Commentary Sexuality

The Change We Need: A Federal Government Rep Speaks the Truth About the Needs of LGBT Youth

Sophie Godley

At an otherwise mind-numbing conference, something incredible happens: A federal government employee responsible for billions of dollars in budget allocations talks openly about queer youth in our communities and he tells the truth. He talks about their struggles, their needs, and our inherent prejudices.  And he insists we can do better. 

It’s 8:30 on a Monday morning and I’m sitting in yet another anonymous hotel “grand ballroom” at yet another conference. This time it’s Expanding Our Experience and Expertise: Implementing Effective Teenage Pregnancy Prevention Programs, a federally sponsored conference in Baltimore for Teenage Pregnancy Prevention grantees.  I’ve been in public health for 19 years—I’ve attend a lot of conferences. Human service providers and public health folks like me seem to spend tons of time talking to one another about what we do, how we could do it better, who we serve, who we are missing, and on and on. 

This conference is for folks directly funded by the federal government through grants from the Administration for Youth and Families with names like the State Personal Responsibility Education Programs, the Personal Responsibility Education Innovative Strategies Grants, Abstinence Education Grants, and Tribal Personal Responsibility Education Program Grants.  There are also more bluntly named “teen pregnancy prevention” grantees funded from the Office of Adolescent Health.  It’s a diverse crowd of people who work in communities across the country all with one central mission—reducing too-early teen sexual activity resulting in teen pregnancy and births.  The conference is strictly required attendance for all funded programs and the room is packed. 

I’m actually here by choice—I have worked in the field of teen pregnancy prevention and adolescent health for most of my career, and I’m here to present some of my work. The opening plenary begins.  I’m thinking about the session I’m presenting in the afternoon (a workshop on the built environment and teen sexual health—it’s a bit of mouthful as workshop titles go and I’m wondering if I’ve travelled all this way from my home north of Boston to speak to three people).  I’m thinking about how stingy the feds are not even to provide coffee.  I’m thinking about how much work I have to do when I get back to Boston. You know, usual conference mode—pay attention to everything but the deadly dry and boring people speaking up in the front of the room.

The plenary speakers drone a bit—not a lot of enthusiasm, and as always there is the sense that these people forget who they are actually speaking with.  Yes, we all know youth are at risk of too early pregnancy.  Yup, we know it’s worse for youth of color (don’t you fund us to know this?!).  Uh huh, we know your role as the feds, the partnerships you have with one another (as if we should be impressed with this revolutionary act in government), and the hard work you have been engaged in to help us solve our problems back home.

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It feels like I have heard everything before. It feels like I could be anywhere, at any time, listening to the same folks say the same thing.  Honestly, now I’m thinking about lunch and whether or not the nail polish color choice was a mistake (La Moss by Butter, London.  A fabulous color, but unforgiving in the chipping-while-traveling-department).

Then the Commissioner for Youth and Families, Bryan Samuelson takes the podium.  He’s lovingly introduced by his staff: no shocker here.  Many of these conferences are just self congratulation fests.  He begins speaking—talking about the work happening in communities, the commitment his office has to foster care youth, his team and their work. 

And then, suddenly, seriously, out of nowhere, he is speaking about queer youth.  I mean, he is REALLY speaking about queer youth.  He’s identifying them as particularly at risk in the area of teen pregnancy, he’s naming them as desperately underserved, and he’s NAMING them. He’s talking about the L, the G, the B, and most amazingly the T.  He doesn’t stumble over the alphabet soup of letters. He names them clearly and without fanfare.  He doesn’t stammer, pause, or stop.

I am no longer doodling, I am no longer fussing with my bag and my stuff and my life—I am riveted.  A federal government employee who is responsible for billions of dollars in budget allocations is talking about queer youth in our communities and he is telling the truth. He tells us they need our support, our understanding, our time, and our effort.  He talks about how there may be resistance in our communities from people who don’t want us to work with these children.  He says that even some of us providers may be uncomfortable with this population.  But then he talks about their struggles—he tells a beautiful and sad story about youth in Chicago trying to start a charter school during his tenure there that would have focused on social justice and GLBT youth.  He talks about the ugliness that ensued—the homophobia and the bigotry.  He decries it.  He insists we can do better. 

There has been data and research identifying the seemingly upside down truth that our gay, lesbian, and bisexual youth are at between two and seven times the risk of their heterosexual peers to either become pregnant or cause a pregnancy during adolescence.  After all, when faced with rejection, stigma and homophobia, what better way is there to prove you are straight?  Despite the research they have been ignored in teen pregnancy prevention for years. Until now.

And I am pinching myself.  I am looking around—do people hear what he is saying?!  Do they know what this means?!  Commissioner Samuels goes on—he talks about naming GLBT youth in all their funding announcements.  He describes the technical assistance that will be specifically required for federally funded programs around ensuring access and competencies in working with GLBT youth.  Again and again, he is using words like “must” and “have to” and “critical” in describing this work. 

I have chills.  I have goose bumps.  I can’t believe it.  This is a call to action.  This is real.  This is happening.  Serve this population.  Overcome your discomfort. They need you.  Be there.  We—the federal government—insist that you do this work.  When he finishes speaking there is loud applause and several of us stand up.  Because for once, our youth, our queer youth, have been placed front and center and no one has apologized or pathologized them.  He has simply stated the truth—this is a population who needs us, and we have an obligation to serve them. 

I  remember once during a conference not unlike this one, I overheard a federally-funded abstinence-only until marriage provider get asked about what she would do if a gay or lesbian youth came to seek services.  She blithely replied, “But that’s what is so wonderful about abstinence-only-until marriage!  You don’t have to address those issues!” 

And now, in 2012, a presidential appointee is making a specific and unequivocal pledge to serving gay, lesbian, bisexual, and transgender youth. I have never been prouder of President Obama than I was in that moment.  We on the far left of liberal have often criticized the President for his lack of leadership on GLBT issues. We’ve whined, we’ve complained, we’ve cajoled.  But honestly, in this one moment at this conference I believe in the power of leadership—real true courageous leadership.  We know all too well that the far right in this country continues to enjoy using issues of sexual health to distort reality, to misinform, and to mislead and manipulate the public.  For President Obama to appoint a leader in his administration who issues directives at a public meeting about serving gay, lesbian, bisexual, and transgender youth is courageous, and necessary, and amazing. 

Of course, in and of itself, it’s not enough.  We still need to eliminate the abstinence-only funding that was restored by the Republicans in Congress during the health care reform debates of 2010.  We need performance measures that specifically articulate and how GLBT youth will be served and how the quality of their lives will improve.  We need to articulate and advocate sexual health goals for young people that include all young people—and that go beyond “not pregnant” and “not diseased.”

Yes, we have a right to insist on more.  But to have come this far is indescribable.  Thank you, Commissioner Samuels, and thank you, President Obama.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.