Weekly Audit: Millions of Americans Could Lose Unemployment Benefits

Weekly Audit: Millions of Americans Could Lose Unemployment Benefits

According to official statistics, nearly 15 million Americans are unemployed. Between 2 and 4 million of them are expected to exhaust their state unemployment insurance benefits between now and May. Historically, during times of high unemployment, Congress provides extra cash to extend the benefits. Congress has never failed to do so when unemployment is above 7.2%. Today’s unemployment rate is above 9% and the lame duck session of Congress has so far failed to extend the benefits.

Congress has until November 30 to renew two federal programs to extend unemployment benefits, as David Moberg reports for Working In These Times. Last week, a bill to extend benefits for an additional three months failed to garner the two-thirds majority it needed to pass in the House. The House will probably take up the issue again this session, possibly for a one-year extension, but as Moberg notes, it’s unclear how the bill will fare in the Senate. The implications are dire, as Moberg notes:

The result? Not just huge personal and familial hardships that scars the lives of young and old both economically and psychologically for years to come.  But failure to renew extended benefits would also slow the recovery, raise unemployment, and deepen the fiscal crises of state and federal governments.

But wait! There’s more:

  • The Paycheck Fairness Act died in the Senate last week, as Denise DiStephan reports in The Nation. The bill would have updated the 1963 Equal Pay Act to close loopholes and protect employees against employer retaliation for discussing wages. All Republican senators and Nebraska Democrat Ben Nelson voted not to bring the bill to the floor, killing the legislation for this session of Congress. The House already passed its version of the bill in 2009 and President Barack Obama had pledged to sign it.
  • Economist Dean Baker talks with Laura Flanders of GritTV about quantitative easing (a.k.a. the Fed printing more money) and the draft proposal from the co-chairs of the deficit commission. Baker argues that we’re facing an unemployment crisis, not a deficit crisis.
  • Charles Ferguson’s documentary “Inside Job” is a must-see, according to Matthew Rothschild of The Progressive. An examination of how Wall Street devastated the U.S. economy, the film details the reckless speculation in housing derivatives, enabled by crooked credit rating schemes, that brought the entire financial system to the brink of collapse. The film is narrated by Brad Pitt and features appearances by former Governor and anti-Wall Street corruption crusader Eliot Spitzer, financier George Soros, and Prof. Nouriel Roubini, the New York University economist who predicted the collapse of the housing bubble.

This post features links to the best independent, progressive reporting about the economy by members of The Media Consortium. It is free to reprint. Visit the Audit for a complete list of articles on economic issues, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Mulch, The Pulse and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

Post-Election: Will Wisconsin Be the Next Battleground Over Pro-Choice, Pro-Health Policies?

Updated 11/24/10, 6:10pm EST

Governor-elect for Wisconsin, Scott Walker, has worked hard over the years to wrest control away from women when it comes to their own medical and health decisions. During his time in the state legislature, Walker wrote a bill that would, according to Planned Parenthood, “allow pharmacists to deny women’s doctor-prescribed birth control” as well as sided with “big insurance companies who refused to provide coverage of prescription birth control as well as maternity care, mammograms and cervical cancer screenings.” 

Walker is as far from the state’s current Democratic Governor Jim Doyle, on women’s health issues as one can get. Doyle has been a key women’s health and rights supporter over the years. And while the voters elected Walker, Nicole Safar, Legal & Policy Advisor for Planned Parenthood Advocates of Wisconsin, says that voters didn’t necessarily agree with him on these issues in particular – they didn’t vote on the issues about which Walker presented himself as “far to the right” during the campaign. Still, the make-up of the state legislature also “dramatically shifted” notes Safar.

“Not only did we lose many pro-choice advocates who were replaced with anti-birth control advocates but the leadership is extremely conservative on this issue.”

Safar says that some of those include legislators, like State Representative Daniel LeMahieu (now on the Joint Finance Committee) who sponsored a bill in 2006 which passed the State Assembly, banning college campuses from advertising, prescribing or dispensing emergency contraception; it was written so broadly, however, that it may have banned all prescription birth control. Is this what Wisconsin residents can expect, in terms of their reproductive and sexual health care access and ability to make their own health care decisions, from a a new set of state leaders?

Safar is not so sure. “If they push too far to the right too quickly there will be significant backlash from residents.” She says that post-election polls show that independent voters supported Walker despite feeling “very uncomfortable” about his extreme stances on social issues. Those who expressed they were “very worried” about the economy voted for Walker by a 70 to 30 percent margin. In fact, the more “divisive” issues, like abortion, took a back-seat to the economy for voters in the state, as they did around the country when it came to supporting candidates.

In his gubernatorial campaign, Walker was endorsed by the extreme, anti-birth control, anti-choice group Pro-Life Wisconsin, and he supports extreme restrictions outlawing abortion across the spectrum – believing that young women who become pregnant as a result of rape or incest should be forced by the government to carry their pregnancy to term. In their endorsement the group called out Walker’s belief that “unborn children are persons deserving full legal protection” as a key reason for their support. The group’s mission includes total opposition not only to abortion in all cases but to birth control as well. Robin Marty, writing on Rewire, quotes Planned Parenthood Advocates of Wisconsin as noting that:

Pro-Life Wisconsin opposes all forms of FDA approved methods of contraception, including birth control pills and condoms. In the 2007 Senate hearing on the Compassionate Care for Rape Victims Act, a Wisconsin law requiring emergency rooms to provide rape victims with information about and access to emergency birth control to prevent pregnancy, Pro-Life Wisconsin Legislative Director Matt Sande explained that the “consistent” position of the organization is that birth control causes abortion, and that they find contraception and abortion equally objectionable.”

Given that Walker seems likely to walk a resolutely anti-choice line in his role as Governor of the state, and that the state legislature leadership is anti-choice, what might women of all ages, young adults needing sex-ed, and those who wish to plan for their families without government intrusion, as well as health providers themselves look forward to in terms of policies related to reproductive and sexual health?

Safar puts it bluntly: “We’re hoping he [Walker] beomes a little more moderate but he hasn’t given any indication he would.”

In his first official act as Governor, in fact, Walker intends to authorize the state’s Attorney General to join the group of nearly two dozen AGs from around the country in the Florida lawsuit charging the unconstitutionality of the health reform law.

On November 1st, under Democratic Governor Jim Doyle, Wisconsin implemented a plan to make permanent the state’s expanded Medicaid program which provides free contraception to low-income residents ages 15 – 44 years old, doing away with the requirement that the state re-apply to the program each year. The plan, under the new health care reform law, allows the state to “continue providing free birth control pills, vasectomies and other contraceptives (as well as Pap smears and sexually transmitted infection testing) to more low-income people than some states without having to periodically reapply, as the state must do now.” Though the plan hasn’t actually been approved by the federal government yet, the state has gone ahead under the assumption that it will.

Pro-Life Wisconsin and other anti-choice advocacy groups have made it a priority to attempt to block access to the program by low-income young adults.

Walker has said that Wisconsin’s Medicaid program, BadgerCare, should be cut completely, in fact.

