Commentary Abortion

A Doctor Speaks: “Horrific” Arizona Law Would Allow Doctors to Practice Bad Medicine Without Accountability

Dr. Megan L. Evans

The Arizona Senate passed a bill that would prohibit any medical malpractice lawsuits against physicians who chose to withhold valuable information regarding their patient’s pregnancy that could lead her and her family to seek termination.

Imagine carrying a baby to term.  You’ve waited nine long months for this moment.  You’ve planned for her arrival, you’ve had the baby shower, and you’ve gone to all your prenatal appointments. All along you are told that you are progressing normally and your baby is healthy. Your delivery day comes and, at delivery, your doctor tells you your baby has a devastating abnormality.  A cardiac defect or a severe structural abnormality or chromosomal abnormality… something that was likely already detected early in your pregnancy. 

You then discover your doctor withheld this information from you for fear you would seek an abortion.  What a nightmare. 

Unfortunately, the Arizona legislation is working to make this nightmare a reality. On Tuesday, the Senate passed a bill that would prohibit any medical malpractice lawsuits against physicians who chose to withhold valuable information regarding their patient’s pregnancy that could lead her and her family to seek termination.  Much to my chagrin, this type of legislation is already law in Minnesota, Missouri, North Carolina, Utah, Idaho, Pennsylvania, North Dakota, South Dakota, and is being discussed in Kansas. 

But fear not! Nancy Barto (R-Phoenix), who sponsored the bill, has allowed for medical malpractice suits for “intentional or grossly negligent” acts.  I would be interested to hear where Senator Barto draws her line of allowable omissions and unacceptable exclusions.

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Although I am not a lawyer, I am a doctor and what this law is proposing is horrific and against everything we, as physicians, learn throughout medical school and our training.

My role as a physician, specifically an Obstetrician and Gynecologist, is to provide my patients with safe, quality care, and to provide them with information to help them make informed decisions.  I may follow my patients through their pregnancy and deliver their children, but I do not participate in the care of that child or share the responsibilities in raising the child.  Viewing a patient’s ultrasound of her pregnancy and knowingly omitting information that could change her and her family’s life is unimaginable.  And it is malpractice. 

I respect my patients, I trust them to make the best decision for themselves and their families, and I trust my colleagues to do the same.  I, as a physician, have no right to make medical decisions for my patients based purely on what I think is best or based on my religious beliefs.    

As physicians, it is our job to inform patients, not make decisions for them.    

This bill will move to the Arizona House at an undetermined time.

Culture & Conversation Maternity and Birthing

On ‘Commonsense Childbirth’: A Q&A With Midwife Jennie Joseph

Elizabeth Dawes Gay

Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

Jennie Joseph’s philosophy is simple: Treat patients like the people they are. The British native has found this goes a long way when it comes to her midwifery practice and the health of Black mothers and babies.

In the United States, Black women are disproportionately affected by poor maternal and infant health outcomes. Black women are more likely to experience maternal and infant death, pregnancy-related illness, premature birth, low birth weight, and stillbirth. Beyond the data, personal accounts of Black women’s birthing experiences detail discrimination, mistreatment, and violation of basic human rights. Media like the new film, The American Dream, share the maternity experiences of Black women in their own voices.

A new generation of activists, advocates, and concerned medical professionals have mobilized across the country to improve Black maternal and infant health, including through the birth justice and reproductive justice movements.

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Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.

At her clinics, which are located in central Florida, a welcoming smile and a conversation mark the start of each patient visit. Having a dialogue with patients about their unique needs, desires, and circumstances is a practice Joseph said has contributed to her patients having “chunky,” healthy, full-term babies. Dialogue and care that centers the patient costs nothing, Joseph told Rewire in an interview earlier this summer.

Joseph also offers training to midwives, doulas, community health workers, and other professionals in culturally competent, patient-centered care through her Commonsense Childbirth School of Midwifery, which launched in 2009. And in 2015, Joseph launched the National Perinatal Task Force, a network of perinatal health-care and service providers who are committed to working in underserved communities in order to transform maternal health outcomes in the United States.

Rewire spoke with Joseph about her tireless work to improve maternal and perinatal health in the Black community.

