Roundup: Melody Barnes on HIV/AIDS, Domestic Violence Against Military Spouses

Emily Douglas

Obama economic advisor Melody Barnes outspoken on HIV/AIDS; New York Times highlights domestic violence against military spouses; was Kansas abortion provider George Tiller trapped?

Obama Economic Advisor Melody Barnes Outspoken on HIV/AIDS

Todd Heywood has the story on new Obama economic advisor Melody Barnes’s background working on HIV/AIDS and connecting health care issues to the economy. You can read more about Barnes’s position on HIV/AIDS in a 2004 op-ed she wrote with Shira Saperstein. Writing about the high rate of HIV among African-American women, Barnes says, 

At this point, we do not truly understand all of the reasons
for these health disparities, although disproportionately high rates of
poverty and low rates of access to health care are certainly on the
list. So, too, is the fact that public funding – for prevention,
treatment and care – has not kept pace with the epidemic nor been
reallocated appropriately to meet current needs and demographic
changes. To the contrary, while most African American women are
infected with HIV through heterosexual sex, funding continues to
increase for unproven abstinence-only programs rather than for
comprehensive and culturally appropriate reproductive health programs
that provide condoms and counseling on safe sexual behavior. Despite
rising demand for treatment, budget cuts have resulted in long waiting
lists for access to AIDS Drug Assistance Programs (ADAP) in almost
every state. This has left thousands of HIV-positive Americans unable
to secure the drugs they need to save their lives. An estimated half a
million Americans currently living with HIV are not getting medical
care.

New York Times Highlights Domestic Violence Against Military Spouses

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Inaction and stalling in cases of domestic violence perpetrated against soldiers’ spouses continues to be a problem in the Army, the New York Times reports. The article notes that sound procedures to deal with domestic violence are even more important in wartime, when more soldiers are deal with post-traumatic stress disorder, which is linked to "increased violence in the home."

(Thanks to Feministing for the heads up.)

Was Kansas Abortion Provider George Tiller "Trapped"?

Pre-trial hearings against Kansas abortion provider Dr. George Tiller are underway, but may be exposing the unethical gathering of evidence against him.  Reports the Feminist Daily News,

Tiller’s attorneys filed a motion in September asking the court to
either suppress evidence or dismiss the charges against Tiller because
of alleged "outrageous" misconduct of the preliminary investigation
into Tiller’s practice by former Kansas state Attorney General Phil
Kline and state attorney Eric Rucker…The defense claims that Kline targeted Tiller without first having
evidence of illegal activity and that the evidence against him was
obtained as a result of abuse of power.

Senate Seats Still Undecided in Georgia and Minnesota

Haven’t quite let your election anxiety go because of the Senate races still undecided in Georgia and Minnesota? Blog for Choice
has updates for you. The Coleman-Franken recount is underway, and the
Saxby Chambliss v. Jim Martin runoff will take place December 2.

Analysis Law and Policy

Dear Incompetency Ruling Is the Latest Dangerous Signal From Courts on Anti-Abortion Violence

Jessica Mason Pieklo

Two different courts in as many weeks handed down rulings potentially sending some terrifying cues to the anti-choice movement.

On Wednesday, Colorado District Court Judge Gilbert Martinez ruled that Robert Lewis Dear Jr., the admitted Colorado Springs Planned Parenthood shooter, will not immediately stand trial for the November 27, 2015 siege that killed three people. Dear faces 179 counts, including murder and attempted murder, from the attack.

Martinez’s ruling, which came after two competency exams and hours of contested courtroom testimony, was that Dear was not legally competent to stand trial. Dear spoke out during the court proceedings against him again and again, despite court warning. Dear also has some fringe political beliefs that could fairly be described as delusional—he believes the FBI has been tracking him, that President Obama is the Antichrist, and that the federal government has been systematically targeting Christians since the 1993 siege on the Branch Davidians in Waco, Texas.

Based on the evidence disclosed so far, however, it is hard not to second-guess Martinez’s ruling here. Being behaviorally unpredictable or existing on the political fringe is not the same thing as being legally incompetent to stand trial. It’s dangerous for the court to decide otherwise.

Under Colorado law, a defendant is considered “incompetent to proceed” if, as the result of a mental or developmental disability, they do not have the sufficient present ability to consult with their lawyer with a reasonable degree of rational understanding in order to assist in the defense, or if they do not have a “rational and factual understanding of the criminal proceedings.”

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I’ve put the emphasis on a couple of key points, because they are important for understanding the difference between whatever psychiatric diagnosis Dear got and the legal standard for whether or not he is competent to stand trial.

