With New York legalizing gay marriage, more and more children will be exposed to same-sex couples (much to the chagrin of conservatives). Here is great video of one little boy's reaction to seeing his first gay couple -- watch how he figures things out:

 

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Abortion Rights Advocates Launch ‘Circus Disco’ Counter-Protest in New York

Supporters of the clinic have wanted to fight back for a long time, but were waiting for a window of opportunity to take a stand.

Being in New York, a state with a left-of-center reputation and laws that generally uphold reproductive rights, the city of Buffalo might not seem a natural fit for anti-abortion extremists.

But “pro-life” activism in the large upstate city is storied. Sixteen years ago, Dr. Barnett Slepian, then an abortion provider at Buffalo Womenservices in New York, was shot dead in his home by an anti-abortion sniper. Six years before Slepian’s murder, almost 200 protesters from around the country descended on the city, picketing and blocking access to abortion clinics, as part of Operation Rescue’s “The Spring of Life.”

During a similar anti-choice effort in the late 1980s, hundreds more were arrested.

“There is this history of hostility in Buffalo,” says Sally Heron, services coordinator and office manager of the Buffalo Womenservices, a health clinic that offers abortion and birthing services, along with other reproductive care, to women and queer people in upstate New York.

Decades later, four abortion providers serve the Buffalo area, including Womenservices. And while picketing has subsided over the past decade, Heron says there are still protesters in front of the clinic every day.

“We get this feeling that they own the space, the sidewalk in front of the clinic,” Heron told RH Reality Check. “It’s easy to feel frustrated by them taking up that space every day.”

Supporters of the clinic have wanted to fight back for a long time, but were waiting for a window of opportunity to take a stand. That moment came this week, when clinic staff found out that anti-choice leader Steve Karlen would be traveling to Buffalo to give a speech in front of protesters at the clinic.

Karlen was to arrive on behalf of 40 Days for Life, a nationally coordinated protest event against abortion in which anti-choice activists picket and hold vigils outside abortion clinics across the country. By the time Karlen was set to arrive, the protesters had already been stationed in front of Womenservices for more than three weeks.

Once Heron got word of Karlen’s arrival, she and a friend decided to organize a counter-protest, with the theme “circus disco”—the idea being that a lively protest could drown out the speaker and distract from the negative energy created by the usual picketers.

It worked: The next day, some 100 people streamed in front of Womenservices, dancing with fire poi and hoola hoops and cheering with reproductive rights banners.

Heron also says that the raucous, party-like nature of the protest was meant to create a fun, open, and happy environment around a procedure so often mired in stigma and secrecy. In the vein of glitter-bombing, the circus disco theme of the protest would be a fabulous way to call out the absurdity of anti-choice activists and point to the normalcy of abortion as a medical procedure.

Heron said Womenservices plans to continue the counter-protests. “It was so much fun it’s hard to imagine not doing it again,” she said. “And people were so hungry for it. We’re clearly so hungry to come out and make this point.”

“It really felt like it was an important thing that was happening, like we were reminding them that we are the majority,” she added. “We felt really supported and like we had a whole community that was behind us.”

Womenservices has been doing much more than playing defense against relentless anti-choice activists. On Valentine’s Day, the facility opened a birthing center, becoming the first in the nation to house a birth center alongside an abortion clinic.

Plans are also in the works to create a reproductive justice advocacy nonprofit, to connect the dots between direct service and change.

“We already have a center where people can receive care regardless of the outcome of their pregnancy,” Heron said. “It’s about so much more than providing medical care though. It’s about economic justice, trans care, and prison justice. We’re really on our way to increase access and build community around reproductive justice and rights in Buffalo.”

Image: Courtesy of Anthony Brown

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Silicon Valley’s Egg-Freezing Perk Is Bad for People Across the Board

Egg freezing is an individualized, questionably effective technical fix for a fundamentally social problem.

News about Silicon Valley’s egg-freezing perk has ignited many much-needed conversations about the tech industry’s family-unfriendly workplaces and policies that make it hard to reconcile being a mother and having a job. But of dozens of articles and blog posts, only a few have noted that establishing egg freezing as an employee benefit for a small number of privileged women is a bad idea across the board. For women who opt to freeze their eggs, the procedure’s safety is dubious; for everyone else, the practice shifts the focus away from the social changes that working families urgently need.

Defenders of the egg-freezing offer have welcomed it as an “option” for women lucky enough to work for Facebook or Apple—itself a highly limited career path, as recently compiled statistics about the lack of diversity in high-tech companies can attest. Like its lexical sister “choice,” “option” often functions as a trump card in potentially fraught debates like this one. I’m not arguing that “choice” or “options” are unimportant, but we need to to situate them in broader social contexts, too, including those of class, race, and gender.