Rewire: What motivates and drives you each day?

Jennie Joseph: I moved to the United States in 1989 [from the United Kingdom], and each year it becomes more and more apparent that to address the issues I care deeply about, I have to put action behind all the talk.

I’m particularly concerned about maternal and infant morbidity and mortality that plague communities of color and specifically African Americans. Most people don’t know that three to four times as many Black women die during pregnancy and childbirth in the United States than their white counterparts.

When I arrived in the United States, I had to start a home birth practice to be able to practice at all, and it was during that time that I realized very few people of color were accessing care that way. I learned about the disparities in maternal health around the same time, and I felt compelled to do something about it.

My motivation is based on the fact that what we do [at my clinic] works so well it’s almost unconscionable not to continue doing it. I feel driven and personally responsible because I’ve figured out that there are some very simple things that anyone can do to make an impact. It’s such a win-win. Everybody wins: patients, staff, communities, health-care agencies.

There are only a few of us attacking this aggressively, with few resources and without support. I’ve experienced so much frustration, anger, and resignation about the situation because I feel like this is not something that people in the field don’t know about. I know there have been some efforts, but with little results. There are simple and cost-effective things that can be done. Even small interventions can make such a tremendous a difference, and I don’t understand why we can’t have more support and more interest in moving the needle in a more effective way.

I give up sometimes. I get so frustrated. Emotions vie for time and energy, but those very same emotions force me to keep going. I feel a constant drive to be in action and to be practical in achieving and getting results.

Rewire: In your opinion, what are some barriers to progress on maternal health and how can they be overcome?

JJ: The solutions that have been generated are the same, year in and year out, but are not really solutions. [Health-care professionals and the industry] keep pushing money into a broken system, without recognizing where there are gaps and barriers, and we keep doing the same thing.

One solution that has not worked is the approach of hiring practitioners without a thought to whether the practitioner is really a match for the community that they are looking to serve. Additionally, there is the fact that the practitioner alone is not going to be able make much difference. There has to be a concerted effort to have the entire health-care team be willing to support the work. If the front desk and access points are not in tune with why we need to address this issue in a specific way, what happens typically is that people do not necessarily feel welcomed or supported or respected.

The world’s best practitioner could be sitting down the hall, but never actually see the patient because the patient leaves before they get assistance or before they even get to make an appointment. People get tired of being looked down upon, shamed, ignored, or perhaps not treated well. And people know which hospitals and practitioners provide competent care and which practices are culturally safe.

I would like to convince people to try something different, for real. One of those things is an open-door triage at all OB-GYN facilities, similar to an emergency room, so that all patients seeking maternity care are seen for a first visit no matter what.

Another thing would be for practitioners to provide patient-centered care for all patients regardless of their ability to pay.  You don’t have to have cultural competency training, you just have to listen and believe what the patients are telling you—period.

Practitioners also have a role in dismantling the institutionalized racism that is causing such harm. You don’t have to speak a specific language to be kind. You just have to think a little bit and put yourself in that person’s shoes. You have to understand she might be in fear for her baby’s health or her own health. You can smile. You can touch respectfully. You can make eye contact. You can find a real translator. You can do things if you choose to. Or you can stay in place in a system you know is broken, doing business as usual, and continue to feel bad doing the work you once loved.

Rewire: You emphasize patient-centered care. Why aren’t other providers doing the same, and how can they be convinced to provide this type of care?

JJ: I think that is the crux of the matter: the convincing part. One, it’s a shame that I have to go around convincing anyone about the benefits of patient-centered care. And two, the typical response from medical staff is “Yeah, but the cost. It’s expensive. The bureaucracy, the system …” There is no disagreement that this should be the gold standard of care but providers say their setup doesn’t allow for it or that it really wouldn’t work. Keep in mind that patient-centered care also means equitable care—the kind of care we all want for ourselves and our families.

One of the things we do at my practice (and that providers have the most resistance to) is that we see everyone for that initial visit. We’ve created a triage entry point to medical care but also to social support, financial triage, actual emotional support, and recognition and understanding for the patient that yes, you have a problem, but we are here to work with you to solve it.