Lon Newman, executive director of Wisconsin’s Family Planning Health Services, says that while he can only speculate as to what anti-choice state leaders may attempt to push through this session, advocates in the state are preparing to defend against a host of state legislative attacks, including the fight to eliminate teens from eligibility for the Medicaid-paid family planning access program. In addition, however, Newman notes that they could be looking at a push to defund family planning services in general, and an attempt to repeal the state’s Healthy Youth Act, which provides for medically accurate, age appropriate, unbiased, sexuality education in middle and high schools which offer human growth and development classes for students. The act was signed into law by Governor Doyle earlier this year.

Safar says that Planned Parenthood’s “number one priority”  this upcoming session is to protect family planning in Wisconsin. Planned Parenthood serves 75,000 patients in Wisconsin and the total family planning network (including Newman’s Family Planning Health Services) in the state serves between 120,000 and 150,000 patients in total. “Maintaining our ability to provide effective family planning provision to those patients – that’s our priority,” Safar says.

Two years ago “Compassionate Care for Rape Victims” was launched in Wisconsin – a program to ensure that women who have been the victim of rape have access to emergency contraception (EC) – and Newman also is steeling for a potential push from Catholic agencies to lobby for “conscience protections” which would allow them not to provide the EC. Earlier this year a survey found that 22 percent of state hospitals were still not complying with the law. 

In regards to abortion legislation, the legislature may add to the long list of restrictions already in place in the state. The state imposes mandatory waiting periods, state-directed counseling, parental consent and funding prohibitions, says Safar, and fetal pain legislation may be next. 

In 2006, the Wisconsin legislature passed a “Fetal Pain” bill which would have required physicians who provide abortions at twenty weeks or later, to tell the women undergoing the procedure that abortion can cause substantial pain to the fetus. Governor Doyle vetoed the legislation. But with a new anti-choice sheriff in town, will Wisconsin physicians and women be in for more government intrusion?

Despite the potential for an infusion of intrusive anti-choice bills, Newman is interested in a pro-active agenda for reproductive health advocates. Safar says she’s proud that advocates in the state were able to get pro-active legislation like the Healthy Youth Act signed into law, as well as legislation opposing pharmacy refusal, recently. Other pro-active bills may include a push to mandate that so-called “crisis pregnancy centers” post what Newman calls “truth in advertising disclaimers” providing clarity that they do not provide birth control services, or referrals for birth control or abortion. In addition, Newman would like to see a revision of the state laws related to rape victims and paternity issues. Specifically, he says, research is needed into strengthening laws related to child support and Medicaid benefits in order to be more sensitive to rape victims who are impregnated by their attacker.

Despite the challenges ahead, though, both Safar and Newman seem bright-eyed. Newman looks towards the outcomes of a Wisconsin Young Women’s Agenda, organized by the Wisconsin Women’s Network, on December 3rd. Safar says that 2011 is Planned Parenthood Advocates of Wisconsin’s 75th birthday.

“We’ve been providing care for patients in Wisconsin for seventy-five years and we’ve seen difficult political times like this before. We will protect our patients and continue providing care. It’s a much different environment – it will take a lot more organizing and educating and it’s not going to be easy but we’ve done it before and we’ll do it again.”

2009 STD Data in the United States: Not a Pretty Picture

Earlier this week, the Centers for Disease Control and Prevention (CDC) released its annual update of sexually transmitted disease (STD) data for the United States.  There are more than 19 million STD infections every year in this country. The 2009 data suggest a mixed bag of both progress and ongoing challenges to achieving sexual health in the nation when it comes to the three most commonly reported STDs: Chlamydia, Gonorrhea, and Syphilis.

In 2009, some modicum of good news can be reported for Gonorrhea as there were the fewest recorded cases than in any other year since the CDC began tracking the disease in 1941.  The CDC reports 301,174 cases of Gonorrhea being reported in 2009, down 10 percent since 2008 and down 17 percent since 2006.  Still, we should not be breaking out the champagne – 300,000 cases of any disease is too much, but as I have previously written, we are on the verge of having a Gonorrhea epidemic that resists existing treatments.  With that frightening perspective, is there any comfort with the fact last year nearly 100 out of every 100,000 Americans had Gonorrhea?  

However, with both syphilis and Chlamydia, reported cases again increased in 2009.  Nearly 1.25 million cases of Chlamydia were reported in 2009 – an increase of 3 percent since last year and up 19 percent since 2006.  The CDC credits increased testing for identifying a larger number of infections, but also indicate that screening remains too low as there are likely nearly 3 million actual new infections each year.  So while increased testing may explain why reported cases of Chlamydia are increasing, it should also serve as a clarion call to ensure that screening and treatment are consistently expanded and that health care reform can help that process along significantly.

For syphilis, the nation continues to experience a disturbingly dramatic resurgence in the disease with rates steadily increasing since 2001.  In 2009, 13,997 cases of primary and secondary syphilis were reported to the CDC, an increase of 5 percent over the previous year and up 39% since 2006. A glimmer of good news is that for the first time in five years, syphilis declined among all women by 7 percent.

Just below the layers of these numbers, however, lie some of the most profound health disparities of any diseases in this country.  With all three reportable STDs, shockingly high patterns of health inequities persist, particularly among African-Americans.  While blacks represent only 14 percent of the population, they experienced 71 percent of all Gonorrhea cases in 2009, 48 percent of all reported Chlamydia cases, and 52 percent of all primary and secondary syphilis cases.  Health inequities in syphilis infection are also significant among gay men and other men who have sex with men (MSM), with nearly two-thirds of all syphilis cases in 2009 occurring in this population. 

While sexually transmitted diseases (STDs) in and of themselves are not discriminatory, additional factors in society – including inadequate access to health care, poverty, stigma, discrimination, and homophobia – conspire to create unjust and shameful health inequities among communities of color and gay men.  Further, the persistence of such high rates of STDs among African-Americans and gay men are getting worse, not better, and yet, the resources to combat the situation have only declined over the past decade.

For example, when adjusted for inflation, federal resources for STD prevention and treatment have declined by 17 percent since 2000 and state budget crises have seen state resources for these efforts dwindle.  Yet, the CDC estimates that STDs cost the U.S health care system upwards of $16.4 billion a year.

This makes abundantly clear that our failure to invest in prevention up front means we pay exponentially on the back end.  And while the lame duck Congress finishes its business this year – or punts their constitutionally mandated role of controlling the federal government’s purse to the next Congress – both Houses of Congress and the President have recognized the need for increased resources to combat STDs in this country.  So whoever finishes the appropriations process for 2011, this recent data should serve as sufficient evidence for why additional resources are needed for state and local health departments and their partners to get the nation on the road to being sexually healthier.