Perhaps it’s unfair to link upscale frozen eggs to the overwhelming issue of economic inequality. But it’s worth noting that the dilemma of “work-family balance,” which seems to have spurred these corporations’ initiatives, is connected to the struggle for reproductive justice. Through that lens, we need policies that support women—all women—if and when they decide to have children, as well as if and when they decide not to bear a child.

Companies like Apple and Facebook are trend-setters, and their decisions about how to spend human resources budgets may well affect other corporate employers. That influence could be wielded in any number of ways. Imagine, for instance, that instead of upping the ante in the escalating “perk war” to attract and retain high-end employees, Apple and Facebook had worked with the HR departments of the security firms, caterers, and other companies with which they contract to develop basic parent-friendly benefits.

After all, it’s safe to say that few working women in Silicon Valley or elsewhere would otherwise spend an unexpected $20,000 to put their eggs on ice. In every state in the country, $20,000 is more than a year’s salary at the hourly minimum wage. Even middle-income women would be far more likely to allocate such a windfall toward enrolling a toddler in a higher quality preschool, putting more food on the table, taking time off to take care of a newborn or sick parent, or signing up for a better health-care plan. Yet rather than committing to strategies that could conceivably aid families at all points on the employment spectrum, Facebook and Apple evidently chose to put time and money toward an extremely narrow slice of the population.

Furthermore, because egg freezing is a medical procedure, we need to assess its safety as well. In that context, the procedure is an “option,” all right—but one that is risky, invasive, and highly unreliable.

Egg retrieval itself is neither simple nor safe. It involves weeks of injections with powerful hormones, some used off-label, to hyper-stimulate the ovaries. Nausea, bloating, and discomfort are common. More serious reactions requiring hospitalization—including severe pain, intra-abdominal bleeding, and ovarian torsion—occur at low, but not negligible, rates. Deaths, though fortunately rare, have been reported.

Some studies suggest that egg retrieval is associated with higher rates of infertility and cancer. But shockingly, though the fertility industry has harvested eggs for decades, there have been too few follow-up studies to ascertain the extent of these longer-term risks.

With so much that is unstudied or under-studied about the safety of egg retrieval, meeting the bioethical standard of “informed consent” for patients is actually quite challenging. Of course, women who freeze their own eggs for possible later use, like those who undergo egg retrieval when they’re actively pursuing a pregnancy, often say they’re willing to take risks because of their deep desire for a genetically related child.

But even the motivating strategy here—work and freeze now, then mother later—carries low odds of success. According to a 2013 meta-analysis, even the newest flash-freezing method fails up to 77 percent of the time among women age 30, and close to 90 percent of the time in women age 40.

Then there’s the matter of safety for children who result from frozen-and-thawed eggs. The chemicals used in the freezing process are toxic, but no one knows whether they’re absorbed by embryos, or whether that might cause problems as children get older. Even the American Society for Reproductive Medicine, whose fertility clinic members have an arguable financial interest in promoting expensive new procedures, discourages egg freezing for elective, non-medical reasons.

Though it’s unfortunate that Facebook and Apple are endorsing an unproven technique that puts their own employees’ health at risk, it makes sense that this quick-fix engineering approach would appeal to high-tech giants used to reshaping the world with gadgets and gizmos. And while they probably weren’t expecting the backlash, covering the egg-freezing tab to keep more of their female employees “leaning in” for more hours, and more years, may turn out to be a net plus for the companies. A lucky few women among this already tiny minority may also wind up winners, with higher-powered careers, and babies too.

But egg freezing is an individualized, questionably effective technical fix for what is fundamentally a social problem—or, rather, a whole raft of them. Let’s hope the next round of conversations about work and families includes strategies for confronting those issues, too, such as public policies and family-friendly workplaces that support reasonable and gender-equitable wages, paid parental leave, quality health care, and affordable child care for all of us.

Image: Shutterstock

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Legal Scholars, Reproductive Health Advocates Comment on Exemptions to Birth Control Benefit

The administration sought comments on how to define a closely held for-profit company and whether other reporting or enforcement steps might be appropriate to implement an exemption to the birth control benefit.

The commenting period on a proposed expansion of the Affordable Care Act’s accommodation to the contraception coverage benefit for religious objectors closed Tuesday, leaving the Obama administration to the task of deciding what kind of companies can avoid covering contraception for their employees.

The proposed expansion is a result of the U.S. Supreme Court’s decision in Burwell v. Hobby Lobby that ruled some types of closely-held corporations can raise religious objections to providing contraception coverage in their employee health insurance plans.

