Commentary Sexual Health

Can We Have A Grown-Up Conversation About HPV Yet?

Amanda Marcotte

Michele Bachmann's been all over the place making comically outrageous claims about the supposed dangers of the HPV vaccine.  Will her behavior shed light on the more serious problem of people having vague, unarticulated fears of the vaccine?

One thing guaranteed about presidential election season is that any issue that a major candidate chooses to raise, no matter how obscure beforehand, can suddenly rise to an issue of national importance.  Thus it has been with the HPV vaccine.  Ever since it’s come out, those of us in the trenches on reproductive health care have been trying to raise the alarm about right-wing opposition to the vaccine, which prevents transmission of harmful forms of Human Papilomavirus (HPV), thereby also preventing the possible development of genital warts and of cervical cancer, and all the various and unpleasant treatments women have to endure to make sure they don’t get cervical cancer, such as coloscopies  and LEEP procedures.  But because it prevents a disease you get through sexual contact, many on the Christian right oppose the vaccination.  They tend to mindlessly support anything—even deadly cancers—that can be perceived as divine justice for the very human act of having sex.

Before Michele Bachmann started yapping on national TV about the vaccine and claiming that it makes girls “retarded”, pervasive right wing opposition to the vaccine wasn’t deemed worthy of much mainstream media attention.  I suspect that it was seen as a fringe phenomenon, like the belief that fluoride in the drinking water is a mind control agent. In one sense, it is a fringe belief—there’s consensus amongst experts that this vaccine is a good thing.  But because the experts believe something doesn’t mean that nutty opinions in the public at large can’t have widespread negative effects.  Whisper campaigns against the HPV vaccines are a perfect example. Only a third of girls are getting all three shots, for instance.  Part of the problem is that it’s a hassle to get three shots, and part of the problem is that it’s expensive.  But the research has shown that as income levels rose past a certain point, vaccination rates declined slightly.  This probably reflects the fact that people on the somewhat wealthier end of the spectrum are more likely to be conservative, and therefore more likely to think it’s appropriate to use the fear of disease and death to control female sexuality.

Whisper campaigns work. Conservatives have been chugging away, insinuating in a person-to-person way that the vaccines cause sluttiness, retardation, and all sorts of sundry evils.  Since people tend to already have deep-set fears about female sexuality—especially when they’re forced to think about how their own little girls are going to turn into grown women who have sex—these rumors can do tremendous damage. Even liberals are holding off on vaccinating their girls because they heard “somewhere” that the vaccines are “untested” and “dangerous,” even though that’s simply not true in the slightest, something they could verify for themselves by consulting with the Centers for Disease Control.  If you hear that the vaccine is dangerous and untested, it’s wise to stop and think about where that idea is coming from, and that is basically people who think sex is so evil that they literally believe young women should face death as a possible consequence of having sex.

It took Michele Bachmann saying the sorts of things on TV that people have been saying in private for the story to get covered.  And really, when you hear with your own ears the clumsy fear-mongering around the vaccine, you start to see why it was so hard to cover the story before.  It’s simply that difficult to believe anyone would buy the legends that have been circulating about the vaccine, particularly the notion that a 12-year-old could get it and suddenly and without warning develop severe mental illnesses. 

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What I don’t see happening, however, is what most needs to happen: a national dialogue on how irrational fears about sexuality, especially female sexuality, allow people to believe all sorts of nonsense about women’s bodies and sexual health.  I see this topic being avoided in no small part because a lot of otherwise rational people can get completely silly on this issue, and when called out for it, they get incredibly defensive.

After all, they’re not like those people, aka fundamentalist Christians who believe Satan speaks to kids on records and that you can go to hell for masturbating.  So they lock up and refuse to discuss how it is that they have a totally irrational fear of a vaccine that just so happens to prevent a common STI.  Mary Beth Williams’ reaction to being criticized because she had an irrational freak-out over her daughter accidentally being vaccinated against HPV instead of against meningitis is typical. Even though her original article regurgitated rumors and innuendo that have been spread through the public by right wingers with an anti-sex agenda, she simply couldn’t accept that was perhaps why she irrationally believed that the HPV vaccine was dangerous and untested, even though the information demonstrating that it’s safe and tested is easily available.  Being a rational person, she did eventually get her daughter vaccinated, but the insistence that this vaccine is somehow scarier and requires more hand-wringing, crying it out, and worrying about choice than any other vaccine on the market—which is simply administered, no questions asked—does have its roots in this right wing whisper campaign.  Rumors work because they prey on unconscious fears, and one of the biggest is our unconscious fears about female sexuality.

