Good News in New York

Teens at thirteen New York City high schools have had access to emergency contraception for over a year–but it wasn’t news until the New York Post got wind of it in an “exclusive” report on Sunday. In other words, the program did not make any of its critics’ wildest fears come true. No crazy rise in teenage sexual shenanigans. No rash of teens stricken with any of Plan B‘s side effects, real or imagined. The Post and fair-weather parental advocates like Cardinal Timothy Dolan would never have passed up the opportunity to fan even the slightest concern into a full-blown controversy.

Now the belated hand wringing has begun, and as long as the schools keep following the state law that allows doctors to prescribe emergency contraception pills to women fourteen or older without parental consent–yes, once again, New York state is ahead of the curve–I don’t mind in the least.

Okay, maybe I do mind, but I can also hope that the special provision included to protect parental rights (how I want to put quotations around that phrase), will force the parents who are really only fighting for the right not to think about teenage sexuality at all, to consider the possibility that their child may have the same feelings that have been making adolescents infamous for ages, even if only for the moment it takes them to ”opt-out” of the program. Best case scenario, it starts an honest dialogue between parent and child. Worst case scenario, at least the child knows where his or her parent stands, if and when the poor kid needs to talk to a grown-up.

Elsewhere in New York state, the news in teenage reproductive health hasn’t been good. A recent investigation by the NYCLU revealed “glaring inaccuracies about basic anatomy, reinforced negative gender stereotypes, and stigmatized LGBT students and families” in Sex Ed classes statewide. In one district, the ignorance reaches Todd Akin proportions: definition of vagina–”a sperm deposit.” No word on whether it shuts down or not. (Maybe it has bankers’ hours? Get it?)

I have every sympathy in the world for parents, and the argument about school nurses needing a parent’s permission to dispense Tylenol is at least as old as I am. But I’m still pretty sure teenage girls don’t use Tylenol (or aspirin, anywhere) to prevent pregnancy. (“Not now, I have a headache,” comes much later.) Maybe today’s parents are less hung-up about sex than my parents were back in the day. It wouldn’t take much. But I have a hard time believing even the coolest parents in the world have figured out how to make their children believe they’re always “easy to talk to” about sex. (I’d be impressed and probably a little creeped out, but I wouldn’t believe.) I’m too uptight to say I think the taboos we have about sex are a good thing; but I do think they’ve survived thousands of years because they’re powerful. If loosey goosey New Yorkers with all their culturally elite street cred can still get tongue-tied–or willfully blind–about teens and sex, I, for one, am glad city teens have professional health care providers looking out for them while their parents work out their feelings.

 

What Are We Teaching Kids About Sex?

Sex education is a constant source of debate in American society. As a proponent for sex education in school, I believe that it is important to teach children not only about contraception, pregnancy, and STDs, but also about sexual orientation, feelings, desires, being ready for sexual intimacy, and love. But with the current focus on abstinence and sex being acceptable only within marriage, teens are expected to delay sex until they are married. And that is exactly what most American teenagers are doing, right? They wait until marriage and they only have one sex partner their whole life? Wrong!

Most American teenagers have sexual experiences during their teenage years, and most have sex before marriage. Therefore, abstinence-only programs are not very effective. So is it not better to teach children how to be prepared, protected, and emotionally ready for sex, so that they can avoid unwanted teen pregnancy, contracting STDs, or having sex with a partner before they are mentally and physically ready?

[Read more...]

De-Queering the Fetus

recent article by Alice Dreger, Ellen K. Feder, and Anne Tamar-Mattis documents the controversial application of prenatal dexamethasone in pregnant women. The impetus for this pharmacological therapy is to stop virilization in female fetuses that may be affected by a form of congenital adrenal hyperplasia (CAH) called 21-hydroxylase deficiency or 21-OHC CAH.

Don’t allow the medical jargon to turn you away from what’s taking place here: the steroid is administered to pregnant women with the goal of stamping out intersexed bodies while ultimately minimizing the likelihood that a female will grow to be butch, lesbian, bisexual, and/or transgender. Yes, you read that right. This is an ongoing medical project that is motivated by homophobia, transphobia, sexism, and cissexist ideals. Let’s back up a bit and unpack some of the medical jargon that complicates our understanding of systemic hate.

CAH is a disease of the endocrine system (the hormone regulating mainframe of the body). There are variations of CAH and the one of interest here is 21-OHC CAH. 21-OHC CAH leads to an over production of androgens, which could lead to a genetic female fetus “developing along a more masculine pathway neurologically and genitally” (5). The term for this masculinization is virilization, which manifests in many ways but can lead to masculinized female genitalia, of which is a surface motivation (e.g. justification on grant applications) for the use of prenatal dexamethasone. CAH is a serious disease and as such, every U.S. state requires that newborns be screened for it. However, at case here are fetuses that may be affected by CAH, not newborns that are affected by it. The authors expose that 87.5% of those fetuses that are exposed to prenatal dexamethasone stood no chance to benefit from the therapy at all.

