Friday Musing: Something To Think About Edition

When I went to urgent care after stepping on a sharp metal object in the driveway (thanks dear!), I was told I should take a round of antibiotics.  The doctor was nice enough, informing me that the antibiotics would interfere with my contraceptive method, and therefore I should use a backup method for the next month.

It was nothing I didn't already know, and yet I left thinking, "That's not the way I would have phrased that."  Okay, I say that a lot.  Obviously I'm the kind of person with certain ideas about how health care should and should not be.  But I really mean that here... that is not the way I would have phrased that.

Last week, the Affordable Care Act went into effect, giving women specifically increased access to health care and support.  While the health care bill has obvious short-comings, women's health advocates celebrated the accomplishment, primarily the new contraception without copay rule that will benefit many (but not all) women using birth control.

Don't get me wrong... increasing economic access to a range of birth control methods is awesome.  It absolutely should be lauded as a great accomplishment for sexual health.  But what's left to battle over are the other barriers.  Social stigma, attacks by religious institutions, and a lack of access to education all shape our society's relationship with birth control, not to mention a common issue that is very often overlooked completely: lack of partner support.

Because it's so hidden, it's difficult to gauge how many women are in relationships that impede their ability to use consistently effective birth control.  Birth control sabotage is particularly common in abusive relationships, the idea being that a person is less able to leave the relationship if she is kept in what amounts to reproductive slavery. Abusers don't always covertly sabotage contraception to force pregnancies on their partners; intimidation, threats, or simple unwillingness to use a condom all create significant obstacles that mere co-pay free contraception is not about to remedy.

Given its potential to go unreported, health care providers need to be able to create a plan of care that can work with or around a patient whose partner is unwilling (or just refuses) to play an active role in safer sex practices.  Today many reproductive health clinics (such as Planned Parenthood) staff providers who are able to do this, helping patients choose a method that cannot be sabotaged or, in some cases, even detected by an intimate partner.  But many general health practitioners - particularly those from "the old school" - fall short of even recognizing this as a potential issue.

So back to my doctor's health counseling.  "You should use a backup method for the next cycle" isn't at all inaccurate.  It's actually good information, clearly stated and with little room for confusion.  However, his counseling in no way acknowledged the fact that using a backup method might be out of the question for me. 

What if he phrased it, "You should use a backup method for the next cycle, is that going to be a problem?"  To be sure, the majority of his patients would have said, "No, that's not going to be a problem," and maybe wondered why he thought it might be.  No harm done.  And the ones who would potentially have a problem would be given the opportunity to say so, possibly receiving advice to prevent pregnancy or even some resources to help them change their situations. 

Health care providers need to be at the forefront of these conversations.  We entrust them with our confidential information, knowing our intimate details are protected by law and by their oaths.  They need to be able to first see if they can help patients get out of abusive situations, but they also need to know that getting out is not always possible, and therefore working within those situations to reduce harm may be the best conceivable option.

Women who wear the hijab are being oppressed by the patriarchy. Ima rock this corset now.

It started out innocently enough: the Facebook page for a mainstream feminist group featured an image of Team USA fencer Ibtihaj Muhammad, the first American woman to compete in an international competition while wearing a hijab.

You know where I'm going with this, don't you?

Oh yes, it happened.  Before I even clicked "view all comments," I knew what I'd find.  And sure enough, I found it:

•  "That's awesome.  Too bad she feels the pressure to cover though.  Damn patriarchy."
• "Good for her! But I can't get past the covering. Poor woman."
• "I hope she wins gold!!  And can be empowered enough to stop having to cover!!!!"

It's really the defining trait of liberal/reformist feminism: privileged Western white ladies having clear-cut ideas about what does and does not constitute oppression, never taking issues of race/class/ethnicity/gender identity into the equation, all the while failing to see where or how they specifically fall into the role of oppressor themselves.  And they just can't shut up about the hijab.  I mean, the second comment says it all, "I can't get past the covering."