Repro Rights Afternoon Style: Protesting the Death of a Pregnant Prisoner, Planned Parenthood Sues Alaska

Where are the pro-life forces when a pregnant inmate dies from lack of reproductive health care in jail and how can we prevent this from happening to other women? Planned Parenthood sues the state of Alaska, and it seems that physicians are giving women seeking birth control unnecessary pelvic exams…

  • Planned Parenthood of the Great Northwest along with several doctors have sued the state of Alaska to block a new parental notification law for teenage girls to access abortion services. The suit charges that the new law violates privacy rights embedded in the state constitution and also treats teenage girls who want to have an abortion differently from teens who want to continue with their pregnancy – a violation of the equal protection clause in the state constitution.
  • The American College of Obstetricians and Gynecologists have issued a practice bulletin on guidelines of care for HIV-infected women given that women with HIV are “living longer, healthier lives and their need for gynecological care is increasing.” They hope to educate clinicians about the need for women’s health screenings as well as family planning for HIV infected women.
  • Ms. Magazine’s Feminist Daily News Wire reports that the American Journal of Obstetrics and Gynecologists released the results of a study which found that one-third of doctors required that women seeking birth control undergo an (unnecessary) pelvic exam before dispensing it. This is despite the fact that the World Health Organization guidelines say different and there is no medical reason for doing so. It places, as well, an additional barrier for women seeking contraception as well. 
  • A group fighting for reproductive justice for pregnant women in jail are protesting in front of an Pittsburgh jail today. The jail is the target of a federal lawsuit after a female inmate allegedly died, while pregnant, from being denied access to health care. As far as I can tell from the news reports, there were no “pro-life” activists in attendance. I’m just noting. 
  • Are aspirin and ibuprofen worse for the reproductive health and future fertility of boys than more the more notable chemicals – like BPA – found in plastics? European researchers say yes based on a study of pregnant women who took those common painkillers.

Study: New Therapy Shows Promise for HIV Prevention

Earlier today we published an article by Anna Forbes on the implications of the iPrEx trial for women, and an article this past summer about the findings from the CAPRISA trial.

Long-awaited results were released today in the New England Journal of Medicine of a study on the effectiveness of a single daily tablet for preventing HIV transmission among those at high risk of infection. Findings from the iPrEx trial, conducted among HIV-negative gay men, transgender women, and other men who have sex with men (MSM), showed that individuals who took the oral therapy containing two widely-used HIV medications, emtricitabine and tenofovir (FTC/TDF), experienced an average of 43.8 percent fewer HIV infections than those who received placebos.  The combined antiretroviral drug is known under its brand name as Truvada.

The trial, as summarized by Medscape and in a release from the AIDS Foundation of Chicago (AFC), included 2,499 participants, including individuals from Peru, Ecuador, Brazil, South Africa, Thailand and the United States.

Half the men were randomized into the active arm that received Truvada, which is currently approved by the US Food and Drug Administration for treatment of HIV infection, and the other half were randomized into the placebo arm and received a look-alike pill with no active ingredient. All the participants tested negative for HIV at the beginning of the trial, but reported engaging in sexual practices that put them at high risk for infection. Both groups in the study were followed up for over a year, also received HIV education, testing, and condoms. Neither the participants nor the researchers knew who was assigned to which arm (placebo or Truvada) of the study.

Enrollment for the trial began in June 2007 and was completed in December 2009. The primary analysis of the results released today includes participants who were followed until May 1, 2010, or for an average of 14 months.

Each participant was tested for HIV at monthly trial visits and given intensive pre-and-post test counseling. Additionally, they were regularly screened for sexually transmitted infections and received condoms, making up a very robust prevention package.

Study materials note that while pill-taking measures that rely on self-reports are not objective, testing to measure levels of the PrEP drug in the blood of study participants — a more reliable measure of pill-taking — also indicated that those participants who were protected against HIV infection were likely taking the study drug more regularly.  Among a subset of study participants who received the active drug, detectable levels of the PrEP drug combination were found in the blood of 51 percent (22 of 43) of a group that remained HIV-negative, but in only 9 percent (3 of 34) of participants who became HIV infected.  Low or absent drug levels underlay all of the infections that occurred among those who received active PrEP, while those who used the drug more regularly had higher levels of protection against HIV infection.

At the end of the trial, there were 36 infections in participants who received Truvada and 64 in recipients who took the placebo. Researchers calculated that the use of Truvada reduced new HIV infections by an estimated 43.8 percent overall when compared to placebo. While there appeared to be few side effects reported by the men who were taking the Truvada tablet, researchers and advocates make clear that much more information is needed regarding long term safety of this drug.

Advocates and researchers alike expressed cautious excitement about the development.

“This discovery alters the HIV prevention landscape forever. While this level of efficacy is relatively strong, PrEP is not quite ready for prime time and work remains before this strategy is rolled out. However, we are thrilled to have a new prevention option beyond male and female condoms visible on the horizon,” said Jim Pickett, Director of Advocacy at (AFC) and Chair of IRMA – International Rectal Microbicide Advocates (IRMA).  The full IRMA statement can be found here.

According to AFC: “It is important to emphasize the factors that led to successful use of Truvada to prevent HIV in iPrEx.” Adherence was a critical, so that taking the pill regularly was one of the most important factors in reducing the risk of infection. According to AFC, men who did not take the pill regularly did not see a protective benefit.

Regular HIV testing and ongoing monitoring by a physician was also critical. For this strategy to work, each of these pieces, including a doctor’s prescription, need to be in place.

“The study team found that about half of the men in the active arm of the trial were in fact not taking their pills regularly, if at all,” said Pickett of AFC. “It is not clear why this happened, but it certainly suggests that alternate means of using ARVs to prevent HIV infection may be more acceptable for these men. The primary means of transmission among gay men and other MSM is through unprotected anal intercourse. If we develop an ARV as a gel or lubricant applied rectally – a rectal microbicide – it could be more acceptable for some individuals who don’t like taking pills.”

Many gay men and other MSM already use lubricants for anal intercourse, notes Pickett, so they wouldn’t have to modify their behavior to achieve higher levels of protection with a rectal microbicide formulated as a lubricant. Adopting a new behavior—such as taking a pill every day—can be a considerable challenge for some.

A statement from The Global Forum on MSM & HIV (MSMGF) said that:

“These findings are promising and show that there is a potential role for PrEP to play in HIV prevention for MSM. However, with this new reality comes the fact that we, as a community of advocates, must now confront difficult questions about roll-out, cost, HIV-prevention messaging and the place PrEP takes in a broader continuum of prevention interventions.”

Today, said MSMGF, “Access to ARVs remains extremely difficult around the world. UNAIDS has estimated that only 36 percent of people living with HIV who need ARVs could access them just one year ago.”

Implementation of PrEP is highly unlikely in countries where access to ARVs is already seriously limited.  Even in places where access to ARVs is more stable, PrEP will likely be targeted to groups most at risk for HIV, including MSM. This would in turn require disclosure of same-sex behavior, which could prove difficult or even dangerous in countries where violence, stigma and discrimination against MSM persists.  

The iPrEx team has rightly noted that this is not a study of PrEP in a vacuum, but a study of PrEP when combined with a suite of other proven HIV prevention interventions – a state-of-the-art model of combination prevention, which may have been an important contributing factor underlying these encouraging results, continued the MSMGF statement.

However, the additional components of this intervention also remain out of reach for the vast majority of MSM; an estimated 90 percent of MSM globally lack access to even the most basic prevention services.  To achieve true combination prevention, we must not only significantly expand access to ARVs, but also promote much greater access to condoms, lubricant and other basic sexual health services.

