Roundups Sexuality

This Year in Sex: We’re Living in the Future

Martha Kempner

Between the high-tech sex toys, transplanted uteri, lab-grown penises, and perils of hookup apps, 2014 sometimes sounded like a science fiction novel. But we can't forget the news about IUDs and STIs that came out this year, either.

This Year in Sex takes a look back at the news and research related to sexual behavior, sexuality education, contraception, sexually transmitted infections, and other topics that captured our attention in 2014.

The HPV Vaccine Works, It Doesn’t Cause Promiscuity, and There’s an Even Better One Coming

HPV and its vaccine made headlines many times this year. The upsetting news is that two new studies came out suggesting that we had been underestimating the number of both HPV cases and cervical cancer, but as far as the vaccine itself was concerned, things were looking pretty good.

First, and most importantly, it appears to be working. A 2013 study found that despite the fact that only half of teen girls had gotten one dose of the vaccine—and fewer than a third had gotten the recommended three doses—the proportion of teen girls infected with the HPV strains that the vaccine addresses has dropped by 56 percent. This year, another study confirmed this success when it found that states with high rates of HPV vaccines have lower rates of cervical cancer, and vice versa.

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Additional research this year should (though probably won’t) also put to rest the idea that giving young people the HPV vaccine encourages them to engage in sexual behavior. One study found that young women do not change their attitudes or behaviors toward safer sex if they get the shot, and the other showed that girls with the vaccine are no more likely to get pregnant or be tested positive for a sexually transmitted infection than their unvaccinated peers.

More good news: Last week, the Food and Drug Administration (FDA) approved a new version of Gardasil, one of the two HPV vaccines on the market, which will protect against more strains of the virus. The original vaccine protected against strains 11 and 6, which cause most genital warts, and strains 16 and 18, which cause 70 percent of cervical cancer. The new vaccine, called Gardasil 9, will protect against these four strains in addition to five more cancer-causing strains—31, 33, 45, 52, and 58. Public health experts are hopeful that this added defense can prevent 90 percent of cervical, vulvar, vaginal, and anal cancers.

Wins and Losses for Those Who Want Condoms in Porn

Last year ended with a shutdown of filming—the third of its kind in 2013—in the porn industry after another actor was found to be HIV-positive. So it should be no surprise that this year included numerous rounds in the battle between producers who say no one wants to see condoms on film and public health experts who insist safer sex should start on set.

An effort to get California to pass a statewide law mandating condom use ultimately failed after facing a lot of opposition from porn company representatives, who threatened to take their business to a friendlier state, and porn stars who said it would force their industry underground and make their work more dangerous.

Defenders of the ban, however, did get an end-of-year victory this week when Measure B—a Los Angeles County ordinance requiring condoms on adult industry sets—was upheld by the Ninth Circuit Court of Appeals. A lower court had formerly upheld the measure, though it has yet to be systematically enforced.

The IUD Gains Supporters and Users

The intrauterine device (IUD) was once one of the more popular methods of birth control available. Then one model, the Dalkon Shield, came on the market with numerous design flaws that caused many users to become infertile, even resulting in several deaths. Though the dangers were unique to Dalkon Shield, women and physicians became suspicious of all IUDs; for many years, very few women—and only those who had already had children—would use them for contraception. In the last few years, however, IUDs have started getting more attention as providers and public health experts note the safety of newer models and the unparalleled efficacy rates.

This year, the IUD gained even more supporters, such as the American Academy of Pediatrics, which came out with a recommendation in October suggesting that IUDs be considered a first-line contraception for sexually active young people. Three months prior, research out of Colorado suggested that increasing the number of young women at Title X clinics using long-acting reversible contraceptives (which include both IUDs and implants) had led to lower than expected fertility rates among low-income women ages 15-to-24 in the state.

Other states, even conservative ones, decided this year that fixing the way Medicaid pays for IUDs—to make it possible to obtain one in a single visit, or even while still in the hospital after delivering a baby—could help prevent unintended pregnancies.

All of this support seems to be translating into increased use of the method. The National Survey of Family Growth found that 6.4 percent of contraceptive users were using an IUD in 2011-2013, compared to just 3.5 percent in the 2006-2010 survey.

Lab-Grown Penises and Transplanted Uteri

The future of reproductive health may include penises grown in a lab and babies born from transplanted uteri.

