President Obama on Thursday said that now is the time for “peace and calm” in the streets of Ferguson, Missouri, where the death of 18-year-old Michael Brown at the hands of a police officer the department has not yet identified, has sparked protests and violent police response.
Obama said that there is no excuse for violence against police or for vandalism and looting, but that there is also no excuse for using excessive force against peaceful protesters who are exercising their First Amendment rights.
Many commentators on Twitter were left cold by the president’s remarks, saying they were too timid and failed to properly name the problems on the ground:
me too RT @profblmkelley: POTUS comments left me wanting…
— Zerlina Maxwell (@ZerlinaMaxwell) August 14, 2014
We didn’t “lose” a young man in “tragic and heartbreaking circumstances.” A cop killed Michael Brown. — Meredith Clark (@MeredithLClark) August 14, 2014
Others said that if Obama was overly careful, it was because he feared backlash for speaking about racial issues:
No question that Obama’s response to Ferguson today is informed by what happened with Skip Gates and Trayvon Martin. — AdamSerwer (@AdamSerwer) August 14, 2014
— ProfB (@AntheaButler) August 14, 2014
The president also referred to police interfering with the press: “Here in the United States of America, police should not be bullying or arresting journalists who are just trying to do their jobs,” he said. While President Obama didn’t mention the incident specifically, he was likely referring to the Wednesday arrest of Huffington Post reporter Ryan J. Reilly and Washington Post reporter Wesley Lowrey as police were clearing a McDonald’s that journalists used as a home base. Lowrey wrote that he was slammed up against a Coke dispenser after officers judged he was taking too long to pack up and leave, and Reilly said that an officer refused to identify himself, purposefully smacked Reilly’s head against a window, and sarcastically apologized. The Huffington Post Washington bureau chief called the incident a false arrest and a violation of press freedoms.
The highly militarized local police force has been criticized for using excessive force against largely peaceful protesters as well as journalists. While reports of protesters throwing Molotov cocktails and looting have grabbed headlines, on-the-ground reports indicate that most protesters have been peaceful, that the police response is disproportionate, and that the protesters didn’t start the violence. Video and photos have been circulating online of police shooting flash-bang grenades at protesters holding their hands in the air, firing tear gas rounds at people attempting to flee, using a deafening sonic weapon, injuring protesters with rubber bullets, and firing tear gas at an Al Jazeera camera crew. Multiple agencies with a rotating cast of commanders are in charge, causing doubts that the police can be held accountable or controlled.
Advocates have also pointed out that the violence in Ferguson, and police violence against young Black men in general, is a reproductive justice issue because it robs women of color the chance to raise their children in peace. Black mothers feel they have to protect their sons from the police, advocates say, and their fear and grief grows with every new report of an unarmed young Black man being killed by law enforcement officers.
Expectant mothers themselves can also be endangered by police violence. Another video from Ferguson appears to show police officers slamming a woman who is six-months pregnant to the ground, while bystanders protest and she says that she can’t lie on her stomach. And while the link isn’t definitive, studies have suggested that tear gas can cause miscarriages.
Activists are organizing “national moment of silence” vigils across the country on Thursday evening to protest excessive police force and honor victims of brutality.
Image: White House via YouTube
The post Obama Responds to Ferguson Unrest as Advocates Decry Police Violence appeared first on RH Reality Check.
Sometimes when I think we’ve hit the limit on what anti-choicers will try to link to their single-minded obsession with policing women’s sexual choices, someone will surprise me with a new low. Kevin Burke drew the card this week with a repugnant attempt to blame the suicide of comedian and actor Robin Williams Monday on, you guessed it, abortion. The article was at LifeNews.com but, unsurprisingly, was taken down when the negative feedback started. Unluckily for them, Talking Points Memo has some of the details and Burke still has the same writing up at the Priests for Life blog.
In the article, Burke focuses on the fact that Williams had a girlfriend in the 1970s that had an abortion, which Williams brought up in a Playboy interview in 1992. From this information, Burke wildly speculates that pretty much every sad or bad thing that happened to Williams was because of this abortion. He starts by blaming the end of Wiliiams’ relationship on the abortion, arguing, “Few relationships survive the complex emotional pain and complicated grief that naturally follows the decision to abort one’s unborn child.” He goes on to speculate that Williams struggled with addiction and depression because of abortion.
The fact that Williams was unabashedly pro-choice is also rationalized away in a nasty manner: “The energy that would be better directed toward healing this loss is instead focused on the need to promote abortion accessibility for the poor and protecting woman’s health.” I love how he holds it out as self-evident that there’s something wrong with a person—they must be stifling their true feelings!—if they care about the well-being of women, particularly low-income women.
I’ll do RH Reality Check readers a favor that Burke did not and actually link the interview where Williams talked about his personal experience with abortion, giving Williams the dignity of speaking for himself instead of letting some fundamentalist exploit him before his body is even cold.