I actually engaged that specific commenter in a private conversation, because I do that sometimes.  I've become more particular about who I will engage in deeper-level conversations about privilege and oppression, because let's face it, when you go into an argument with a rabid antichoicer about the morality of abortion, it's just never going to be productive.  But seeing how this particular woman was at least a feminist, I figured what could be the harm.

And it was good.  We had some decent exchanges of ideas and both came out having earned a slightly different perspective on some things.

Then I clicked on her profile.  She had a few photos public, and the ones I could see featured a person, I'm assuming her, dressed up in a corset, fishnets, and heels.  Don't get me wrong, she looked amazing.  If I'd been out and seen her walk by, my reaction would have been one of "hot damn she looks good."  And I'm not one of those feminists who thinks that donning a corset sets women's liberation back three or four decades... while I don't own a corset myself, I have been known to occasionally rock some sexy stuff that would make Andrea Dworkin cringe.

But you must understand that this person made some very scathing comments about how a woman's decision to wear a hijab can never be free of patriarchal influence.  She was very clear about that, even echoing one of my personal favorite talking points: we don't live in a vacuum. It's beyond me, really.  Here's this intelligent woman expressing her discontent with another culture's patriarchal standards while at the same time proudly playing into a centuries-old standard of her own.

I mean obviously it goes back to intersectionality.  There are tons of feminists who believe that they never "buy in" to patriarchal standards with their appearance, but a woman who simply covers her head and hair because of religious tradition has zero autonomy in the matter.  It goes back to our deep-seeded racism and Islamaphobia that, admit it, exists in the majority of us on some level, which is deeply problematic.  For one, it's ignorant: few people who criticize the hijab actually know why it's worn. We're told, mostly by American-based media, that such coverings are required by law in all those mean evil Middle Eastern countries and that's bad.  We pretty much leave it at that.  Secondly, it assumes that we in the United States live in a post-patriarchal society where we've "moved past" all that sexist stuff.  Putting on a vintage-inspired apron and baking cookies for your boyfriend doesn't mean the same thing that it meant 50 years ago... goodness no, the systematic oppression of women - at least in our forward-thinking society - is a thing of the past.  (That's post-feminism, baby!)

Lastly, it's paternalistic.  Liberal/reformist feminists continue to buy into the idea that privileged Western white ladies need to be the ones to "save" other women (Muslim women specifically) from themselves.  This is nothing new... white feminists have been doing this since feminism was feminism. (If you haven't read White Women's Rights by Louise Newman, that should be added to your reading list.  Like now.)  Co-opting the neocolonialist language of our government, these women assume that liberation is something that needs to be given to the women of the world, not something they can achieve for themselves in a way that will jive with their cultures.  Worst of all, no one even attempts to ask Muslim women whether or not they feel oppressed by wearing a hijab, and if they do, they question one or two women of color to gain the appearance of inclusitivity by means of tokenism.  

So my feminist friend "feels bad" that Muslim women are "pressured" to don "unnecessary and uncomfortable articles of clothing" because of patriarchal rule.  I'm picturing the modestly-dressed Muslim women of the world peering at her Facebook pictures, thinking much the same thing.

Overheard at Urgent Care

While awaiting my Tdap injection at urgent care today, I overheard a troubling conversation.  This specific care center has curtains instead of doors closing off exam rooms, so I was able to hear the situation fairly clearly.

A woman had come in with what I understood to be a very serious GI infection.  She had a fever of 103* and was experiencing nausea, chills, and severe dehydration.  After an initial consultation with the doctor, it was advised that she immediately commence a regimen of a certain antibiotic.  She said she'd first have to see if that medication was on the $4 prescription list at Wal-Mart's pharmacy; a quick call by a staff member on her behalf confirmed that this specific medication was not on their $4 prescription list.  The doctor spent a few minutes discussing with her alternative treatment options that would involve a higher dosage and more side effects on top of being less effective, but may be on the pharmacy's low-cost prescription list regardless.

At this point the LPN came in to get my Tdap authorization form, so I was unable to really hear what was going on in the room across the hall.