Another challenge of concern according to MSMGF and others is the question of  adherence, especially outside a study context.  Although study participants learned about PrEP and the importance of adherence as part of the trial protocol, researchers reported that only about half of study participants took the medication consistently.  Compounding the problem of adherence is the challenge of developing communication strategies about an intervention that is just 44 percent effective – and only when taken in combination with a full complement of prevention services.  

Dr. Ian McGowan, one of the principal investigators of the Microbicide Trials Network and Scientific Vice Chair of IRMA agreed.

“The data from the iPrEx study are encouraging but the less than ideal adherence rate to oral PrEP clearly show that we need additional prevention approaches such as rectal microbicides that could be used by men and women at risk of HIV infection through unprotected receptive anal intercourse,” he said.

The world’s third rectal microbicide trial is currently underway with sites in Pittsburgh, Pennsylvania; Boston, Massachusetts; and Birmingham, Alabama. Scientists are testing the rectal safety and acceptability of tenofovir gel, a microbicide developed for vaginal use that has shown promise for preventing HIV through vaginal intercourse. Depending on the outcome of this new study, tenofovir gel could be further evaluated to determine if it can reduce the risk of HIV among both men and women who engage in receptive anal intercourse.

According to IRMA’s Pickett, this new Phase I rectal microbicide study, known as MTN-007, aims to determine if rectal use of tenofovir gel is safe, and in particular, does not cause cells in the rectum to become more vulnerable to HIV. Investigators will also ask trial participants questions regarding the gel’s desirability. The trial is planning to recruit a total of 60 men and women.

While the rectal microbicide field has gained significant momentum, more focus and resources are needed. In 2010, U.S. $7.2 million is being spent globally on rectal microbicide research. IRMA has calculated that annual investments must increase by 40% from 2011 – 2014, to U.S. $10 million/year and must increase further to U.S. $44 million (a six-fold increase) in the years 2015 – 2020. These targets need to be met to ensure a minimum of candidate products are moving through the research pipeline into late stage testing for effectiveness.

As noted in Medscape, the iPrEX is the second major study this year demonstrating the efficacy of PrEP. In July, South African researchers in what is known as the CAPRISA 004 trial published an article in Science Express reporting how a vaginal gel containing tenofovir lowered the risk of HIV infection in sexually active women by 39 percent.

As these highly promising advances in both science and technological are being made, researchers and advocates both underscore again and again there is no silver bullet.

“PrEP is best conceived as a back-up [to more direct HIV prevention strategies],” said Robert Grant, MD, lead study author of an article published online today in the New England Journal of Medicine that reports the study findings.

Other PrEP trials are ongoing. Results from studies among heterosexuals in Africa and injection drug users in Thailand are expected next year.

Roundup: The Pope, Anti-Gay Hate Groups, and the Mormons

We’ve got a religion-themed round-up this morning, and first on deck is the Pope, who is continuing to clarify his recent statement on condoms. The Associated Press reports that he meant that heterosexual couples can use condoms as well as male prostitutes:

“I personally asked the pope if there was a serious, important problem in the choice of the masculine over the feminine,” Lombardi said. “He told me no. The problem is this … It’s the first step of taking responsibility, of taking into consideration the risk of the life of another with whom you have a relationship.”

“This is if you’re a woman, a man, or a transsexual. We’re at the same point,” Lombardi said.

The pope is not justifying or condoning gay sex or heterosexual sex outside of a marriage. Elsewhere in the book he reaffirms the Vatican opposition to homosexual acts and artificial contraception and reaffirms the inviolability of marriage between man and woman.

But by broadening the condom comments to also apply to women, the pope is saying that condom use in heterosexual relations is the lesser evil than passing HIV onto a partner.

In somewhat religion-related news, the Southern Poverty Law Center will designate the Family Research Council and twelve other gay-bashing organizations as hate groups next year.  But really, it has nothing to do with their religion, and everything to do with hate and propaganda.

(A) hard core of smaller groups, most of them religiously motivated, have continued to pump out demonizing propaganda aimed at homosexuals and other sexual minorities. These groups’ influence reaches far beyond what their size would suggest, because the “facts” they disseminate about homosexuality are often amplified by certain politicians, other groups and even news organizations. Of the 18 groups profiled below, the Southern Poverty Law Center (SPLC) will be listing 13 next year as hate groups (eight were previously listed), reflecting further research into their views; those are each marked with an asterisk. Generally, the SPLC’s listings of these groups is based on their propagation of known falsehoods — claims about LGBT people that have been thoroughly discredited by scientific authorities — and repeated, groundless name-calling. Viewing homosexuality as unbiblical does not qualify organizations for listing as hate groups.

Below is a list of the anti-gay hate groups according to SPLC. See their website for complete description of each group.

*Abiding Truth Ministries, Springfield, Mass.
*American Family Association
*Americans for Truth About Homosexuality
*American Vision
*Chalcedon Foundation, Vallecito, Calif.
Christian Anti-Defamation Commission, Vista, Calif.
Concerned Women for America, Washington, D.C.
Coral Ridge Ministries, Fort Lauderdale, Fla.
*Dove World Outreach Center, Gainesville, Fla.
*Faithful Word Baptist Church, Tempe, Ariz.
*Family Research Council, Washington, D.C.
*Family Research Institute, Colorado Springs, Colo.
*Heterosexuals Organized for a Moral Environment, Downers Grove, Ill.
*Illinois Family Institute, Carol Stream, Ill.
Liberty Counsel, Orlando, Fla.
National Organization for Marriage, Princeton, N.J.
*Traditional Values Coalition, Anaheim, Calif.

And lastly, the official Morman handbook on social issues is now available online. Previously, only church elders and clergy had access to the information, but in an effort to be more open, the LDS church decided to make the volume available to church members and the general public. On abortion, the handbook says:

The Lord commanded, “Thou shalt not … kill, nor do anything like unto it” (D&C 59:6). The church opposes elective abortion for personal or social convenience. Members must not submit to, perform, arrange for, pay for, consent to, or encourage an abortion. The only possible exceptions are when:

1. Pregnancy resulted from forcible rape or incest.

2. A competent physician determines that the life or health of the mother is in serious jeopardy.

3. A competent physician determines that the fetus has severe defects that will not allow the baby to survive beyond birth.

Even these exceptions do not justify abortion automatically. Abortion is a most serious matter and should be considered only after the persons responsible have consulted with their bishops and received divine confirmation through prayer.

Church members who submit to, perform, arrange for, pay for, consent to, or encourage an abortion may be subject to church discipline.

As far as has been revealed, a person may repent and be forgiven for the sin of abortion.

It doesn’t seem to me as if the LDS church wants abortion to be illegal.

Mini-Roundup: An HIV drug already on the market shows great promise at blocking infection.

Nov 22

Women’s Preventive Services Needed in Health Insurance

Cross-posted from National Women’s Law Center’s site, Womenstake.