Seems like he understood perfectly well how he felt about it, and didn’t need some stranger telling him how to feel.
I’d love to write off this incident as just an example of one man whose obsessive nature has shut down all self-awareness, but the sad fact of the matter is that this willingness to distort the truth and to exploit the lack of public understanding about the realities of mental illness is endemic to the anti-choice movement. In fact, deliberately lying about the relationship of abortion and mental illness is a strategy that is employed by the anti-choice movement from top to bottom, and not only is it dangerous for abortion rights, it’s dangerous for people who have mental health issues.
Molly Redden at Mother Jones has an important piece up demonstrating how morally bankrupt the anti-choice movement is when it comes to pushing the discredited idea that abortion causes depression. She exposes how the State of Texas has paid Vincent Rue—a huge proponent of the abortion-causes-depression myth—$42,000 in the past six months to help the state defend the asinine idea that its abortion regulations aimed at shutting down most of its safe clinics are necessary. Problem is, Rue is a full-blown quack who doesn’t deserve to be trusted on the question of the sky’s color, much less on the mental health risks of abortion. As Redden writes:
But Rue, who holds a doctorate in family relations from the University of North Carolina School of Home Economics, is an odd choice for the job—”a long-discredited quack,” in the view of one state representative from Wisconsin, where Rue performed similar defense work. Although Rue testified about the harms of abortion in two landmark abortion cases in the early 1990s, the judges in those cases dismissed his testimony as personally biased and lacking expertise. Rue has pushed the medical mainstream to recognize “post-abortive syndrome”—a mental illness that supposedly results from abortion—only to have organizations such as the National Center for Health Statistics pan his research. In 1981, he claimed in a report to the US Senate that “abortion re-escalates the battle between the sexes” and “abortion increases bitterness toward men.”
Rue isn’t testifying in this case, but he has been paid to help the state put their case together, despite being an obvious charlatan. That is because anti-choicers clearly do not care one bit. Not about facts. Not about evidence. Not about women’s health. Not about integrity. Not about anything but punishing and controlling women who make sexual and reproductive decisions without their approval.
Meanwhile, the actual scientific evidence remains the same. The American Psychological Association performed a review of studies on abortion and mental health and found “no evidence that a single abortion harms a woman’s mental health.” In 2011, the American Psychiatric Association joined in a brief for Hope Clinic for Women v. Illinois Department of Financial and Professional Regulation, which stated, “the Act’s [Illinois Parental Notice of Abortion Act of 1995] premise that abortion causes ‘serious and long-lasting’ negative ‘medical, emotional, and psychological consequences’ for minors—and that parental notice laws such as the Act protect against these consequences—is contradicted by the weight of scientific authority.”
Not that this claim about depression and abortion has anything, really, to do with science or fact. Despite all the lip-smacking poses of concern, the fact of the matter is the anti-choice movement is wielding depression like a threat, treating depression like it’s a punishment for your “sins.” Because they can’t get the “abortion means you’re going to hell” argument past basic First Amendment concerns, they just replace the word “hell” with “depression” and presto blammo! Their religious agenda looks secular enough to pass legal scrutiny.
The problem with this, of course, is positioning depression as a punishment for one’s supposed sins just encourages people with mental illness to blame themselves for their problems, even though mental illness is usually caused by a series of complex factors that are rarely up to the person suffering. Considering that one of the major symptoms of depression is a feeling of hopelessness—which can, in some cases, lead to suicide attempts—it is beyond irresponsible to encourage people who already feel bad about themselves to feel even worse. That’s not “pro-life.” That shows such an indifference to life that it’s bordering on depraved. People suffering from depression sure as hell don’t need to be told that they have to go over their past with a fine toothed comb looking for something they did “wrong” to “deserve” this. Believe you and me, many of them are already trapped in a cycle of self-doubt and shame that usually owes more to their illness than their actual actions. People who are depressed need support and therapy, not accusations.
LifeNews.com may have taken down the original post about Robin Williams, but this issue is a lot bigger. Continuing to link abortion to depression, despite the countervailing evidence to the contrary, is exploitative and abusive. It’s not just hurtful to women who have abortions. It also treats mental illness like it’s some kind of punishment doled out to people who don’t make choices that religious fanatics want them to make. You can call that “pro-life” if you want to, but in reality, it’s just mean-spirited and cruel.
You've gotta be kidding me!
According to Mother Jones, anti-choice Republicans are falling all over themselves to defend their extreme abortion-blocking laws. That's what happens when you get sued for making it impossible for some women to access legal health care. And they're using your tax dollars to defend these terrible laws.
But what really boggles the mind is that Alabama, North Dakota, Texas, and Wisconsin have hired "discredited expert" to push their agenda to the tune of $192,505.50.
What is wrong with these anti-choice politicians? If they hate abortion so much, how about using these funds to support women's health programs that would help prevent unintended pregnancy?
Here's a better way to spend $192,000:
Cover a year of birth control for 1,200 women.