This year, the first baby to grow in a transplanted uterus was born to a 36-year-old Swedish woman whose name is being withheld. The woman, like the nine others who began the trial, had functioning fallopian tubes but was born without a uterus. After she received a donor organ from a friend of the family, doctors put her on anti-rejection drugs immediately. She became pregnant using IVF and had a relatively uncomplicated pregnancy, though the baby was delivered at 32 weeks when she showed signs of preeclampsia.

The medical team who undertook the trial hailed this as great news for assisted reproductive technologies, but others have expressed worry that the procedure is too invasive for both the donor and the recipient. Two of the nine women in the original study had to have their donor uteruses removed.

Meanwhile, no one has yet to be given a lab-grown penis, but new research on rabbits publicized in October suggests that it’s just a few years off. The process starts with a donor organ that is first stripped of its cells, then seeded with two different types from the genitals of the intended recipient. By making the penis out of the recipient’s own cells, scientist say they are reducing the chance of organ rejection. The procedure was tested on 12 rabbits; all successfully tried to mate using their engineered penis, eight were able to ejaculate, and four impregnated their bunny partner.

Truvada Dominates HIV-Prevention Discussion

Truvada is a combination of two antiretroviral drug used to treat individuals who have HIV. When used daily in HIV-negative individuals, these drugs have been shown to prevent transmission of the virus. The FDA approved the use of Truvada as a form of pre-exposure prophylaxis (PREP) in 2011 and it has been gaining popularity ever since.

This year, both the Centers for Disease Control and Prevention and the World Health Organization released guidelines suggesting that those at high risk of HIV infection—including injection users and men who have sex with men who are not in a monogamous relationship—consider using Truvada.

The method is highly effective. Studies have found that men who take it every day can reduce their risk of HIV infection by as much as 92 percent.

Still, some HIV advocates are concerned that those who choose Truvada—which can cost as much as $10,000 a year and needs to be taken every day—will stop using condoms, putting themselves and their partners at increased risk of other STIs, such as gonorrhea or syphilis.

The Dangers of Mixing Sex and Technology

The intersection between technology and sex got a little tricky this year as officials pointed to a dating app, Grindr, as being at least partially responsible for a syphilis outbreak; meanwhile, a jury in California found that an STI dating site called PositiveSingles had been sharing private information.

Grindr uses global positioning technology to help users meet other users nearby who are interested in getting together, presumably for sex. Grindr is marketed to men who have sex with men, but similar apps exist for heterosexual couples and women who have sex with women. This March, the popular app was at the center of an outbreak of syphilis in Onondaga County, New York.

A few months later, research in Los Angeles found that men who have sex with men who met partners on apps like Grindr had a 25 percent greater incidence of chlamydia and a 37 percent greater incidence of gonorrhea than those who met men in person at a bar, club, gym, private sex party, or even an online dating site. There was no difference in HIV rates or syphilis rates based on where men met.

The online dating sites, however, might pose another problem, at least according to a California jury that awarded 16.5 million dollars last month to a man who says the dating website PositiveSingles—which advertises itself as a place where people can meet other people living with STIs—violated consumer law and committed fraud by sharing information among many other niche websites owned by the same company. As the plaintiff’s attorney put it: “[my client] is not Black, gay, Christian or HIV positive and was unaware that [the] defendant was creating websites that focused on such traits that would include his profile, thus indicating that he was all of these things and more.”

Always a New Sex Toy

Finally, lest anyone worry that we will get bored heading into the new year, we take a look at the sex toys that emerged in the public eye in 2014. There’s the Svakom Gaga, a new vibrator introduced by a Chinese company that comes equipped with a camera and a USB port—plug it into your computer and star in your very own vulva video.

Of course, if you’re not ready for your close-up or you live far from your partner, you could instead turned to the OhMiBod, a vibrator that can be controlled from an iPhone via Bluetooth.

And, for the fitness buffs who aren’t satisfied knowing that they took their 10,000 steps a day, there is the kGoal, a U-shaped device that counts kegels. Women put one side of the device inside their vagina and the hook the other to their phones and are able to know exactly how many times they squeezed their pelvic floor muscles. Known as kegels, these exercises have been shown to help during childbirth, prevent or control urinary incontinence, and improve orgasms.

Analysis Law and Policy

Federal Court Says Trans Worker Can Be Fired Based on Owner’s Religious Beliefs

Jessica Mason Pieklo

“Plain and simple, this is just discrimination against a person because of who she is,” said John Knight, the director of the LGBT and HIV Project of the American Civil Liberties Union of Illinois, in an interview with Rewire.