Prenatal dexamethasone is a steroid that is theoretically used to stop the effects of 21-OHC CAH. However, the drug is experimental and there is no substantial support for its use. In the U.S. it is categorized as “off-label,” which means that it is not FDA approved. As it stands, there is very little known about the impact of the therapy but it may alter “fetal programming,” which can result in serious metabolic problems that may not be apparent until adulthood. For 30 years, the steroid has been used to combat virilization in female fetuses and yet, little is known of its impact because there are few long-term studies that explore its impact—of those, the populations are not representative and the protocol does not meet national or international scientific standards. In fact, the Endocrine Society set up a task force to look at the effectiveness of the pharmacological therapy. The task force found very little support for the use of the steroid and “could not even say with confidence whether prenatal dexamethasone works to reduce genital virilization” (2).

Nonetheless, it has been administered to pregnant women on false pretenses. The pregnant women were/are not informed that the “off-label” steroid is experimental, that benefits and risks have not been established due to lack of adequate testing and scientific protocol, and that exposed fetuses are studied retrospectively effectively rendering moot any correlation between the drug and the fetus born one way and/or raised another.

The “most prominent promoter” of this therapy is Maria New, a pediatric endocrinologist at Mount Sinai School of Medicine. By 2003, New has “treated” more than 600 pregnant women with dexamethasone in order to prevent virilization in CAH-affected female fetuses. That number is as high as 2,144 fetuses. This is where the story turns sour and scary—or more sour and scarier.

Despite a lack of support for prenatal dexamethasone Maria New insists that it “has been found safe for mother and child” (15-16). The authors of the article do some bold investigative work and turn to New’s grant applications discovering some interesting motivations for the continued use of the steroid.

Those few studies that do exist show that girls affected with 21-OHD CAH exhibit “behavioral masculinization.” These girls are on average “more interested in boy-typical play, hobbies, and subjects that non-affected females, less interested in becoming mothers, and more likely to grow up to be lesbian or bisexual” (6). Some clinicians find that of those females with 21-OHD CAH, 5% may ultimately identify as male. “Behavioral masculinization” is a euphemism for non-traditional gender performance or expression in women, females, and/or girls. It seems that the underlying motivation has less to do with ambiguous genitalia (which is problematic itself) and more to do with minimizing “tomboyism,” non-heterosexuality, and trans* embodiment.

Interestingly, the U.S. National Institutes of Health have funded Maria New’s work in figuring whether or not prenatal dexamethasone works to stop “behavioral masculinization.” Said another way, the U.S. government funds New’s work in stopping queerness and/or trans*ness in those potentially affected with 21-OHD CAH. Please, read that again for the sake of letting it sink in.

One justification for using prenatal dexamethasone is to minimize the chances of having a child that is intersex so that “corrective” surgeries will not be necessary. However, such “corrective” surgeries are elective and yet this reason is used as grounds to administer this potentially dangerous drug.

The unknown effects of prenatal dexamethasone are as potentially damaging and traumatic to intersex bodies as invasive “corrective” surgeries that claim to “fix” a problem when the problem isn’t the fetus at all. The inspiration for this pharmacological therapy is stigma and anxieties surrounding intersexed and/or queer bodies. It is a medical intervention that works to ensure the production of relatively normative bodies no matter the cost to those that are at risk of teetering between cissex and intersex embodiment. The anxiety/fear-inspired application of prenatal dexamethasone points us to the intersection of sex, gender, and sexuality and those systems that work to keep them aligned more nicely.

Speaking to parents of children with CAH, Maria New “showed a picture of a girl with ambiguous genitalia and said: The challenge here is to see what could be done to restore this baby to the normal female appearance which would be compatible with her parents presenting her as a girl, with her eventually becoming somebody’s wife, and having normal sexual development, and becoming a mother. And she has all the machinery for motherhood, and therefore nothing should stop that, if we can repair her surgically and help her psychologically to continue to grow and develop as a girl” (italics mine 6).

For New, the prominent cheerleader in prenatal dexamethasone therapy, girl/female/woman are one and the same and are heterosexual desiring motherhood and marriage. For New, queer variation is inconceivable. For New, prenatal dexamethasone is the ultimate in conversion therapy because it gets at the “problem” before it is a problem. It does so even though the long-term impact is unknown and potentially fatal. New, and her supporters, will do whatever it takes to ensure that queerness is squashed at every chance. For the record, you can contact Maria New at maria.new@mssm.edu.