Enroll 2,560 teens in a local comprehensive sex education program.
Hand out 505,263 condoms.
Screen 6,193 women for cervical cancer.
But hey, when you're an anti-choice politician, what's hundreds of thousands of dollars to a quack to make sure women in your state don't have reproductive freedom and access to basic health care? At least they're making their priorities crystal clear.
08.14.14 - In LaKeisha’s hometown of Atlanta, African American women die in childbirth at a rate more than three times the national average. Following an emergency c-section, LaKeisha experienced a brush with this unsettling statistic when she developed a painful infection.
While post-cesarean complications are not uncommon, inadequate follow-up care meant that LaKeisha was neither treated for nor informed about the signs of infection. For countless women like her, racial and socio-economic disparities in health care quality and insurance access have made childbearing an increasingly dangerous proposition in this country.
“There were no calls from the doctor’s office to say, ‘How are you doing?’” recalls LaKeisha. “I sat with an infection for two weeks. I thought it was just the pain [from the cesarean]. . . . I remember feeling horrible.” The lingering infection traumatized LaKeisha both physically and emotionally, especially when her financial situation forced her to return to work earlier than planned.
LaKeisha is one of 25 women we spoke to during the Center for Reproductive Rights’ joint effort with SisterSong Women of Color Reproductive Justice Collective to gather firsthand accounts of Southern Black women’s sexual and reproductive lives. The project documents the experiences of women living in Georgia and Mississippi—two states with the highest rates of maternal death in the country. Analyzing their stories has helped the Center identify key areas in which U.S. government policy is failing to address racial and gender discrimination in the sphere of sexual and reproductive health care.
This week, the Center and SisterSong brought these findings before the United Nations Committee on the Elimination of Racial Discrimination (CERD) during the committee’s periodic review of the United States. The CERD is the UN body responsible for assessing the efforts of member states to end racial discrimination.
In addition to testifying, the Center submitted a shadow report intended to supplement the government’s account of actions taken to address the Committee’s concerns from their last review, in 2008.
“These reviews allow us to spotlight issues of racial discrimination in the U.S. and bring to light various concerns that are not normally talked about in terms of racial discrimination,” notes the Center’s senior human rights counsel, Katrina Anderson, who is representing the Center at the review.
Anderson identifies specific concerns such as poor-quality care for women of color in public hospitals, inadequate public transportation to health facilities, and lack of coverage for preventive care as systemic issues for which the government needs to be held accountable.
“Most people in the U.S. don't know we have a maternal mortality rate double that of Saudi Arabia. And those who do know about it view it as a public health issue,” she says. “Globally, however, preventing maternal mortality is a key human rights concern, and the international community has developed standards to hold governments accountable for high ratios of maternal deaths.”
Kendra, another woman we spoke to during the joint project with SisterSong, is from Mississippi, where a disproportionately high percentage of people of color live in poverty. In that state, there are counties where the risk of maternal death has risen to more than 20 times the national average—a higher maternal mortality rate than in Kenya or Rwanda.
No surprise then that Kendra, who became pregnant in the 12th grade after receiving virtually no sex education, says of her community, “We really don't have a lot of good experiences when it comes to childbirth.”
During this week’s testimony, the Center and SisterSong are urging the CERD to question the U.S. government about how it is addressing racial disparities in maternal mortality, especially in the South, where states have largely rejected Medicaid expansion yet are comprised of a disproportionate number of people of color who are unable to afford private insurance.
Additionally, the Center hopes the CERD will press the U.S. about laws that exclude immigrants from being able to obtain health care benefits. The shadow report points to Texas, where lawmakers have imposed sweeping barriers to essential reproductive health services, essentially blocking Latinas and immigrants in poor, rural areas such as the Rio Grande Valley from accessing such care.
“The 136% rise in maternal deaths in the U.S. over the past 20 years and the dramatic increase in racial disparities is a human rights crisis, brought on to large degree by gender and racial discrimination in the health care system,” notes Anderson. “Our hope is that the Committee will identify how the U.S. is falling short in policy and practice and offer recommendations for how federal and state governments can reduce racial discrimination.”
Taking the stories and statistics of this developing crisis to the international stage helps ensure that the distressing experiences of women like Kendra and LeKeisha cannot be dismissed. As with governments across the world, we aim to hold the U.S. responsible for addressing the complex of factors—including race, gender, and poverty—that continue to imperil the lives of millions of already marginalized women.Reproductive Injustice: Racial and Gender Discrimination in U.S. Health Care Women’s Health Advocates Call on United States to Address Widespread Discrimination in Health Care
On Wednesday, attorneys for the State of Mississippi asked the full Fifth Circuit Court of Appeals to reconsider a decision that kept open the state’s only abortion clinic.