All of those things get to happen because we offer the first visit, regardless of their ability to pay. In the absence of that opportunity, the barrier to quality care itself is so detrimental: It’s literally a matter of life and death.

Rewire: How do you cover the cost of the first visit if someone cannot pay?

JJ: If we have a grant, we use those funds to help us pay our overhead. If we don’t, we wait until we have the women on Medicaid and try to do back-billing on those visits. If the patient doesn’t have Medicaid, we use the funds we earn from delivering babies of mothers who do have insurance and can pay the full price.

Rewire: You’ve talked about ensuring that expecting mothers have accessible, patient-centered maternity care. How exactly are you working to achieve that?

JJ: I want to empower community-based perinatal health workers (such as nurse practitioners) who are interested in providing care to communities in need, and encourage them to become entrepreneurial. As long as people have the credentials or license to provide prenatal, post-partum, and women’s health care and are interested in independent practice, then my vision is that they build a private practice for themselves. Based on the concept that to get real change in maternal health outcomes in the United States, women need access to specific kinds of health care—not just any old health care, but the kind that is humane, patient-centered, woman-centered, family-centered, and culturally-safe, and where providers believe that the patients matter. That kind of care will transform outcomes instantly.

I coined the phrase “Easy Access Clinics” to describe retail women’s health clinics like a CVS MinuteClinic that serve as a first entry point to care in a community, rather than in a big health-care system. At the Orlando Easy Access Clinic, women receive their first appointment regardless of their ability to pay. People find out about us via word of mouth; they know what we do before they get here.

We are at the point where even the local government agencies send patients to us. They know that even while someone’s Medicaid application is in pending status, we will still see them and start their care, as well as help them access their Medicaid benefits as part of our commitment to their overall well-being.

Others are already replicating this model across the country and we are doing research as we go along. We have created a system that becomes sustainable because of the trust and loyalty of the patients and their willingness to support us in supporting them.

Photo Credit: Filmmaker Paolo Patruno

Joseph speaking with a family at her central Florida clinic. (Credit: Filmmaker Paolo Patruno)

RewireWhat are your thoughts on the decision in Florida not to expand Medicaid at this time?

JJ: I consider health care a human right. That’s what I know. That’s how I was trained. That’s what I lived all the years I was in Europe. And to be here and see this wanton disregard for health and humanity breaks my heart.

Not expanding Medicaid has such deep repercussions on patients and providers. We hold on by a very thin thread. We can’t get our claims paid. We have all kinds of hoops and confusion. There is a lack of interest and accountability from insurance payers, and we are struggling so badly. I also have a Change.org petition right now to ask for Medicaid coverage for pregnant women.

Health care is a human right: It can’t be anything else.

Rewire: You launched the National Perinatal Task Force in 2015. What do you hope to accomplish through that effort?

JJ: The main goal of the National Perinatal Task Force is to connect perinatal service providers, lift each other up, and establish community recognition of sites committed to a certain standard of care.

The facilities of task force members are identified as Perinatal Safe Spots. A Perinatal Safe Spot could be an educational or social site, a moms’ group, a breastfeeding circle, a local doula practice, or a community center. It could be anywhere, but it has got to be in a community with what I call a “materno-toxic” area—an area where you know without any doubt that mothers are in jeopardy. It is an area where social determinants of health are affecting mom’s and baby’s chances of being strong and whole and hearty. Therein, we need to put a safe spot right in the heart of that materno-toxic area so she has a better chance for survival.

The task force is a group of maternity service providers and concerned community members willing to be a safe spot for that area. Members also recognize each other across the nation; we support each other and learn from each others’ best practices.

People who are working in their communities to improve maternal and infant health come forward all the time as they are feeling alone, quietly doing the best they can for their community, with little or nothing. Don’t be discouraged. You can get a lot done with pure willpower and determination.

RewireDo you have funding to run the National Perinatal Task Force?

JJ: Not yet. We have got the task force up and running as best we can under my nonprofit Commonsense Childbirth. I have not asked for funding or donations because I wanted to see if I could get the task force off the ground first.

There are 30 Perinatal Safe Spots across the United States that are listed on the website currently. The current goal is to house and support the supporters, recognize those people working on the ground, and share information with the public. The next step will be to strengthen the task force and bring funding for stability and growth.

