Waiting to Exhale: An Advocate Struggles with the Debate Over Warren

Jodi Jacobson

Most of the public debate on Obama’s selection of Rick Warren for the inauguration has centered on his opposition to gay rights, his “good works” on poverty and global AIDS, and Obama’s promise to “disagree without being disagreeable.”  This advocate struggles with “getting to yes.”

Most of the public debate on Obama’s selection of Rick Warren for the inauguration has centered on his vocal opposition to gay rights and to some extent abortion, his “good works” on poverty and global AIDS, and Obama’s desire to embrace those of different viewpoints in an effort to “disagree without being disagreeable.”

Even those most publicly vocal about their anger at the selection have tried to balance their criticism.  Writing in the Washington Post, Joe Solmonese, president of the Human Rights Campaign, cited Warren’s role as “a general in the campaign to pass California’s Proposition 8, which dissolved the legal marriage rights of loving, committed same-sex couples.”  At the same time he also nodded to Warren’s alter-identity by stating that he “has a sound message on poverty.”   On CNN’s After Party, Democratic consultant Donna Brazile disagreed with Warren’s positions on gay rights and abortion, but noted his work on poverty and global AIDS.

These two ends of the Warren spectrum have been cited by many commentators as evidence of Obama making good on campaign promises to find middle ground and move to meet the challenges we all face.  In Religion Dispatches, Anthony Pinn writes:

I personally reject Rick Warren’s theological orientation [and] conservative theological stances that demean, dehumanize, and limit life options.  [But] I understood what Obama’s call for common ground would entail long before I cast my vote for him.  “Getting to Yes,” as some might name it, would involve a surrender of some ground (in this case theologically-grounded viewpoints and stances) for the sake of larger, productive work on rather significant issues.

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And some, like Colbert King, also writing in the Washington Post, tell us all to just chill out.  

In all of recorded American history, no invocation preacher (not even Billy Graham)…has ever gone on to determine the course of U.S. policy, foreign or domestic.  Exhale, y’all.

I have been waiting to exhale, and have not yet found the place inside me to do so, despite the eloquent argument made by my colleague Scott Swenson on Reality Check that this is a long-term process of social change to which Obama is fully committed and that we are well on the road to realizing the changes toward which we have been working.

I wish I were this confident.  It is not the rhetorical promises about which I am worried.  It is the place where the legal rubber hits the road as we go forward about which I am less sure.  And it is the tendency in much of this debate, as Washington Post columnist Richard Cohen writes, to treat the “categorization of a civil rights issue — the rights of gays to be treated equally – [as] some sort of cranky cultural difference." 

I worry that many people have heard the “headlines” of Warren’s involvement on poverty and global AIDS so often they have failed to read the fine print. We treat the domestic and international sides of Warren almost as if they existed in alternative universes.  They do not.  His stands on women’s rights, gay rights, evidence-based prevention of HIV…these are the same domestically and internationally, though perhaps even more insidious internationally because the consequences of this type of thinking ingrained in our international policies often are hidden to us by the very distance between the US and countries recieving our aid, and the profound lack of power of those affected to speak out.

I worry that we use words like “disagreement and compromise” so frequently without specificity that we will fail to examine what tradeoffs we are talking about and whose interests we are trading off for what purpose.  Maybe it is just me: An Obama supporter from the beginning, I still felt much more comfortable when the nice but vague "The Change We Need" campaign slogan gave way to speeches and commercials that got down to brass tacks proposals about environment, economy, and health care.  Abraham is asked by God to make the unfathomable sacrifice of his son, but at least he knew what the sacrifice was and what the terms were on which he was being asked to make it. Abraham was an agent in the decision. 

I fear that legitimizing Warren and others with an extreme social conservative agenda makes it more likely that the kinds of compromises we have been making for the past 15 years—and which often are more in the hands of Congress and the states than the President to decide–will only become more rather than less pronounced.  

It is unlikely, for example, that there will be much controversy in working with Warren and his followers on issues like global warming.  I doubt the same is true of sexual and reproductive health and rights.