According to the attorneys, last month’s 2-1 decision that struck as unconstitutional a Mississippi law which would require doctors performing abortions in the state to have admitting privileges at area hospitals was wrong in two fundamental ways. First, the attorneys argued, the Fifth Circuit panel improperly relied on Gaines v. Canada, a 1938 Supreme Court decision involving discrimination in education. In that case, the all-white University of Missouri School of Law denied admission to Lloyd Gaines, a Black man. After the law school denied Gaines’ admission, Missouri told Gaines it would pay his tuition to attend law school in another state. Gaines rejected Missouri’s offer and instead sued, arguing the university’s refusal to allow him to attend violated the Equal Protection Clause of the 14th Amendment. After Gaines lost in state court, the United States Supreme Court reversed the decision, holding that Missouri’s attempts to deny Gaines educational benefit did not even satisfy the “separate but equal” standard from Plessy v. Ferguson.
In Gaines, the Supreme Court explained that Missouri could not simply undue the discrimination created by denying Gaines’ admission by paying for his tuition in a different state. When considering the impact of Mississippi’s admitting privileges law last month, the Fifth Circuit panel looked to Gaines for the idea that anti-choice lawmakers could not constitutionally target for closure the state’s only abortion clinic by claiming patients in need of an abortion in Mississippi could simply travel elsewhere to get that care, holding that Mississippi cannot “lean on its sovereign neighbors to provide protection of its citizens’ federal constitutional rights.”
According to attorneys for the State of Mississippi, this is just wrong. “The majority’s reliance on Gaines, a 1938 racial discrimination/equal protection case based on the Plessy v. Ferguson ‘separate but equal’ doctrine, is misplaced,” attorneys for the state argue in their brief. “Until the Panel decision in this case, in the seventy-six year history of the Gaines decision, no court had ever cited or relied on Gaines in the abortion context.”
When the Fifth Circuit turned to Gaines to help buttress its reasoning for striking the Mississippi law, it did so to show how a person’s fundamental constitutional rights should not depend on the state she happens to live in. Closing Mississippi’s only abortion clinic with the reasoning that a patient in need can simply travel to another state offends every basic principle of fundamental constitutional rights, a conclusion the conservative Fifth Circuit panel came to reluctantly.
The reliance on Gaines in the context of an abortion rights challenge alone could be enough to prompt the full fifteen-judge appeals court to take up review of the panel’s decision blocking Mississippi’s admitting privileges requirement. But attorneys for the state go one step further and argue in their brief that the panel’s decision actually creates a discriminatory patchwork of abortion access, placing Mississippi at a disadvantage, compared to states like Texas that can “raise standards” under their own requirements that doctors have admitting privileges at hospitals close to their clinics. This argument seems tailor-made for conservative justices who believe mandatory ultrasounds “empower” women and that traveling hundreds of miles across Texas to access an abortion is not an undue burden because the roads are flat and patients can speed.
As the brief notes:
The Panel decision ostensibly promotes uniformity, at least in regard to the availability of abortion in every state. In actuality, the Panel places Mississippi at a disadvantage when larger states such as Texas are permitted to raise standards for abortion doctors, whereas Mississippi would be prohibited from applying the same standards to abortion doctors that it already applies to other physicians performing outpatient procedures. The Panel emphasized the district court’s concern about creating a “patchwork system where constitutional rights are available in some state [sic] but not in others.” Conversely, the majority has created its own “patchwork system” wherein one state can require higher standards for physician qualifications than its sister states.
Attorneys for the state also claim the panel’s decision conflicts with its own ruling in Planned Parenthood v. Abbot—the decision that upheld Texas’ requirement that doctors have hospital admitting privileges. According to attorneys for Mississippi, in Abbott the Fifth Circuit made it clear that an abortion restriction shouldn’t be struck down simply because it forces patients to travel hundreds of miles to get an abortion.
Conversely, the Panel majority in this case held that Mississippi’s admitting-privileges law is unconstitutional on the grounds that any journey which requires a woman seeking an abortion to cross the Mississippi state line into an adjoining state constitutes an undue burden, regardless of the distance she must travel. For example, a woman in Hernando, Mississippi could readily obtain an abortion at a clinic in Memphis, Tennessee, a journey of only twenty-five miles. Both Casey and Abbott concluded that the practical effect of an increase in travel distance does not constitute an undue burden. However, by declining to consider the availability of abortion services in adjoining states, the Panel here concluded that the intangible effect of crossing a state line to obtain an abortion automatically transforms even a short journey into an unconstitutional and undue burden.
Put another way, attorneys for the State of Mississippi argue how can the Fifth Circuit rule it is an undue burden to make Mississippi patients travel out of state to obtain an abortion when a majority of them already do?
This question of whether or not a patient’s right to abortion is unduly burdened if they cannot access an abortion in their state has ramifications beyond Mississippi. Currently six states have only one abortion clinic within their borders, and the Roberts Court has indicated it is likely to take up the constitutionality of laws requiring abortion providers to have hospital admitting privileges at some point.
