A Montana judge who suggested that a 14-year-old rape victim was at least partially to blame for her attack and sentenced the teacher who admitted attacking her to only 30 days in jail received a public reprimand from the Montana Supreme Court Tuesday.
The Associated Press reports that Montana Supreme Court Chief Justice Mike McGrath delivered the censure to District Judge G. Todd Baugh of Billings, reading from a prepared censure statement. (A censure is a rarely used public declaration by the state’s highest court that a judge is guilty of misconduct.) “We have determined that, through your inappropriate comments, you have eroded public confidence in the judiciary and created an appearance of impropriety in violation of the Montana Code of Judicial Conduct,” McGrath said.
Baugh drew international condemnation after his comments and sentencing in the case of Stacey Dean Rambold. Rambold, a former Billings Senior High School teacher, admitted to raping his former student, who later committed suicide. Baugh originally sentenced Rambold to 15 years in prison, with all but 31 days suspended. With credit for one day previously served, that meant that Rambold was ordered to serve only 30 days in jail, a sentence that dramatically deviated from sentencing guidelines.
At the time he delivered Rambold’s sentence, Judge Baugh explained the unusual order by suggesting that because the victim “looked older than her chronological age,” she was complicit in the crime committed against her, saying at the hearing that the girl was “as much in control of the situation” as Rambold.
Under Montana state law, children under 16 cannot consent to sex.
After protests and emergency filings by prosecutors in response to the sentencing deviation, Baugh apologized for his remarks and tried to amend his sentence. But the Montana Supreme Court intervened, and in April ordered a new sentencing hearing in the case, assigning the matter to a different judge. Rambold is now scheduled to be re-sentenced by District Judge Randal Spaulding on September 26.
In addition to the censure, the Montana Supreme Court also suspended Baugh for 31 days, effective in December. Baugh has said he plans to retire at the end of his term in December.
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While Honduran women attempt to flee their country, trying to get their children out of what they have described as a war zone, elite U.S.-trained and -funded Honduran military forces are reportedly stopping them near Guatamalan border crossings to demand passports and written documentation from the children’s fathers allowing the children to leave the country. The troops have the power to turn back these women and children.
I came across this chilling news in the Los Angeles Times, as reported by Cindy Carcamo the same day I was interviewing Honduran women who had made it to a migrant shelter in Tenosique, Mexico, “La 72,” near the border with Guatemala.
La 72, named in memory of the 72 migrants massacred in northern Mexico in 2010, forms part of an extensive network of migrant shelters in Mexico, run mostly by religious groups, and located near the rail lines where Central American migrants ride freight trains north. For more than a year, La 72, one of the first stops on the route, has experienced a surge in the number of women with children and unaccompanied minors that preceded the more recent humanitarian crisis on the U.S.-Mexico border.
What does the presence of these elite Honduran forces, carrying out what is called “Operation Rescue Angels,” mean for Honduran women who take desperate steps to get their children out of the violence that permeates and controls their lives in the murder capital of the world? Although the women come from all over the country, the largest numbers are from the two major cities, Tegucigalpa and San Pedro Sula.
As Carcamo explains, the special forces are enforcing existing law in Honduras and many other countries, which says that children must have permission from both parents and a passport to leave the country.
According to the national police, the team is primarily funded by the U.S. State Department and was trained by a U.S. Border Patrol Tactical Unit, known as BORTAC. The team’s aim in this operation is to stop the flow not just of unaccompanied minors, but of children who head north illegally with only one parent.
The group professes humanitarian goals, according to Carcamo’s conversation with Commissioner Miguel Martinez Madrid, a Honduran liaison to the U.S. Embassy in Tegucigalpa, coordinator of the special unit and “father of two young daughters.”
“These are little angels,” Madrid told Carcamo. “They are not conscious of the risks they are taking. We are doing something good.”
Carcamo also cites Noel Hernandez, a first lieutenant with the unit, the Honduran Special Tactical Operations Group, who says, “We are saving the lives of our country’s children.”
Honduran women at La 72 told me different stories.
Gangs murdered Ana Elena’s younger brother ten years ago, and when her mother demanded an investigation she was murdered as well. The family continued to insist that authorities investigate, but nothing ever happened. Now Ana Elena is trying to get her 13-year-old daughter, Cecilia, to safety in the United States because she was receiving threats by cell phone, which included threats of abduction, assault, rape, and murder. Cecilia thinks gang members pressured other students at her middle school to pass along fellow students’ phone numbers.
I sit on chunks of cement outside the women’s dormitory at La 72 with Ana Elena, who has her arm around Cecilia’s shoulder. “I am scared,” Cecilia acknowledges, “and I’m glad to be out of Honduras.” She added that she feared being raped if she stayed.
Ana Elena left two other children at home in Honduras with her husband. Her son has been assaulted. Her other daughter hasn’t answered directly her mother’s questions about whether or not anything has happened to her.
This journey is not Ana Elena’s first attempt to provide safety for her family. About a year ago she attempted to go to the United States alone. “I wanted to make money so I could move my family to a safer place in Honduras,” she said. However, she was detained crossing the international bridge in McAllen, Texas, and deported. U.S. Immigration and Customs Enforcement (ICE) gave her a five-year bar, which means that if she is caught entering undocumented within five years, she will serve prison time. “But,” she emphasized, “keeping my daughter safe is my priority.”