But the gawking and laughing at Michele Bachmann for being so clumsy about her attacks on the HPV vaccine might help.  Most people are more sophisticated in generating their irrational excuses for being worried about it, making vague insinuations that it wasn’t tested enough or there’s some unknown and undiscovered danger. By actually making claims about what she believed that danger to be, Bachmann showed how silly people’s fears really are.  Maybe going forward, more people who had these vague, unarticulated fears about the supposed dangers of preventing HPV transmission will cringe in shame at the possibility that they sound like Michele Bachmann, and will instead make the right choice to be more rational about this.    

Culture & Conversation Abortion

The Burden Is Undue: What I Have Learned and Unlearned About Abortion

Madeline Gomez

For all 29 years of my life, the right to abortion has been under attack. In early March, I slept at the Supreme Court overnight, waiting for oral arguments, and had time to reflect on the experiences that have made me an advocate.

Thirteen years before I was born, the Supreme Court declared abortion a fundamental right in Roe v. Wade. Despite this, for all 29 years of my life, the right to abortion has been under attack.

In the past six years alone, states have enacted 288 provisions restricting access to abortion care. Three years ago, the Texas state legislature enacted HB 2, an omnibus anti-abortion bill. And on Monday, the Supreme Court ruled two provisions of that law are unconstitutional.

I am a Texas native, a Latina, a lawyer, and a reproductive justice advocate, so this case, Whole Woman’s Health v. Hellerstedt, naturally hits close to home.

In the years since HB 2 has passed, I have heard from friends who have waited weeks and been forced to drive hours just to get an appointment at a clinic. And, as my colleagues and I wrote in an amicus brief the National Latina Institute for Reproductive Health filed with the Supreme Court, women of color in Texas, particularly the 2.5 million Latinas of reproductive age, have been disproportionately affected by the clinic closings resulting from the expensive, onerous, and medically unnecessary standards HB 2 imposed. For example, if the law had been allowed to go into full effect, residents of my birthplace, El Paso, Texas, where 81 percent of the population is Latinx, would have to drive over 500 miles to San Antonio in order to get an abortion in the state.

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In early March, I slept at the Court overnight, waiting for oral arguments. In the 24 hours I spent outside the Court, I had time to reflect on the experiences that have made me an advocate.

***

I am 12, with my mother and her dear friend at the dinner table. As the three of us sit together, I regale them with stories of a teacher I deeply admire. She’s been telling us about how she prays the rosary and speaks to women entering abortion clinics, urging them to “choose life.” I believe this is a good act, something I want to be part of, and I’m proud of my righteousness. My mother’s friend says to me simply, “There are a lot of reasons women have abortions.” Almost 20 years later I will learn that this friend had an abortion, which makes sense statistically speaking, since one in three women do.

I am 14 and sitting in high school religion class. The male instructor tells us that pre-marital sex and contraception are forbidden by our Catholic faith. He says the risk especially isn’t worth it for women: It is, according to him, physically impossible for women to orgasm. At the time, and still, I despair for this man’s wife, and for him. Shortly after this lesson the class watches a 45-minute “documentary” about “partial-birth abortion.” This concludes my sexual health education.

I am 18 and counting 180 seconds, waiting to see whether one or two lines appear on a white stick. In a few weeks I am moving to New York to begin college. In those 180 seconds I decide with little fanfare that, regardless of the number of lines, I will not be pregnant when I go. One line appears and I move, able to begin the education I’ve dreamed of and worked for.

I am 19 and talking with a friend. We get to a question that often comes up among women: What would you do if you got pregnant? She tells me calmly and candidly that she would have an abortion. She is the first person I’ve heard say this aloud. Her certitude resonates with me. I know that I would too, and that though I always felt I should be sorry, I would not be. I feel the weight of the shame I’ve been carrying and I stop apologizing for what I know.

I am 20 and teaching sexual education classes to high school students. More than one young woman tells me that she believes she can prevent pregnancy by spraying Coca-Cola into her vagina after intercourse. We talk about safe and effective methods of contraception. Years later, I still think about the damage and danger inflicted upon young women out of fear of our sexuality and power.

I am 21 and lying naked in bed next to a man I’ve been seeing. We’re discussing monogamy. I’m on the pill and he’d like to stop using condoms. He wants me to know, though, that if I become pregnant he won’t let me have an abortion. Because I am desperate to be loved and because I don’t yet understand that love doesn’t mean conceding your autonomy, it will take another year before I leave him.

I am 22 and my friend—the first I know oftells me she is having an abortion. After the procedure I do not know the right thing to do or say or how to comfort and support her. We will lose touch. Like 95 percent of women who have abortionsshe will not regret her choice. When we reconnect years later, we will talk about her happiness and success and about how far we’ve both come.

I am 24 and reading about Congress making a budget deal contingent on “defunding” Planned Parenthood. I understand that though I now refuse to date men who believe they have a say in my reproductive choices, I’m stuck with hundreds of representatives and senators who think they do and who will use my body and health as a bargaining chip.

