) and could ban some fertility treatments and birth control methods, including the most common form, oral BC pills.

Those who see zygotes as people don’t seem to care that we will not be moving to a society with fewer abortions.

There are very few ways for us to deal with the issue as a matter of public policy, and I would argue there’s only one ethical stance:

1. Preserve Roe v. Wade, roll back some of the obstructionist nibbles, ensure full sex education and access to birth control.  Ensuring that only wanted pregnancies are allowed to happen and prioritizing the health of mothers will reduce abortion rates, children in need of adoption/foster care and complications from pregnancy.
2. Outlaw abortion and allow women seeking to end pregnancies to start dying, becoming infected and sterile all over again through back room abortionists.
3. Outlaw abortion and in the interests of preventing illegal abortion, require women to submit to pregnancy testing and subordinate their rights to those of potential human beings who may never be born.  Criminalize miscarriages that cannot be proved to be natural**.  Allow women with dangerous pregnancies to suffer complications and risk death.

Only one of these options treats women as full human beings with the right to make choices about their health without uninformed governmental interference.  I know which one I choose.

*Children cannot consent to sex.

**This is not merely hyperbole, as investigation of women suspected of inducing miscarriage has happened in multiple states.

Moar Science Plz

Physical activity program leads to better behavior for children with ADHD

This is kind of headline I’m used to seeing when people talk about press about studies of children with ADHD.  There is so much populist pushback against the idea of medicating of children with drugs like Ritalin (or in my case, dexedrine) that it seems you can’t swing a dead cat without coming across the idea that there is some easier non-pharmacological way to improve outcomes.  And then when I look closer, I find that the glowing ideas are somewhat dubious when you look at the actual procedures behind the headlines.  This one is no exception.

When I came across this study, the person promoting it trumpeted it as “no surprise” since everybody knows that the whole problem with ADHD kids is that they can’t sit still and focus, right?  You know what, fuck you.  You’re part of the problem that led to years and years of my misery going undiagnosed (ignorance, confusion and stigma) and untreated (ZOMG, don’t give kids drugs that clearly help them).  But before we get to that, let’s look at the particulars.

• The study did not include children without ADHD to provide a contrast of neurotypical students (Because this will undoubtedly lead to replacement of other treatment modalities, rather than addition in most cases, you must contrast results of ADHD children with neurotypical children to get some idea of effectiveness as a coping strategy.)
• They studied exactly ten children and eleven as a control, quite a small sample size (Do I even need to point out why a tiny sample size is problematic in scientific research?)
• The control group is not particularly well controlled for environmental variables as they were recruited from numerous other schools while the experimental students all attended the same school (Because the results being measured are of a fuzzy social/behavioral aspect, controlling for variables in teaching and environment is key)
• Girls with ADHD were not well represented in this study, 1 per group (Women are underresearched in medicine to begin with, but I can tell you that as a girl with ADHD, I was basically invisible.  Girls are often underdiagnosed in ADHD, although I hope it’s improved from my childhood, and ignoring their response to treatment modalities as unimportant during behavioral research will continue to produce studies that may not be useful for treating female children and adolescents.)
• The control group were all taking medication while only 30% of the experimental population was on medication to manage their symptoms (I took dextroamphetamines to treat my ADHD and while it was almost miraculously helpful, it is not without physical effects.  I was terribly underweight at times and remember having to force myself to eat when I wasn’t hungry.   I also had to take medication that aided in sleep since I was taking powerful stimulants.  Given that this treatment is physical and measures changes in fitness/strength/motor skills, medical side effects that could include reduced appetite and weight loss should not be ignored.  Moreover, this is one of many ways in which variables in the study were ignored rather than controlled; comparison between these two groups can’t discount medication as a difference.)
• Two of the three types of ADHD were represented in the study (Hyperactive-impulsive, and combined); those with inattentive type were described as “not included in the theoretical model of ADHD” (I have a couple of problems with this. For one, it is another variable that’s not well controlled for in the experiment.  For another, this is simply excluding a whole population of those who meet the diagnosis criteria for ADHD as unimportant while attempting to make generalized statements about improvements in children with ADHD without qualification.)
• Initial evaluations prior to the physical activity program were done with children explicitly not taking their medication, although they were allowed to be on medication during the experiment (Testing conditions prior to the experiment should be the same as those used during and afterward.  Duh.)
• Behavioral results were tracked by parents and teachers using Achenbach’s Child Behavior Checklist; no self-evaluation or independent evaluation was used (Even during the ages referenced, I was a fairly secretive child and tended to hide depressive symptoms and problems with my homework/other tasks out of frustration and shame.  Without any input from the children themselves, we have no way of being sure of many internal behavioral issues that are being evaluated by parents and teachers.  Moreover, much like the sugar/hyperactivity studies in children, we have a huge problem of confirmation bias where teachers and parents expecting to see change will believe they observe change.)
• No way to blind the observers involved for control/experimental groups (Again, confirmation bias)
• Previous evaluation showed the control group had a higher incidence of withdrawn/depressed behavior prior to program and evaluation (Still more methodological problems in getting comparable data between research groups.) 
• [Personal Note: No attempts are made regarding statistical analysis of task completion such as homework.  It would not have been difficult to track any change in ability to finish and turn in homework as a hard statistical evaluator of task-related behavior improvement.]
• Study itself acknowledges flaws within both design and recruitment render the positive results reported more or less useless (They try to spin it positively, claiming that the pointless results are “exploratory” and really means that more study should be done on the subject, hopefully more well designed.  I’m not against this kind of research per se, but I do think that it any positive results need to be cautiously described lest they lead more children to go without treatment like I did for much of my childhood.  No one should have to suffer through that frustration, shame and pain.)

So the rosy headline that physical activity improves outcomes for children with ADHD is basically a lie.  The researchers very clearly state that their data collection and other structural flaws cast doubt on the results.  It’s not entirely the fault of the researchers as medical science reporting is notoriously bad.  Not only can reporters and bloggers often not tell good science from bad, they overstate and exaggerate conclusions until they are sometimes unrecognizable.

So I want more science and I want good science and I want good science reporting.  Is that so much to ask?