“I’m fearful every day when I send my children to school,” she said, noting that she fears they’ll be taken by gangs. “It’s the same for all parents.”
Neither Ana Elena nor her husband have had work in Honduras. Gangs all over Honduras (as well as in much of El Salvador and Guatemala) extort impuestos de guerra, “war taxes,” from everyone—small family businesses and large companies alike—to continue operating. Those who don’t pay in cash pay with their lives. And many who do pay initially can’t afford to keep it up, so they go out of business, which increases unemployment. Ana Elena worked in a large factory that closed two years ago because the owners couldn’t pay.
“Justice?” She shrugs. “That’s for those who have money. For the poor, there is none.”
So far in their journey Ana Elena and Cecilia have been stopped by innumerable men in uniforms, gangs, and other criminals who extort money in return for allowing them to travel along a particular road or cross a border.
Operation Angel Rescue forces have been at work for about three weeks, including the time during which Ana Elena and Cecilia left Honduras, but there’s no way to know if the uniformed authorities they encountered were trained by the United Sates. Whoever the extortionists at the border were, they are part of a long list; extortion at all levels is so rampant in Honduras that it is impossible to imagine that any authorities could remain immune for long.
Ana Elena hugs her daughter tightly and strokes her curly hair. “I hope people understand that these are true stories,” she says. “I remember my mother and my brother, and I think about having to leave my other children. But, there’s no other way.”
Carcamo described how a woman and her child were turned over to governmental child welfare services. In a country where almost no institution functions without intense corruption, we must ask, who are the people running child welfare services in the country? Are they any more trustworthy than the criminals on the street? How do we know they are not connected to gangs or trafficking rings? Even if their intentions are honorable, do they have any actual services or protection to offer the mother and her child? As Human Rights Watch-Honduras has noted, “The institutions responsible for providing public security [in Honduras] continue to prove largely ineffective and remain marred by corruption and abuse.”
Both the United States and Honduran governments make evident their astonishing lack of awareness or concern about the realities poor Honduran women face when they claim that requiring documents to leave the country will protect women and children. The idea that forcing women and children who cannot produce the documents to stay in the country is safer than allowing them to leave only creates a false illusion of safety in a country that migrants describe as a war zone. In this sense, the United States is funding a type of military death squad masquerading as child welfare workers.
Even if we pretend that there is a legitimate reason to demand that mothers and children carry certain documents, finding a possibly absent, unknown, abusive, or non-cooperative father can be impossible. Coming up with the money to get a passport and then obtaining that passport from a barely functional government can be a fantasy. In addition, along the way documents get stolen, often by the same officials who demand to see them. A piece of paper does not protect a child or a mother from rape, kidnapping, or murder.
Then, what happens when a gang, uniformed or not, steals the documents? Now they possess precious, confidential information about people who are trying to escape with their lives. The migrants on the road and their relatives still at home have just fallen into even more danger.
Based on the stories migrants tell of their experiences with other authorities they encounter on their journey, it seems highly doubtful that this newest obstacle for women seeking safety really has anything to do with documents. It seems more likely that these elite forces will soon cross the line and become yet one more set of uniformed men with weapons, whether backed by the United States or not, who extort money from women, and possibly do other things that are much worse. From those stories migrants tell, it becomes obvious that virtually every Central American migrant who has reached Mexico has paid innumerable bribes at just about every point in the journey and will continue to do so all the way into the United States. These bribes, and the threats of violence and death that accompany the “war taxes,” comprise part of everyday life in Honduras and have helped solidify many women’s decision to leave.
Gloria, another migrant at La 72, is guarded about telling her story because she and her family decided to request asylum in Mexico due to credible fears of death if they return to Honduras. Close relatives refused to join gangs and refused to transport drugs, so the gangs threatened to kill the entire family.
She arrived in Tenosique from a large city in Honduras. She and her husband had to decide which two of their four children to bring with them. They chose their 2-month-old baby, whom she is nursing, and their 9-year-old boy. “Boys 10-years-old walk the streets with weapons killing people. That’s why we brought the 9-year-old,” she said. “I can’t let that happen.” The other two children stayed with relatives.
While leaving Honduras through Aguas Calientes, the region Carcamo describes in her LA Times article, Gloria’s family encountered uniformed authorities who demanded bribes to let them continue on their way, along with taxi drivers and bus drivers who charged four to ten times the established prices. “They take advantage of our fear, so we pay. We sold everything before we left to have money for this trip. But we arrived here to Mexico, still far from the United States, without anything because of the extortion. Sometimes we could negotiate to lower the price, but we always had to pay,” she said.
Her priority now “is to bring my other children here. I can’t live without them. We do this for those we brought with us and those we left.”
Gloria then mentioned something that helps explain why the data on numbers of people leaving because of violence may be underreported: “Sometimes when people ask us why we came, we say ‘no work,’ because we’re afraid to tell the real story.”
It is politically inconvenient for the United States to acknowledge its responsibility for the depth of the violence, poverty, and instability in Central America, historically and more recently, such as in the 2009 coup in Honduras. Training Honduran military to stop women fleeing violence and putting women and children who reached the United States on planes and flying them back to Central America, which the the United States began doing on July 14, only inscribes another chapter in this horrific and shameful story.
The names of the women at La 72 have been changed to protect their identity.