RewireYou’re featured in the new film The American Dream. How did that happen and what are you planning to do next?

JJ: The Italian filmmaker Paolo Patruno got on a plane on his own dime and brought his cameras to Florida. We were planning to talk about Black midwifery. Once we started filming, women were sharing so authentically that we said this is about women’s voices being heard. I would love to tease that dialogue forward and I am planning to go to four or five cities where I can show the film and host a town hall, gathering to capture what the community has to say about maternal health. I want to hear their voices. So far, the film has been screened publicly in Oakland and Kansas City, and the full documentary is already available on YouTube.

RewireThe Black Mamas Matter Toolkit was published this past June by the Center for Reproductive Rights to support human-rights based policy advocacy on maternal health. What about the toolkit or other resources do you find helpful for thinking about solutions to poor maternal health in the Black community?

JJ: The toolkit is the most succinct and comprehensive thing I’ve seen since I’ve been doing this work. It felt like, “At last!”

One of the most exciting things for me is that the toolkit seems to have covered every angle of this problem. It tells the truth about what’s happening for Black women and actually all women everywhere as far as maternity care is concerned.

There is a need for us to recognize how the system has taken agency and power away from women and placed it in the hands of large health systems where institutionalized racism is causing much harm. The toolkit, for the first time in my opinion, really addresses all of these ills and posits some very clear thoughts and solutions around them. I think it is going to go a long way to begin the change we need to see in maternal and child health in the United States.

RewireWhat do you count as one of your success stories?

JJ: One of my earlier patients was a single mom who had a lot going on and became pregnant by accident. She was very connected to us when she came to clinic. She became so empowered and wanted a home birth. But she was anemic at the end of her pregnancy and we recommended a hospital birth. She was empowered through the birth, breastfed her baby, and started a journey toward nursing. She is now about to get her master’s degree in nursing, and she wants to come back to work with me. She’s determined to come back and serve and give back. She’s not the only one. It happens over and over again.

This interview has been edited for length and clarity.

Culture & Conversation Human Rights

‘I’m Not Saying Anything That’s Radical’: A Q&A With Matt McGorry

Regina Mahone

Matt McGorry spoke with Rewire about his experience working at the intersections of Hollywood and activism, how personal fitness is nothing like social justice awareness work, and why more men should care about targeted regulations of abortion providers.

You may have seen Matt McGorry’s face splashed across the internet today along with his co-stars promoting season four of Netflix’s hit show Orange Is the New Black. But this interview isn’t about that series’ latest premiere or McGorry’s role in one of my favorite ShondaLand productions, How To Get Away With Murder.

In the past year, McGorry has become an outspoken advocate for gender equality, Black Lives Matter, the importance of sexual consent via the White House’s It’s On Us campaign, and reproductive rights. And I have to admit: I’ve been a bit skeptical of all the headlines about him. For womenespecially Black women, who are constantly being talked over—seeing white men praised in the media for talking about what we’ve been talking about for decades with often zero recognition can feel about the same as when partners are praised for “babysitting” their own kids or for making dinner. As even McGorry will admit, “it can be triggering,” and the actor said that he was planning to pause interviews about his social justice work so he could actually “reflect and figure out a way to have deeper impact.”

But after speaking with him before the annual Gloria Awards in late April and then again in May via phone about everything from the film Captain America: Civil War to targeted regulation of abortion providers (TRAP) laws, I can report that McGorry’s not mansplaining or looking for applause. It’s the media that must focus less on how much of a bae he is and more on how other aspiring allies and accomplices can learn from him. So that’s what this interview is about.

McGorry and I spoke at length about his experience working at the intersections of Hollywood and activism, how personal fitness is nothing like social justice awareness work, and why reproductive rights is a men’s issue.

Here is an edited transcript of our conversation.

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Rewire: You talk a lot about being an advocate for gender equality. What does that mean, and what does that look like in practice?

Matt McGorry: There are obviously many different ways to do it. I think as a man, a big part of it is learning to understand and parse apart my privilege and my understanding of that, essentially how it influences my life and the choices that I’ve made in the past and the choices I continue to make even in doing the work. And continually learning and reading books and reading articles. It’s really about listening, and part of that listening is self-education. And part of that is talking to and being open to conversations with people in my life who are women or people of color when it comes to racial issues, but still being aware of the fact that it’s not women’s responsibility or people of color’s responsibility to educate me about these things.