The post Mississippi Appeals Fifth Circuit Decision Blocking Admitting Privileges Requirement appeared first on RH Reality Check.
An abortion provider in Cincinnati, Ohio, is suing the state Department of Health (ODH), alleging that the department’s move to close the clinic was unreasonable and politically motivated.
The writ of mandamus, filed by the Lebanon Road Surgical Center on Tuesday, focuses on the reasoning behind the clinic’s impending closure: According to the lawsuit, the ODH arbitrarily revoked the clinic’s variance permit, which it needed by law, and then revoked the clinic’s license to operate because it no longer had a variance.
The writ is just the latest move in a battle that began in 2012 to keep the clinic open.
Ohio law requires that ambulatory abortion providers have agreements with local hospitals to transfer patients in the case of an emergency. Alternatively, the law also allows the clinic to operate with a variance permit, if the clinic can show it meets the standards of the law in another way.
The Lebanon Road clinic had been operating with a variance and in October 2012 submitted a request to renew both the variance and its license to operate. Later that month, the state Department of Health issued proposals both refusing to renew and revoking the clinic’s license. The clinic was allowed to stay open pending a hearing and final decision by the department director, the former of which was held in September 2013.
The following January, the ODH director denied the clinic’s request for a variance, and in a separate order denied its license renewal “based on its failure to obtain a written transfer agreement or variance.” The director’s decision has been in the appeal process since January, and a Hamilton County judge is scheduled to hear oral arguments this Friday.
The Lebanon Road clinic says that the director faced significant political pressure to close the clinic, thus preventing him from acting based on his own discretion as a medical professional. According to the lawsuit, the ODH received 240 emails from anti-choice advocates asking that the clinic’s license be revoked. The results of an open records request revealed that the Ohio Department of Health “cleared its response” to the emails “with the Governor’s office and reveal ongoing communications among [the Department], the administration, and Ohio Right to Life about LRSC’s license.”
The lawsuit also says that political pressure and the culture of hostility toward abortion in the state makes finding a transfer agreement with a local hospital increasingly difficult for abortion providers. In a letter submitted as evidence in the case, the CEO of the Christ Hospital, located in Cincinnati, illustrates this point in explaining why the hospital won’t come into a transfer agreement. The letter reads:
We are not able to execute formal transfer agreement with the Lebanon Road Surgery Center given the significant negative messages we have received from the community and the public’s access to those agreements under the Ohio Open Records Act. It is unfortunate that Ohio is now requiring a separate transfer agreement.
An investigation by the Cincinnati Enquirer in February found that “from the start, top officials in the health department were involved in the license review process, directing [ODH staff] not to follow normal practices.” A retired ODH regulator, Roy Croy, told the Enquirer that the department was “looking for anything” to close the clinic, and that “I was pretty sure that when it came time for renewal of the license that it was going to be very unlikely that it would be renewed.”
The struggle to remain open in the face of coordinated political attacks is one that has already plagued clinics across the state. The Ohio Department of Health recently revoked the license of a Toledo-based provider because the clinic did not hold an agreement with a nearby hospital. The Toledo clinic has since appealed the decision.
Image: Lawsuit via Shutterstock
A federal judge once again advised counsel to keep their arguments focused on legal reasoning, rather than emotional pleas, on the last day of arguments in Whole Woman’s Health v. Lakey, the latest challenge to a Texas’ omnibus anti-abortion law expected to shutter all but seven existing abortion providers in the state come September 1, barring judicial intervention.
Judge Lee Yeakel pushed lawyers both for the plaintiffs—a group of independent Texas abortion providers from across the state who say they have been forced to close clinic doors in the wake of HB 2‘s passage—and the State of Texas, which is defending the law, to answer the key question posed in practically every abortion case since Roe v. Wade: “Exactly what is an undue burden?”
Both sides, predictably, answered that decades-old question very differently, though lines of questioning from the judge seemed to indicate that he might be inclined to agree with plaintiffs’ arguments that the law would place substantial obstacles between Texans and legal abortion care. Judge Yeakel also said he found it “disturbing” that the state had attempted to “hide” its use of an anti-choice psychoanalyst from North Carolina who assisted the state’s experts in drafting testimony.
Jonathan Mitchell, a deputy attorney general for the State of Texas, argued that because a computer analyst working for the Texas attorney general’s office had estimated that about 90 percent of women of reproductive age in Texas would live within about 150 miles of an abortion provider should HB 2 go into full effect, the law would place no undue burden on abortion-seeking Texans. A “large fraction” of Texans, he argued, would not be faced with a substantial obstacle to legal abortion care.
But Stephanie Toti of the Center for Reproductive Rights, arguing for the plaintiffs, said that HB 2 “essentially amounts to a $3 million tax on the performance of abortions in the state,” referencing estimates given to Texas abortion providers regarding the costs to upgrade to, or build entirely, hospital-like abortion-providing ambulatory surgical centers required under HB 2. Because only a handful of existing, urban abortion providers could comply with the law, Toti argued, HB 2 would have the effect of severely limiting abortion access for anyone who could not make an overnight trip to a large city to access legal abortion care.