However, by the time I left the situation had gotten worse.  I'm not sure exactly what they discovered, but it seems no effective medication could be found for a price that fit her budget.  She said she would take the prescription slip and get it filled when she got paid.  On Tuesday.  The doctor became very stern and told her that this specific infection can become fatal very quickly.  It needed to be treated immediately, so beginning on Tuesday was out of the question.

By the time I left, they had made a plan of action: the woman was to be admitted to Moses Cone so that she could be treated today without having the immediate funds to pay for it.  This will end up costing her (and her insurance company) thousands more, however, it appeared to be the only way this woman would be treated in a timely manner, possibly saving her life.

I'll admit I don't have all the information here.  Part of me thinks if I'd just walked over and handed her $4, she'd have been able to get her medication today and avoid admission to a hospital.  But maybe not.  Like I said, I wasn't an active part of the conversation, this was just what I overheard.  And given how helpful the staff at the urgent care was being, my guess is that they'd thoroughly explored all other options before referring her to the hospital for treatment.

This is our health care system, folks.

The Humorless Feminist

Yeah, that's right.  I'm weighing in on the Daniel Tosh clusterfuck.

See, when one speaks out against the use of sexism in comic routines, they risk being labeled "one of those feminists without a sense of humor."  The humorless feminist stereotype has been a cultural archetype since the radical feminists of the 1970s first spoke out against using women's disenfranchisement to make a joke. 

Many people continue to tell themselves that rape jokes are not only okay, but they're also funny and don't do anything to perpetuate rape culture.  We've somehow come to allow ourselves the privilege of invoking gender oppression for the sake of humor, all the while telling ourselves that sexism, misogyny, sexual assault, and partner violence are things of the past (or at least don't exist in our own social circles).  However, in a country where 20% of women report being sexually assaulted, where the gender wage gap still exists as prominently as it was decades ago, and where our government continues to legislate our bodies and sexualities with ease, how can even the most light-hearted jab not reaffirm our society's commitment to gender discrimination? 

This kind of humor has really become popular in self-described "enlightened" circles.  Maybe a person fancies himself a feminist and supports the right to choose.  He probably condemns wage discrimination and treats his female friends and partners as equals.  He may have helped organize Take Back the Night events, and he may speak loudly about the importance of consent.  From this, he may feel he's "earned" the right to make a rape joke or two; after all, he would never rape anyone, so what could really be the harm?

What he doesn't realize is that the women in his extra-enlightened, uber-sex positive and politically radical social circle are just as likely to have experienced sexual assault as the women in the repressed circles he and his friends love to scoff at.  That means that, for every rape joke he tells, 20% of his female friends are forced to hear the worst thing that's ever happened to them turned into a mechanism for cheap laughs.  Worse yet, the ever-present stigma of being a sexual assault victim means that these women are unlikely speak up, lest they become labeled "humorless feminists" who allowed themselves to be raped.  Even the playful jabs of "bitch make me a sandwich" smack of regressive social norms and help to maintain the constraints of male dominance.

Not wanting to be left on the sidelines of social clout, women themselves often become complicit in the maintenance of rape as an acceptable source of humor.  For us, it's even harder to unpack.  After all, haven't we, the clear majority of sexual assault victims, also "earned" this right?  We face the threat of sexual assault every single time we work late and have to walk to our cars alone.  We worry about stopping for gas late at night.  Our hearts skip a beat when we're in the shower and think we hear someone in the house.  We're warned from early childhood about getting into cars with boys, accepting alcoholic beverages at parties, wearing clothes that show too much skin, dancing a certain way, etc.  Why not take this horrendous reality and laugh the weight off of it once in a while, if only while in the company of other women?

I struggled with this one for a while, then I finally realized that, at least in my experience, the opportunity to make a rape joke never really comes up in all-woman gatherings.  It's not that we were censoring ourselves: the compulsion simply isn't there.  From this I can only conclude that jokes about sexual assault exist almost exclusively in rooms where male privilege dominates, and let's be real, male dominance exists even inside groups of anti-sexist wingnuts.