When the U.S. Supreme Court ruled in 2014 in Burwell v. Hobby Lobby that the owners of secular for-profit businesses could challenge laws they believed infringed on their religious liberties, civil rights advocates warned that the decision was just the start of a new wave of litigation. On Thursday, those predictions came true: A federal district judge in Michigan ruled that a funeral home owner could fire a transgender worker simply for being transgender.

The language of the opinion is sweeping, even if the immediate effect of the decision is limited to the worker, Aimee Stephens, and her boss. And that has some court-watchers concerned.

“Plain and simple, this is just discrimination against a person because of who she is,” said John Knight, the director of the LGBT and HIV Project of the American Civil Liberties Union of Illinois, in an interview with Rewire.

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According to court documents, Stephens, an employee at Detroit’s R.G. & G.R. Funeral Homes, gave her boss—the business’ owner—a letter in 2013 explaining she was undergoing a gender transition. As part of her transition, she told her employer that she would soon start to present as a woman, including dressing in appropriate business attire at work that was consistent both with her identity and the company’s sex-segregated dress code policy.

Two weeks later, Stephens was fired after being told by her boss that what she was “proposing to do” was unacceptable and offensive to his religious beliefs.

In September 2014, the Equal Employment Opportunity Commission (EEOC) filed a lawsuit on behalf of Stephens, arguing the funeral home had violated Title VII of the federal Civil Rights Act, which prohibits employment discrimination. According to the EEOC, Stephens was unlawfully fired in violation of Title VII “because she is transgender, because she was transitioning from male to female, and/or because she did not conform to the employer’s gender-based expectations, preferences, or stereotypes.”

Title VII of the Civil Rights Act allows those employees who have been discriminated against in the workplace to collect money, known as civil damages. Those damages usually come in the form of lost wages, back pay, and funds to make up for—to some degree—the abuse the employee faced on the job. They are also designed to make employers more vigilant about their workplace culture. Losing an employment discrimination case for an employer can be expensive.

But attorneys representing Stephens’ employer argued that the Religious Freedom Restoration Act (RFRA) protected their client from legal liability for firing Stephens. On Thursday, a federal court agreed. It said that paying such damages for unlawfully discriminating against an employee could amount to a substantial burden on an employer’s religious beliefs. 

According to the court, despite the fact that Stephens’ boss admitted he fired her for transitioning, and despite the fact that the court found this admission to be direct evidence of employment discrimination, RFRA can be a defense against that direct discrimination. To use that defense, the court concluded, all the funeral home owner had to do was assert that his religious beliefs embraced LGBTQ discrimination. The funeral home had “met its initial burden of showing that enforcement of Title VII, and the body of sex-stereotyping case law that has developed under it, would impose a substantial burden on its ability to conduct business in accordance with its sincerely-held religious beliefs,” the court wrote.

In other words, Hobby Lobby provides employers a defense to discriminating against LGBTQ people on the basis of religious beliefs.

“The RFRA analysis is extremely troubling, and the implications of it [are] as well,” said Knight. “I believe this is the first case applying RFRA to a Title VII claim with respect to nonministerial employees.”

If the scope of the opinion were broader, Knight continued, “this would allow [employers in general] to evade and refuse to comply with uniform nondiscrimination law because of their religious views.”

This, Knight said, is what advocates were afraid of in the wake of Hobby Lobby: “It is the concern raised by all of the liberal justices in the dissent in Hobby Lobby, and it is what the majority in Hobby Lobby said the decision did not mean. [That majority] said it did not mean the end of enforcement of nondiscrimination laws.”

And yet that is exactly what we are seeing in this decision, Knight said.

According to court documents, Stephens’ boss has been a Christian for more than 65 years and testified that he believes “the Bible teaches that God creates people male or female,” that “the Bible teaches that a person’s sex is an immutable God-given gift, and that people should not deny or attempt to change their sex.” For Stephens’ former boss, Stephens’ transition to a woman was “denying” her sex. Stephens had to be fired, her boss testified, so that he would not be directly complicit in supporting the idea that “sex is a changeable social construct rather than an immutable God-given gift.”