The post The Stories of Women, Children Stopped by U.S.-Trained Honduran Military While Fleeing Violence appeared first on RH Reality Check.
The Obama administration has announced it is revising the accommodation to the contraception benefit in the Affordable Care Act available to religiously affiliated nonprofits.
The statement was made in a legal brief filed by the Department of Justice with the United States Court of Appeals for the Tenth Circuit as part of a series of cases filed by groups like the Little Sisters of the Poor, which argue that complying with the accommodation process set out by the administration is itself a burden on their religious rights and a violation of the Religious Freedom Restoration Act (RFRA). The current process requires qualifying religious organizationsto complete a form notifying the administration that they object to providing health insurance plans that offer coverage for contraception. Once that form is completed and filed with the administration, a third-party insurance administrator steps in to provide the insurance coverage for those employees or students who want it.
But at the beginning of July, the Roberts Court threw that accommodation into question by issuing a temporary order that allowed Wheaton College—an evangelical Christian college in Illinois that’s challenging the accommodation—to both avoid providing insurance plans that include birth control coverage and complying with the accommodation process. While that order was not a final ruling on the merits of the accommodation, its effect can be seen in the other pending challenges, like the Little Sisters of the Poor and the administration’s statement that it will be making further adjustments to that process.
“The Wheaton College injunction does not reflect a final Supreme Court determination that RFRA requires the government to apply the accommodations in this manner,” the administration wrote in its brief. “Nevertheless, the Departments responsible for implementing the accommodations have informed us that they have determined to augment the regulatory accommodation process in light of the Wheaton College injunction and that they plan to issue interim final rules within a month. We will inform the Court when the rules are issued.”
When completed, those rules will reportedly provide an alternative way for an objecting religious nonprofit to notify the administration of its objection.
The post Obama Administration Says It’s Revising Birth Control Benefit Accommodation appeared first on RH Reality Check.
Forty-six percent of Texas’ legal abortion providers have closed since May 2013, according to a new study led by university researchers in Texas, California, and Alabama, that evaluates the impact of HB 2, the omnibus anti-abortion law passed by Texas lawmakers in July 2013.
Researchers estimate that while the number of unintended pregnancies has likely increased in Texas, the number of legal abortions in the state decreased by 13 percent—and the number of medication abortions decreased by 70 percent—between the six-month period before the passage of HB 2 and the six-month period after the passage of HB 2 and the implementation of three of its four provisions: those that restrict the prescription of medication abortions, require abortion-providing doctors to have hospital admitting privileges, and ban abortion after 20 weeks.
Researchers also estimate that the number of Texans living hundreds of miles from legal abortion facilities has increased by tens of thousands, from 10,000 living more than 200 miles from a clinic in May 2013 to 290,000 by April 2014.
According to the study (abstract available here), the provision of HB 2 that requires abortion-providing doctors to have hospital admitting privileges “was almost certainly the main driver of the large number of clinic closures observed in the months preceding and following its implementation.” At that point, “vast swaths of the state were left without a provider, and the number of women required to travel great distances to reach a provider increased dramatically.”
The corresponding decrease in the overall abortion rate “may have been muted by a potential increased demand for abortion following the severe reduction in public funding for family planning in Texas in 2011.”
The study, to be published in the medical journal Contraception, is the first academic evaluation of the impact of HB 2 to be released since the law passed last year. Researchers at the Texas Policy Evaluation Project, Ibis Reproductive Health, the Bixby Center for Global Reproductive Health, the University of Alabama School of Public Health, and the Population Research Center and Department of Sociology at the University of Texas focused on three six-month periods: November 2012 through April 2013, before legislators filed HB 2; May 2013 through October 2013, during public debate and passage of HB 2 but before it went into effect; and November 2013 through April 2014, when three of HB 2′s four provisions went into effect.
Researchers drew their conclusions from data provided by 36 of the 41 abortion providers that were open in Texas in November 2012, including all six of Texas’ abortion-providing ambulatory surgical centers, along with demographic data from the U.S. Census Bureau.
“Our findings suggest that most women desiring an abortion—but not all—overcame the barriers of distance and additional cost to obtain the service they needed,” wrote the researchers. “In addition, the public opposition to HB2 galvanized a coordinated response among activists who provided financial and logistical support to women seeking abortions.”
Throughout all three research periods, researchers found that less than a quarter of legal abortions in Texas were performed at the state’s ambulatory surgical centers, which will be the only remaining facilities licensed to practice legal abortion care after September 1, when the fourth provision of HB 2 goes into effect. At that time, according to the study, “it seems highly unlikely that existing facilities could expand their capacity four-fold to meet the demand for services.”
Image: Closed sign via Shutterstock
The post Study: Nearly Half of Texas’ Legal Abortion Providers Have Closed Post-HB 2 appeared first on RH Reality Check.
I saw it on posters last summer at the Texas capitol, during protests against the state’s omnibus anti-abortion law: “TEXAS TALIBAN.” I’ve heard pundits and preachers on cable news, decrying the “American Taliban” that wants to take away birth control and abortion access.
These phrases aren’t clever, and they aren’t insightful. They’re racist, and they’re Islamophobic, and people—especially white people—who work in social justice movements and who do advocacy for women’s rights need to stop using them yesterday.