And yet we refrain from speaking up against it, lest we become "the oppressors" ourselves.  How dare we police someone else's god-given right to free speech?  I mean what is this, Nazi Germany?  This is perhaps the most frustrating (and most difficult to refute) accusation, the one that probably silences us more than anything else.  By turning the language of oppression against us, we become the bad guys while they continue perpetuating rape culture under the guise of "freedom of expression."  And with that, we continue to be silenced.

Let me get one thing straight: I have a phenomenal sense of humor.  It's actually a bit warped, which makes some people uncomfortable.  I use the word "fuck" a whole lot.  I enjoy incredibly raunchy jokes, especially those that take an ounce or two of intellect to fully appreciate.  In proper circles, I can make a whole group cringe, laugh, then cringe some more as they add my side-splitting anecdote to their own humor arsenals.  Best of all, I can do it all without having to use sexist or racist language.  That's the opposite of having "no sense of humor." 

My question is, how bad is your sense of humor that you have to turn to years of social injustice to get laughs?  How bad is your vocabulary that you have to use sexist slurs to make a point?  And how lacking in whit are you that you have to use one of the worst possible things that can happen to a person just to make a joke?

Making the Cut: Our Hypocritical Stance on Non-Consensual Genital Modification

You know, a lot of people are going on about how the recent ban on circumcision by a German court violates religious freedom, and to be sure, some courts in the US have been unable to uphold such a ruling on those grounds.

Let me be clear... I support religious practices that don't overtly harm people.  Okay, you might say, where do you draw that line?

Here in the U.S., we obviously don't draw it at the mutilation of a child's genitals.  But we do have express bans on other forms of violence sanctioned by religious texts, such as the stoning of women who have sex out of wedlock [Deuteronomy 22].  In fact, we in the U.S. rail against such literal interpretations of religious texts as practiced in countries under a fundamentalist version of sharia (and we use this as justification for the occupation and destruction of those countries... just sayin'). And we have no problem speaking out against the mutilation of female genitalia in Africa, even though that practice is congruent with religious tradition as well.  Are we so hypocritical in our disdain for religion-induced violence that we only accept the kind practiced by people who live in our neighborhoods and look like us?

Unfortunately the religious freedom card continues to dominate the conversation about circumcision in particular.  But what about the discussion of sexual freedom?  We need to be talking about how the mutilation of child's genitals is a huge sexual rights issue.  When it comes to female genital mutilation, the implications are obvious: no clitoris, no sexual pleasure.  What we don't always realize is that the removal of the male foreskin removes a wealth of nerve endings as well, scarring the penis and removing a lot of sensation.  Obviously the organ can still function enough to perform its "biological task," but what about the quality of that child's future sexual life?

The other socially accepted form of genital mutilation not discussed nearly enough is the mutilation (sometimes called "modification") of organs that are considered "ambiguous" at birth.  Seeing how we all have differently-sized-and-shaped genitalia, I find it ethically repugnant that a parent might opt to have their baby's organs cut to look "more normal" without the child's consent.  Still, I'm sure any parent who's had their child's genitals "modified" for this reason would tell you they thought it was for the best.  After all, we live in a world where only two variations of sex organs are considered acceptable, and parents don't want their kids growing up in a world that might persecute them on the basis of something that can be cut away.  It's amazing, really, that our society is so homophobic and transphobic that parents would rather have their children endure major reconstructive surgery than just leave it be.

By now I've probably offended dozens, and really that's okay.  The non-consensual modification of a person's genitalia is a topic many are passionate about, and many of us have strong opinions one way or another.  But the conversation, so often about either "religious freedom" or "normalizing the child for her/his own sake", misses too many points to not be taken to task.  We can't discuss the above without also taking into account the child's future as a sexual being in charge of her/his own body, and we need to start thinking about the inherent problems with putting things like religious tradition before sexual autonomy.

Vagina

That is all.

Why Birthing Rights Matter to the Pro-Choice Movement

In the more abortion-focused circles of the pro-choice movement, birthing rights often go undiscussed.  My mentions of home birth rights specifically have brought varying responses, from supportive to ambivalent to outright hostile ("Well that is not safe!"). 