First: Sufficient present ability. That means does Dear, at this moment in time, have the ability to talk to his lawyer? Not “does he want to,” but “can he?”

Second: With a reasonable degree of rational understanding. Now there’s some legalese for you. But broadly speaking, it means: Can Dear reasonably and rationally understand the proceedings against him? For example, does he understand his charges? Can he participate in the court hearings as his case proceeds? Again, not “does he want to,” but “can he?”

And here’s what we know so far from court testimony and the few documents Martinez has allowed to be unsealed: Dear crafted a homemade bulletproof vest prior to November 27, which he said he wore on him when he took siege at the clinic. We also know through court testimony and documents that prior to the siege, Dear collected propane tanks and ammunition, which he brought and set up around the clinic first. He said he shot at those tanks. He missed. But he told investigators his goal was to create as much carnage as possible.

We even know that Dear stopped at a crisis pregnancy center about a mile down the road to confirm whether or not it was the Planned Parenthood clinic in question.

We know a lot more about what happened once Dear surrendered to law enforcement, how he cooperated with investigators up until his defense team was appointed, who then suggested an insanity defense. We know Dear didn’t want to plead insanity and instead wants to argue the siege was justified—that, as with Paul Hill, Michael Bray, and Scott Roeder, violence is necessary in the name of preventing what he sees as the “greater evil” of legal abortion.

Dear himself has stated both to the media and the court that he knew exactly what he was doing on November 27 before he was arrested in that Colorado Springs Planned Parenthood. He surrendered. He wants a trial.

He may never get one, though. All the evidence of Dear’s planning, of his specific targeting of Planned Parenthood, of Dear’s insistence he have a platform in the form of a criminal trial—by ruling Dear incompetent to stand trial because of his “political delusions,” Judge Martinez overlooks Dear’s very real but sincerely held religious belief that abortion is a moral wrong that has no legal justification.

The good news is that Wednesday’s decision is temporary. Competency, as the law defines it, is a fluid state. Which means a defendant like Dear can come in and out of legal competency, even if he’s never fully “cured” of the diagnosis that got him declared incompetent in the first place.

The immediate effect of Martinez’s ruling is to send Dear to the Colorado Mental Health Institute in Pueblo. That’s where Dear will be treated for what forensic psychologists diagnosed as his delusional disorder. Under Colorado law, “mental disability,” like that delusional disorder, means a “substantial disorder of thought, mood, perception, or cognitive ability that results in marked functional disability,” which would significantly interfere with Dear’s ability to adapt to society.

In other words, the question is whether a defendant like Dear can keep himself integrated to a reasonable degree in society. The law states that Dear can be held no longer than his possible sentence—in his case, life in prison or possibly the death penalty—in efforts to rehabilitate him to legal competency. If the state psychologists and the court decide Dear will never become legally competent, they could begin the process of civilly committing Dear to a mental health facility for the rest of his life. They could also release him on bond with conditions that he must meet in order to remain out of state custody, such as remaining on medications or regularly meeting with psychiatrists.

Dear’s diagnosis centers on what the psychologists describe as Dear’s conspiratorial beliefs the federal government is targeting Christians and that the FBI has been watching him for decades. I’m curious as to how those beliefs are going to be “rehabilitated,” given that right-wing politicians and personalities use rhetoric similar, if not identical, to Dear’s. Even one of the psychologists herself admitted this fact during court testimony.

Really troubling, though, was the conclusion that Dear’s beliefs on abortion, the target of whatever fringe political beliefs he may espouse, do not fall into that delusional diagnosis. Those, psychologists testified during the first day of Dear’s competency hearing, are simply Dear’s deeply and sincerely held religious beliefs as to the moral wrong of abortion. 

Let me be clear. I am very uncomfortable with the government making conclusions as to which political beliefs are delusional and which are not. But I am even more uncomfortable with this idea that obstruction against reproductive health care can be explained away, and thus legally insulated, by religious beliefs. Political fringe beliefs, apparently, are enough to warrant a diagnosis of a disorder; anti-choice rhetoric, according to these courts, is a religious belief irrelevant to the matter at hand.

Should Dear ever be found legally competent, that would effectively continue the criminal case against him, months, maybe years later. The soonest prosecutors can request Dear be reevaluated to be declared competent to stand trial is three months from Wednesday’s ruling. But I’m guessing it’s going to take more time than those three months. Call it a hunch.

