On the Frontlines: A Counselor Addresses a Gauntlet of Lies

Mary Lou Greenberg

By the time a woman arrives at the clinic, she has already thought a lot about her pregnancy and what to do next.  But she still has to run a gauntlet of people questioning her, and confront their lies.

This article originally appeared in On the Issues magazine and is reprinted here with permission.

Several older women stood on the sidewalk a few feet from the entrance to Choices Women’s Medical Center in Queens, New York. They aggressively approached every woman who walked towards the door, literally getting in their faces with rosaries and anti-abortion literature in hand.

“Don’t kill your baby,” they implored, planting themselves between the woman and the clinic entrance. “We can help you.”

I had come to Choices to interview head counselor Sophia McCoy, and the first thing I asked was what she thought about the protestors.

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“I walk in past them every day. I can’t be up in arms about them all the time or I couldn’t do my job. But they really upset some of the women.”

McCoy has headed up counseling services at Choices for five years, training other counselors and, herself, talking to dozens of women each day who come to the clinic for abortions, both first and second trimester. “I discuss the abortion procedure with them,” she said, “and make sure they are sure and feel secure about their decision.”

“By the time a woman arrives at Choices,” McCoy said, “she has already thought a lot about her pregnancy and what to do next. A woman’s decision depends a lot on how well she knows her partner, relations with her family, what’s going on in her life…her age, her school, work, health. Most have tried to talk to a close friend or relative. Making that first phone call to the clinic for an appointment can be very scary. And then they get here and run into the protestors.

“Most women are very firm in their decision. They are generally confident about what they want to do with their lives and often have good support for their decision to have an abortion. It’s not easy for protestors to approach these women. I’ve seen women say, ‘get away from me,’ and walk right up to the door. But I’ve also seen women go back and forth, inside to the waiting room and outside to the protestors, sometimes for an hour. These women are generally more ambivalent to begin with, and the protestors have an easier time talking to them. Some are affected by the offers of free baby showers and financial help for diapers. But this often doesn’t last long. The protestors also tell a lot of lies.”

In fact, much of McCoy’s job is to educate women, something that she accomplishes by bringing to bear both her medical training and her own personal experience. She is on the front lines, addressing a gauntlet of lies and a vacuum of accurate information daily.

After a woman comes into the clinic and registers at the front desk, she has a sonogram and blood work. Then she sees a counselor. “If a woman expresses doubts,” McCoy said, “I try to explore her feelings with her, what the pros and cons are of having the procedure, based on who she is, and help her resolve any questions. If she feels sad, I tell her it’s okay to be sad, but the main thing is for her to be sure that this is the right thing for her to do at this time. And it has to be her decision, her choice. It’s only after I’m confident this is the case that she has the procedure.”

“The protestors tell women that we don’t care about them. They say that ambulances come and take women away once or twice a day here, that women have to have hysterectomies after an abortion, that we throw away ‘the baby’ (that’s what they call it) in the garbage afterwards. All of these are just lies. And many women don’t know how their own body functions or about the reproductive process.

“I talk to the women about all this. When a patient comes in and she’s upset, I explain to her the importance of being able to come here and what women went through before abortion was legal. I tell them, ‘Today, abortion is very safe, but it wasn’t always that way.’

“Women are not aware of the history of abortion, that women had to be driven long distances to find a doctor who would do one. Or women would get an illegal and unsafe procedure. I tell them this is why we have to fight to keep abortion legal and a woman’s right.”

The Impact of a Photo – And a Teenager’s Death

When she was about 11 or 12 growing up in Queens, McCoy heard her mother and grandmother talking at home about how difficult it had been to get an abortion before it was legal. She read about it in the pioneering women’s health care book, Our Bodies, Ourselves, and saw a photo that she could never forget. It was of a woman lying on a motel room floor who had died from an illegal abortion (now known to be a picture of Gerri Santoro.) After high school when McCoy was an accounting student, she heard about a fellow student who had tried to use a bottle to terminate her pregnancy.

“The topic just kept coming up,” McCoy recalled. “You know how you hear a lot of stories growing up, and some things jump out at you and eventually it all takes shape. Well, these stories stayed with me, and I knew I needed to be part of not letting this happen again.”