The Roberts Court in that decision failed to define “closely held corporation” and no single, uniform definition of a closely held corporation exists under current law. That prompted the Department of Health and Human Services (HHS) to solicit comments from the public to help define the scope of this latest accommodation.

The administration sought comments on how to define a closely held for-profit company and whether other reporting or enforcement steps might be appropriate to implement an exemption to the birth control benefit.

Among those who offered comments on the scope of the proposed accommodation were more than 40 corporate law scholars who strongly urged the administration to restrict the for-profit entities eligible for a religious exemption to entities of a limited size, in some cases no more than 30 equity members, that can provide evidence of religious mission and whose owners unanimously agree to seek the accommodation.

More than 20 law and religion scholars warned HHS and the U.S. Department of Labor that the Obama administration could be vulnerable to lawsuits if it does not create stringent monitoring and enforcement procedures that ensure seamless access to contraception for women whose health insurance is provided by employers who seek exemptions to the ACA’s contraception benefit.

Reproductive health and rights advocates such as the National Family Planning & Reproductive Health Association and the Planned Parenthood Federation of America submitted comments to guide the administration’s deliberation process. Many of the comments from NFPRHA track the law professors recommendations, including calls for tracking and enforcement mechanisms, as well as a requirement that companies seeking the exemption refile on an annual basis.

While the administration crafts its proposed rule for accommodating religious objections of closely held corporations, the next question is whether or not those that have filed lawsuits challenging the contraception rule will accept whatever proposal the Obama administration comes up with.

So far at least 12 cases have settled or are on the verge of settling. In those cases where the parties have indicated they are close but not quite settled, the sticking point appears to be a disagreement between the parties as to whether an injunction would apply only to the contraception rule before Hobby Lobby v. Burwell, or whether it would also permanently bar the for-profit legal challengers from refiling claims challenging whatever accommodation process the administration crafts for closely held corporations.

Among those for-profit challenges that have not yet settled: Hobby Lobby.

The administration’s accommodation woes continue on the religiously affiliated nonprofit front as well. In light of the Roberts Court’s Wheaton College order that called into question the accommodation process for religiously affiliated nonprofits, the Obama administration announced this summer a tweak to that process, seeking comments from the public before making their proposal.

The religiously affiliated nonprofits challenging the accommodation have indicated the administration’s latest offer will not be sufficient and that they will likely continue with their litigation regardless of what accommodation the administration ultimately releases.

Those religious groups include the University of Notre Dame, Priests for Life, and Little Sisters of the Poor, all of whom argue that the very act of participating in the health-care coverage requirement is an act facilitating sin.

The question of the sufficiency of the administration’s accommodation process could land before the Roberts Court yet this term.

The University of Notre Dame has a current request pending before the Supreme Court, and the Obama administration’s brief in response is due November 4. Meanwhile the Fifth, Seventh, Tenth, and Third Circuit courts of appeals all have challenges to the accommodation process for religiously affiliated nonprofits pending with arguments in those cases.

Image: Shutterstock

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New Federal Rules Will Change the Way Colleges Handle Sexual Assault

The rules are the result of months of discussion with campus officials, victim advocates, and students to figure out how to implement the reauthorization of the Violence Against Women Act of 2013.

Read more of our articles on consent and sexual assault on U.S. college campuses here.

The trauma of a campus sexual assault often doesn’t end with the attack itself. Survivors might be forced to continue living in the same dorm as their rapist even though they’ve asked to transfer. They might not even know how to request such a transfer, and at the end of it all, their attacker might be found guilty only to be “punished” with writing an essay or watching a movie about sexual assault.

New rules published Monday by the Obama administration aim to fix these kinds of problems.

The rules are the result of months of discussion with campus officials, victim advocates, and students to figure out how to implement the reauthorization of the Violence Against Women Act of 2013 (VAWA).

The new rules add or redefine new categories of sex crimes that colleges must report, improve campus education and prevention programs, and ensure that victims are given equitable treatment.

“The final VAWA regulations reflect the most sweeping change to federal campus sexual assault policy in 20 years, bringing significant changes to how colleges and universities prevent and respond to this serious challenge,” S. Daniel Carter, director of 32 National Campus Safety Initiative, told RH Reality Check via email.

The VAWA reauthorization codifies practices that used to be just guidance from the Department of Education on how to interpret Title IX laws against sex discrimination. That’s important because it will be much harder for a future administration to overturn the regulations, Laura Dunn, founder of the victims’ advocacy group SurvJustice, told RH Reality Check. “We want these things to last into the future,” she said.

The new rules make clear that schools have to give students reasonable academic or living arrangement accommodations after an assault. Moreover, those accommodations can’t hinge on whether or not a student decides to report.