In the meantime, it’s good to remember that as we saw with Angel Dillard’s case last week in Wichita, Kansas, a trial is no guarantee of any justice or vindication of abortion rights. And like Wichita, Colorado Springs has a deeply ingrained anti-choice movement. Who’s to say a jury wouldn’t excuse Dear’s actions based on those religious beliefs, in much the same way one did in Dillard’s case?

Dear’s case raises troubling questions, then, for reproductive rights advocates: Do we really want him to stand trial? What about the risk of a jury embracing the idea that targeted violence against abortion providers and their patients just comes with the territory for someone who believes in delivering full-spectrum health care, including reproductive services?

What about the fact that anti-choice violence is so normalized in our culture that the courts, in two different cases in as many weeks, will go out of their way to excuse it? Given the increasingly violent anti-choice rhetoric and political climate, do we really have any choice but to fight back in every venue we can, including the courts?

I don’t have a good answer to any of those questions.

I know that these cases, when read together, potentially send some terrifying cues to the radical anti-abortion movement. Dear is now another “lone wolf” delusional person who was arrested for just happening to act out his violent delusions at a Planned Parenthood. Kind of like that young man in Wichita who walked into an abortion clinic to apply for a job. With a homemade bomb in his backpack. Dillard is just another fire-and-brimstone prison minister acting on her sincere religious beliefs that God called her to write a letter to Dr. Mila Means warning her about future car bombs. Not to incite any violence towards Means. Just to save her.

I had a law professor try to explain to me once that the law is often slow to catch up with popular opinion. Just look, for example, at marriage equality: Large swathes of the country had already accepted that discriminating against same-sex couples is wrong before the Supreme Court got around to agreeing with them.

So, then, what does that say right now about anti-abortion violence, if the courts in these cases too are slow to catch up with popular opinion? I think it means that we’ve got a long ways to go before abortion providers and patients can feel like their interests are being heard by the justice system. At all.

Commentary Sexual Health

Fewer Young People Are Getting Formal Sex Education, But Can a New Federal Bill Change That?

Martha Kempner

Though the Real Education for Healthy Youth Act has little chance of passing Congress, its inclusive and evidence-based approach is a much-needed antidote to years of publicly funded abstinence-only-until-marriage programs, which may have contributed to troubling declines in youth knowledge about sexual and reproductive health.

Recent research from the Guttmacher Institute finds there have been significant changes in sexuality education during the last decade—and not for the better.

Fewer young people are receiving “formal sex education,” meaning classes that take place in schools, youth centers, churches, or community settings. And parents are not necessarily picking up the slack. This does not surprise sexuality education advocates, who say shrinking resources and restrictive public policies have pushed comprehensive programs—ones that address sexual health and contraception, among other topics—out of the classroom, while continued funding for abstinence-only-until-marriage programs has allowed uninformative ones to remain.

But just a week before this research was released in April, Sen. Cory Booker (D-NJ) introduced the Real Education for Healthy Youth Act (REHYA). If passed, REHYA would allocate federal funding for accurate, unbiased sexuality education programs that meet strict content requirements. More importantly, it would lay out a vision of what sexuality education could and should be.

Can this act ensure that more young people get high-quality sexuality education?

In the short term: No. Based on the track record of our current Congress, it has little chance of passing. But in the long run, absolutely.

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Less Sexuality Education Today

The Guttmacher Institute’s new study compared data from two rounds of a national survey in the years 2006-2010 and 2011-2013. It found that even the least controversial topics in sex education—sexually transmitted diseases (STDs) and HIV and AIDS—are taught less today than a few years ago. The proportion of young women taught about STDs declined from 94 percent to 90 percent between the two time periods, and young women taught about HIV and AIDS declined from 89 percent to 86 percent during the same period.

While it may seem like a lot of young people are still learning about these potential consequences of unprotected sex, few are learning how to prevent them. In the 2011-2013 survey, only 50 percent of teen girls and 58 percent of teen boys had received formal instruction about how to use a condom before they turned 18. And the percentage of teens who reported receiving formal education about birth control in general decreased from 70 percent to 60 percent among girls and from 61 percent to 55 percent among boys.

One of the only things that did increase was the percentage of teen girls (from 22 percent to 28 percent) and boys (from 29 to 35 percent) who said they got instruction on “how to say no to sex”—but no corresponding instruction on birth control.

Unfortunately, many parents do not appear to be stepping in to fill the gap left by formal education. The study found that while there’s been a decline in formal education, there has been little change in the number of kids who say they’ve spoken to their parents about birth control.