“I discovered that accounting really wasn’t for me; I wanted to work with people more. I studied forensic psychology for three years, but then I saw an advertisement for a school for medical and dental assistants and I thought, ‘maybe that’s for me.’ By that time, I was a single mother with three young children. As part of my medical assistant training, I did an internship at Choices specifically to learn about second trimester abortions. And then it happened that I needed a second trimester procedure myself. Shortly afterwards, I applied for a medical assistant job at Choices and was asked to become a counselor because I had worked in every area of the clinic and knew the procedure so well, including through my own personal experience. During my interview, the social worker showed me the exact same photo that had made such an impression on me earlier…I knew this was where I needed to be.”

Another thing that had a big impact on McCoy was the story of 17-year-old Becky Bell, who died from an illegal abortion in 1988 in Indiana, a state that required minors to get parental notification or a judge’s waiver. But word on the street was that the judge was anti-choice and hardly ever said yes. Becky couldn’t bear to “disappoint” her parents, so, it turned out, she got an illegal abortion. A few days later she ended up in a hospital where she died of a massive infection caused by whatever was done to her.

“I have three children, including a 17-year-old daughter,” McCoy said, “and when we first talked about sex, all I could think about was Becky Bell. Young people get the wrong information on the streets or from boyfriends – so I knew what I had to do…even if it meant getting her birth control at a young age. I want my daughter alive and healthy.”

“A parent’s views on sex may differ from her child’s, but I am so happy there is a place like Choices where my children can go if they need to. Teenagers, like Becky Bell, can become desperate to avoid hearing those words, ‘You disappoint me.'”

In fact, McCoy encourages her daughter’s friends to come over to her home to talk, and this has developed into a regular weekly session about what’s going on in their lives, their thoughts and feelings, including about sex, contraception and other reproductive health matters.

Getting Patients to Open Up

“I have to keep asking the patients, ‘how do you feel?'”

“What gets to me most in counseling at the clinic,” McCoy said, “is the lack of self-esteem the women have. I try to get the woman to focus back on herself, her own life, and what she wants.”

This isn’t easy. “Often,” McCoy continued, “a woman will talk about how everyone else feels about the pregnancy but herself. It’s never about them, and I have to keep asking, ‘how do you feel about becoming a mother, what do you want?’ I worry most about the 15-16-17-year olds. They have such low self-esteem, and they think that having a baby would make them more of a person… They also think that a baby would give them the love they often don’t feel from anyone or anywhere else.”

I have to keep asking, ‘how do you feel about becoming a mother?’

“It gets to me sometimes,” McCoy said. “Some women think that having the baby would make their boyfriends stay with them, even though they really don’t want to have a child right now. Their need for someone else’s approval takes over everything else. It comes from an empty space that needs to be filled; until you look in the mirror and like the person you see in it, you’re always going to be seeking approval from someone else. They’ve got to learn to stand up for what’s right for them, and sometimes that means simply saying ‘no’.”

She sees this lack of self-esteem among her daughter’s friends, as well. “The message they get from music videos and TV is it’s okay to run around naked and have sex with multiple partners, that this is the way to get attention, to get love.” McCoy cited one young woman who got her tongue pierced. “I asked her why, and she said she did it because men liked that when women gave them oral sex. Now, I could see it if she said she liked the way it looked or the way it felt,” McCoy continued, “but this was to please a man, not herself!”

“Sex is sometimes not really consensual, with girls just going along with it because their boyfriends want it. This is really just another form of abuse,” she said. “Adult women find themselves in this situation so how could teens be different?”

McCoy said her experience at the clinic as well as with her daughter’s friends shows “there’s a great need for programs in schools and other places where teens can come and talk about these things. When you give them a chance to say what’s on their minds, they really open up, and in a group, they encourage each other to talk. They can see that what they’re thinking and going through is similar to what’s happening to others.”

Until that time comes, Sophia McCoy will be on the frontlines, offering her experience, wisdom and reality-based information to help women make informed decisions that are truly right for them.

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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