I have to be careful that I’m not requiring that of people that I’m talking to who are marginalized. Sometimes I won’t be wanted or invited to conversations, and that’s OK too. And sometimes they won’t even tell me that they don’t necessarily want me in the conversation, and I have to be aware of that and take that into consideration as well.

I have been fortunate enough to have a platform due to acting that, since I have a certain number of followers [on social media], as I’m educating myself on these issues, I can retweet or repost articles or videos. I think that’s valuable for people to do even if they don’t have a following of my size.

One of the friends who got me very interested in Black Lives Matter was posting about these issues—and, unfortunately, it took my friend who’s a white man … to get me to pay attention. But sometimes that is the unfortunate nature of privilege.

It’s not that I need to be telling Black people about Black Lives Matter and I don’t need to be telling women about gender issues, but I need to be telling the people who are in my position. Some people have said that it’s useful to be able to point to me when talking to their white male friends about these things … I think there is some value for other men to see a man who says, “I am a feminist.” But it’s now asking myself the question: How do I make a deeper impact?

Rewire: You’ve written and spoken about how it’s only been a year in your journey as a feminist. Tell us what that experience has been like up to this point.

MM: I’m starting to examine my own views on the world … I don’t care how well your parents raised you or how inclusive your parents are—and my parents were very inclusive. You still grow up in a society where your media, your peers, and all these outside forces are pushing you toward sexism, racism, and all these things in a very insidious way. So … I then said I want to hold myself to a higher standard, but you don’t even know what that looks like at that time.

As you start learning about injustices, you start to realize aspects of your own self that are problematic. And that can be painful because, in these moments of realization, someone calls you out and you already feel like this is a risk. Obviously, the risk that I take in speaking about these things is relative to the risk that people who are not white or men or cis or straight take in this.

Rewire: I do wonder if there is a bit of a tension between the celebrity aspect of your identity, which may be about promoting the self, and the activist aspect, which is about lifting up other people who are not as privileged. How do you navigate that?

MM: I’m always thinking about it and always trying to figure out what might be the best way … as I have had opportunities like this or getting on the Nightly Show to say these things, it was important for me to have enough education on these topics, and conversations [with people] in real life to know how to not fuck up something like that, and to hopefully be more of service to any of these movements than to make it about myself, therefore excluding people and not being able to have as much of an impact. 

There’s not any [clear-cut path with these things] … I can ask women in my life about issues of feminism, and they are going to disagree with other women. And there are people online who don’t think that men should call themselves feminists. It was a conflicting moment for me actually when I was nominated [through an online poll, by supporters] as a potential “Feminist Celebrity of the Year.”

It’s a tricky conversation and has to be had with the right people because … essentially feminism is about gender equality. I think even in the community the word does tend to be gendered … and there were people, even friends of mine, who were like this [nomination] feels wrong.

I said, what if it was “Gender Equality Advocate of the Year,” would that feel different? And a lot of the time they would say, yeah maybe, which is very telling about our own perception with how we gender the word that we know is not really supposed to be gendered.

Bridging the gap between celebrity culture and [advocacy] is tricky … [but] if we’re not making ourselves uncomfortable, then we’re not really growing and we’re not forcing other people to grow too.

Rewire: It’s like when you decide to go on a diet, right? In order to go on this diet, you need to change your lifestyle. You want to exercise more, you want to start eating healthier, but often the people around you will say, “What is wrong with you? You’re acting strange.” Has that been your experience?

MM: I’ve never inherently been someone who likes confrontation. I was a personal trainer for ten years and even then I never really liked to force anyone to do anything. I would have clients come in and say, “Well, how much should I weigh,” or “What body type should I be”? I would answer, “Well, it’s whatever you want it to be. If you’re happy the way you’re now, then that’s great. Let’s work out, have fun, and keep you healthy. But if you have an issue with the way you look or with your health, let’s examine that.”