Because there is indeed a powerful, well-funded and rigidly patriarchal religious movement behind America’s most misogynist laws, and it isn’t any iteration of Islam.
There’s no need to try and incite fear that right-wing lawmakers are going to turn America into an extremist Islamic theocracy when they’re doing just fine turning it into an extremist Christian theocracy. The answer to countering right-wing attacks on Americans with uteri isn’t to create a turban-wearing bogeyman looming half a world away, but to look at what’s happening right here in our own country, in our own statehouses, at our own national capitol.
I seem to remember someone once saying something about removing the plank from your own eye before trying to pluck a splinter out of someone else’s.
I’ve followed the “Holly Hobby Lobby” meme with eyes rolling hard, as lefty Americans work themselves into a froth about a young white American woman holding a rifle and a bible. But what’s scary about that photo isn’t that the woman pictured is echoing the posture of an Islamic extremist, it’s that she’s using a rifle and a bible to advocate for government-sanctioned misogyny. American government-sanctioned misogyny.
The five judges who joined the majority opinion on Hobby Lobby aren’t Muslim. They’re Catholic. So are Rick Santorum and House Speaker John Boehner (R-OH). Rep. Louie “Terror Babies” Gohmert (R-TX) is a Southern Baptist, and so is Sen. Ted Cruz (R-TX). Texas Gov. Rick Perry (R) attends an evangelical megachurch, and Minnesota Rep. Michelle Bachmann (R) is also an evangelical Christian. Oklahoma Gov. Mary Fallin (R) is a member of the Church of God. Sen. Rand Paul (R-KY) is a Presbyterian.
The call is coming from inside the house, y’all.
We need to ask ourselves: What’s wrong with our own American Christianity that we are unable to face the very real fact that we are perfectly capable of using our own Christian traditions to oppress the most vulnerable among us?
There have been a grand total of two Muslim Americans elected to the United States Congress—the first in 2007. Islam, and its many variants, are not a threat to the U.S. legislative system. American lawmakers didn’t learn misogyny from Muslim extremists in Afghanistan—we grew it ourselves, right here on American soil. We’ve baked it into every slice of the American pie.
To fixate on an “American Taliban” is to derail an important and necessary conversation about the ways Christianity has been used, and continues to be used, as an excuse and a means to oppress and marginalize American citizens, right here on our own turf.
Words express shared cultural ideas, and to pretend that “American Taliban” or “Texas Taliban” are just cute accidents of speech, or innocent verbal shorthand, is to ignore the very real history of organized, politically endorsed, and perpetuated systemic racism expressly meant to oppress and silence a particular group of non-white folks, both inside and outside the United States.
It’s no accident that, in the vast and varied religio-cultural landscape of planet Earth, which offers no shortage of examples of misogynist ideologies, Americans choose “Taliban” when they want to try and insult right-wing lawmakers, and try to incite their fellow citizens to action against those lawmakers. Because 9/11. Because the war in Iraq. Because racism. Because brown people from the Middle East are, more than any other people, the “baddies” right now in American culture.
The result? Widespread American Islamophobia, a fear of the millions of Muslims who call this country home. Anti-Muslim violence in America is a very real problem, as the Los Angeles Times reported way back in 2010:
Law enforcement authorities in California classified the vandalism at the Madera Islamic Center in the Central Valley that nearly smashed a window as a hate crime when they discovered signs that read “Wake up America the enemy is here” and “No temple for the god of terrorism.” In New York, an intoxicated man forced his way into a mosque in Queens and urinated on several prayer rugs. Michael Enright, a 21-year-old New York film student, is being charged with attempted murder in connection with the stabbing of a Muslim cab driver. The act has been classified as a hate crime.
Maybe you’re not the kind of American who’s going to plant a pipe bomb at a mosque, but when you try and foment fear by hollering “AMERICAN TALIBAN!” at the top of your lungs, you give those who might an awful lot of culturally sanctioned leeway to try.
Muslim Americans, and people who are perceived to be Muslim Americans, are singled out at airport checkpoints and targeted in domestic spying operations. Women who wear hijab in public are ridiculed and harassed. And every cry of “Texas Taliban!” or “American Taliban!” makes it worse, because we do not have, and have never had, a nuanced, thoughtful national conversation about Islam—in part because we usually stop with “Taliban!” and a pat on the back.
Last year, right here in supposedly hyper-liberal Austin, Texas, a Muslim woman named Beeta Baghoolizadeh joined the thousands of Texans who descended upon our state capitol to show support for abortion rights. On her first trip, she accidentally wore blue:
Lest anyone assumed that I was another anti-choice activist—and a Muslim one no less—I quickly created a sign reading “PRETEND I’M WEARING ORANGE.” I wanted to make sure people didn’t conflate my blue outfit with Christian-centric religious arguments. I didn’t need any #creepingsharia tweets with my picture on them.
Later, Baghoolizadeh wrote of another trip to the capitol, wearing an orange scarf, and seeing protesters holding signs “about the Sharia and Taliban taking over Texas.” Afterward, she saw a disturbing image:
It was a picture of woman dressed in a black burqa with a “Miss Texas” sash around her inside the Capitol. It felt like a slap across the face. I had gone to the Capitol wearing an orange scarf–not a black burqa–and was forced to deal with a more intense fast than usual because of my decision to stand for women’s rights, health and engage in the democratic process. In return, I was met with a caricature of a “Muslim woman” to protest the GOP’s [non-Muslim] oppression.