And contrary to King’s assertion, for example, Warren is indeed already heavily involved in making policy ranging from domestic policy (Prop 8) to international policy (global AIDS, trafficking).

Warren and other religious leaders helped ensure passage of the President’s Emergency Plan for AIDS Relief (PEPFAR), legislation that over the past 5 years has brought HIV treatment to between 1.5 million and 2 million people suffering from AIDS-related illnesses.  This is to be applauded.

But it is also true that Warren is one of the most powerful supporters of PEPFAR’S ideologically driven abstinence-only prevention policies.  In sub-Saharan Africa, where unprotected sex is responsible for 80 percent of new HIV infections, we’ve been funding programs that simply do not work.  With an estimated 5 to 6 new infections for every person put on treatment, sound prevention policies are fundamental to ending the AIDS epidemic.  But we constantly sacrificed these to compromise with the religious right.

Also during the first 5 years of PEPFAR, policies supported by Warren and other members of the social conservative far right led to the denial of funding to groups working with men who have sex with men and with sex workers.  Our policies on human trafficking reflect similar ideological approaches to a highly complex problem.  The result is to make highly marginalized groups even further marginalized.  When you raise these issues, you are labeled as divisive.

During the recent reauthorization of PEPFAR, which approved spending of $48 billion dollars on global AIDS through 2013, Warren lobbied heavily for maintaining restrictions on prevention that had been rejected by both government agencies and the public health community, as has been described in several recent articles on Reality Check.  To satisfy social conservatives, the bill purposefully omits mention of the links between HIV prevention and family planning.  Under pressure from the far right, guidance was written forbidding use of PEPFAR funding for the purchase of contraceptives for HIV positive women who wish to avoid a future pregnancy.  The law also contains a conscience clause allowing discrimination in the delivery of prevention, treatment, and care based on ideological objections to the individuals or groups in need.  

All of these policies were dressed up as “compromises” made to pass PEPFAR.  The problem is that the actual compromise effort never included representatives of any of the groups whose interests were on the chopping block.  So while we are treating people on one hand, we are also leaving others at greater risk of HIV infection in that same period, slowing progress toward ending the HIV epidemic.  From where I sit, these policies are neither morally or ethically sound nor financially responsible.  But they came out of the “compromises and common ground” in a Democratic Congress that primarily satisfied the ideological agenda of the far right.

And this is what worries me.  Is it a compromise when someone gives away your rights and you are not even there to object?  Why is it that the most fundamental issues of women’s health and basic human rights are always labeled as "cranky cultural differences" and as "too divisive?"  Why is that the place we are always forced to compromise?  The culture war is invariably invoked when it comes to women’s rights
and health, abstinence-only versus comprehensive sexual health, and a
host of other issues having to do with reproduction and sexuality. 
Never mind the facts and the overwhelming scientific evidence.  At some point, we need to draw a line, as I imagine many of my fellow citizens in the gay community may also feel.  When we do, we are "divisive."  Why is it divisive to stand up for your beliefs when others are doing the very same thing?

I am not against reaching out to or “hearing” the other side.  In fact, as someone who has worked for over 20 years on reproductive health, violence and HIV and AIDS, I’ve tried to find common ground with and negotiate with and compromise with many players.  And I am not advocating for disruptive action at the invocation.

But I am very clear on one thing: I have a fundamental disagreement with the religious right (as I have come to know it over the past 15 years) on core issues regarding safer sex, reproductive and sexual health, women’s rights, contraception, abortion, and a host of other issues.  Though I am an active participant in my own faith community, I don’t believe there is “one way” determined by God.  I believe there is the right way for each person, given their circumstances, their religious beliefs, their value system and their moral standards.  I believe all people have both rights and responsibilities when it comes to sex and sexuality, but it is not for government or religion to decide how responsible consenting adults can or should live, when and whether they choose to have consensual sex, or when and whether they choose to have children.  I believe women have the right to make decisions about their bodies.  I believe basic reproductive and sexual health care is primary health care.  I believe that people should have the right to marry whomever they desire.  I believe public health and human rights objectives should drive health and development policy.