The process of implementing the new health care law continued last week as a panel of independent experts meet to begin to develop evidence-based preventive health guidelines for women that will be used to determine what preventive services will be covered in all new health insurance plans and provided with no cost-sharing.

Under a part of the new health care law that went into effect in September, all new insurance plans are required to cover certain preventive measures like mammograms, pap smears, smoking cessation therapy and folic acid and provide them to patients at no cost.  To supplement these new rules, the Institute of Medicine has been tasked with addressing serious gaps in the definition of preventive care for women and ensuring that this landmark protection meets the full range of women’s health needs. This week the Institute of Medicine’s panel of women’s health experts is holding its first meeting to begin the process of making preventive care more accessible and affordable for women.

As a part of this meeting, I testified before the panel and discussed general barriers to care that women face and recommended five services that the panel should be sure to include in their final recommendations to Department of Health and Human Services (HHS).

Women seeking affordable health care face significant and unique barriers. Women generally make less than men. With women making on average just 78 cents for every dollar a man earns, women have less money to spend on their health care. It is then not hard to imagine why more women than men have faced economic hardship due to health care needs. Women are also more likely to delay or avoid seeking care, including preventive care, due to cost. Evidence also suggests that even moderate co-pays can cause individuals, especially those with low and moderate incomes, to forgo needed preventive care.

As NWLC has shown, before the Affordable Care Act, the individual insurance market routinely failed women, making access to affordable health care even more challenging. Women obtaining identical plans to men oftentimes pay higher premiums. To add insult to injury, maternity care is rarely included in basic individual plans, and as a result women must purchase a supplemental policy to cover pregnancy. These riders can be prohibitively expensive. Women who obtain coverage through an employer are partially protected from these barriers due to federal and state employment discrimination laws, but cost and coverage challenges continue to exist.

The National Women’s Law Center also proposed five additional services to be included in the final list: 

  • Family Planning Counseling and All FDA- Approved Prescription Contraceptive Drugs and Devices- Nearly all American women use contraceptives during their reproductive years. Family planning counseling and supplies allow women to control the spacing, timing and number of births, which leads to improved health and mortality outcomes for women and their children. The ability to plan a pregnancy can prevent a range of pregnancy related complications that can endanger a woman’s health, and allows women to the take the necessary steps to ensure her own health is adequate to undergo pregnancy and childbirth.

    A wealth of information supports the recommendation that reversible and permanent forms of contraception be covered by health insurance.

    • A consensus study by a panel convened by the IOM in 1995 to address unintended pregnancy recommended that financial barriers to contraception be reduced by “increasing the proportion of all health insurance policies that cover contraceptive services and supplies…with no copayments or other cost-sharing requirements, as for other selected preventive health services.”

    • The Centers for Disease Control and Prevention named family planning one of the ten most important public health achievements of the 20th century because of its contribution to “the better health of infants, children, and women.”

    • Contraceptive use is one of the cornerstones of Healthy People 2010, the nation’s agenda for promoting health and preventing disease.

    • The National Business Group on Health, a non-profit organization representing large employers’ perspectives on national health policy issues, conducted a comprehensive review of available evidence and recommends a clinical preventive service benefit design that includes all FDA-approved prescription contraceptive methods at no cost-sharing.

    Including family planning counseling and supplies in the final recommendations would also build on key federal protections in place for millions of women. For almost 40 years, Medicaid has covered family planning services and supplies and provided them without co-payments for millions of low-income women.

    Because the only FDA-approved prescription contraceptives available today are for women, and pregnancy is a condition unique to women, the panel has the opportunity to rectify a long-standing inequity for women. Failure to cover contraceptives forces women to bear higher out-of-pocket health costs, totaling approximately $9,000 over her lifetime.  Nearly ten years ago, the Equal Employment Opportunity Commission issued an interpretation of the federal civil rights law that prohibits discrimination in employment, stating that it is sex discrimination for employer-sponsored health insurance plans to provide coverage of other prescription drugs and preventive services, but fail to provide coverage of contraception.

  • Screening for Intimate Partner Violence- Three women are murdered each day by their husbands or boyfriends, and two million injuries result from domestic violence each year. We should be using every tool at our disposal to identify and help victims of intimate partner violence and we believe routine behavioral assessment for intimate partner violence could help reduce these numbers.

  • Screening for Cervical Cancer- Cervical cancer was once the leading cause of cancer death for American women, but screening and early intervention has greatly reduced the number of deaths each year. It has been a several years since the United States Preventive Service Task Force (USPSTF) has updated its recommendations. We urge the panel to review relevant evidence to ensure women are receiving the appropriate care.

  • Breast Pump Equipment- Studies have shown that breastfeeding provides important long-term health benefits for mothers. Lactation supplies, including breast pumps, are critical for mothers to sustain breastfeeding and receive the preventive health benefits that lactation affords.

  • Physician-Recommended Preventive Services- Many of the services that are provided in a routine preventive visit are included among USPSTF recommendations, yet the Task Force does not recommend the actual visit itself, and women are often charged co-payments at the time of service. We urge the panel to consider covering all well-woman and preconception care visits.  When a doctor recommends a preventive health visit, a woman’s decision about whether to comply should not turn on her ability to afford the care.

A number of organizations, including the U.S. Conference of Catholic Bishops, decried the possibility that contraception may be included among the preventive health services covered, but this extreme position is without merit and harmful to women. Sound science should trump ideology, and we’re confident that the Institute of Medicine panelists will not let the religious views of some interfere with their expert review of the scientific and medical evidence and the needs of American women. 

The IOM is expected to submit its final recommendations to HHS in June 2011.

A Pill to Prevent HIV? What the New iPrEx Results Mean for Women

“Pill May Prevent HIV” — it’s an attention-getting headline. On November 23, the announced results of a clinical trial conducted in Peru, Ecuador, Brazil, the United States, South Africa and Thailand showed that taking an antiretroviral drug (in the class of those used to treat HIV/AIDS) may help prevent an HIV-negative person from becoming infected if exposed to HIV. The study, called iPrEX (Iniciativa Prophylaxis in Spanish or the Pre-exposure Prophylaxis Initiative in English) showed that, overall, those taking the medication were 44 percent less likely to become infected than participants using the placebo pills. Researchers also reported that the study participants who took the drug strictly according to schedule and did not miss doses were 73 percent less likely to become infected. 

Pre-exposure Prophylaxis (PrEP) refers to the practice of using medicine to prevent yourself from getting a disease or condition before you are exposed (pre-exposure) to the thing that can cause it. You take malaria medication, for example, before traveling to areas where you may be bitten by mosquitoes that carry malaria. Having the medicine already in your system greatly reduces your chances of getting malaria if you are bitten. Some people who are severely allergic to cats may take an allergy medication before visiting a friend who has cats – another form of PrEP.  In this case, the iPrEx trial showed that HIV-negative people can reduce their risk of acquiring HIV by taking an antiretroviral pill every day.  Obviously, this strategy is nowhere nearly as effective as using condoms or having sex only with people who are HIV negative.  But it may be a good prevention tool for people who are at high risk of HIV because they do not or cannot use those risk reduction strategies.