No matter how orange my scarf was that night, people had managed to conflate the politics of the swaying, praying Christian right with “oppressed” Muslim women swathed in black. Suffice to say, this shallow, knee-jerk polemic both disappointed and infuriated me. Indeed, this atrocious bill has given birth to (no pun intended) a number of facile and unfortunate proclamations about the Muslim world.
I mean, we can technically do those things—but only if we’re unwilling to confront the fact that in doing so we are charging admission for our allyship, telling people that they need to be the right color, the right religion, the right sex, the right gender in order to receive our support.
I also see another side to the “American Taliban” rhetoric, one that’s not just racist and Islamophobic but misogynist, one that is about a certain kind of fetishization of the oppression of women of color, about the kind of subconscious work a phrase like “American Taliban” or “Texas Taliban” does for white people: it titillates us, allowing us to imagine ourselves as beneficent saviors of brown-skinned damsels in distress. In the popular American cultural conscience, women of color are particularly situated as sexual objects according to particular racist stereotypes about what it means to be not-white and also a woman—seductive or submissive, aggressive or unrapeable. On the surface, “American Taliban!” centers an imagined male figure, but the reason why the “Taliban!” as a linguistic trope is supposed to incite such fear in the first place is because that imagined male figure is abusing, oppressing, silencing a woman—not just any woman, but a woman of color. A woman who, by virtue of the way she is embodied in the world, we expect to be oppressed, abused, silenced.
We can imagine that woman being oppressed in the way we expect her to be oppressed, and imagine ourselves—Americans wielding lipstick and high heels—as liberators. As if beauty products and fashionable shoes were unknown to Muslim women, and as if wearing lipstick got us government-mandated parental leave, and high heels have earned American women equal pay for equal work.
When a white person cries “Texas Taliban!” or “American Taliban!” what they’re saying is “I thought only brown people deserved to be oppressed.” They’re saying, “My whiteness was supposed to insulate me from things like this.” They’re saying, “I’m afraid—for my privilege.”
But patriarchy and misogyny pay no heed to national borders, and are not uniquely suited to certain geographical climes. They thrive everywhere—including in America, and including in our churches.
And yes, I know, not all Christians. Are there compassionate, loving Christians out there who are deeply invested in committing radical acts of social justice? Absolutely—for reference, see North Carolina’s Moral Monday protests. Are there reasonable Christians out there who believe in science and medicine? Definitely. Are there Christians out there who just like to go to church and do the Jesus thing and have a nice time in fellowship? Indeed; I just described about 99 percent of my relatives.
You might be one or all of these kinds of Christians. If you are, I’m not talking about you. Keep doing that good work you’re doing.
People know what they’re doing when they say “Texas Taliban” or “American Taliban.” Everybody else does, too. That’s why they say it in the first place: They want to make clear that when American lawmakers are bad, they’re imitating brown men on the other side of the world, where the “real” oppression happens. The word “Taliban” conjures up images of brown men wearing turbans, and brown women wearing burkas. Nevermind the fact that white, male Americans are doing just fine at oppressing women with bibles at their right hand. Using “Taliban” rhetoric to describe American politics is a salve that serves only to soothe Americans into dangerous complacency.
If you get to the end of this piece and you’re raring for a fight so that you can continue to holler “Taliban!” every time a white Christian man rails against birth control, I want you to ask yourself: Why am I so invested in being able to continue using this word? Like, really sit with that. If you could never say “American Taliban” or “Texas Taliban” ever again, how would you be unable to do good social justice activism? How would never saying those phrases again impede your ability to help Americans access legal abortion care? Will equal pay, or mandated family leave, become a reality only on the condition that you get to keep saying “Taliban”?
Or will you be able to drop an ignorant, racist dogwhistle that helps no one, hurts many, and does nothing to stop or silence the American Christians behind our country’s worst laws?
The post Stop Calling U.S. Christian Lawmakers the ‘Taliban’ appeared first on RH Reality Check.
Last week, the World Health Organization took a seemingly bold step by suggesting that all men who have sex with men should consider Pre-Exposure Prophylaxis (PrEP) as a means of preventing HIV. Headlines appeared almost instantly questioning why the organization would want all gay men to be on PrEP when not all men who have sex with men are at risk of HIV. The organization quickly clarified that this was not the intent of its announcement. Instead, the group wants all men who have sex with men to work with their health-care providers to assess their personal risk and determine whether this option is right for them.
This clarification brings the World Health Organization (WHO) guidelines in line with those released by the Centers for Disease Control and Prevention (CDC) in May. While not nearly as provocative as initial reports suggested, the release of these guidelines indicates growing support for PrEP and a new global focus on groups that remain disproportionally affected by the HIV epidemic.
PrEP is a combination of two anti-retroviral drugs—tenofovir and emtricitabine—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.
In the United States, PrEP is given using one pill that contains both medications, sold under the brand name Truvada. Truvada was approved by the Food and Drug Administration for prevention purposes in 2011. Studies have found that it is very effective. One study of men who have sex with men, for example, found that those who were given PrEP were 44 percent less likely to contract HIV than those who weren’t. More importantly, those who remembered to take their medication every day or almost every day saw a reduction in risk of 73 percent or more (some up to 92 percent). Studies of HIV-discordant, heterosexual couples (couples in which one partner has HIV and the other does not) found that PrEP reduced the risk of the uninfected partner becoming infected by 75 percent, or as much of 90 percent among those who took the pill every day or almost every day.
