Monday, August 31, 2009

Loss of a Hero, New Heroes for a Changing World

Petri dish

Seems like everybody’s talking about heroes these days. It’s natural just now, of course, with the passing of Senator Edward Kennedy. But even before that tragic loss, I was noticing that the theme of Legal Voice’s annual auction, “Heroes,” was echoed in various media and community events. (Don't forget to join us!)

I’ve been enjoying thinking about just why I or others view someone as a hero – courage in the face of danger? Standing up for others? The ability to articulate a vision others can only dimly glimpse? All of these, I think, and last week I was lucky enough to spend time with two women whose work and lives fit in the last category.

It’s a truism that the law often (okay, usually) lags behind social and technological advances and challenges. We social justice and social change lawyers do our best to keep up and anticipate emerging issues, but let’s face it: we can’t always stay abreast of all these issues, let alone anticipate them. Here’s a sample of conundrums:

· How do we reconcile the needs of gay and lesbian couples and infertile different sex couples to form their families using assisted reproductive technology with concerns about the health of women who provide eggs or serve as surrogates?
· If we support the rights of women to do what they choose with their bodies (and we do), what should our position be about sex-selected abortion?
· Is there a meaningful distinction – practically, morally, ethically and legally – between the (permitted) sale of human eggs and the (prohibited) sale of kidneys?
· Should we as a society permit, prohibit, or regulate germline modification, which some people believe would lead to “designer babies”?

Questions of this type abound as technology and biotechnology surge forward. And they are extremely difficult to grapple with. That’s why two of my current heroes are Dr. Sujatha Jesudason, the founder and Executive Director of Generations Ahead, and Kathryn Hinsch, founder and Executive Director of Women’s Bioethics Project.

Generations Ahead works with social justice organizations around the country to expand the public debate on genetic technologies. Its work bringing together advocates and thought leaders on social justice, reproductive justice, the rights of persons with disabilities, and LGBTQ people and families for respectful, insightful discussions and analyses of genetic and reproductive technologies shines as an example of social justice in action. Sujatha’s leadership and scholarship have helped diverse communities, organizations and constituencies articulate shared values, important questions, and looming challenges in these and other areas.

Women’s Bioethics Project is a nonprofit, nonpartisan public policy think tank dedicated to ensuring that women’s voices, health concerns, and unique life experiences strongly influence ethical issues in health care and biotechnology. Since 2004 the Women’s Bioethics Project has identified, researched and commented on cutting-edge issues around stem cell research, end-of-life concerns, neuroethics, and women’s health. Kathryn has established herself and WBP as key participants in bioethics debates around the country, and ensured that a feminist, pro-choice, pro-science viewpoint is heard.

Kathryn and Sujatha understand (and embrace) the enormity of what they’ve undertaken, and they both approach their work in the spirit of inquiry as well as advocacy. Their leadership and their dedication to helping the rest of us understand the issues and develop sound policies around them make them my heroes of the week.

Well, except for the everlasting hero Teddy Kennedy. I hope – how I hope – that Congress responds to our enormous loss in the same way it did when his brother was assassinated: just as we owe the Civil Rights Act in no small part to the determination to honor JFK, we should have comprehensive health care reform that protects women - indeed, protects all people in our country, to honor Teddy’s legacy.

Friday, August 28, 2009

Sex-selection: A brain-bending intersection of ideals.


You will find few experts who will spout definitive answers around the subject of sex-selection. The topic is neither simple, nor clean-cut along lines of political beliefs or moral values.

Some view the issue as a matter of simple economics: Bioethicist Jacob M. Appel posits that if governments were to offer financial incentives for having female children, the gender imbalance currently happening as a result of sex-selection would even itself out. But does this view leave out some very important aspects of the issue? Sex-selection often comes from deeply-rooted cultural traditions. While these traditions are often influenced by economic factors, such as dowries and inheritance, how much does it have to do with a more underlying view of a woman’s role in society?

Passing anti-sex-selection legislation is a tactic that many experts on the subject believe to be questionable, at best. That hasn’t stopped legislators from trying, however. U.S. Representative Trent Franks (R- Ariz.) has introduced federal legislation that would make it illegal to terminate a pregnancy, based on the sex or race of a fetus. Franks is hardly the first person to have gone down the policy road. There are a large handful of countries that have some sort of law on the books relating to sex-selection - including Australia, China, India, and Canada - and just earlier this year Oklahoma passed a bill banning sex-selective abortions. Though there’s some research on how well sex-selection laws work, there’s still a lot to learn, and a lot of the effects are not so easily measured.

Perhaps the most high profile dilemma concerning sex-selection is its intersection with the pro-choice community. How does this fit into the feminist perspective of a woman having autonomy when it comes to her own body? Hillary Clinton recently spoke out against sex selection and her comments have been labeled by anti-abortion groups as “traitorism in the ranks of the abortion advocates.” Is it not possible to have a nuanced view on such a highly contentious issue as abortion?