Started in June 2007, the iPrEx study ended in 2009 after enrolling 2,499 HIV-negative gay men, male-to-female transgendered women, and other men who have sex with men (MSM).  It was conducted at 11 sites in six countries: two sites in Lima, Peru, one site in Iquitos, Peru, one site in Guayaquil, Ecuador, one site in Boston and one site in San Francisco in the United States, one site in Cape Town, South Africa, two sites in Rio de Janeiro and one site in Sao Paulo, Brazil and one site in Chiang Mai, Thailand. These locations were selected because the prevalence of HIV infection among the men and transgender women having sex with men there is extraordinarily high, between 10 and 28 percent. The iPrEx study was funded by the US National Institutes of Health (NIH) and the Bill and Melinda Gates Foundation.  The medication tested in the study was donated by their manufacturer, Gilead Sciences. 

Proof that PrEP works – that there is, literally, a pill can help to prevent HIV — is an extraordinary breakthrough, as was the news received last summer that an effective vaginal microbicide had been identified.  But what does a study focused on people engaging in rectal-penile sex have to do with women and their reproductive health?  There are many ways to answer that question — some of them cause for celebration and some reasons for real concern. Consider the following:

1.  What do the iPrEx results mean for women? 

It’s great to know that PrEP may be an effective HIV prevention tool that women could use on their own, without a partner’s cooperation. Taken orally, the drug goes into the bloodstream and could help protect women who are having vaginal sex, anal sex or are exposed to HIV through other means. They may actually be of particular interest to women who have anal sex because many report that it is easier to insist on condom use during vaginal sex, where they can make the pregnancy prevention argument, than it is during anal sex.  This puts them at serious risk because, although estimates vary, unprotected receptive anal intercourse with an infected partner is probably five to twenty times more likely to transmit HIV than receptive vaginal sex.

Between 10 percent and 35 percent of heterosexual women in the US and UK acknowledge practicing receptive anal intercourse.  Among American men, 40 percent report having engaged in anal intercourse with a woman at some point in their lived. 

Clearly, we can’t assume that the PrEP medications tested in iPrEx will have the same effect in women’s bodies as they did in the bodies of the male and transgender study participants.  Additional PrEP trials are already underway, including a study enrolling heterosexual men and women in Botswana and the UK, one enrolling just heterosexual women in seven African countries, and one enrolling serodiscordant couples (couples with one HIV-positive and one HIV-negative member) in Kenya and Uganda.  Studies enrolling injection drug users and adolescents of all genders are also occurring. Expected to produce results in 2011-2013, these studies will tell us more about the gender-based differences (if any) in how the drugs tested in iPrEx work. But the iPrEx results are certainly cause for optimism that PrEP may provide women with another HIV prevention tool in the near future.

2.   Who will get these PrEP medications now?

Truvada® (a combination of Tenofovir Disoproxil Fumarate or TDF and Emtricitabine) is the medication tested in the iPrEx trial.   In the short term, this drug will only be legally available to iPrEx study participants, who will be offered the option to volunteer for the follow-up “open label” study. This standard procedure recognizes the ethical responsibility to allow those who took on the burden of study participation to be the first to benefit from the study results and it allows investigators to gather more information about use of the medication..    

The unusual aspect of this process, however, is that Truvada® is already on the market and regularly prescribed to treat people living with HIV.  Typically, it takes three to five years to get a new drug into consumers’ hands after it is proven to be effective. It has to be reviewed and approved by government regulators, manufacturing of it has to be scaled up, a supply chain has to be created to get it from factory to stores, etc. Truvada® is now only approved as a treatment for HIV and will have to go through a separate regulatory approval to be marketed for HIV prevention once  at least one other study confirms its efficacy at an acceptable rate.  Nevertheless, some consumers can already access it for prevention from private health care providers. Physicians in the U.S. and some other countries can, at their discretion, prescribe drugs for purposes other those for which they have been approved (a practice usually known as “off-label” use). Thus, these drugs are already available as prevention tools to those able to pay for them privately.

The third option — and one of which women’s health advocates need to be particularly mindful – is that the “pill may prevent HIV’ headlines could escalate the informal (or black market) sale of Truvada®.  Envision the following:  On one hand we have people who read the headlines and want to take a pill to protect themselves rather than having to use condoms. But they either don’t want to go to a doctor or can’t find one willing to prescribe these drugs for HIV prevention. 

On the other hand, we have people living with HIV who are being prescribed Truvada®. How do HIV-positive individuals who are poor choose between maintaining the treatment regimen they need to stay healthy and selling their pills at a high price on the street?  This may be particularly problematic for indigent women living with HIV who are trying to make ends meet for their families. What about the woman who brings the pills home only to have her partner or someone else take them away from her to use himself for prevention or to sell on the street?  This threat of mis-appropriation is one of the major differences between PrEP and microbicides. Men are foreseeably much less likely to grab up a woman’s microbicidal gel (once we have one) because they will not see it as something that other men want or that they can use, themselves.

Informal marketing and non-prescription use of PrEP drugs may also have serious public health implications. To get these pills prescribed for prevention, consumers will have to take an HIV test before each refill to ensure that they are still HIV negative. If you use PrEP when you are already HIV-positive, you may develop drug resistant virus.  You could pass this resistant strain on to other people and having it is likely to make it harder to treat your HIV infection on an on-going basis. Experts warn that epidemiological “train wrecks” could occur if access to these drugs used for both prevention and treatment is not well controlled.

Very little drug resistant virus was detected among participants in the iPrEx study because they received HIV tests monthly and stopped using the Truvada® immediately if they tested positive.  In real world use, people obtaining Truvada® without a prescription will likely not be tested regularly.  The longer they, unknowingly, continue to take the drug after acquiring HIV, the higher the chance that they may develop drug resistant virus.

Uncontrolled access could result in a rise in the prevalence and transmission of virus that is resistant to these drugs, resulting in reduced utility of first-line treatment regimens involving Viread® (an antiretroviral drug containing TDF) and Truvada® and a subsequent rise in the death rate. Someone using black market Truvada® occasionally (rather than daily) or those who sometimes buy counterfeit versions of Truvada® that contain no active drug may be particularly susceptible to developing resistant virus if they become HIV positive, are not tested, and continue to take non-prescription PrEP drugs. At the very least, we have to anticipate that increased levels of drug resistance would increase the cost of treating HIV because more second-line treatments (those able to overcome drug resistant virus) would be required.

3. How might PrEP work in the real world?

As women’s health advocates, there are things we can do to try to ensure that the iPrEx results lead to good outcomes for women that are not eclipsed by unintended consequences. Among other things, we must:

Insist that policy makers look at real world issues, not just clinical trial results:

The CDC is preparing a PrEP implementation plan that will include public education, guidance for physicians and health care providers regarding PrEP use, and implementation research.  Advocates need to insist that the implementation research agenda include examination of the impact of informal marketing and drug sharing on the well-being of people living with HIV and on public health generally.  If evaluators focus solely on the experience of people with legal access to PrEP drugs, they may miss effects such as treatment non-adherence due to drug misappropriation, increases in drug resistant virus levels due to sporadic use of illegally obtained and/or counterfeit PrEP drugs, and other consequences indicative of informal marketing and drug sharing practices.