If the “complicit in denying God’s will” sounds familiar, it should. It has been the exact argument used by businesses challenging the birth control benefit of the Affordable Care Act. Those business owners believe contraception is contrary to God’s will and that complying with federal law, which says birth control should be treated in insurance policies as any other preventive service, makes them complicit in sin. Thursday’s decision cites Hobby Lobby directly to support the court’s conclusion that complying with federal nondiscrimination law can be avoided by asserting a religious objection.

Think of the implications, should other courts follow this lead. Conservatives have, in the past, launched religious objections to child labor laws, the minimum wage, interracial marriage, and renting housing to single parents—to name a few. Those early legal challenges were unsuccessful, in part because they were based on constitutional claims. Hobby Lobby changed all that, opening the door for religious conservatives to launch all kinds of protests against laws they disagree with.

And though the complaint may be framed as religious objections to birth control, to LGBTQ people generally, and whatever other social issue that rankles conservatives, these cases are so much more than that. They are about corporate interests trying to evade regulations that both advance social equity and punish financially those businesses that refuse to follow the law. Thursday’s opinion represents the next, troubling evolution of that litigation.

CORRECTION: This article has been updated to clarify John Knight’s position with the American Civil Liberties Union of Illinois.

News Human Rights

Mothers in Family Detention Launch Hunger Strike: ‘We Will Get Out Alive or Dead’

Tina Vasquez

The hunger strikers at the Berks County Residential Center in Pennsylvania are responding to recent comments made by Department of Homeland Security Secretary Jeh Johnson in which he said the average length of stay in family detention is 20 days. The women say they've been in detention with their children between 270 and 365 days.

On Monday, 22 mothers detained inside Pennsylvania’s Berks County Residential Center, one of the two remaining family detention centers in the country, launched a hunger strike in response to recent comments made by Department of Homeland Security (DHS) secretary Jeh Johnson in which he said the average length of stay in family detention is 20 days.

The average length of stay for the 22 hunger strikers has been between 270 and 365 days, they say.

Erika Almiron, director of the immigrant rights organization Juntos and a core member of the Shut Down Berks Coalition, informed the women detained inside Berks of Johnson’s recent comment via email, hoping they would want to release a statement that her organization could help amplify. Instead, the women decided to launch a hunger strike, with recent reports indicating the number of participants has risen to 26.

“When Johnson said [ICE] only detain[s] people for 20 days, he said that thinking that no one would care,” Almiron told Rewire. “Our goal has always been to make people aware of the inhumane nature of detention in general, but also that children are being locked up and moms are being held indefinitely.”

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By definition, “family detention” means the women in Berks are detained alongside their children, who range in age from 2 to 16 years old. In an open letter addressed to Johnson, the women share that their children have routinely expressed suicidal thoughts as a direct result of being imprisoned. The women allege that they are being threatened by psychologists and doctors in the detention center for making this information public, but are choosing to move forward with the hunger strike.

In part, the letter reads:

The teenagers say being here, life makes no sense, that they would like to break the window to jump out and end this nightmare, and on many occasions they ask us if we have the courage to escape. Other kids grab their IDs and tighten them around their necks and say that they are going to kill themselves if they don’t get out of here. The youngest kids (2 years old) cry at night for not being able to express what they feel … We are desperate and we have decided that: we will get out alive or dead. If it is necessary to sacrifice our lives so that our children can have freedom: We will do it!

An August 2015 report about the Berks center by Human Rights First, a human rights advocacy organization, seemed to confirm what women and children detained inside of the facility have been saying since the detention center’s inception in 2001: Detention is no place for families and being imprisoned is detrimental to the health and well-being of children.

According to the Human Rights First report, detained parents in Berks experience depression, which only exacerbates the trauma they experienced in their countries of origin, and their children exhibit symptoms of depression, anxiety, and increased aggression. Frequent room checks that take place at 15-minute intervals each night also result in children experiencing insomnia, fear, and anxiety, the report says.

Families detained inside of Berks have no real means to alleviate these symptoms because the facility does not provide adequate mental health care, according to the report. Human Rights First notes that Berks does not have Spanish-speaking mental health providers, “though the majority of families sent to family detention in the United States are Spanish-speaking and many have suffered high rates of trauma, physical and sexual violence, and exploitation.”

The organization also explains that only 23 of the total staff at Berks (or less than 40 percent) reportedly speak some conversational Spanish, “making it difficult for many staff members to effectively communicate with children and their parents.”