The most important thing, it seems, is to allow the debate to have its own framework. To recognize that the world of assisted reproductive technology is ever-changing and that the way in which we approach a dialogue on these issues must change along with it.

Wednesday, August 26, 2009

Women’s Equality Day: “It’s a Matter of Justice”


August 26 was Women’s Equality Day – a day set aside each year by congressional resolution to commemorate the date U.S. women got the right to vote through the passage of the 19th Amendment. However, as great and hard-won an accomplishment suffrage was, it hasn’t quite yet translated into true equality for women.

But I don’t mean to be a total downer here. Instead, let’s take a page from our suffragist sisters’ playbook. How does their battle inform the ones we're currently engaged in, and those yet to come?

First, though we take only a day to commemorate suffrage, of course, suffrage was not won in a day. It took another 72 years after the historic Seneca Falls Convention in 1848 before the 19th Amendment became the law of the land. Change takes time – and persistent pressure.

Second, the suffrage movement first took root in the states before succeeding nationally. When Washington State became the fifth state in which women gained suffrage, it was a tipping point in the national suffrage movement. So what happens in your state, county, or neighborhood does matter. Let a thousand flowers bloom.

Third, while strong leaders are important, don’t underestimate the power of individual actions. The success of Washington State’s suffrage campaign “relied on convincing women, some who preferred to focus on their role at home, that women's voting rights were necessary.” Barbara Ehrenreich made a similar observation about more recent feminist actions: “Women's rights … weren't brokered by Betty Friedan and Gloria Steinem over tea. … [T]he feminist movement of the 70s took root around kitchen tables and coffee tables, ignited by hundreds of thousands of now-anonymous women who were sick of being called ‘honey’ at work and excluded from ‘men’s’ jobs. … [I]t took an army of unsung heroines to stage the protests, organize the conferences, hand out the fliers, and spread the word to their neighbors and co-workers.”

And finally, let’s not forget what the fight for suffrage was all about. Suffrage is not just a symbol of equality: it is the means to equality. We can honor those original suffragists by taking up the torch and actively working to build a better future for all.

If you haven’t already, check out – and sign – our Women’s Bill of Rights. And let us know what equality means to you.

p.s. Oh, and the title of this post – “It’s a Matter of Justice?” That was the official slogan of the Washington State suffragists. Some things, we don’t need to change at all.

Friday, August 21, 2009

Who decides?



The first question asked about most of us – before we’re old enough to answer it ourselves – is “Is it a boy or a girl?” People expect a straightforward answer. For some, though, it’s more complex.

Caster Semenya ran an astonishingly, gold-medal-winningly fast race at the world track and field championships. Now her gender is being called into question, and the International Association of Athletics Federation is performing gender testing to determine if Semenya is eligible to compete in women’s events.

The IAFF has an interesting opportunity here. If Semenya turns out to be intersex , or have a genetic condition like Androgen Insensitivity Syndrome, they could take a strong and public position of supporting intersex athletes – it would be an insanely powerful example to set for the global athletic community.

Not that that would fit in with their gross history of performing mandatory invasive gender tests and revoking medals from athletes post-test. But we can hope. At the very least, we can hope that they own up to their often icky role in policing gender norms. And that they continue to evolve in a positive way: gender testing is no longer mandatory, and psychological counseling is offered to athletes who are tested.

And what does a gender test tell us? Not much, it would seem. Genes, outer appearance, and behavior don’t always align in strictly male and female categories. A person with the genetic characteristics of one sex can look and act and be raised as a member of the other sex. And the “be raised” part is critical – gender socialization starts in the delivery room, the moment someone says “It’s a (boy/girl)!”

For many of us, it really is clear and easy. But what if you are born with characteristics that make you hard to label? Semenya’s story suggests a head-spinning number of possible answers to “Who decides?”

  • You*
    I.A.A.F. officials and South African track and field officials had agreed that it would be too much to ask of an inexperienced teenager to field questions about the gender issue from the news media.

    *You can’t speak for yourself when you’re a baby, so you probably won’t get a vote until later on. Or possibly you are a young athlete who suddenly finds herself on trial in the court of public opinion, and maybe at age 18 you’re not about to get on the international stage and defend your gender to the whole world.

  • Your family
    "She is a woman and I can repeat that a million times," her father, Jacob, told the Sowetan newspaper. "It is God who made her look that way," said Semenya's grandmother, Maputhi Sekgala, who helped raise her.

  • People at school
    Semenya's tale begins with a tomboy who always wore pants to school, didn't mind playing rough, and endured plenty of taunts from the boys she regularly competed against in a poor village 300 miles north of Johannesburg. The head of her secondary school thought Semenya was a boy until Grade 11.