Debra Hauser, president of Advocates for Youth, told Rewire that this can lead to a dangerous situation: “In the face of declining formal education and little discussion from their parents, young people are left to fend for themselves, often turning to their friends or the internet-either of which can be fraught with trouble.”

The study makes it very clear that we are leaving young people unprepared to make responsible decisions about sex. When they do receive education, it isn’t always timely: It found that in 2011-2013, 43 percent of teen females and 57 percent of teen males did not receive information about birth control before they had sex for the first time.

It could be tempting to argue that the situation is not actually dire because teen pregnancy rates are at a historic low, potentially suggesting that young people can make do without formal sex education or even parental advice. Such an argument would be a mistake. Teen pregnancy rates are dropping for a variety of reasons, but mostly because because teens are using contraception more frequently and more effectively. And while that is great news, it is insufficient.

Our goals in providing sex education have to go farther than getting young people to their 18th or 21st birthday without a pregnancy. We should be working to ensure that young people grow up to be sexually healthy adults who have safe and satisfying relationships for their whole lives.

But for anyone who needs an alarming statistic to prove that comprehensive sex education is still necessary, here’s one: Adolescents make up just one quarter of the population, but the Centers for Disease Control and Prevention estimate they account for more than half of the 20 million new sexually transmitted infections (STIs) that occur each year in this country.

The Real Education for Healthy Youth Act

The best news about the REHYA is that it takes a very broad approach to sexuality education, provides a noble vision of what young people should learn, and seems to understand that changes should take place not just in K-12 education but through professional development opportunities as well.

As Advocates for Youth explains, if passed, REHYA would be the first federal legislation to ever recognize young people’s right to sexual health information. It would allocate funding for education that includes a wide range of topics, including communication and decision-making skills; safe and healthy relationships; and preventing unintended pregnancy, HIV, other STIs, dating violence, sexual assault, bullying, and harassment.

In addition, it would require all funded programs to be inclusive of lesbian, gay, bisexual, and transgender students and to meet the needs of young people who are sexually active as well as those who are not. The grants could also be used for adolescents and young adults in institutes of higher education. Finally, the bill recognizes the importance of teacher training and provides resources to prepare sex education instructors.

If we look at the federal government’s role as leading by example, then REHYA is a great start. It sets forth a plan, starts a conversation, and moves us away from decades of focusing on disproven abstinence-only-until-marriage programs. In fact, one of the fun parts of this new bill is that it diverts funding from the Title V program, which received $75 million dollars in Fiscal Year 2016. That funding has supported programs that stick to a strict eight-point definition of “abstinence education” (often called the “A-H definition”) that, among other things, tells young people that sex outside of marriage is against societal norms and likely to have harmful physical and psychological effects.

The federal government does not make rules on what can and cannot be taught in classrooms outside of those programs it funds. Broad decisions about topics are made by each state, while more granular decisions—such as what curriculum to use or videos to show—are made by local school districts. But the growth of the abstinence-only-until-marriage approach and the industry that spread it, researchers say, was partially due to federal funding and the government’s “stamp of approval.”

Heather Boonstra, director of public policy at the Guttmacher Institute and a co-author of its study, told Rewire: “My sense is that [government endorsement] really spurred the proliferation of a whole industry and gave legitimacy—and still does—to this very narrow approach.”

The money—$1.5 billion total between 1996 and 2010—was, of course, at the heart of a lot of that growth. School districts, community-based organizations, and faith-based institutions created programs using federal and state money. And a network of abstinence-only-until-marriage organizations grew up to provide the curricula and materials these programs needed. But the reach was broader than that: A number of states changed the rules governing sex education to insist that schools stress abstinence. Some even quoted all or part of the A-H definition in their state laws.

REHYA would provide less money to comprehensive education than the abstinence-only-until-marriage funding streams did to their respective programs, but most advocates agree that it is important nonetheless. As Jesseca Boyer, vice president at the Sexuality Information and Education Council of the United States (SIECUS), told Rewire, “It establishes a vision of what the government could do in terms of supporting sex education.”

Boonstra noted that by providing the model for good programs and some money that would help organizations develop materials for those programs, REHYA could have a broader reach than just the programs it would directly fund.

The advocates Rewire spoke with agree on something else, as well: REHYA has very little chance of passing in this Congress. But they’re not deterred. Even if it doesn’t become law this year, or next, it is moving the pendulum back toward the comprehensive approach to sex education that our young people need.

CORRECTION: This article has been updated to clarify Jesseca Boyer’s position at the Sexuality Information and Education Council of the United States.