Deputy AG Mitchell also argued that whatever evidence—insubstantial or even non-existent in the state’s view—the plaintiffs may have shown that HB 2 would be difficult to comply with for abortion providers, or would deter some Texans from accessing legal abortion care, the plaintiffs had not met the burden of proof required by the Fifth Circuit Court of Appeals. HB 2, argued Mitchell, “fits comfortably” within the “safe harbors” afforded abortion regulations by the Fifth Circuit, and noted that the plaintiffs had not brought to the stand any individual woman who had been unable to access a legal abortion as a result of HB 2.
Parts of HB 2 have already gone into effect and are unchallenged in this court case: the ban on abortion after 20 weeks and the severe restriction of medication abortions. In this suit, the plaintiffs challenge HB 2′s requirement that abortion providers obtain admitting privileges at local hospitals—specifically as it applies to doctors in the Rio Grande Valley and El Paso—and that all abortion facilities operate as ambulatory surgical centers.
Judge Yeakel, who interrupted counsel a number of times to push them to elaborate on their arguments and question them on recent Fifth Circuit rulings in a previous Texas lawsuit and on an admitting privileges suit in Mississippi, mused in court as to whether abortion, as a medical procedure, was being uniquely targeted by state lawmakers, and whether a day-long drive or overnight stay would be acceptable burdens for accessing any other kind of medical care.
“If you had a sprained ankle, would we stand for that?” asked Yeakel, questioning Toti. “Would we stand for that if you needed an appendectomy? Is there any other procedure where we would stand for an entire day to have a minor procedure done?”
Yeakel also peppered both sides with constitutional questions related to the 14th amendment, which grants all Americans equal protection under the law, and asked whether the large number of Texans affected by HB 2, even if it was not a “large fraction” of the Texas population, should be taken into account.
He also challenged the state’s assertion that, per the Fifth Circuit Court of Appeals, a distance of under 150 miles from a Texan’s home to an abortion clinic would not constitute an undue burden and wondered why HB 2′s increased travel time requirements, and related increased costs of abortion care, would only need to burden a small population of low-income Texans living in the Rio Grande Valley and El Paso.
“If a rich woman who drives a Mercedes, and drives it fast, wants to visit an abortion clinic, why is [HB 2] not an undue burden for her?” asked Yeakel. He later added that he has “a problem with believing it’s reasonable to require anyone to travel 150 miles for medical care when they could get medical care closer.
Yeakel also questioned the extent to which anti-choice North Carolina psychoanalyst Vincent Rue had helped the state’s experts craft their testimonies, and said he found it “very disturbing” that the state had attempted to “hide” Rue’s involvement under the auspices of attorney-client privilege.
Wednesday’s closing arguments came after four days of testimony the previous week, wherein Texas abortion providers said they’d been forced to close clinics after their doctors were unable to obtain admitting privileges in the Rio Grande Valley and El Paso, and that they would be unable to afford the million-dollar or more costs involved in building abortion-providing ambulatory surgical centers (ASCs). Experts for the state countered that ASC building costs had been overblown, and that abortion as a procedure is more dangerous than is reported in mainstream science publications, necessitating the ASC and admitting privileges mandates.
Judge Yeakel is expected to issue a written opinion before HB 2′s ambulatory surgical center provision goes into effect on September 1. Legal experts told RH Reality Check that whichever side loses this round of federal hearings is almost certain to appeal it to the Fifth Circuit Court of Appeals in New Orleans, and that the case could eventually make its way all the way to the Supreme Court.
Image: Justice via Shutterstock
The post Judge Hears Closing Arguments in Texas Abortion Law Case appeared first on RH Reality Check.
During the 2014 International AIDS conference, The Lancet medical journal released a series of articles focused exclusively on HIV and sex work. One study by Kate Shannon et al., demonstrates that decriminalization of sex work could reduce HIV infections by 33 to 46 percent over the next decade. Shannon’s team showed that “multi-pronged structural and community-led interventions” are essential to promoting the human rights of sex workers, as well as improving their access to HIV prevention and treatment. Dr. Chris Beyrer, the researcher who coordinated this Lancet series, told AIDS conference participants that “[e]fforts to improve HIV prevention and treatment by and for people who sell sex can no longer be seen as peripheral to the achievement of universal access to HIV services and to eventual control of the pandemic,” drawing an irrefutable line between the social, legal, and economic injustices sex workers face and their subsequent vulnerability to HIV.