There has been mixed reaction about PrEP among public health professionals since the drug was introduced. Many are excited about this new addition to the HIV-prevention arsenal, which has been the relying on risk-reduction and condoms for too long. Some, however, worry that it is too expensive; in the United States it costs upwards of $10,000 a year. Others say that it is hard enough to get people who have HIV to stick to a daily drug regimen and suggest that it’s unreasonable to expect compliance from healthy individuals. The most heated debate, however, is about whether taking PrEP will give individuals an excuse to stop using condoms and taking other precautions (such as limiting the number of partners they have) and will ultimately drive the rate of other sexually transmitted diseases up.
In May, PrEP got a big endorsement from the CDC, which released guidelines suggesting that HIV-negative individuals who are at “substantial risk for HIV infection” consider taking the drug. The agency defined those at substantial risk as: anyone in an ongoing relationship with an HIV-infected partner; gay or bisexual men who are not in a mutually monogamous relationship with an HIV-negative partner and who have had sex without a condom or been diagnosed with a sexually transmitted infection within the past six months; heterosexual men or women who are not in a mutually monogamous relationship with an HIV-negative partner and do not regularly use condoms when having sex with partners known to be at risk for HIV (such as injecting drug users or bisexual male partners of unknown HIV status); or anyone who has injected illicit drugs and shared equipment or been in a treatment program for injection drug use within the last six months.
The CDC emphasizes that PrEP is not for everyone and that those who choose to use it have to commit to taking the pill every day (at least for the period of time in which they are at risk) and must be monitored by a health-care provider and tested for HIV every three months. It also stresses that PrEP should be used alongside other prevention methods such as partner reduction, selecting low-risk partners, and using condoms.
Though the WHO’s guidelines sound broader than the CDCs, the intent is similar. Rachel Baggaley, an official with the group’s HIV department, told NPR:
We’re not suggesting that PrEP will be an appropriate choice for all men who have sex with men. It may be something that some people will want to use for a short period of their life. Or it may be appropriate for use in the long term. It will be something that they will come to a decision on with their health care provider.
The emphasis on men who have sex with men is new for the WHO but comes as the organization sees the epidemic changing in many places around the world. Baggaley explained, “In countries like Ghana, or Kenya or Nigeria, where it was once generalized, now more than 30 percent of new infections are among these key vulnerable populations.” She added that men who have sex with men are usually not targeted by existing intervention strategies and often face discrimination, stigmatization, and abuse.
In a press release, the WHO noted that rates of HIV infection among men who have sex with men remain high almost everywhere, and new prevention options are urgently needed. The organization estimates that PrEP use among men who have sex with men over a ten-year period could reduce HIV transmission by 20 to 25 percent—representing a million new infections—worldwide. In order for this to happen, however, men who have sex with men need access to PrEP. For this reason, the WHO guidelines also say that countries need to remove the legal and social barriers that prevent many people from accessing these services.
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Abortion rights organizations in Colorado launched a campaign Tuesday opposing a proposed constitutional amendment on the November ballot that would add “unborn human beings” to the state’s criminal code.
Speakers at a rally on the west steps of the state capitol warned that the initiative, called Amendment 67, would go much further than allowing prosecutors, for example, to file murder charges against a drunk driver who hits a pregnant woman and terminates her pregnancy without killing her.
Instead, the “deceptive measure” is “truly an attack on family planning and women’s health,” Vicki Cowart, president of Planned Parenthood of the Rocky Mountains, told the crowd. With “unborn human beings” left undefined, the measure would lead to a ban on all abortion, even in cases of rape or incest, and restrict access to birth control, she said.
“Amendment 67 would do exactly the opposite of protecting women and their babies from drunk drivers,” Cowart said.
“Amendment 67 would eliminate a woman’s right to make personal and private decisions about her health,” said Cristina Aguilar, interim executive director of the Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), who delivered her speech in both Spanish and English. “For a woman who has suffered a miscarriage, this allows the government to investigate.”
“Amendment 67 is, put simply, bad medicine for women and for Colorado,” Dr. Ruben Alvero, professor of obstetrics and gynecology at the University of Colorado, told the crowd. “We want to protect pregnant women from harm, but Amendment 67 is not the way.”
Before being shuffled off by police to a public sidewalk near the “Vote No 67” rally, backers of Amendment 67 said the warnings about far-reaching impacts of their measure were unfounded.
Similar “fetal homicide” laws in other states have “never led to an abortion ban,” Personhood USA spokesperson Keith Mason told RH Reality Check. Personhood USA supports Amendment 67.
“Who looks at Brady and says he wasn’t a person?” asks Mason, referring to a fetus killed by a drunk driver who slammed into Heather Surovik two years ago. A photo of Brady is on the campaign materials of backers of Amendment 67, which they refer to as the Brady Amendment.
Colorado law allows abortion throughout pregnancy, and a fetus doesn’t receive legal protection under state law prior to birth. A 2013 Colorado law, passed after Surovik’s tragic loss of her pregnancy, allows prosecutors to file charges if a pregnancy is terminated due to reckless acts of violence, but murder charges cannot be brought because the fetus is not considered a person under state law.