I am 26 and in my home state of Texas, Wendy Davis is filibustering an anti-abortion bill with two pink tennis shoes on her feet. I watch her all night, my heart swollen with pride at hundreds of women screaming in the rotunda, refusing to be ignored. Despite their efforts, Texas HB 2 will pass. Within three years, over half the abortion clinics in Texas will close.

Today I am 29 and five justices of the Supreme Court have declared the burden imposed by two provisions of HB 2 undue. Limiting abortion and lying about the effects of these laws hurts women’s health, and now the highest court in this nation has declared these actions and these laws unacceptable and unconstitutional. I am in Washington, D.C., 1,362 miles from the home where I grew up, the day the decision is announcedbut it is not just about me and it’s not just about Texas. It is about the recognition and vindication of our worth and rights as human beings. All 162 million of us.

Commentary Human Rights

Preventing a Provider From Talking About Abortion Isn’t About Safety, It’s About Stigma

Maureen Shaw

For pro-choice activists and supporters, the complaint filed against the MedStar Washington Hospital Center represents much more than a passionate doctor pitted against her employer. This is about abortion stigma and the need to affirm and normalize abortion’s role in basic health care—something that’s infinitely harder to achieve when providers are silenced.

Last week, news broke that outspoken OB-GYN and abortion advocate Dr. Diane Horvath-Cosper has filed a federal civil rights complaint against the MedStar Washington Hospital Center in Washington, D.C., where she is completing a two-year Family Planning Fellowship. She alleges her employer broke the law by forbidding her from publicly speaking about abortion at the risk of losing her job.

On its face, this case may appear to be a localized, isolated incident. But for pro-choice activists and supporters, it represents much more than a passionate doctor pitted against her employer. This is about abortion stigma and the need to affirm and normalize abortion’s role in basic health care—something that’s infinitely harder to achieve when providers are silenced.

In her complaint, Horvath-Cosper argues that the imposed “gag order” discriminates against her pro-choice principles. Her case hinges on the Church Amendment, a Roe v. Wade-era conscience clause that bans federally funded institutions from discriminating against doctors “because of … religious beliefs or moral convictions respecting sterilization procedures or abortions.” The law is typically used to shield medical personnel who refuse to participate in the provision of abortion care, but Horvath-Cosper’s counsel asserts the law is also intended to protect doctors who perform them.

For their part, according to the complaint, MedStar Washington hospital officials claimed the silencing was motivated by safety concerns following the deadly attack on a Colorado Springs Planned Parenthood this past November. However, the hospital has yet to institute robust security measures, such as physical security recommendations as per the National Abortion Federation, according to the New York Times. This leads me to believe its real motivation has to do with stigma, not safety.

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Abortion stigma is everywhere you look: in the media, throughout state legislatures, and outside clinics. It’s largely responsible for proliferating the myth that abortion care is not a form of basic health care (when it is, in fact a commonplace procedure for millions of American women) and for its demonization in public discourse. What’s more, it fuels anti-choice violence—something Horvath-Cosper knows all too well (she’s previously written about what it’s like living in fear of your life simply for providing compassionate abortion care to patients who need it).

Make no mistake about it: Stigma is a pervasive form of gender discrimination that aims to silence providers and punish women for seeking abortions. It is something no other medical specialty contends with. And it is at the heart of this case. Stigma has effectively made free speech and doctor/patient safety mutually exclusive ideals, like a dysfunctional Venn diagram in which the circles exist next to each other, but never overlap.

It’s worth noting that this divisive segregation didn’t happen in a vacuum; two very powerful social contexts have paved the way for Horvath-Cosper’s complaint. In the past year, anti-choice violence, hate speech, and online harassment flourished in the wake of heavily edited and misleading videos attacking Planned Parenthood—all of which are direct products of abortion stigma. In response, the pro-choice community embraced and promoted abortion as a social good. From the popular #ShoutYourAbortion social media campaign to the 1 in 3 Campaign’s Abortion Speakout, activists of all ages and backgrounds have sought to reframe the reproductive rights conversation.

But a conversation can’t happen when silence—the preferred tool of anti-choice bullies—is wielded in the very establishments that provide abortion care. When a hospital’s medical director tells his family planning fellow that the hospital does “not want to put a Kmart blue light special on the fact that we provide abortions,” the message is clear: Abortion is morally repugnant and an unsuitable medical procedure, unworthy of discussion. It’s likewise clear that anti-choice rhetoric and ideology have seeped into the places they least belong, and are being replicated.

Silencing providers does not protect anyone. It only fuels stigma and undercuts the pro-choice community’s efforts to promote and protect reproductive health care. It’s a vicious cycle that doesn’t stand a chance of being broken unless brave advocates like Dr. Horvath-Cosper are allowed to speak the truth.