But let's be clear about something.  Reproductive justice means that everyone has complete control over if, when, where, how, and with whom they bring a child into the world.  It means that people have accurate, unbiased access to information regarding all facets of their reproductive lives, from contraception to pregnancy options, from practices surrounding birth to parental rights. It means that our choices are not constrained by politics, financial barriers, or social pressure.  In other words, how can the right to give birth at home - safely and legally - not be on a reproductive justice advocate's radar?

I mention this because we in North Carolina are enduring yet another vicious attack on the rights of pregnant and childbearing individuals.  Women seeking home births may have the legal right to do so, but just like the women seeking abortion care, these laws do nothing to protect access.  As far as home birth attendants go, our state only recognizes certified nurse midwives (CNMs), and in order for these phenomenal women to legally attend births, they must be supervised by an MD currently licensed to practice obstetrics in the state.  As you can imagine, physicians that will supervise homebirth CNMs are few and far between, and this week one of them was advised (under threats of sanction) that he cannot sign off on CNMs who are not under his direct employment.  Even though the law does not dictate these terms, the medical board's sanction left seven of our eleven home birth CNMs without a licensing MD, and countless women without a care provider.

The research is abundantly clear: when labor is progressing normally, a woman under the care of a trained midwife is as safe giving birth at home as she would be under the care of an obstetrician in a hospital.

Anti-abortion birth advocates are already taking a hypocritical stance on the matter as they decry abortion rights while asking why women's reproductive decisions are limited.  I've been biting my tongue while reading the Facebook comments of fellow birth professionals all week.  One such statement went, "It is legal to have an abortion but a woman can't choose to have a home birth with a midwife! This is crazy!"  Another, "A mother can kill her baby in all three trimesters but can't give birth at home.  The government is nuts."  [Fact-Check Sidebar: North Carolina restricts abortion access after the 20th week of pregnancy (hardly "all three trimesters"); additionally, this ruling didn't come from the government, it came from the NC Board of Medicine, an agency independent from the state's governing body.]  These ramblings are usually followed by the contradictory co-opting of pro-choice language, ripe with phrases like "right to choose" and "my body, my choice."

The abortion rift amongst birth advocates is really nothing new.  After all, to simply be an advocate for varying birthing options does not encompass any official position on the politics of pregnancy itself.  Birth advocates come to the work for a variety of reasons, while it certainly seems odd to me that a person could support the "right to choose" in one pregnancy outcome but not another, the social stigma surrounding abortion means that this rift is bound to exist. 

That home birth rights are not at the forefront of the reproductive justice movement, on the other hand, is beyond me.  The struggles are just too similar.  Every time someone points out that women might have to cross state lines to access a home birth midwife, I think of the women who still - in the year 2012 - have to seek abortion care in a state with fewer restrictions or more providers.  When we worry that women will have to give birth with midwives who operate illegally (or go unassisted), I think of the women who risked their lives going to see illegal abortion providers with no public credentials, or the women who simply did it themselves.  Medicaid and many private insurers restrict access to home birth midwives just like they restrict access to abortion, making both more or less a privilege to those with the means to pay out of pocket. 

Reproductive justice advocates who are involved in birthing rights see both - the right to an abortion and the right to give birth at home - as the same struggle.  We understand that any assault on reproductive freedom comes from a system of patriarchal self-interest that sees women not as autonomous beings, but as objects to be regulated and "fixed."  We know that any women who choose home birth have done their research and don't need "warnings" from government institutions, just like women seeking abortions don't need the ideological jargon in "Right To Know" legislation.  We know that women and their families are capable of making the best possible decisions regarding the births of their children, and we seek to create a world where access, stigma, and social pressure don't sway these decisions.  In other words, we live up to the full spectrum of our ideology... we Trust Women.

I call on the reproductive justice movement to make birthing rights a part of their pro-choice consciousness.  If we are to create a world that ensures sexual and reproductive well-being for all women and girls, no struggle to protect our choices or desires can go unsupported.