“I hear a lot of complaints from students who are furious that they are never given the opportunity to move out of the dorm where a person who harmed them lived, or have a class changed even though they have to see either a perpetrator or someone who retaliated against them after their report,” Dunn said. “There’s no excuse for that.”

Under the new rules, schools will also have to be much more clear and up-front about informing victims about how to apply for those accommodations.

“A survivor is never going to request what they don’t know exists,” Dunn said.

The final VAWA rules also force schools to be more transparent and equitable about their disciplinary proceedings.

Schools have to publish information about each type of disciplinary proceeding they use, the expected timing, and the decision-making process.

If schools include, say, essays or films as possible disciplinary actions against a rapist, they have to list that, along with any other sanctions like expulsion or suspension.

Colleges and universities also have to inform students in writing of not just the outcome but also the reasoning behind any decisions they make after a proceeding, and give students a reason if a proceeding is being delayed.

Being required to put the reasoning and not just the result in writing, Dunn said, will hopefully encourage schools to think twice before dismissing a case on spurious grounds. Dunn said that if she’d had in writing that her own rape case was dismissed just because she had been drinking, she could have sued her school.

And both parties in a proceeding have the right to any kind of adviser they choose, including a lawyer, which wasn’t the case before this new set of rules and regulations.

Schools are also required to provide “primary prevention” programs to educate students on preventing sexual violence, and the rules for what these programs have to teach are much more detailed than ever before.

“One of the things I really appreciated is that [the rules] didn’t look at primary prevention in the stereotypical way of, ‘Women, don’t walk alone at night,’ that kind of thing,” Dunn said. “It pushed past that, and it talked about really getting to the root cause of social norms that allow violence against women to be prevalent.”

Primary prevention programs must promote “healthy, mutually respectful relationships and sexuality.” Bystander intervention should teach people how to recognize threatening situations and safely intervene, but also to understand “institutional structures and cultural conditions that facilitate violence.”

Risk reduction is defined to be about reducing the number of perpetrators and inactive bystanders as well as empowering victims.

The word “consent” is not defined in the VAWA regulations, but schools are required to teach about consent as it is defined by local jurisdictions.

The new VAWA rules also added dating violence, domestic violence, and stalking to the list of crimes a school has to include in its annual crime report, broadened the definition of a “hate crime,” and also divided “sexual assault” into four categories: rape (which now matches the FBI’s new, much less regressive definition), fondling (which includes most unwanted sexual touching), incest, and statutory rape.

Redefining rape to include any unwanted sexual penetration was especially important for LGBT survivors, Dunn said, because their assaults may not fit the FBI’s old bill of “carnal knowledge of a female forcibly and against her will.”

The rules make clear that a student’s personal information does not have to be released when schools issue a “timely warning” report to the community that a sex crime has occurred.

The new rules will take effect on July 1, 2015, giving institutions at least seven months to comply.

Image: littleny / Shutterstock.com

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North Dakota Set To Be First State to Pass Radical ‘Personhood’ Amendment

Anti-choice ballot initiatives in Colorado and Tennessee have gained national headlines, but a ballot initiative in North Dakota that would have significant consequences for women’s reproductive rights has gotten far less attention.

Anti-choice ballot initiatives in Colorado and Tennessee have gained national headlines, but a ballot initiative in North Dakota that would have significant consequences for women’s reproductive rights has gotten far less attention.

Measure 1, if approved by voters, would amendment the state constitution to read that the “inalienable right to life of every human being at any stage of development must be recognized and protected.” North Dakota would join Missouri as the only states with constitutions that define life as beginning at conception—North Dakota would be the first to do so through a constitutional amendment approved by the voters.

Measure 1, known as the “Life Begins at Conception” Amendment, would give constitutional rights to fertilized eggs, embryos, and fetuses, and would ban abortion, birth control pills, intrauterine devices (IUDs), and emergency contraception.

It could also eliminate certain medical procedures such as cancer treatments and in vitro fertilization. Women who miscarry may be subject to police investigations to determine if their actions were the cause.

The latest polling shows that 49.9 percent of those surveyed would vote to approve the ballot measure. The poll was conducted by the University of North Dakota (UND) College of Business and Public Administration, and surveyed 505 likely voters in the state. The pool has a margin of error of plus or minus 5 percent.

Robert Wood, a professor of political science at UND who helped conduct the poll, told the Forum News Service that for the measure to be defeated, all of the 17 percent of undecided voters would have to break against the measure. “By and large, there are not that many undecideds on this particular measure,” he said.

Similar so-called personhood amendments have been on the ballot three times in other states: voters rejected the amendments in Mississippi in 2011 and in Colorado in 2008 and 2010.