Maybe Footlooose Was Ahead of the Curve

Earlier this month, Michigan Representative Lisa Brown drew the ire of her male colleagues for using the word “vagina” on the House floor. Her comment, “Finally Mr. Speaker, I’m flattered that you’re all so interested in my vagina, but ‘no’ means ‘no.’” was made while the state’s politicians were discussing proposed anti-choice legislation that is considered to be among the strictest in the country.

As Brown recalls, there was no immediate reaction from her colleagues until the following day, when she and Rep. Barb Byrum were informed that Republican House leaders had barred the two women from speaking on the House floor. “Given my speech, I could only assume it was because I spoke to my Jewish values or because I had said vagina,” she writes in an article published last week. “But later that day, Rep. Mike Callton told the press that what I had said was so vile, so disgusting, that he could never bear to mention it in front of women or “mixed company. … Since we share the same religion, I’m guessing he wasn’t referring to my kosher sets of dishes. Even though Callton has a bachelor’s degree in biology and worked as a chiropractor, it was the word “vagina” that did him in.”

Oh those delicate Michigan men, done in by an anatomically correct term! Perhaps they will find sympathy among equally squeamish politicians of Tennessee, who voted this week to bar “gateway sexual activity” yet were unable to verbalize just what that meant. In lieu of the bill’s supporters being able to use their words, critics of the bill – which is intended to promote teen abstinence – have dubbed it the “no hands-holding bill.” [Read more...]

The Little Blue Party Pill: Sex, Boners, and Lots of Viagra


Editor’s Note: Today’s guest post comes from Saira Khan. Saira currently works in publishing but dedicates her free time to social commentary on her personal blog. She is a soon to be Master of Science candidate at Columbia University. Follow her on twitter @sairakh.

In the past two years we’ve seen an onslaught of Republican led bills to limit women’s access to safe and affordable abortions, cheap birth control, and health care. A recent Kansas bill allows doctors to lie to women in order to prevent abortions including lying about breast cancer treatments. They’re also trying to add a 6.3% tax to abortions even for rape victims. This is just one in a slew of bills we’re seeing red states draft in order to deny women the right to choose and deny them access to affordable contraception.

But it’s not just birth control and abortion that are under attack. Women and their sexuality are now in the spotlight. After the whole Limbaugh-Fluke fiasco, Bill O’Reilly went ahead and aligned himself with the likes of Limbaugh by stating “You Want Me To Give You My Hard-Earned Money So You Can Have Sex?” To sum it up: they don’t want women getting abortions, they don’t want to help women who choose not to have an abortion, and they don’t want women using birth control. Basically, they don’t want women having any sort of sex whatsoever unless it’s to procreate. What’s interesting about all these discussions is: where the hell are the men? Somehow conservatives make it sound like women get pregnant all by their slutty selves and then recklessly get abortions. Seriously though, where are the men in this equation? Oh yeah, they’re out there having lots of sex and getting cheap and easy erections…

Not only are men entirely excluded from this whole we’re not paying for you to have sex conversation, men and their overuse and abuse of Viagra is actually defended! The common excuse I hear in defense of the little blue pill is “well, Viagra is life-giving.” So, really what it comes down to is that they seem to believe men can have as much sex as they want because, you know, they’re men. And somehow birth control promotes sex and Viagra promotes, what, abstinence?

Let’s clear a few things up here about Viagra. [Read more...]

Utah Joins the War on Contraception

Just weeks after California Representative Darrell Issa felt the need to call a special hearing to bemoan the oppression of the Catholic Church’s First Amendment rights–the freedom of religion–Utah Republicans are ready to legislate away another First Amendment right, their teachers’ right to free speech. The Utah House passed a bill, HB363, that would allow schools to ban sex ed and prohibits instruction in the use of contraception by a 45-28 vote. The bill now moves on to the state Senate.

But not to worry, the bill’s sponsor,  Rep. Bill Wright, R-Holden, “a dairyman“(!), has got the doublespeak down. Perhaps realizing that banning the discussion of contraception (under the guise of forbidding ”advocacy” of its use) might leave educators tongue-tied–and on the brink of a crime spree–if asked a direct question about contraception, he maintained that teachers could respond to students’ questions on the matter. How, exactly, he couldn’t say. The language of the bill states: “An instructor may respond to a spontaneous question as long as the response is consistent with the [bill's] provisions.”