The Lancet series authors join many other prominent public health voices in identifying the decriminalization of sex work as vital to preventing the spread of human immunodeficiency virus (HIV) and of acquired immune deficiency syndrome (AIDS). For two decades, sex workers rights’ activists throughout the world have pushed human rights, public health, and HIV and AIDS response leaders to recognize that they, along with people who inject drugs and men who have sex with men, are “key populations” without whom an effective HIV and AIDS response is impossible. In 2012, the World Health Organization (WHO) declared that “all countries should work toward decriminalization of sex work and elimination of the unjust application of non-criminal laws and regulations against sex workers.” In South Africa (with the largest population of people living with HIV in the world), the National AIDS Council is urging its government to decriminalize sex work—a demand that advocates and health policy professionals are making in dozens of other countries as well. Amnesty International, Human Rights Watch, and the UN’s Global Commission on HIV and the Law all endorse this position. The latter points out “the impossibility of governments stigmatizing people on one hand, while simultaneously actually helping to reduce their risk of HIV transmission or exposure on the other.”
Sex work has been decriminalized in New Zealand and one province (New South Wales) in Australia leaving sex work businesses subject to standard occupational health and safety regulations. Law enforcement treats the sale of sex as it does any other business, without any intrusion or interruption unless existing laws are being violated.
Decriminalization has resulted in higher rates of condom use and enables sex workers to organize community-based health practices that demonstrably improve health and reduce HIV risk. It also makes it possible for sex workers to report and for the police to address illegal acts as they occur, such as assault, theft of services, employment of minors, or client coercion. In this decriminalized setting, sex workers can be strong allies in the fight against trafficking, intimate partner violence, and child abuse since they can report incidents to the police and social service agencies without putting themselves at risk of arrest.
So, why is the HIV-AIDS field only just beginning to recognize the connection between the decriminalization of sex work and HIV? And why is the trend toward criminalizing populations involved in the sex trades increasing in the United States—moving in the opposite direction from other countries? The following are three contributing factors.
Conflating Sex Work With Trafficking
Public debate around sex work in the United States increasingly focuses on people who have been trafficked or otherwise coerced into the sex trade. Anti-trafficking advocates conflate sex work (people choosing to sell sexual services from among employment options available to them) with trafficking (people being forced into the sex industry against their will). Laws that criminalize all people selling sex (voluntarily or involuntarily) violate the rights of the former and undermine efforts to identify and assist the latter. The Global Commission on HIV and the Law states unequivocally that, “Sex work and sex trafficking are not the same. The difference is that the former is consensual, whereas the latter is coercive.”
A commentary by Steen et al. in the recent Lancet series notes that “repressive and counterproductive police action,” including the arrest and incarceration of trafficking victims for the purposes of “rescue,” has overtaken far more effective responses in several countries. The understandable, but destructively over-simplified, mandate to “rescue and restore” sex workers is also being imposed in public health settings where providers are now charged with identifying and intervening with potential victims of trafficking in the sex trade. Certainly, health-care providers have a duty to watch for and help patients in abusive situations of all kinds. They also have a duty to understand the complexities of human experience, respond to patient-identified needs, and maintain that patients are experts of their own lives, whatever that may look like.
Lack of Access to Health Care for Sex Workers
Providing access to health-care services targeted to consumers’ needs is a vital part of any country’s HIV response. Without it, those most in need of prevention, care, and treatment are least likely to get it.
In a 2010 survey, 53 percent of medical students said they were not adequately trained to address their patients’ sexual issues comfortably. Far fewer professional medical curricula explicitly prepare students to understand that they will encounter sex workers as patients who, like all other patients, are individuals with a wide range of experiences, backgrounds, and needs that can best be treated with patient-centered care.
When sex workers receive demeaning and unprofessional treatment in health-care settings, they see health-care providers as an extension of the larger system that criminalizes them. A survey by the New York City-based Persist Health Project found that few sex workers disclosed their occupation to their health-care provider; only one study participant reported a positive experience after doing so. As one respondent explained, “I think for security reasons, I don’t usually disclose. Mainly because I don’t trust doctors … I sort of treat them like law enforcement.” Another noted that most health-care providers “have no clue who you are, no clue about your background, you can’t read them or know that they’re not going to try to lecture you or give you a stink-eye.”
St. James Infirmary, a peer-based occupational safety and health clinic for sex workers in San Francisco, corroborates these findings. Of their incoming patients, 70 percent had never previously disclosed their occupation to a medical provider for feared of bad treatment. Providing sex-worker friendly health care requires training health-care workers appropriately and supporting services designed specifically with and for the communities they serve.
Violence Risk Exacerbated by Criminalization
People usually envision a sex worker as someone soliciting on the street, but only about 20 percent of U.S. sex workers are street-based. The vast majority see clients in other venues including massage parlors, brothels, apartments they share with other sex workers, or a client’s hotel room. Many connect with clients online.
HIV risk is high among street-based sex workers who experience high levels of violence at the hands of clients and abusive law enforcement personnel. One important way they reduce this risk is assessing a potential client before getting into his car—looking for signals that he might be violent and relaying his license number to a colleague in case the worker disappears. This assessment time is also used to negotiate price and condom use. Law enforcement crack-downs compel sex workers to complete their negotiations quickly (in order to avoid arrest), depriving them of the time needed for assessment and negotiation.