Recent polling shows that this year’s Colorado personhood ballot initiative shows that the measure isn’t likely to pass, with only 37 percent of survey respondents in support of the amendment.

The ballot measure is a legislatively referred constitutional amendment, which means that state lawmakers voted to place the amendment on the ballot. The state legislature passed SCR 4009 in March 2013. It was passed narrowly in the senate by a 26-21 vote, and then overwhelmingly in the house by a 57-35 vote.

Proponents of the measure made no secret of its true intent. “This amendment is intended to present a direct challenge to Roe v. Wade,” state Sen. Margaret Sitte (R-Bismarck) said during the senate floor debate.

Abortion is already highly regulated in the state, and access is extremely limited. Fargo’s Red River Women’s Clinic is the only clinic that provides abortion care in the state, and it subject to significant regulation.

The state legislature passed multiple laws restricting abortion access during the 2013 legislative session. State lawmakers passed SB 2368, the Pain-Capable Unborn Child Protection Act, and HB 1456, the Human Heartbeat Protection Act; both have been blocked by the courts and are being litigated.

Supporters of the measure have raised more than $577,000 in campaign contributions, including $186,000 in contributions from the North Dakota Catholic Conference. Opponents have raised more than $815,000 in campaign contributions, the vast majority coming from the Planned Parenthood Action Fund in North Dakota, South Dakota and Minnesota.

Image: Shutterstock

The post North Dakota Set To Be First State to Pass Radical ‘Personhood’ Amendment appeared first on RH Reality Check.


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North Dakota Set To Be First State to Pass Radical ‘Personhood’ Amendment

Anti-choice ballot initiatives in Colorado and Tennessee have gained national headlines, but a ballot initiative in North Dakota that would have significant consequences for women’s reproductive rights has gotten far less attention.

Anti-choice ballot initiatives in Colorado and Tennessee have gained national headlines, but a ballot initiative in North Dakota that would have significant consequences for women’s reproductive rights has gotten far less attention.

Measure 1, if approved by voters, would amendment the state constitution to read that the “inalienable right to life of every human being at any stage of development must be recognized and protected.” North Dakota would join Missouri as the only states with constitutions that define life as beginning at conception—North Dakota would be the first to do so through a constitutional amendment approved by the voters.

Measure 1, known as the “Life Begins at Conception” Amendment, would give constitutional rights to fertilized eggs, embryos, and fetuses, and would ban abortion, birth control pills, intrauterine devices (IUDs), and emergency contraception.

It could also eliminate certain medical procedures such as cancer treatments and in vitro fertilization. Women who miscarry may be subject to police investigations to determine if their actions were the cause.

The latest polling shows that 49.9 percent of those surveyed would vote to approve the ballot measure. The poll was conducted by the University of North Dakota (UND) College of Business and Public Administration, and surveyed 505 likely voters in the state. The pool has a margin of error of plus or minus 5 percent.

Robert Wood, a professor of political science at UND who helped conduct the poll, told the Forum News Service that for the measure to be defeated, all of the 17 percent of undecided voters would have to break against the measure. “By and large, there are not that many undecideds on this particular measure,” he said.

Similar so-called personhood amendments have been on the ballot three times in other states: voters rejected the amendments in Mississippi in 2011 and in Colorado in 2008 and 2010.

Recent polling shows that this year’s Colorado personhood ballot initiative shows that the measure isn’t likely to pass, with only 37 percent of survey respondents in support of the amendment.

The ballot measure is a legislatively referred constitutional amendment, which means that state lawmakers voted to place the amendment on the ballot. The state legislature passed SCR 4009 in March 2013. It was passed narrowly in the senate by a 26-21 vote, and then overwhelmingly in the house by a 57-35 vote.

Proponents of the measure made no secret of its true intent. “This amendment is intended to present a direct challenge to Roe v. Wade,” state Sen. Margaret Sitte (R-Bismarck) said during the senate floor debate.

Abortion is already highly regulated in the state, and access is extremely limited. Fargo’s Red River Women’s Clinic is the only clinic that provides abortion care in the state, and it subject to significant regulation.

The state legislature passed multiple laws restricting abortion access during the 2013 legislative session. State lawmakers passed SB 2368, the Pain-Capable Unborn Child Protection Act, and HB 1456, the Human Heartbeat Protection Act; both have been blocked by the courts and are being litigated.

Supporters of the measure have raised more than $577,000 in campaign contributions, including $186,000 in contributions from the North Dakota Catholic Conference. Opponents have raised more than $815,000 in campaign contributions, the vast majority coming from the Planned Parenthood Action Fund in North Dakota, South Dakota and Minnesota.

Image: Shutterstock

The post North Dakota Set To Be First State to Pass Radical ‘Personhood’ Amendment appeared first on RH Reality Check.


