The Wrong Recipe for Ending The Culture Wars? A Response to Saletan

Jodi Jacobson

In today's New York Times, William Saletan offers a misguided prescription for ending the "culture" wars and perpetuates the myths of "moral" versus "practical."

In his op-ed in today’s New York Times, William Saletan offers what appears to be a simple prescription for "ending the culture wars," by offering proposals for birth control, abortion, and gay marriage.

His basic premise:

"Our moral debates have become stale and fruitless.  The reason is that we’ve pitted morality against practicality.  These two principles need each other.  Let’s marry them"

I will leave aside the issue of gay marriage, about which I agree with Saletan’s conclusion.  Extend to all who want to marry the right to marry. 

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But I disagree with the basic premises underlying the rest of Saletan’s piece and found much of it deeply troubling. 

In suggesting President Obama take on the issue of abortion in his address to Congress, Saletan says that to change the debate on contraception and abortion, President Obama will have to:

"tell two truths that the left and the right don’t want to hear: that morality has to be practical and that practicality requires morals."

He later states:

"Our challenge is to put these two issues [abortions and birth control] together. For
liberals, that means taking abortion seriously as an argument for
contraception. … Reproductive-health counselors must speak bluntly to women who are
having unprotected sex. And as Mr. Obama observed last year, men must
learn that ‘responsibility does not end at conception.’"

To be honest, I found this insulting, for several reasons.  First, women’s rights advocates and reproductive health providers have always put these two issues together.  It’s called "prevention" and it is the core of reproductive health services that include efforts to prevent unintended pregnancies, prevent infections, assist people who wish to get pregnant, offer pre-natal and maternal care, and much more.

What exactly does Mr. Saletan think reproductive health counselors do, but guide people toward protected sex, help them find the methods they need and which will work best for them, and counsel them on correct and consistent use?  Has he ever been in a clinic and availed himself of the services?  I have.  Many times.  It might be time for him to take a trip to one. 

Yet Mr. Saletan wraps up his argument in a neat little set of statistics meant to show that access to birth control is not the problem, but rather the cavalier attitudes of women having sex. 

I beg to differ.

Real access to birth control and to accurate information is a huge problem in this country.  Given the current climate, everything from condoms to emergency contraception is contested by the Catholic Church and various entities on a daily basis.  Hormonal methods and IUDs are labeled as abortifacients, and many anti-choice organizations don’t recognize the medical definition of pregnancy as defined by professional medical societies in the US and internationally.  We have come out of 8 years of efforts to deny women access to primary health services, and out from under an Administration that tried everything it could to hamstring service delivery and to misinform the public, including having the Centers for Disease Control put out inaccurate information on condoms and on abortion and breast cancer; giving a pass to Senator Frist–a medical doctor–when he claimed on a news program that HIV could be transmitted through saliva; delays in approval of emergency contraception; delays in approval of waivers for Medicare coverage of family planning; and now regulations that allow any provider to deny people access to legal services for any reason.  These are but a few examples.

It gets a little harder each day to deliver services to prevent unintended pregnancy
and perform your duties when you might at any moment have your clinic
bombed, have false clients with hidden video cameras telling lurid stories to try to entrap you, or when, as will begin this Wednesday, February 25th, the
anti-choice movement begins a "40-days-for-Life" series of Lenten
protests outside of clinics, many of which don’t even provide abortions,
but do provide birth control.  When discussing this with the head of a
clinic in the midwest today, I asked (knowing the answer but I had to
ask), "if you are not providing abortions, why are they protesting
there?" 

Answer: "They object to birth control."

How many people do you think will end up with unintended pregnancies
in the next 40 days who otherwise might not have gotten pregnant if
they did not need riot gear to enter a clinic?

Is this moral?

And let’s at least mention a much-discussed issue on Rewire: we’ve spent $1.5 billion the past 10 years on abstinence-only-until-marriage programs that have been completely discredited, tell girls it is their fault if they are raped and ensure that girls who are "prepared for sex" (e.g. birth control) are made out to be dirty, slutty, and immoral.

Think they are going to raise the issue of birth control when the time comes?

Saletan does not address or critique these policies in depth, he simply glides over them as "a second front in the culture wars" on the way to blaming women, providers, and liberals for, again, being too cavalier about and not recognizing the moral dimensions of abortion.

Abortion, he says, isn’t about:

"a shortage of pills or condoms. It’s a shortage of cultural
and personal responsibility. It’s a failure to teach, understand, admit
or care that unprotected sex can lead to the creation — and the
subsequent killing, through abortion — of a developing human being."

This is the piece I find most insulting. And if Saletan wanted to bridge some sort of divide, he lost me right there.

Why?  Because this is not about pitting "morals" against
"practicality."

It is about fundamental moral differences. 