“Amendment 67 is just about protecting babies like my son Brady,” said Surovik, who wants murder charges to be filed in cases like hers.
Asked whether the passage of Amendment 67 could lead to government investigations of miscarriages, Surovik said, “My intent is that babies are protected.”
November will be the third time Colorado citizens vote on “personhood” amendments, which were defeated overwhelmingly by voters in 2008 and 2010. Activists fell just short of gathering enough signatures to place a “personhood” amendment on the ballot in 2012.
The 2010 “personhood” measure, like the similarly worded 2008 proposed amendment, would have defined a “person” in the Colorado Constitution as “every human being from the beginning of the biological development of that human being.”
This year’s ballot question asks if voters want to protect “pregnant women and unborn children by defining ‘person’ and ‘child’ in the Colorado criminal code and the Colorado wrongful death act to include unborn human beings.”
The presence of Amendment 67 on November’s ballot could intensify the election-year debate about abortion and contraception issues.
Already, Sen. Mark Udall has been pounding his opponent, Rep. Cory Gardner, for his previous support of a personhood ballot initiative and for his ongoing co-sponsorship of a federal “personhood” bill.
ProgressNow Colorado Director Amy Runyon-Harms sent an email to Gardner Tuesday, asking him, in light of his decision this year to un-endorse state personhood amendments, to attend the Vote No 67 rally.
You may have read that the NO on Amendment 67 campaign is kicking off their opposition to this year’s Personhood abortion ban amendment with a rally at the Capitol today. Can I tell them you’ll be joining us?
Runyon-Harms told RH Reality Check she did not hear back from Gardner, who’s run TV advertisements emphasizing that he’s withdrawn his previous support for “personhood” bans.
In fact, Gardner has not withdrawn his support for the federal “personhood” bill. To do so, Gardner would have to make a brief speech from the floor of the U.S. House of Representatives.
This month, Gardner’s spokesperson stated, erroneously, that the federal “personhood” legislation, co-sponsored by Gardner, “simply states that life begins at conception” and does not aim to confer legal protections on fertilized human eggs.
Image: Jason Salzman
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Within minutes of each other Tuesday, two separate federal appeals courts handed down conflicting rulings as to whether or not the text of the Affordable Care Act (ACA) allows the federal government to subsidize insurance premiums in its federally run exchanges.
First came the decision from a divided three-judge panel of the D.C. Circuit Court of Appeals, which ruled in Halbig v. Burwell that federally run health insurance exchanges cannot provide subsidies for residents of the more than 30 states that participate in the federal exchanges.
Then a panel of judges for the U.S. Court of Appeals for the Fourth Circuit unanimously ruled the opposite, in King v. Burwell, finding that the text of the ACA does not prevent the administration from providing subsidies in those markets where states have refused to set up their own exchanges.
The decisions, and their differing results, encapsulate the political-turned-legal fight over one of the Obama administration’s most significant policy achievements.
The conservative case against subsidies in the federal health-care exchanges started in 2012, when the Cato Institute’s Michael Cannon and law professor Jonathan Adler wrote a paper setting out the argument adopted by those challenging the subsidies, including one self-described “Republican operative” at the front of the D.C. Circuit case. They claim that the statutory language of the ACA only allows states, and not the federal government, to subsidize health-care payments. According to the challengers, the actual text of the law says that the sliding-scale tax credits that millions of Americans currently receive are available only for coverage purchased “through an exchange established by the state,” and since only 16 states have established insurance exchanges so far, only residents in those states can qualify for subsidized coverage.
The challengers’ argument is compelling in its simplicity—after all, the statute doesn’t say “through an exchange established by the state and federal government.” But accepting that argument means ignoring the entire context and purpose of the ACA, including all the ways in which the federal government is required to step in when states fail to do so, including when states throw political temper tantrums and refuse to participate in health-care reform. This is the point made by Judge Harry T. Edwards in his dissent in Halbig. “This case is about Appellants’ not-so-veiled attempt to gut the Patient Protection and Affordable Care Act,” wrote Edwards.
The decision, Edwards notes, is effectively a “poison pill to the insurance markets in the States that did not elect to create their own Exchanges. This surely is not what Congress intended.”
This [plaintiffs'] claim is nonsense, made up out of whole cloth. There is no credible evidence in the record that Congress intended to condition subsidies on whether a State, as opposed to HHS, established the Exchange. Nor is there credible evidence that any State even considered the possibility that its taxpayers would be denied subsidies if the State opted to allow HHS to establish an Exchange on its behalf.
But denying subsidies to taxpayers who are otherwise entitled to them because of a typo or a hyper-constrained reading of the statute is exactly the case conservatives are making in these challenges, and it’s a case two Republican appointees were more than willing to advance. “We conclude that appellants have the better argument: a federal Exchange is not an ‘Exchange established by the State’ and section 36B does not authorize the IRS to provide tax credits for insurance purchased on the federal Exchanges,” the majority in Halbig wrote.
“No one—not the people who wrote the law in Congress, not those who implemented the law in the states—understood this law to work the way that two judges of the D.C. Circuit today said it does,” Elizabeth Wydra, chief counsel at the Constitutional Accountability Center, said in a statement in reaction to the Halbig ruling. The Constitutional Accountability Center wrote the legal brief on behalf of Senate Majority Leader Harry Reid, House Democratic Leader Nancy Pelosi, and every major committee chair involved in writing the ACA, as well as state officials from across the country.