Wright can be added to the ever-growing list of public officials who have gone on the record with their light-years-beyond-the-mainstream belief that birth control is a dodge, an “intellectually dishonest” way of “getting away with” sex. Boldly ignoring the biological truth that even married women aren’t able to get pregnant every day of their married life, he, along with Senator Santorum and the Catholic Church, have decided that sex is for procreation only and that the consequences of unprotected premarital sex aren’t grave enough already. (Apparently the threat of eternal damnation isn’t what it used to be.) Though Wright, like Santorum and the Church, professes to be protecting all of us from the consequences our mainstream “brainwashing” has left us unable to recognize without their intervention, everybody knows the wages of sexual sins are not distributed equally. To be sure, the Mormon influence in Utah may make it harder for an unmarried dad to shirk his parental responsibilities. Still, we all know who gets pregnant and who had to wear that scarlet letter.

There’s reason for hope though, even in this ultra-conservative state. Anyone who has visited Utah over the past thirty years can tell you how much influence the Mormon Church has lost over the state liquor laws. Where there once was no MTV, “16 and Pregnant” airs unmolested. And a Democratic lawmaker from Salt Lake City like Rep. Brian King can fight the self-appointed contraception police and go on the record saying that bills like HB363 make ”reasonable people think we have lost it up here on the Hill.”

1 in 4 College Students Has Cooties

Last week an eye-catching infographic was posted at Online Colleges, a resource for people looking for information on web-based education and related topics. The graphic alarmingly states that 1 in 4 college students have a sexually transmitted disease, citing improper or lack of male condom use and the consumption of alcohol as major contributing factors. The graphic, featuring an illustration of a young Caucasian male wearing a fetching pair of boxer shorts, was immediately picked up by a number of blogs and websites for college students. It seems the idea that getting sick from having sex is new and surprising to young people, and that’s as disturbing as the 1 in 4 statistic.

The infographic was created in-house using data collected from a number of third-party sources: getstdtested.com, a business that provides at-home STD testing for outrageous fees, stdandhivtesting.com, another service fee-based testing service, collegehealthadvisor.com, a clearinghouse of articles related to generalized health on campus, nursingschools.net, a guide for online nursing schools, ashastd.org, a page from the American Social Health Association, who advocate the same STD prevention methods as the CDC (see below), stdservices.org.net, a defunct address for a page now called yeah.com, that bastion of completely vetted double-blind tested scientific information: wikipedia, and cdc.gov, the website for the Centers for Disease Control and Prevention.

When asked why the team chose to exclude women who have sex with women as a demographic, Muhammad Saleen, one of the creators of the poster said: “It was not our intention to exclude anyone from our infographic, all the data presented on there is from third-party sources and data sets and any gaps in the information are because of the datasets used.” [Read more...]

New Website and PSAs Focus on Birth Control

Coming in first is usually a good thing – except when, well, it’s not. Case in point: the U.S. has the highest rate of teen pregnancy in the developed world. And older couples aren’t doing that much better: nearly half of all pregnancies in this country are unplanned.

The Ad Council and the National Campaign to Prevent Teen and Unplanned Pregnancy are teaming up to do something about that. They recently launched a three-year multimedia campaign that address the importance of birth control through a series of humorous PSAs and Bedsider, a new website that’s chock full of information and advice about birth control options.

[Read more...]

Sex in the City

Sex is all over the news up here in New York City, and not just because the newly-wedded Kardashian is divorcing. Between the CDC Advisory Committee on Immunization Practices’ recent recommendation that 11- and 12-year-old boys be vaccinated against the Human Papalloma Virus (HPV) and the reaction to the city’s mandatory sex ed program set to begin this spring, even a reasonably polite, mild-mannered adult like myself can be forgiven for thinking about the sex lives of strangers. Even if they’re underage strangers. Hopefully.

Not for the first time, I’m wondering how people manage to do the whole parenting thing. As a licensed therapist once told me, cultures have taboos for a reason. And let’s face it, how many taboos do we have left besides those having to do with S-E-X? I have serious doubts as to how many adults can really have an adult conversation about sex with other adults. So, to put it mildly, I do not envy anyone having to have “the talk” with their kids. But part of parenting—and part of being an adult in a mostly-functioning society—is to put the well-being of the most vulnerable above our own feelings, icky as they may be. [Read more...]

Vatican Family Values

As my people like to say, there is chutzpah, and then there is chutzpah. And if you are Michele Bachmann there is even chitzpah. 

But this needs a bigger word. Probably in Italian. With an issimo on the end.

Don’t get me wrong. I like my Vatican predictable. So I wasn’t surprised when the Catholic Church came out to condemn the new mandatory sex ed classes in New York City. That’s what the Church does. Like the sun rises each morning and sets each night, the Church condemns.

Likewise, I’m not surprised that the Church didn’t pass up the opportunity to kick the condemnation up a notch. New York is only the biggest city in the world. Why not needle “the State” and “public institutions in the West” for their “magical trust in the effectiveness of sex education?” [Read more...]