Street-based sex workers have little or no protection if a client becomes violent or refuses to use a condom. Of the street-based workers surveyed in The Lancet study by Shannon et al., 25 percent reported being pressured by clients to have sex without a condom. Those working in remote areas (such as industrial parks) to escape local policing were three times more likely to report being pressured into having sex without a condom than the study population overall. The recent Lancet series data also shows that, in some countries, up to one-third of sex workers do not carry an adequate supply of condoms due to “condoms as evidence” policies that allow police to seize a sex worker’s condom supply and use it as evidence of their intent to engaged in sex work—a widely-used policy in several U.S. cities.
Getting From Here to There
Punitive laws against sex work are in place in 116 countries, including the United States, creating, according to the Open Society Foundations, “a state-sanctioned culture of stigma, discrimination, exploitation, and police and client violence against sex workers.”
Decriminalizing sex work in the United States is a long and challenging process, but there is a path to follow. The 1988 ban on federal funding for syringe exchange remained in place for 20 years and, after briefly lifting it in 2009, the Obama administration agreed to its reinstatement in 2011 at Congress’ insistence. Advocacy pressure to overturn it continues.
Thanks to the efforts of dedicated researchers and activists during the two decades between 1988-2009, public health professionals, medical institutions and virtually everyone working in the HIV-AIDS field learned why harm reduction practices are essential. Services to people who use drugs began to improve, although they are still inadequate, primarily because they are grossly under-funded. Progress has been made.
The U.S. National Institutes of Health (NIH) issued a consensus statement that addressed the need for syringe exchange but also observed that “[p]rograms targeting sex workers have been highly efficacious in other countries, but [in the U.S., programs] will encounter cultural and political barriers.” The public silence maintained on this issue for the last 17 years is emblematic of those barriers.
But sex workers’ rights organizations in most U.S. cities, though heavily marginalized, have not been silent. They are struggling to end “condoms as evidence” practices, train health-care providers, find or establish sex worker-friendly health-care services, and demand their rightful place as invaluable allies in ending human trafficking and preventing the spread of HIV. Like the harm reductionists who set up the first syringe exchange sites in the United States, they need the support of mainstream sexual and reproductive health advocates willing to learn from them and join them. Like the early harm reductionists, they need the rest of us to bring our money, skills, and political support this human rights struggle.
We can’t stop HIV in the United States without sustainable and long-term solutions to end the arrest, detention, and incarceration of sex workers in the United States, as well as end the violations against sex workers within the correctional system. A meta-analysis of more than 800 other studies and reports, published in the recent Lancet series, listed abuse experienced by sex workers as including “homicide; physical and sexual violence, from law enforcement, clients, and intimate partners; unlawful arrest and detention; discrimination in accessing health services; and forced HIV testing.” It added “protection of sex workers is essential to respect, protect, and meet their human rights, and to improve their health and well-being.”
Expert voices in support of community-led, sex worker-centered health care in the fight against HIV are becoming more and more numerous. When will the mainstream HIV and AIDS organizations and women’s health advocacy communities join loudly in this demand?
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The post The Evidence Is In: Decriminalizing Sex Work Is Critical to Public Health appeared first on RH Reality Check.
The Obama administration announced it plans to issue new interim rules to accommodate those religious nonprofits that object to complying with the birth control benefit under the Affordable Care Act by August 22.
The statement was part of a status report filed by the administration with the U.S. Court of Appeals for the Tenth Circuit in connection with a handful of legal challenges by religiously affiliated nonprofits like Little Sisters of the Poor currently before the federal appeals court. The administration told the appeals court it was issuing the new rules in light of the U.S. Supreme Court’s order in the Wheaton College case, which held the evangelical Christian college out of Illinois did not have to complete the paperwork required to qualify for the accommodation because filling out the paperwork substantially burdened the college’s religious beliefs. The Wheaton College order came just after the Roberts Court ruled closely held for-profit companies could object to the contraception benefit on religious grounds as well, relying in part on the existence of the nonprofit accommodation to support its conclusion the Obama administration had other less restrictive means of providing contraceptive coverage for workers.
In its status report, the Obama administration suggested that whether or not the legal challenges continue after the new rules are announced will be entirely up to the plaintiffs, and asked they notify the court by September 2 of their intentions to either continue or drop their challenges.
Meanwhile, a different federal appeals court ruled that Fresh Unlimited Inc., the parent company of the secular for-profit Freshway Foods, won’t have to provide contraception coverage for its employees. The one-page order in the Gilardi v. the U.S. Department of Health and Human Services case is believed to be the first to apply the Supreme Court’s Hobby Lobby decision. The order sends the case back to the district court, according to news reports, with instructions to issue an order that grants an exemption and to consider whether to extend it to the Gilardis individually.
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