But social justice work is different from the world of personal training. In the world of fitness and personal training, it’s all very much personal preference. I do believe there is a right way of treating other people in this world, and I think that’s why activists and social justice work can quickly get so radical. It’s because, as soon as you see that you’ve been doing things wrong for a long time and then essentially, if there is a right way to do the things, it’s hard to pace oneself in terms of how much you try to turn other people to that as well and—I’m only a year in doing this. I’m engaged to see how the journey evolves over time, but I’m in a optimistic stage right now.

I feel like it’s quite possible that two years from now or a year from now, I won’t be arguing with someone like Piers Morgan because I’ll realize that he might not ever get it.

I think there was a value to having that conversation about what he thinks of as “reverse racism.” Having that conversation publicly in a way that other people can see it as well, even if he doesn’t get it. But it’s a very strange process. Because, it felt like the moment that I understood how bad things were, was the moment I felt compelled to act. There’s a bit of a disconnect for me [when I see] people that do understand it or that have some understanding of it or are starting to understand it, but that don’t act.

And what I’ve found is anyone who doesn’t take action on these things doesn’t really fully understand them yet. We can understand there is a problem with how our criminal justice system is run in our country, but I think understanding it in a really full and deep way and understanding how … someone like me gets to benefit from the criminal justice system that essentially keeps us safe but doesn’t keep everyone else safe in quite the same way.

Rewire: So, you have aligned yourself as an ally with various social justice movements. Are there any issues in particular within these movements that you’re most concerned with?

MM: In terms of racial justice issues, I would say that The New Jim Crow has had a profound effect on me and my view of the criminal justice system, and according to [its author] Michelle Alexander, that’s the biggest issue of our time, or what she calls the New Jim Crow. And so that’s been the thing that has stood out the most for me—how the “war on drugs” disproportionately has had negative effects on communities of color.

People are still serving lifetime sentences for first-time nonviolent drug crimes. And getting to meet in Washington, D.C., a number of these people who have received clemency from different administrations and are now free and are now really incredible members of their communities who are advocating for at-risk youth and other incarcerated individuals—I mean it’s incredible.

We have these internal biases—a lot of us do—that if someone ended up in prison, [we think] they must have done something that was terrible and violent. It’s not to say that drugs are good, but people make bad choices and people are more likely to make bad choices when they don’t have a lot of choices available to them.

Understanding what other people don’t have the luxury of has made me appreciate and understand more what I have had the luxury of growing up. Things that I didn’t even particularly like—I didn’t really enjoy much of classes in college or being tutored in high school or taking SAT prep classes—but those things are actually all privileges. And it does put me in a more advantageous position to succeed if I do have those opportunities available.

The criminal justice stuff for me stands out in a very big way because it’s just something that I’ve been totally blind to my whole life. I think what the book is very successful in accomplishing is forcing us to look at how we discriminated against criminals or people who have been incarcerated and how we justify the tactic, and we think that that’s okay.

Rewire: Earlier this year you launched a fundraiser to benefit NARAL Pro-Choice America. Why was it important for you to advocate for reproductive rights?

MM: A lot of men don’t understand it, or that this group is under attack, because of the TRAP laws and all this new legislation that people are trying to push. And again, as it always is with any of these issues, it’s really important to have people with privilege give a shit and say something and stand up against [bad policies].

These are not just women’s issues: They are human issues and human rights issues. In my mind, staying silent on this stuff when you have an opportunity to say something is essentially just telling women, “It’s your problem to deal with pro-choice issues.” That’s not fair and it’s not right.

We [as a society] need more men who care, and who care enough to say something. I’ve come to believe that if you say that you care about a thing but you don’t actually do something about it, you can’t really say that you care that much.

You might feel like you care. You might, if you had the choice to make abortion legal everywhere, you might wave the magic wand and say yes. But if you’re not willing to take a risk on for yourself, then you’re really not doing the work that needs to be done.

And I actually lost an opportunity because of the shirt. But it’s important for people in my position to be willing to make those sacrifices. The more men we have speaking out about these things, the less anyone else has to take the brunt of all these attacks.

If enough men gave a shit about women’s reproductive rights, these clinics would be staying open, and these TRAP laws wouldn’t be going into effect. The problem is, ultimately, not as many men care about these issues as women do.