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Discussing Disabled Sexuality Is a Radical Act

The American Academy of Pediatrics recently released an update to its guidelines that included an expansion discussion of sexual health for disabled teens. That's an incredibly important addition—so why are so few media outlets covering it?

On September 29, the American Academy of Pediatrics (AAP) published a critical update to its guidelines on teen and adolescent sexuality, providing important new information for pediatricians preparing to help their patients access reproductive health services at a critical time in their lives. The media, including numerous progressive sites, quickly zeroed in on one aspect of the update: the advice that long-lasting contraceptive options, including intrauterine devices (IUDs), were the best choice for sexually active teens. What the news seemed less interested in, however, was the discussion on handling sexual health for disabled teens buried halfway through the document.

By acknowledging that disabled teens are sexually active at all, the AAP committed a radical act—but the public appeared largely indifferent. Although the AAP found the subject of disabled sexuality important enough to dedicate an entire section of the guidelines to it, only a handful of pieces, like this one on the disability-specific news site Disability Scoop, addressed that aspect. The AAP isn’t new to this, either: The organization even specifically noted in 2007 that sexuality for disabled teens was “often forgotten.” September’s new guidelines expand on the subject while also reminding pediatricians that this is a continuing issue.

Though the new guidelines in no way guarantee a universal change in doctors’ behavior, they do spell out a number of clear strategies for changing the dismal status quo surrounding teen sexual education and reproductive health care. The recommendations for doctors to provide long-acting birth control to teens is, indeed, a vital aspect of the update, as such methods have historically been provided primarily to adults. Important, too, is the section encouraging pediatricians to keep up with law and policy in their states in terms of patient confidentiality—particularly that of teens. (While this subject received comparatively less attention in the media, it was still noted.)

But the update on disabled sexuality is equally important, and underreporting of the issue underscores a common social problem. The guidelines make it explicitly clear that some disabled teens, just like non-disabled ones, are sexually active: They need appropriate care, including sexual health screenings, advice about birth control, supplies of condoms and contraceptives, and answers to questions about safer sex and relationships. Similarly, the guidelines note, disabled teens may also need birth control for issues like controlling heavy menstruation or acne, making it critical to protect access to those contraceptive methods as well.

Overall, the recommendations in the guidelines stated:

Pediatricians should remember that adolescents with chronic illnesses and disabilities have similar sexual health and contraceptive needs to healthy adolescents while recognizing that medical illness may complicate contraceptive choices.

The AAP also points clinicians to the U.S. Medical Eligibility Criteria for Contraceptive Use, which provides specific information from the Centers for Disease Control and Prevention about interactions between various contraceptives and specific disabilities and medications. Including this resource sends a clear message to clinicians that information on the safety of contraceptives for disabled teens is readily available; therefore, ignorance on the subject is inexcusable.

Disabled children and teens tend to see doctors more frequently than non-disabled ones, providing numerous opportunities for education and intervention. So if care providers follow these guidelines, outcomes could radically improve for disabled teens. Such a move would reduce pregnancy and sexually transmitted infection (STI) rates, reduce the incidence of abuse, increase adolescents’ comfort with reporting sexual assault and rape, and empower disabled teens to make their own sexual choices.

But by noting that disabled teens have sex, the AAP wasn’t just providing vital medical guidance. It was also forcing the sexual health community—including sex educators, medical professionals, and the media—to recognize the truth of disabled sexuality. We live in a society where many individuals seem unaware that disabled people have sex, enjoy sexuality, and are at some unique risks in terms of reproductive health. The document serves as a reminder that teens, like many other people, have sex, and that disabled teens are no different. Perhaps the most striking evidence of this is the fact that the section on disability and sexuality was quietly and calmly included in the document, rather than flagged for special attention.

And yet, it fell entirely off the radar. It was almost as though reporters were blinkered during that section of the report, unable to acknowledge that it existed. This was characteristic of the way society interacts with disability issues in general. The public views disability as an object of fear and sometimes active hatred, rather than something that should be engaged; non-disabled individuals are often reluctant to explore the topic of disability at all, let alone interact directly with disabled people.

The media’s decision not to cover the section, in turn, reinforced dangerous social attitudes about sex and disability. Notably, it wasn’t just the mainstream media who ignored the subject: Websites that ostensibly provide more intersectional, holistic coverage of feminist issues also overlooked it, and it wasn’t a topic of discussion on outlets explicitly dedicated to reproductive health and rights topics. In short, anyone who didn’t read the guidelines would have missed it. And propagating the idea that disabled people are not sexual has real consequences.