Berks has a history of human rights abuses. A 41-year-old former counselor at Berks was recently sentenced to between six and 23 months of jail time for the repeated sexual assault of a 19-year-old asylum-seeking mother. The young woman, along with her 3-year-old son, fled sexual domestic violence in her native Honduras. The assaults on the young mother at the detention center were witnessed by at least one of the children detained with her.

There have also been health-care issues at Berks, including the failure by the detention center to provide adequate services, according to Human Rights First.

The organization was able to collect some of the letters women detained at Berks wrote to Immigration and Customs Enforcement (ICE), along with ICE’s response to their concerns. One woman, detained at Berks for four months, told ICE that her 5-year-old daughter had diarrhea for three weeks and that the detention center’s doctor failed to provide her child with any medication or other care. The woman asked for “adequate medication” for her daughter and for the opportunity to have her asylum case handled outside of detention. ICE’s response: “Thank you! You may disolve [sic] your case at any time and return to your country. Please use the medical department [at Berks] in reference to health related issues.”

Using family detention as a way to handle migrants, especially those fleeing violence in Central America, has been called inhumane by many, including activists, advocates, mental health specialists, and religious leaders. But the prolonged detainment of women and children at Berks is in violation of ICE’s own standards.

In June of 2015, Johnson announced a series of reforms, including measures aimed at reducing the length of family detention stays for families who had passed a protection screening. But then earlier this month, Johnson defended family detention, saying, “The department has added flexibility consistent with the terms of the [Flores] settlement agreement in times of influx. And we’ve been, by the standard of 1997, at an influx for some time now. And so what we’ve been doing is ensuring the average length of stay at these facilities is 20 days or less. And we’re meeting that standard.”

But all of the 22 mothers on hunger strike at Berks have been in detention for months, according to the letter they sent Johnson.

There’s also the issue that in July, a federal appeals court ordered DHS to end family detention because it violates Flores v. Johnson, which determined that children arriving to the United States with their mothers should not be held in unlicensed detention centers. Soon after, family detention centers scrambled to get licensed as child-care facilities (a battle they’re losing in Texas), but the Pennsylvania Department of Human Services (PA DHS) licensed Berks to operate as a children’s delinquency center. In October 2015, PA DHS decided not to renew the license, which would have expired February 21, 2016, because the facility holds asylum-seeking families as opposed to only children, as the license permitted. Berks appealed the decision to not renew its license, and continues to operate until it receives a ruling on that appeal.

“Our argument from the start has been that we don’t think any of this is legal,” Almiron told Rewire in a phone interview Friday afternoon. “What is happening inside of Berks is illegal. I have no idea how they continue to operate. Right now, Berks does not have a license. It was revoked because the license they did have didn’t fit what they were doing. They also have prolonged detention. Women who are hunger striking have been there 360-something days, but then Jeh Johnson says it’s only 20 days. There is no accountability with DHS or ICE. There are numerous ways [DHS and ICE are] not accountable, but Berks is a prime example. There is no transparency and they can to change the law whenever they like.”

Neither DHS nor Berks responded to requests for comment from Rewire.

Advocates have expressed concerns that the women in Berks will be retaliated against by ICE and detention center employees because of their participation in the hunger strike. As Rewire reported, when women at Texas’ T. Don Hutto Residential Center, a former family detention center, launched a hunger strike in November 2015, participants alleged that ICE used solitary confinement and transferred hunger strikers to different facilities, moving them further from their family in the area and their legal counsel. ICE denied a hunger strike was even taking place.

In December 2015, men detained at the Etowah County Detention Center in Gadsden, Alabama, ended a 14-day hunger strike after a local judge authorized officials to force-feed one of the hunger strikers because of his “deteriorating health” due to dehydration. Advocates told Rewire force-feeding was being used as a form of retaliation.

Almiron said the hunger strikers at Berks have already been threatened by guards, who told the women that if they continue to hunger strike and they get too weak, their children will be taken away from them. The organizer said the letter the women wrote to Johnson shows their bravery, and their understanding that they are willing to take whatever risk necessary to help their children.

“Honestly, I think they’ve been retaliated against the moment they came to this country. The fact that they’re in detention is retaliation against their human survival,” Almiron said. “Retaliation happens in detention centers all the time, women are threatened with deportation for asking for medical care for their children. These women are incredibly strong. In my eyes, they’re heroes and they’re committed to this fight to end family detention, and so are we.”


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