Mendacity Exposed: Researcher Debunks the Big Lie on Abortion and Mental Health

Jodi Jacobson

Increasingly our politics and policies are shaped by lies and misinformation spread with the purpose of supporting a political agenda.  The issue of abortion and mental health--discussed in this weekend's Washington Post--illustrates the case.

We live in a mendocracy.

As in: rule by liars.

These are the words of Rick Pearlstein writing in the Daily Beast about the complicity of both the Obama Administration and the mainstream media in perpetuating lies about Obama’s policies told by the far right during midterm election campaigns. These lies shaped public opinion and as a result, the outcome of the election.

“When one side breaks the social contract,” he continues, “and the other side makes a virtue of never calling them out on it, the liar always wins. When it becomes “uncivil” to call out liars, lying becomes free.”

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Pearlstein’s analysis can easily be extrapolated to the failure of mainstream media–and of government officials–to do their job in the debate around abortion in the United States, as was forcefully and eloquently argued in the Washington Post this past Sunday by Brenda Major, a professor of psychology at the University of California at Santa Barbara and a fellow at the Center for Advanced Study in the Behavioral Sciences at Stanford University.

Major writes about the distortion of scientific principles and research findings in one of the “newer” battles in abortion care, that which focuses on “harms” done to women who choose not to continue an unwanted or untenable pregnancy.  As we’ve reported here extensively on a state-by-state basis, and as Major points out in her article, under the banner of “a woman’s right to know” a number of states (Mississippi, Nebraska, South Carolina, South Dakota, Texas, Utah and West Virginia) have passed laws mandating that women seeking abortions be told that abortion is associated with mental health risks that include post-traumatic stress and a greater danger of suicide.

Except that it is patently untrue.

“It’s commendable to help women make an informed choice,” writes Major. “But an informed choice requires accurate information. And these laws mandate that women be misled.” [emphasis added].

Rigorous U.S. scientific studies have not substantiated the claim that abortion, compared with its alternatives, causes an increased incidence of mental health problems. The same conclusion was reached in 2008 by an American Psychological Association task force, which I chaired, as well as by an independent team of scholars at Johns Hopkins University. As recently as September, Oregon State University researchers announced the results of a national study showing that teenagers who have an abortion are no more likely to become depressed or to have low self-esteem one year or five years later, compared with their peers who deliver.

In other words, just like the case of the midterms in which a large share of the electorate believed “facts” about Obama’s policies that had no basis in, well, fact, “the claim that abortion harms women’s mental health persists,” states Major, despite scientific research and evidence completely debunking these claims.

Instead, as with other restrictions on women’s access to abortion and other forms of reproductive health care:

“Promoting this claim is part of a political strategy aimed at dissuading women from terminating a pregnancy and at making abortions difficult, if not impossible, to obtain. It is a strategy that distorts scientific principles, even as it uses the umbrella of scientific research to advance its aims.

Major points out two logical flaws in the arguments made by anti-choice proponents.

First “is a confusion of correlation with causation.” As part of their strategy, some anti-choice advocates “scour” existing data for evidence linking abortion and a wide variety of mental health issues, such as depression, anxiety and alcohol use. They cite any correlations they find as evidence that abortion causes harm to women.”

But “the most plausible explanation for the association that some studies find between abortion and mental health is that it reflects preexisting differences between women who continue a pregnancy and those who end one.”

A substantial amount of research shows that women who deliver babies are, on average, more likely to have planned and wanted their pregnancies and to feel emotionally and financially capable of becoming a mother. In contrast, women who seek abortions are, on average, less likely to be married or involved in an intimate relationship, more likely to be poor, and more likely to have suffered physical or psychological abuse. All of these latter qualities are risk factors for poor mental health.

Laws such as those in Nebraska ignore the fact that “the very characteristics that predispose women to emotional or mental health problems following an abortion also predispose them to postpartum depression if they deliver or to mental health problems in general, even if they do not become pregnant.”  Of course, if you’re worried about women you’d then also want to screen women for postpartum depression to assist them after birth. None of the laws in question do.

The second logical flaw in these campaigns “involves what psychologists call the “availability heuristic.””

Essentially, it means that vivid, first-person accounts that can be easily brought to mind, such as the personal stories of women who feel harmed by abortion, influence our estimates of the frequency of an event more than dry, statistical data do. For example, people think the probability of dying by homicide is greater than that of dying by stomach cancer, even though the rate of death by the latter is five times higher than death by the former. They err because examples of homicide are easier to recall than examples of stomach cancer.

In just this way, she underscores, “the emotionally evocative stories of a minority of women can lead people to overestimate the frequency of those experiences.”

Citing her own research, Major writes:

[B]ased on clinic interviews in the 1990s with more than 400 women who obtained a first-trimester abortion, shows that women who terminate an unplanned pregnancy report a range of feelings, including sadness and loss as well as relief. Nonetheless, two years after their abortion, most women say they would make the same decision if they had it to do over again under the same circumstances. Because of the stigma attached to abortion in our society, however, most women feel they can’t talk about their abortions – unless they repent. [emphasis added].

Yet despite the evidence, claims about the adverse effects on women of abortion are widespread and rarely challenged by the mainstream media.  In fact, they are, to the contrary, perpetuated by the media. 

For example, unsubstantiated claims about mental health were rife in debates about Nebraska’s abortion law, yet few if any stories generated by media outside the reproductive health community pointed to the lack of any evidence to support the claims on which the law was being written. Moreover, when quoting “experts,” equal time was often given to those who had no evidence to back up their claims as to those with knowledge of solid research and evidence on these issues, implying that the “viewpoints” or blatant misinformation spread by one set of actors were of equal merit to peer-reviewed research and data, even when that data proved otherwise. 

A similar failure of media responsibility occurrs with claims about “fetal pain,” a claim made by anti-choicers for which there is no evidence.  Recently, the Washington Post’s “On Faith” section gave a platform to each of two anti-choice advocates who spread misinformation on fetal pain (among a range of other things), Charles Camosy and Jill Stanek.  These are people whose agenda it is to deprive women of their agency in making choices for themselves about when, whether, and with whom to bear a child, and use wild and unsubstantiated claims in doing so, yet get space in “venerated” papers such as the Post. It does not suffice to say, “well, the Post also published Brenda Major’s article,” because again that is drawing equivalency between people who use lies to push for policies that accord with their own ideological agenda, and those who seek to inform public policy based on the best available evidence.  What standard is the Post accountable for when publishing people who are using religion and ideology as a means of depriving women (gay people, teens, prisoners, others) of their rights using unsupported claims?  Is it enough to articulate a “religious view” as a marker of legitimacy?  If the Catholic Church tomorrow decided it once again supported the view that the earth is flat, would the Post give the United States Conference of Catholic Bishops a page to argue that, and leave it unanswered?

False claims and lies used to advance political and ideological agendas are a central component of the anti-choice uber-strategy, but these same efforts to distract, deflect, and misinform are becoming an increasingly prevalent and uncontested characteristic of our social discourse more broadly–on gay rights, immigrants rights, climate change and inequality, among other areas of concern. In the abortion debate as in the political debate writ large, campaigns gear up to “inform” through misinformation leading to “misinformed choices” that comport with the agendas of those in power or who wish to be in power.  As our “mendocracy” has become more and more entrenched, Pearlstein states at Daily Beast: “Governing has become impossible.”  These trends endanger and diminish all of us and undermine the very fabric of a society seeking to survive and prosper.  It is up to each of us to protest the “age of misinformation” and stop it in its tracks.

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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