Doctors, schools, and even disabled teens’ own parents often either deprive them of sexual education or provide them with inadequate information that doesn’t address their specific needs and risk factors. This can lead to confusion among disabled teens as they wrestle with their own sexuality. Subjects of sexual orientation and gender, for example, may be unfamiliar, which can harm LGBQT disabled teens and increase their risk of depression, anxiety, and other mental health conditions. Disabled teens may also not understand the mechanics and prevention of STI prevention and pregnancy; tragically, they may not be able to recognize the signs of pregnancy early enough to make an informed decision about whether to terminate it or proceed with it.

In addition, disabled teens may not learn about healthy relationships or have access to the context necessary for discussions about assault and personal boundaries. This can lead to sexual exploitation. In a particularly disturbing example, an Australian nonverbal rape survivor was challenged during her testimony because her communication book—a booklet with images and words illustrating various concepts, allowing her to convey needs, commentary, and other things without speaking—hadn’t included the words “penis” or “rape.” Police would not allow these terms to be added after the assault, effectively preventing the survivor from describing what had happened; officials’ logic was that doing so might create bias or false testimony.

Desexualization also creates “perfect victims” through disbelief and isolation. Because society as a whole thinks that disabled people do not and cannot have sex, members of the public, law enforcement, policymakers, and even medical professionals have difficulty conceiving of the idea that they might be targets for rape and assault. This leaves disabled people, particularly those in institutional care or under the “care” of abusive individuals, vulnerable to danger. Again, some may not realize that they are being sexually abused, as they lack understanding about what kinds of touch and interactions are appropriate. Others have limited social support, making them prime targets.

The lack of follow-up when people report abuse is also both a result of and a contributor to the problem. As exposed in a PBS and ProPublica documentary, administrators often ignore neglect and abuse in assisted living facilities (which include disabled people as well as older adults), even when residents and family members report it. Law enforcement and coroners, when extreme cases cause death, can also write off such mistreatment. And the same holds true for disabled people living in their communities.

Creating more access to reproductive health services increases safety for disabled people and raises the profile of disabled sexuality overall by making members of the public aware of disability issues. So for disabled teens, having their sexuality acknowledged and addressed by the AAP is a huge step forward. In turn, the AAP guidelines reflect larger, and critical, issues that the reproductive health community needs to acknowledge: In the greater fight for reproductive rights for all, disabled people belong under the banner alongside everyone else.

Image: Shutterstock

The post Discussing Disabled Sexuality Is a Radical Act appeared first on RH Reality Check.


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Discussing Disabled Sexuality Is a Radical Act

The American Academy of Pediatrics recently released an update to its guidelines that included an expansion discussion of sexual health for disabled teens. That's an incredibly important addition—so why are so few media outlets covering it?

On September 29, the American Academy of Pediatrics (AAP) published a critical update to its guidelines on teen and adolescent sexuality, providing important new information for pediatricians preparing to help their patients access reproductive health services at a critical time in their lives. The media, including numerous progressive sites, quickly zeroed in on one aspect of the update: the advice that long-lasting contraceptive options, including intrauterine devices (IUDs), were the best choice for sexually active teens. What the news seemed less interested in, however, was the discussion on handling sexual health for disabled teens buried halfway through the document.

By acknowledging that disabled teens are sexually active at all, the AAP committed a radical act—but the public appeared largely indifferent. Although the AAP found the subject of disabled sexuality important enough to dedicate an entire section of the guidelines to it, only a handful of pieces, like this one on the disability-specific news site Disability Scoop, addressed that aspect. The AAP isn’t new to this, either: The organization even specifically noted in 2007 that sexuality for disabled teens was “often forgotten.” September’s new guidelines expand on the subject while also reminding pediatricians that this is a continuing issue.

Though the new guidelines in no way guarantee a universal change in doctors’ behavior, they do spell out a number of clear strategies for changing the dismal status quo surrounding teen sexual education and reproductive health care. The recommendations for doctors to provide long-acting birth control to teens is, indeed, a vital aspect of the update, as such methods have historically been provided primarily to adults. Important, too, is the section encouraging pediatricians to keep up with law and policy in their states in terms of patient confidentiality—particularly that of teens. (While this subject received comparatively less attention in the media, it was still noted.)

But the update on disabled sexuality is equally important, and underreporting of the issue underscores a common social problem. The guidelines make it explicitly clear that some disabled teens, just like non-disabled ones, are sexually active: They need appropriate care, including sexual health screenings, advice about birth control, supplies of condoms and contraceptives, and answers to questions about safer sex and relationships. Similarly, the guidelines note, disabled teens may also need birth control for issues like controlling heavy menstruation or acne, making it critical to protect access to those contraceptive methods as well.