  • Fellow athletes
    “These kind of people should not run with us,” Elisa Cusma of Italy, who finished sixth, said in a postrace interview with Italian journalists. “For me, she’s not a woman. She’s a man.”

  • Athletic officials
    "They're judging her based on what?" asked South African athletics federation president Leonard Chuene. "Who can give me conclusive evidence? I want someone to do that."

  • Doctors and scientists
    Dr. Peter Bowen-Simpkins of the UK's Royal College of Obstetricians and Gynaecologists told CNN: […] "This South African athlete couldn't have AIS because her problem is that it is suggested that she looks rather male, she's got a big jaw and has very little breast development, but so many athletes are like that, "

  • Scholars and experts
    Alice Dreger, a professor of medical humanities and bioethics at Northwestern University said in a telephone interview. “There isn’t really one simple way to sort out males and females. Sports require that we do, but biology doesn’t care.

Tuesday, August 18, 2009

The Name Game

Have we entered the fourth wave of feminism, or did we all just get knocked off our surfboards? Seriously, what does it mean when 70% of respondents in a survey opined that women should take their husband’s name when they got married, and 50% thought the government should mandate it?!

First things first: if you want to take your husband’s name, go for it. We feminists (of whatever wave) didn’t work this hard to dictate your choices about how you live, what you call yourself, whether you have kids or don’t, stay home with them or not. Really. You get to choose: THAT’S what we’ve been fighting for.

Indeed, when I got married I offered to let my husband use my name. Mine’s easier to spell; unlike him, I don’t have a former spouse active in the same professional community whose name is the same as mine; his is harder to pronounce – why, there were all sorts of reasons he might choose to change to my patronymic. But he didn’t.

Can’t blame him, really: why would he choose to exchange his father’s last name for my father’s last name? That’s one of the funny things about the whole name controversy when analyzed from a feminist perspective. We trace our familial lines through the paternal side. Yes, the genealogists delve into both sides, but the name, the source of one’s familial identity, comes from the male side. So some people think it’s silly for feminists to object to changing their name to their husband’s; after all, hers is a man’s name anyway, right?

Yes, and no. My last name came from my father’s side of the family. But my whole name, the moniker I use in my personal and professional life, is now what I have made it. When people see my name they associate it with me (I hope). And that’s why I chose to keep using the name I was given at birth.


But when you get down to it, why the fuss? Just use the name you want. (Check out the man running for King County Executive named Goodspaceguy.)

Well, this study, small as it is, indicates we still have a long way to go to ensure true equality and freedom from discrimination. Honestly, people – all 815 of you in the study – why in the world do you care? And more important, why do you think the government should mandate my name or anyone else’s? What else do you think the government should mandate?

Never mind. I can guess. And it’s scary.

Friday, August 14, 2009

The Art of Conversation: Health Care Shouting matches and why we must reach a meaningful dialog.


Health Care is a matter of life and death for Americans. Whether you are underinsured, uninsured, or the proud owner of the best health care plan available, the issue of healthcare reform affects you and everyone around you. The truth is that every one of us is one illness or one job loss away from losing our healthcare coverage. Currently, the fact that President Obama’s plan seeks to rectify this situation is being lost beneath a bunch of hostile behavior from opponents of healthcare reform.

The most ridiculous rumors I’ve ever heard have been running rampant around the blogosphere, on Facebook, and from the mouths of the usual suspects. Stories of mandatory abortions, “death panels,” and mandatory sex-change operations are stealing the limelight, making it impossible to have a real conversation about the true aim of the legislation.

In order to dubunk these myths senators and representatives have been setting up town-hall-style meetings . Instead of providing a forum for serious conversation around health care reform however, they’ve turned into full-on shouting matches. As columnist Paul Krugman reports “congressmen (are being) shouted down, hanged in effigy, surrounded and followed by taunting crowds.” Both opponents and proponents of reform are accusing the other side of using “plants” at the town hall meetings to further their agenda.

This is the question I keep asking myself: When, how, and why did we return to grade school tactics? Health care is too important for these shenanigans! Whether you’re for or against Obama’s health care plan, or even health care reform itself, we must all agree to create a dialog that brings us toward a better understanding of both sides of the issue. That’s what democracy is about, isn’t it?

Tuesday, August 11, 2009

When does a free market not equal a free ride?

It’s been a month since the 9th Circuit Court of Appeals ruled in our clients’ favor in the pharmacy refusal case, and we’ve settled down a bit. What a relief. Getting the decision exactly one year to the day from oral argument was poignant, but earlier would have been better.