Call for resistance monitoring systems:

Once approved for use in the U.S., PrEP is only likely to be prescribed to high-risk people who are demonstrably unable to use other HIV prevention methods consistently.  Nevertheless, we need to put systems in place now to do baseline assessments of population-level drug resistance and then monitor the level periodically so that any effect PrEP has on the prevalence of drug resistant virus can be tracked. Research has shown that, in places where anti-retroviral drugs are widely used, between 5 and 15 percent of new HIV infections transmit drug-resistant virus from one person to another. We will need an effective evidence base to determine whether or not use of PrEP—formal or informal/”off-label”—is increasing the prevalence of HIV that is resistant to PrEP drugs. 

Demand stakeholder involvement in setting the PrEP research agenda and roll-out:

As mentioned above, trials showing how PrEP works in women’s bodies are likely to produce results in the next few years. Additional data are needed to show whether gender-based differences occur in terms of overall effectiveness and the incidence and severity of side effects during long term use. Additional trials will also be needed to determine how use of PrEP drugs affects pregnancy or breastfeeding.  Advocacy will be required to get those trials on the research agenda sooner rather than later.

Implementation research is also needed to understand the barriers that keep people from accessing HIV testing and how they can be overcome.  Women who need PrEP because they have no other prevention alternative when their partners don’t use condoms will be unable to get it if they feel unable or unwilling to get HIV testing.

Most of all, community stakeholders need to play key roles in planning and delivering highly targeted community education about PrEP.  This is essential to ensuring that women and men in high risk communities understand about how PrEP works and why it is not a replacement for condoms. People will need to hear clearly, from those they perceive as credible, that they endanger their own health—and the community’s health—if they use PrEP without a prescription or buy it on the street.

No matter how well PrEP works to prevent HIV in tightly controlled clinical trials environments, significant stumbling blocks exist to its effective use in the real world. Unfortunately, these “real world” challenges are often set aside as issues that can be addressed once roll-out of an intervention to the target population has been achieved. Funders and policymakers often see work to address them prior to introduction as optional and aspirational, rather than as an investment that is essential to the intervention’s success.

We can’t let PrEP go the route of condoms and circumcision—becoming an HIV prevention tool primarily benefitting men. As we celebrate evidence of its potential effectiveness, we must also pay close attention to what next steps are needed to put this new HIV prevention tool into the hands of the women who need it most.

An Anti-Choice Wishlist for the New Congress

The anti-choice movement spent a great deal of time and money in campaigning for Republican candidates that would flip the leadership of the House from Democrat to Republican control in 2011.  Focusing primarily on the weakest candidates, anti-abortion Democrats running in conservative districts, groups like National Right to Life and the Susan B. Anthony list managed to create a new army of Republicans who owe their seats to the funding and backing of anti-choice activists.

Now those activists want their payback.

Via Lifenews, the anti-choice Republican groups have created a wishlist of the “top priorities” for congress once the new members are sworn in.  For the most part, the list is unsurprising — it is legislation that they have been pushing for nationally for years, and advocating for and often passing on a state by state basis.

At the top of the list is the “No Taxpayer Funding for Abortion Act.” Introduced in July by Republican Rep. Chris Smith of New Jersey, the Act prohibits:

(1) the expenditure of funds authorized or appropriated by federal law or funds in any trust fund to which funds are authorized or appropriated by federal law for any abortion or for health benefits coverage that includes coverage of abortion;
(2) any tax benefits for amounts paid or incurred for an abortion or for a health benefits plan (including premium assistance) that includes coverage of abortion; and
(3) the inclusion of abortion in any health care service furnished by a federal health care facility or by any physician or other individual employed by the federal government. Exempts from such prohibitions an abortion if the pregnancy is the result of rape or incest with a minor, or if the woman suffers from a physical disorder, injury, or illness that would, as certified by a physician, place the women in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself. Makes such prohibitions applicable to federal funding within the budget of the District of Columbia. Prohibits federal agencies or programs and states and local governments that receive federal financial assistance from discriminating against any individual or institutional health care entity on the basis that such entity does not provide, pay for, provide coverage of, or refer for abortions. Designates the Office for Civil Rights of the Department of Health and Human Services (HHS) to receive, and coordinate the investigation of, discrimination complaints.

The No Taxpayer Funding for Abortion Act essentially makes the Hyde Amendment into a permanent rule, rather than one that must be renewed once a year in order to continue.  It also would extend the Amendment beyond medicaid to all health plans in all branches of any form of government.  And it would provide a permanent conscience clause that would allow insurers to opt out of abortion coverage even if the mother’s health were in danger, or a victim of rape or incest, as well as allow medical workers to opt out of any assistance in providing an abortion as well.

The bill essentially could be called a Hyde Amendment Plus, as it wraps together the Hyde Amendment, related to programs funded through the HHS appropriations, along with the Helms amendment, which applies to overseas programs, the Smith FEHBP amendment to stop abortion funding in federal employee health insurance programs, the Dornan amendment prohibiting abortion funding in the District of Columbia, and other policies governing programs such as the Peace Corp and federal prisons.

The beauty of the new bill is also seen in the fact that it will make these policies banning abortion funding in various situations permanent federal law instead of annual battles that pro-life advocates sometimes lose depending on who controls Congress and the White House.

Only an act of Congress to reverse the law would reinstate the abortion funding.

The new comprehensive abortion funding ban will also apply to the new national health care program President Barack Obama signed into law.

And it would codify the conscience clause known as Hyde-Weldon offering protections for medical workers who refuse to participate in abortions — something Smith told his fellow members of Congress is important.

The No Taxpayer Funding for Abortion Act is at the top of their list, and encompasses a majority of the goals that the anti-choice movement has for congress in one tight, neat little bill.  But it is by no means all that they are pushing for.  Just as they have been doing on a state by state basis through the last session, the anti-choice activists are pushing to defund the entirety of Planned Parenthood, though the Title X Abortion Provider Prohibition Act.

Planned Parenthood is the largest abortion provider in the country, doing over 305,000 abortions per year (according to their last yearly report in 2008) and receives over $300 million taxpayer dollars yearly. They have been caught on tape covering up child rape and abuse and accepting money specifically targeted to abort African-American babies. In several states, the organization is undergoing audits for improper billing practices as well. This organization deserves no funding from taxpayers.

The funding that Planned Parenthood receives from the government goes to family planning, contraception, sex education, and prevention and treatment of STIs, and is carefully monitored so that none of it is used to provide abortions, as per federal law.  But, just as anti-abortion activists believe that the definition of “pregnant” can span even to before a fertilized egg implants in the womb, they also believe that if any money goes to an organization that is at all affiliated with abortion, that money is then directly funding abortions.

But defunding abortions and defunding Planned Parenthood’s preventative programs simply isn’t enough.  To truly create the gift that keeps giving, the anti-choice wishlist includes a final item: defunding embryonic stem cell research.