The real issue is that when we talk about "morals," we only ever posit one set of morals in all of this,
the "morals" of the ultra-right, of fundamentalist Christian
evangelicals and of the Catholic Church (as opposed to the Catholic
laity who use contraception and turn to abortion at the same rates as
anyone else in the population).  

In fact, contrary to what Saletan says, part of the problem is that the issues of
sex, birth control, reproduction, sexuality, and abortion are always
portrayed as "moral" versus "practical" or as "lifestyle" issues.  Put it this way and it is a quick slide down the slippery slope to "you have no morals if
you are only thinking of your own practicality."  You can substitute the words convenience, needs,
career, lifestyle….you get the picture.  This is the argument of the far right. They are moral, we are hedonistic and "practical" about the consequences.

However, there are those of us who believe that abortion is a moral choice. That it is not
"killing another human being" to have an abortion before a fetus is viable.  That there are moral reasons for late-term abortions if a woman’s life or health is in danger or for other reasons about which the decision should be made between the woman, her doctor, and her God, if she has any. 

There are those of us—women, men, people of faith—who believe women
are indeed moral actors in deciding to have an abortion, and who have moral
positions on positive approaches to sex, sexuality, and contraception.  These moral
positions just don’t comport with the
"other" moral positions and they were not the moral positions of the powerful over the past 8 years. 

But the premise of a pluralistic society is that we have the right to make moral decisions based on our personal beliefs in contested
areas such as sex and reproduction in which we don’t want to follow
someone else’s God or party line. 

The real problem, I would argue, contrary to Saletan, is the immorality of a set
of actors who have used these issues as a way to increase their power
and their own flocks, and on the way, enrich themselves. 

I am not claiming that good people in good faith do not have difficulty with the issue of abortion.  I do claim that they have no right to decide such a personal issue for someone else, and especially not in a climate in which the very preventive tools and services necessary to reduce unintended pregnancies have become so contested.  And I do dismiss those who I see as being there more for political gain than anything else.

Saletan either does not understand this or wishes not to address it.

The real problem here is that we are simply unable as a nation to have a conversation about what
it would mean to have healthy, safe, consensual sexual lives as a normal aspect of human development. We deny
people basic services.  We mislead adolescents and young adults.  We let women suffer health consequences of lack
of care without admitting any social responsibility.  And then we blame
the women.  I call that immoral and unethical.

So let’s be practical and moral.  Let’s zero out the abstinence-only-until-marriage funding that has fed the coffers of groups who undermine effective prevention and responsible decision-making by perpetuating misinformation and using fear, shame, and ideology to mislead adolescents.  The President needs to do this in his budget this week.  Let’s work to pass–this spring–the Prevention First Act, the Responsible Education About Life (REAL Act), the Affordable Birth Control Act, the Medicaid waiver about which the Republicans so bombastically grand-standed during the stimulus debate.  Let’s ensure that all government funded reproductive health services get full funding without delay, in this next appropriations bill.  Let’s get rid of the ridiculous regulations put in place by HHS before Bush left office. Let’s condemn the misinformation campaign that as dominated the debate for too long and which is enabled by silence of those who talk morality about abortion but never call out the actors who misrepresent the issues.  Address gender-based violence, stigma, and discrimination against women, and against gay, lesbian, and transgender persons.  This strategy is moral because it fulfills the real needs of individuals and groups who need access to health care and services, improves health and saves lives, and practical because it enables people to make responsible decisions in their own contexts, and also because it saves us all money in health care and social costs down the line.  Prioritize these and other efforts, and engage a healthy national conversation about sex as part of life, and I assure you unintended pregnancies and infections will decline.

So I think what President Obama most needs to say is what he should have said during the stimulus debate: 

Reproductive health care is basic health care.  It is a personal issue, an economic and family issue, and a social issue.  We need to focus on prevention based on evidence of what works, and honor the diverse views of a pluralistic society.  Therefore, I will no longer allow this issue to become politicized, nor allow policy to be based on misinformation spread about birth control, reproductive health services or sexual health education.  We all want to reduce unintended pregnancies.  By doing so, we can reduce the number of abortions.  But understand that women will still need access to safe abortion services and must be respected as the moral agents in choosing what is best for them.  We must respect each other as moral actors.  We must understand that our strength lies in the plurality of views in this country and the fundamental right to freedom of religion.  We can not allow these principles to be further eroded.  Therefore, I pledge as a first step to lay the basic foundation for "common ground" by creating the policies and the funding needed to expand access to the services and information needed by all people to make responsible choices about sex and reproduction.  

Recognizing diversity of moral choices and positions, and putting prevention first despite the outcry of the powerful minority, is the only way to move beyond the "tired debates" of the past.

[This post was updated at 7:18 am February 23rd.]

 

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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