So far about 5.4 million people have signed up for health insurance through a federal exchange, and about 87 percent of those consumers received subsidies in the form of sliding-scale tax credits to make that coverage affordable. This savings is critically important in states where mostly Republican lawmakers are politically opposed to the ACA and have refused to establish their own exchanges and expand Medicaid to increase insurance coverage and affordability. For example, as reported by the Washington Post, an individual in Wyoming who buys a mid-grade plan on the federal marketplaces is receiving a subsidy of around $444 per month, which cuts their monthly premium cost to a much more affordable $99 per month. So there’s a lot on the line in these cases, beyond just arguing over the semantics of where the bureaucratic burdens of health-care reform may lie. Real lives are at stake.
Thankfully, the immediate impact of Tuesday’s conflicting rulings will be mostly show among pundits and political organizations. Nobody will immediately lose their subsidies, nor is the ACA immediately gutted. And even though there is a momentary disagreement among the federal courts on the legality of the subsidies, that doesn’t necessarily mean the Roberts Court will immediately jump in to resolve it. The Obama administration has said it plans to ask for a full-panel review of the D.C. Circuit panel opinion, a process that could take months and which helps keep the case away from the Supreme Court for the time being.
The full D.C. Circuit Court of Appeals now comprises mostly Democratic appointees; while that doesn’t guarantee a ruling in the administration’s favor, it doesn’t hurt its chances either. Should the full D.C. Circuit Court of Appeals rule in favor of the administration, that could mean, at this point at least, that there’s no longer any disagreement in the federal courts as to whether or not insurance purchased via a federal exchange qualifies for subsidies. Without that kind of split in the federal courts, the Supreme Court may not have any means to get involved in the case, which is good news, since the Roberts Court is not known to respect precedent, especially if there’s a good political reason not to.
In the meantime, federal courts in both Indiana and Oklahoma have similar legal challenges pending, which means that like the legal challenges to the contraception coverage requirement that persist despite the Hobby Lobby ruling, we’re as far away from resolving the legal challenges to the various provisions of the Affordable Care Act as we are from resolving the political ones.
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This year, April 9 was known as Equal Pay Day, representing the extra three months and change that the average woman has to work in 2014 if she wants to earn what the average man already earned by the end of 2013. But as an analysis released Monday by the National Women’s Law Center (NWLC) points out, the wait is longer for Black women: Equal Pay Day for African-American women was July 16, and Equal Pay Day for Latinas won’t come until November.
African-American women only earn 64 cents to every dollar earned by non-Hispanic white men, according to the NWLC analysis; the figure for women overall is 77 cents. That’s based on the average earnings of female and male full-time, year-round workers taken from Census data.
The pay gap for Black women varies based on age and industry. Older Black women have it the hardest—the pay gap is only 82 cents on the dollar for 15-year-old to 24-year-old Black women compared to white men, but the gap widens to 67 cents and 59 cents, respectively, for Black women ages 25-to-44 and 45-to-64.
As for industries, Black women working as physicians and surgeons—a high-wage and male-dominated occupation—make only 52 cents for every dollar paid to their white male counterparts. Black women fared slightly better in lower-paid occupations, making 86 cents on the dollar in male-dominated, mid-wage construction industries and 85 cents on the dollar working as low-wage, mostly female personal care aides.
The fact that Black women are overrepresented in low-wage jobs doesn’t help, the analysis said. Black women make up 14 percent of low-wage workers and 6 percent of the overall workforce.
Education levels don’t make much of an impact on the high wage gap between Black women and non-Hispanic white men. While more education corresponds with higher wages for both Black women and white men, Black women still make between 61 and 66 cents on the dollar compared to their counterparts at every education level. African-American women have to have at least a Bachelor’s degree to make as much as white men who didn’t finish college.
The NWLC analysis also notes that the wage gap for Black women varies by state. Louisiana, Wyoming, and Mississippi take the top three slots for worst wage inequality, but Washington, D.C., is right behind them, with a wage gap of 55 cents to the dollar. D.C.’s result is especially noteworthy because women overall in the District have the country’s smallest wage gap, 90 cents to the dollar.
The “77 cents to the dollar on average” wage gap statistic for women overall is frequently called into question because while it’s often used in pay discrimination debates, there are factors behind the figure other than outright pay discrimination. President Obama cited it when he passed an executive order, on this year’s Equal Pay Day for women overall, that will make it easier for some women to discover and redress being paid unequally due to gender bias.
But a pay gap persists even when researchers control for workers who have similar characteristics, like college majors and occupations. A report from the Center for American Progress notes that about 40 percent of the wage gap can’t be explained by work experience or occupational differences, and that much of that 40 percent is likely due to the failure of U.S. workplaces and other institutions to adapt and support working families.
Broad average statistics, like the 77-cent figure for women in general, the 64-cent figure for African-American women, or the 55-cent figure for Latinas, draw attention to the fact that women are usually the ones to make career sacrifices for the sake of raising a family. Policies like universal child care and maternity and family leave, advocates argue, would mean fewer women had to make the “choice” to take a lower-paying job, fewer hours, more unpaid leave, or fewer promotions in order to care for their children.
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