Rewire: You spoke in a recent interview about how important it was to your gaining a deeper level of consciousness that you are working on shows like Orange Is the New Black and How to Get Away With Murder that allow you to wave your intersectional feminist flag with pride. What about the folks who aren’t in those environments? Just thinking about what it might be like if your next gig isn’t as “woke.” How do you see people navigating those spaces?

MM: I’m not in a place in my life where I have enough money to live even an extended period of time without working .… There is almost a guarantee that at some point in my future where I will work with someone on a project who is problematic, and I unfortunately won’t necessarily be able to call it out in a way that I would want to.

I have thought about that and I dread that day.

I just saw Captain America: Civil War, and there’s a great quote in that movie that resonated for me in terms of the social justice work. The theme behind it is that the United Nations wants to govern the Avengers and some of them do think it’s okay to be governed and some of them don’t want to be governed.

The quote is, “Compromise where you can. But where you can’t, don’t.” That’s not an easy thing to figure out, where you can and can’t. But it is an important part [of the work] and it’s one that’s a continual process.

I also think that part of the thing that scared me initially [about taking a stand] was I’m not always going to know what opportunities don’t come to me because of this stuff. The director is not going to call me up. They are going to go another way and you are not going to know.

I think for people who think they can’t speak out in some way, there is always other work to be done. There is always volunteering, community organizing, and having conversations with people [in small groups and] educating them.

I hope that I’ll be able to stay as much in line with my beliefs as possible as time goes on. It’s a constant process of figuring out and navigating, and I think it always will be. Any time you’re trying to go against the status quo, that’s not going to be a simple task.

Rewire: In the past year, you’ve gone from posting on Facebook about the gender pay gap and writing for Cosmo about your feminism to calling out Piers Morgan on Twitter about his response to Beyoncé’s Lemonade. In the spirit of trope-ing, why are you such an angry white man speaking about these injustices?

MM: There is a component of it that I’m never [taking] the direct brunt of this, of speaking out about these issues the way, for example, that Black women are. And I’m not getting that same backlash and hate and threats of violence against me.

So when I do speak to other people about this, I try to remind myself that the less angry I can be or the less angry at least I can appear to be, the more effective I think I am at having these conversations. That has to be the paramount thing, because I am angry but I am not angry from a first-person perspective having to experience these things directly.

There are too many people who don’t listen to Black women for example, and claim that it is because they are too angry. As you know, if someone is telling you the right thing, even if they are not telling you it in the way that you want to hear, it is important to listen to them as much as you can.

Ultimately white people, white men, need to be more outraged with the injustices of racism and discrimination than we are when someone is telling us that they don’t like something that we are doing, for example.

I think if I’m talking to people whose points of view I simply couldn’t help but be infuriated by, I probably don’t need to be talking to them, because they are not welcoming any sort of actual dialogue.

It’s unfortunate that some of the deeply, deeply bigoted people are harder to [communicate with] and are not going to change through social media posts. But most of my work is really focused on how do I activate and change the minds of those people who really are interested in justice and maybe don’t understand these things fully, and don’t understand how to be an ally or that they even can be an ally as a white person. For me, if we can get enough people in these positions to care and to take action, there would be a point of critical mass that would pull the rest of everyone else even further toward the side of progress, whether they wanted to or not.

It’s what Martin Luther King said in his “Letter from Birmingham Jail”—he said that the KKK is not the greatest stumbling block for the African American; it’s the white moderate who prefers order rather than justice. And who says, essentially what in today’s terms would be, “Whoa, you are being too loud” or “You should not go to these political rallies and yell Black Lives Matter.” It’s the people who prefer the order, who think, “not now, this is not the time or the place.”

I read in an article a while back how the movement [for racial justice] doesn’t need allies; it needs accomplices. That was an interesting way to think about [the work white people like me can do] too. We need to be there getting our hands dirty and taking on some of the risks, even in Hollywood, where we pretend we’re expressing those [messages], but we’re really not.

Again, I’m not saying anything that’s radical or that women and people of color haven’t been saying for years.

This interview, which was conducted in-person and later finished on the phone, has been edited for clarity and length.

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