Overall, the recommendations in the guidelines stated:

Pediatricians should remember that adolescents with chronic illnesses and disabilities have similar sexual health and contraceptive needs to healthy adolescents while recognizing that medical illness may complicate contraceptive choices.

The AAP also points clinicians to the U.S. Medical Eligibility Criteria for Contraceptive Use, which provides specific information from the Centers for Disease Control and Prevention about interactions between various contraceptives and specific disabilities and medications. Including this resource sends a clear message to clinicians that information on the safety of contraceptives for disabled teens is readily available; therefore, ignorance on the subject is inexcusable.

Disabled children and teens tend to see doctors more frequently than non-disabled ones, providing numerous opportunities for education and intervention. So if care providers follow these guidelines, outcomes could radically improve for disabled teens. Such a move would reduce pregnancy and sexually transmitted infection (STI) rates, reduce the incidence of abuse, increase adolescents’ comfort with reporting sexual assault and rape, and empower disabled teens to make their own sexual choices.

But by noting that disabled teens have sex, the AAP wasn’t just providing vital medical guidance. It was also forcing the sexual health community—including sex educators, medical professionals, and the media—to recognize the truth of disabled sexuality. We live in a society where many individuals seem unaware that disabled people have sex, enjoy sexuality, and are at some unique risks in terms of reproductive health. The document serves as a reminder that teens, like many other people, have sex, and that disabled teens are no different. Perhaps the most striking evidence of this is the fact that the section on disability and sexuality was quietly and calmly included in the document, rather than flagged for special attention.

And yet, it fell entirely off the radar. It was almost as though reporters were blinkered during that section of the report, unable to acknowledge that it existed. This was characteristic of the way society interacts with disability issues in general. The public views disability as an object of fear and sometimes active hatred, rather than something that should be engaged; non-disabled individuals are often reluctant to explore the topic of disability at all, let alone interact directly with disabled people.

The media’s decision not to cover the section, in turn, reinforced dangerous social attitudes about sex and disability. Notably, it wasn’t just the mainstream media who ignored the subject: Websites that ostensibly provide more intersectional, holistic coverage of feminist issues also overlooked it, and it wasn’t a topic of discussion on outlets explicitly dedicated to reproductive health and rights topics. In short, anyone who didn’t read the guidelines would have missed it. And propagating the idea that disabled people are not sexual has real consequences.

Doctors, schools, and even disabled teens’ own parents often either deprive them of sexual education or provide them with inadequate information that doesn’t address their specific needs and risk factors. This can lead to confusion among disabled teens as they wrestle with their own sexuality. Subjects of sexual orientation and gender, for example, may be unfamiliar, which can harm LGBQT disabled teens and increase their risk of depression, anxiety, and other mental health conditions. Disabled teens may also not understand the mechanics and prevention of STI prevention and pregnancy; tragically, they may not be able to recognize the signs of pregnancy early enough to make an informed decision about whether to terminate it or proceed with it.

In addition, disabled teens may not learn about healthy relationships or have access to the context necessary for discussions about assault and personal boundaries. This can lead to sexual exploitation. In a particularly disturbing example, an Australian nonverbal rape survivor was challenged during her testimony because her communication book—a booklet with images and words illustrating various concepts, allowing her to convey needs, commentary, and other things without speaking—hadn’t included the words “penis” or “rape.” Police would not allow these terms to be added after the assault, effectively preventing the survivor from describing what had happened; officials’ logic was that doing so might create bias or false testimony.

Desexualization also creates “perfect victims” through disbelief and isolation. Because society as a whole thinks that disabled people do not and cannot have sex, members of the public, law enforcement, policymakers, and even medical professionals have difficulty conceiving of the idea that they might be targets for rape and assault. This leaves disabled people, particularly those in institutional care or under the “care” of abusive individuals, vulnerable to danger. Again, some may not realize that they are being sexually abused, as they lack understanding about what kinds of touch and interactions are appropriate. Others have limited social support, making them prime targets.

The lack of follow-up when people report abuse is also both a result of and a contributor to the problem. As exposed in a PBS and ProPublica documentary, administrators often ignore neglect and abuse in assisted living facilities (which include disabled people as well as older adults), even when residents and family members report it. Law enforcement and coroners, when extreme cases cause death, can also write off such mistreatment. And the same holds true for disabled people living in their communities.

Creating more access to reproductive health services increases safety for disabled people and raises the profile of disabled sexuality overall by making members of the public aware of disability issues. So for disabled teens, having their sexuality acknowledged and addressed by the AAP is a huge step forward. In turn, the AAP guidelines reflect larger, and critical, issues that the reproductive health community needs to acknowledge: In the greater fight for reproductive rights for all, disabled people belong under the banner alongside everyone else.

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