Of course we’re pleased with the decision: it was a win on virtually every element of the case! The appeals court set out the standard the trial judge must use as the case moves forward, and it’s precisely the standard for which we advocated. Mind you, the case isn’t over. The plaintiff anti-choice pharmacy and pharmacists have asked the appeals court to rehear the case. We think it seems unlikely such a clear, decisive opinion will be reconsidered, but it’s their right to ask. And maybe they’ll ask the U.S. Supreme Court to review the decision. Again, it’s unlikely the Court will accept a case that is still in its preliminary phase (I know, I know, it feels like it should be over by now), but you never know. Keep your fingers crossed.

Ever since we started this case, it’s been clear that most people in our community – and indeed, polls show most people around the country – believe our position is the correct one: patients are entitled to receive their lawful medications, and pharmacies should not refuse to provide them. Various media editorial boards and scholars (nerd alert!) support our position. But not everyone agrees. Some people assert that a business should not be forced to provide a medication (or any product) of which it disapproves. Let the market be the driver, say these folks. If the people want a certain item, they can go to a business that provides it.

It sounds appealing, perhaps, until you really analyze it. Now, we’re not saying that every business should have to keep every known product on its shelves. If a halal or kosher market chooses not to provide meat that is forbidden by the religion of the owner, we would certainly not assert they must stock and sell that meat. And there are exceptions to the dispensing requirement in the pharmacy regulation that take into account things like fraud, lack of demand, etc.

But that is not what’s at stake in the pharmacy context; indeed, context is what matters here. What distinguishes pharmacies from grocers is that the pharmacy owner or pharmacy has entered a highly regulated, licensed industry and profession. She is permitted to practice pharmacy: it’s not an entitlement. Lots of reasons exist for the stringent regulation: the danger inherent in drugs, the intimacy of the interaction between the pharmacist and the customer, and – especially when we’re talking about emergency contraception – the immediate need for the medication. The consequence of entering the field of pharmacy is that you can’t substitute your judgment for a doctor’s or, as in this case, for the government’s determination that the public health is enhanced by patients’ being able to get their medications immediately.

While grocery and butcher stores are regulated to some degree by the government, they are not in the business of health care, while a pharmacy is. At the core of medical professionalism is the requirement that practitioners give patients’ needs primacy. Refusals not only jeopardize a woman’s health and well-being, they can also interfere with the patient’s moral values: what if a woman is opposed to abortion, but knows the reality that emergency contraception is just that – contraception? Refusing to provide EC could place her in the position of deciding between an unwanted (and entirely avoidable) pregnancy, and undergoing a procedure to which she is morally opposed. The pharmacy owner has imposed his moral views on the patient, in violation of his ethical and professional obligations.

The bottom line? Pharmacy owners are in the profession of health care, and the government not only can, it should regulate that business. Otherwise, what does “public health” really mean?

Wednesday, August 5, 2009

Women in the Bullseye, or Why We Need Feminists



Breaking news in today’s headlines about a Pennsylvania man who went on a shooting rampage, killing three women and himself, chronicling his rejection by women on a personal webpage, stating, “Women just don’t like me. There are 30 million desirable women in the US (my estimate) and I cannot find one.” His diary read, “Many of the young girls here look so beautiful as to not be human, very edible.”

I am sickened, horrified, saddened.

This tragic incident has echoes of the Montreal massacre. Do you remember this? In December 1989, at the École Polytechnique in Montreal, Canada, a 25-year-old man separated the male and female students. After claiming that he was “fighting feminism,” he shot all nine women in the room, killing six. He continued through the building, specifically targeting women to shoot, ultimately shooting twenty-eight people and killing fourteen women before turning the gun on himself.

I’m sure, as with Montreal, this incident in Pennsylvania will be much dissected for all the societal ills it exposes – misogyny, gun violence, mental illness.

But let’s not shrug this off as just another horrific headline, removed from each of our daily lives. No. Let this remind us of why it is so important to challenge sexism whenever and wherever it occurs. To quote Andrea Dworkin (in her book about the Montreal tragedy):

We have to stop men from hurting women in everyday life, in ordinary life, in the home, in the bed, in the street, and in the engineering school.... We have to be the women [and men] who stand between men and the women they want to hurt….

The feminist is the woman who is there not because she is his woman, but because she is the sister of the woman he is being a weapon against. Feminism exists so that no woman ever has to face her oppressor in a vacuum, alone. It exists to break down the privacy in which men rape, beat, and kill women.

So I challenge you: Be a feminist. Do it in your own way – quietly and privately, or loudly and publicly, in small ways or big. Join us in supporting a basic Women’s Bill of Rights.* Because all of us women need you.

*We believe that all women have these rights:
• The right to equal treatment and to be free from discrimination
• The right to decide when and how to form and maintain their families
• The right to be safe wherever they are
• The right to economic equality and independence
• The right to be healthy and active