Plenty of research has yielded very positive results from using adult stem cells to treat of range of diseases and conditions while embryonic stem cells have shown little to no positive conclusions. Taxpayers should not be funding research that intentionally kills and uses for research a human being at its very beginning stages of life, especially when there is a viable alternative that does not take life.

The effectiveness of embryonic stem cells over adult stem cells is a scientific fact that everyone except the most extreme of the anti-choice movement has recognized.  In order to continue to push the belief that what exists at the absolute moment of conception is actually a baby, embryonic stem cell research has to be rejected all together in order to avoid any potential wedge that could be considered compromise, regardless of whether that affects the health of the already born who could be cured via research.

The Reverand Dr. Carlton W. Veazey pointed out the conflict of using moral arguments to advocate for an embryo’s frozen perpetual existence over the life of someone who is born and suffering in a post about the recent lawsuit that put a halt to federal funding of stem cell research back in August.

The lawsuit leading to the injunction involves a serious moral issue that the Religious Right has seized upon as part of its crusade against women’s reproductive rights and dedication to establishing its interpretation of Christianity in law: namely, the status of embryos that are the source of stem cells used for research. Halting this research shows great regard for embryos – but not the millions of people with incurable conditions including diabetes and Parkinson’s who could benefit from this research.

Respect for all human life is a basic principle of the Religious Coalition for Reproductive Choice (RCRC)  – but the facts are that these embryos were created for fertility treatments, are no longer needed, and are slated by those who created them for destruction. In RCRC’s view, in weighing competing moral claims, it is less ethical to keep them frozen indefinitely and then to destroy them than to allow them to serve a healing purpose.

Is it truly “pro-life” to keep an unaware, unborn entity in limbo at the expense of living creatures who are suffering?  The anti-choice believe that embryo does have more value, if just for the political sake of their argument, but they may find most of the public does not agree.

The list is a greedy power grab for groups that believe that because of the election results, their demands must be met.  But for a large number of candidates that they advocated for, trying to win a second term may mean more to them than passing the entirety of the anti-choice’s agenda, especially when so many of the demands are out of the mainstream.

Defending Your Rights? Study Finds Few Law Schools Offer Training in Reproductive Justice

Advocates working in the reproductive rights, health, and justice movements know that training is important.  Whatever medium, forum, or discipline we work in, we know there are important skills and lessons to be learned, enabling us to do our work more thoughtfully and effectively.  Sometimes we face challenges obtaining the training and mentorship we need and, as in the case of abortion training in residency programs, advocates must work to create or improve access to skill-building opportunities.  In other contexts we may not even realize where the gaps in training are until we are challenged to step back and assess the landscape from a broader perspective.  Law Students for Reproductive Justice (LSRJ) is committed to making sure that law students understand those gaps while in law school and that they ultimately secure the tools necessary to fill them.

For those of us dedicated to using legal tools in the pursuit of reproductive justice for all people, the formal training available in law schools is limited.  In a new study, LSRJ has for the first time surveyed reproductive rights and justice course offerings at all American Bar Association-approved law schools in the U.S. for the last seven years.  The results, while perhaps not surprising to anyone who has been involved with legal education, paint a nevertheless troubling picture for the vast majority of law students who lack any opportunity to study reproductive rights legal issues formally during their three years in law school. 

Specifically, LSRJ found that only 18 percent of law schools have offered a reproductive rights law course sometime during the last seven years.  In real numbers, that amounts to 37 separate courses and instructor-led reading groups, which were taught at 32 different law schools located in 17 states (including the District of Columbia). 

Furthermore, 49 percent of those courses have been taught only once.  While it is true that some law students are able to acquire relevant training for careers in reproductive rights and justice through advanced constitutional law courses, clinical opportunities, and electives on law & sexuality or assisted reproductive technology & bioethics, the complete dearth of reproductive rights law courses at over 80 percent of law schools leaves a significant gap in training for future legal advocates.  The message is clear—most law schools still do not see reproductive rights as a legitimate subject worthy of the stand-alone classes that are taught regularly for other legal specialties.

Both the format and substance of legal education have been slow to evolve since Dean Christopher Langdell first introduced the case method at Harvard Law School in the late 19th century.  Lawyers long out of school still cringe at memories of being cold-called in class—and yet the Socratic method persists.  Although developments like the clinical movement, co-education, and critical legal studies have broadened the accepted wisdom about what contributes to quality training for future lawyers, the standard core curriculum— contracts, property, torts, criminal law, and civil procedure—remains largely unchanged from the curriculum instituted over 100 years ago by Langdell. 

Despite the fact that law school graduates proceed not only to private practice but also become public interest lawyers, policymakers, judges, and law professors, many law schools have been slow to add specialized courses in certain areas, including reproductive rights.  This must change.  Such specialized courses are important, providing a valuable opportunity to amass more substantive knowledge in one’s chosen field.  They also give law students a chance to delve deeper into the cutting-edge issues and theoretical challenges they will face throughout their legal careers—an opportunity currently unavailable to the majority of future reproductive rights legal advocates.

There is, however, some reassuring news for those who believe that reproductive rights and justice have an important place within mainstream legal education.  The LSRJ course survey results suggest that law schools may slowly be heeding the call for more repro-related course offerings:  Forty-one percent of all known courses were first introduced during the last two years, and more than one-third of known classes have resulted from on-campus advocacy by LSRJ chapters.  

The fact that law students themselves are responsible for such a significant number of existing reproductive rights law courses not only reflects the dedication and passion of RJ-oriented law students, but also speaks to the importance of student involvement in efforts to change legal education.  Student-led advocacy for new courses puts those most affected at the center of legal education reform efforts, while simultaneously helping students hone their skills in a form of on-the-ground advocacy training.

LSRJ is committed to educating, organizing, and supporting law students to ensure that a new generation of advocates will be prepared to right reproductive wrongs and realize reproductive rights as basic civil and human rights.  From its early days, LSRJ has supported law student campaigns for new reproductive rights law and justice courses, believing such efforts to constitute important steps in a larger movement towards the de-marginalization of reproductive rights law within the legal academy and law practice.  In this process LSRJ encourages law students to develop relationships with supportive faculty members, some of whom have long been incorporating reproductive justice issues into other courses they teach, using such opportunities to expose all law students—including those who would never enroll in a reproductive rights law course—to important RJ topics and themes.

While in some ways the course survey results simply confirm what was already known anecdotally about the limited reproductive rights law coverage in law school course catalogs, it does provide new and more detailed information about the current landscape of training for law students.  It highlights the dedicated, forward-thinking professors who already teach reproductive rights and justice courses—for a number of years, in some cases—and enables us to celebrate their contributions to the training of new leaders in the field.  The broad analysis should be interesting and useful both for law school administrators and faculty who care about providing quality legal education and for non-lawyer colleagues and allies within the reproductive rights and justice movements.  Most importantly, the course survey serves as a call to action for law students to mount new course campaigns at their law schools and to secure for themselves the educational opportunities that will prepare them to be effective reproductive rights and justice advocates.  Law school is an investment, and an expensive one at that.  With our support, it’s time for law students to demand the kind of relevant training in reproductive rights law they deserve.