From what I have heard to date, Warren and his colleagues in the institutional evangelical and Catholic Church believe that it’s “god’s way or the stairway to hell.”

So when we talk about “getting to yes” and “compromise” in such a vague way on such a large scale, it worries me.  Historically, that means giving away women’s rights.  I have seen this movie repeatedly.  We have compromised with the social conservatives for years—indeed they have in many ways controlled the debate by using misleading statements and by flouting evidence to steadily reduce access to sexual and reproductive health care here and abroad.

Where does it stop?

I sincerely and truly hope we can find common ground on policies that seek to reduce the number of unintended pregnancies, but I also would maintain that we will never eliminate the need for access to safe abortion.  We must provide education, information, and training to adolescents and encourage them to delay sexual activity–I have a 12-year old and a 9-year old and believe me they are being taught these values.  But they still have to be equipped for the day they do have sex, whether or not they are married.  We can decide to hold our own individual beliefs on—and choose as individuals whether or not to join a faith community that denies–the rights of gays to marry, but for me it is morally indefensible for religious leaders to use the law to prevent gays from having the same legal rights in partnership as others.

The generational change about which Scott speaks on gay rights came on reproductive health came long ago.  The vast majority of the American population supports family planning, comprehensive sexuality education and access to safe abortion.  Laws and policies that infringe on these rights do not represent “compromise” but rather capitulation to a small minority of voters by politicians who have not acted on their own moral authority to stand up and oppose the erosion of these rights.

So I wonder, at the inauguration, could we not have had a voice whose message could propel the Administration into its first few months by unapologetically claiming as moral and ethical those very areas that have been contested for so long only through one lens?  

Scott writes that “Obama demonstrates that progressive ideas on gay issues, sex ed, contraception and abortion are moral choices.  He invites Warren to join him, even while disagreeing on gay rights and abortion, to find new common ground.”

I wish, for one day, that this could have been part of a seamless and unequivocal message to Americans:  “These are moral choices and we embrace them as a critical component of the “significant issues” on which we are going to be working together from today forward.”  Having made this statement unapologetically, having established this framework and this platform—we all are making moral choices as we understand them, but we have a communal responsibility to public health and human rights–we could have moved forward.  We—all Americans as responsible and vested parties in the future of our country—could have moved forward with the new President and the new Congress into the next four years of critical work to address pressing issues, and worked through negotiation and compromise with all the stakeholders at the table.

If we had started on that footing, I would be a lot less worried.  I pray I have no reason for concern.

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

Commentary Sexuality

Black Trans Liberation Tuesday Must Become an Annual Observance

Raquel Willis

As long as trans people—many of them Black trans women—continue to be murdered, there will be a need to commemorate their lives, work to prevent more deaths, and uplift Black trans activism.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

This week marks one year since Black transgender activists in the United States organized Black Trans Liberation Tuesday. Held on Tuesday, August 25, the national day of action publicized Black trans experiences and memorialized 18 trans women, predominantly trans women of color, who had been murdered by this time last year.

In conjunction with the Black Lives Matter network, the effort built upon an earlier Trans Liberation Tuesday observance created by Bay Area organizations TGI Justice Project and Taja’s Coalition to recognize the fatal stabbing of 36-year-old trans Latina woman Taja DeJesus in February 2015.

Black Trans Liberation Tuesday should become an annual observance because transphobic violence and discrimination aren’t going to dissipate with one-off occurrences. I propose that Black Trans Liberation Tuesday fall on the fourth Tuesday of August to coincide with the first observance and also the August 24 birthday of the late Black trans activist Marsha P. Johnson.

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There is a continuing need to pay specific attention to Black transgender issues, and the larger Black community must be pushed to stand in solidarity with us. Last year, Black trans activists, the Black Lives Matter network, and GetEQUAL collaborated on a blueprint of what collective support looks like, discussions that led to Black Trans Liberation Tuesday.

“Patrisse Cullors [a co-founder of Black Lives Matter] had been in talks on ways to support Black trans women who had been organizing around various murders,” said Black Lives Matter Organizing Coordinator Elle Hearns of Washington, D.C. “At that time, Black trans folks had been experiencing erasure from the movement and a lack of support from cis people that we’d been in solidarity with who hadn’t reciprocated that support.”

This erasure speaks to a long history of Black LGBTQ activism going underrecognized in both the civil rights and early LGBTQ liberation movements. Many civil rights leaders bought into the idea that influential Black gay activist Bayard Rustin was unfit to be a leader simply because he had relationships with men, though he organized the 1963 March on Washington for Jobs and Freedom. Johnson, who is often credited with kicking off the 1969 Stonewall riots with other trans and gender-nonconforming people of color, fought tirelessly for LGBTQ rights. She and other trans activists of color lived in poverty and danger (Johnson was found dead under suspicious circumstances in July 1992), while the white mainstream gay elite were able to demand acceptance from society. Just last year, Stonewall, a movie chronicling the riots, was released with a whitewashed retelling that centered a white, cisgender gay male protagonist.

The Black Lives Matter network has made an intentional effort to avoid the pitfalls of those earlier movements.

“Our movement has been intersectional in ways that help all people gain liberation whether they see it or not. It became a major element of the network vision and how it was seeing itself in the Black liberation movement,” Hearns said. “There was no way to discuss police brutality without discussing structural violence affecting Black lives, in general”—and that includes Black trans lives.

Despite a greater mainstream visibility for LGBTQ issues in general, Black LGBTQ issues have not taken the forefront in Black freedom struggles. When a Black cisgender heterosexual man is killed, his name trends on social media feeds and is in the headlines, but Black trans women don’t see the same importance placed on their lives.

According to a 2015 report by the Anti-Violence Project, a group dedicated to ending anti-LGBTQ and HIV-affected community violence, trans women of color account for 54 percent of all anti-LGBTQ homicides. Despite increased awareness, with at least 20 transgender people murdered since the beginning of this year, it seems things haven’t really changed at all since Black Trans Liberation Tuesday.

“There are many issues at hand when talking about Black trans issues, particularly in the South. There’s a lack of infrastructure and support in the nonprofit sector, but also within health care and other systems. Staffs at LGBTQ organizations are underfunded when it comes to explicitly reaching the trans community,” said Micky Bradford, the Atlanta-based regional organizer for TLC@SONG. “The space between towns can harbor isolation from each other, making it more difficult to build up community organizing, coalitions, and culture.”

The marginalization that Black trans people face comes from both the broader society and the Black community. Fighting white supremacy is a full-time job, and some activists within the Black Lives Matter movement see homophobia and transphobia as muddying the fight for Black liberation.

“I think we have a very special relationship with gender and gender violence to all Black people,” said Aaryn Lang, a New York City-based Black trans activist. “There’s a special type of trauma that Black people inflict on Black trans people because of how strict the box of gender and space of gender expression has been to move in for Black people. In the future of the movement, I see more people trusting that trans folks have a vision that’s as diverse as blackness is.”

But even within that diversity, Black trans people are often overlooked in movement spaces due to anti-Blackness in mainstream LGBTQ circles and transphobia in Black circles. Further, many Black trans people aren’t in the position to put energy into movement work because they are simply trying to survive and find basic resources. This can create a disconnect between various sections of the Black trans community.

Janetta Johnson, executive director of TGI Justice Project in San Francisco, thinks the solution is twofold: increased Black trans involvement and leadership in activism spaces, and more facilitated conversations between Black cis and trans people.

“I think a certain part of the transgender community kind of blocks all of this stuff out. We are saying we need you to come through this process and see how we can create strength in numbers. We need to bring in other trans people not involved in the movement,” she said. “We need to create a space where we can share views and strategies and experiences.”

Those conversations must be an ongoing process until the killings of Black trans women like Rae’Lynn Thomas, Dee Whigham, and Skye Mockabee stop.

“As we commemorate this year, we remember who and why we organized Black Trans Liberation Tuesday last year. It’s important we realize that Black trans lives are still being affected in ways that everyday people don’t realize,” Hearns said. “We must understand why movements exist and why people take extreme action to continuously interrupt the system that will gladly forget them.”


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