When I read about Angelina Jolie’s announcement this week, I cringed.

I have greatly admired her willingness to speak out on important issues over the years. Her public announcement about her mastectomies will certainly reassure some women that losing a breast to breast cancer isn’t quite as frightening as it had once seemed. But Ms. Jolie is a powerful role model to millions of women. What are the unintended consequences of the role she is modeling regarding breast cancer?

Is breast cancer so frightening that it is better for a woman to remove her breasts before she is even diagnosed? Obviously, that isn’t what Ms. Jolie is saying. She has one of the breast cancer genes (BRCA1), and that greatly increases her chances of getting breast cancer.

However, the extremely high risk that she quoted from her doctor (87 percent chance of getting breast cancer) was based on old, small studies. Newer studies have found that the risk of getting breast cancer for an average woman with BRCA1 is 65 percent. Since being overweight and smoking increase the risk and exercising and breastfeeding lower the risk, Ms. Jolie’s risk of breast cancer, even with the BRCA1 gene, could be considerably lower.

Of course, the lifetime risk of breast cancer would still be high, but it wouldn’t be nearly as high a risk during the next 10 years or even 20 years. According to experts, a 40-year-old woman with the BRCA1 gene has a 16 percent chance of getting breast cancer before she turns 50. That’s not nearly as frightening, and with regular screening and all the progress in breast cancer treatments, the survival rate from breast cancer is higher than ever. Many breast cancer patients live long and healthy lives. And, it is possible that by the time Ms. Jolie (or any other woman with BRCA1) got breast cancer in the future–if she ever did–the treatments available would be even more effective than they are today.

Thanks to mammograms, women are getting diagnosed with breast cancer at much earlier stages, making it safe to undergo a lumpectomy (which removes just the cancer) rather than a mastectomy (which removes the entire breast). And yet, American women are undergoing mastectomies at a higher rate than women in other countries–many of them medically unnecessary. Breast cancer experts believe that many women undergoing mastectomies don’t need them and are getting them out of fear, not because of the real risks.

As an actress whose appeal has focused on her beauty, surgically removing both her breasts when she didn’t have cancer was a very gutsy thing to do. But if we care about women’s health, we need to stop thinking of mastectomy as the “brave” choice and understand that the risks and benefits of mastectomy are different for every woman with cancer or the risk of cancer. In breast cancer, any reasonable treatment choice is the brave choice.

Nobody can second-guess Angelina Jolie’s choice–it’s hers alone to make. Fortunately for her, she has access to the best reconstructive surgeons in the country, and they will keep her breasts looking as natural and beautiful as possible, an advantage that most implant patients don’t have. If she has any of the common problems with her breast implants, she can afford to get those problems surgically fixed whenever she wants to. She can also afford breast MRIs every other year ($2,000 each), which the Food and Drug Administration recommends as a way to make sure that the silicone from the implants is not leaking into the lymph nodes.

Angelina Jolie is not in any way an average woman, and what felt right for Angelina Jolie might not be right for most women who are afraid of getting breast cancer, and not even for most women with the BRCA1 or BRCA2 gene.

I thank Ms. Jolie for speaking up about her decision, and I thank the many cancer experts who are doing their best this week to explain why double mastectomies are not the best choice for most women. Let’s use this teachable moment to have a frank discussion of the treatment choices for breast cancer and to encourage women to make decisions based on their own situations, not on the choice of a celebrity, however admirable she is. For each woman, it’s important to weigh her own risk of cancer–in the next few years, and not just over her lifetime–and the risks of various treatments, and to make the decision that is best for her.

Diana Zuckerman is the president of the National Research Center for Women & Families and the Cancer Prevention and Treatment Fund. She received her PhD in psychology from Ohio State University and was a post-doctoral fellow in epidemiology and public health at Yale Medical School. After serving on the faculty of Vassar and Yale and as a researcher at Harvard, Dr. Zuckerman spent a dozen years as a health policy expert in the U.S. Congress and a senior policy adviser in the Clinton White House. She is the author of five books, several book chapters, and dozens of articles in medical and academic journals, and in newspapers across the country

Photo Credit: TipsTimes via Creative Commons

This piece was originally posted on Huffington Post and it was cross-posted here with permission.

Editor’s Note

The Breast Implant Information Project is a project of the National Research Center for Women & Families. The project provides info that women need about breast implants, based on the latest research and talking to thousands of women with implants. Dr Diana Zuckerman, President of the National Reseach Center for Women & Families told us when we met in person last week:

By launching our new website and joining Facebook  & Twitter  we hope to talk more with women of all ages, and especially young women, about the importance of making careful, informed choices for their bodies and reminding them to stay healthy and beautiful everyday of their lives”

Breast implants as therapy?  Not so much

More than 300,000 teens and women in the U.S. decide to get breast implants every year.  To hear them talk about it, you’d think they were getting therapy instead of surgery.  They almost never say “I want larger breasts” (or even “I want better boobs.”)

What they say is “I don’t like my body and I want to feel better about myself.”  And plastic surgeons will tell their patients “this will really improve your self-esteem.” But their advertisements seemed designed to make us feel insecure about our bodies, not better about ourselves.

Unfortunately, breast implants don’t deliver on that promise of feeling more self-confident. 

On the contrary, the breast implant companies’ own studies prove it.  There are 2 major breast implant companies in the U.S., Allergan and Mentor.  Both tried to prove to the FDA that breast implants helped women’s self-esteem and both failed miserably.  Allergan used 12 different quality of life measures to compare augmentation patients before surgery and 2 years later.  Nine of the 12 (75%) were worse after the women got their breast implants, including self-esteem. 

The results were similar for women getting Mentor breast implants.  The women got worse in their self-reported physical health and mental health, with most showing no difference in their self-concept or how they felt about their body.

Why do they feel worse?  For some women, it is the disappointment that even after plastic surgery they are still not beautiful enough.  And for some women, the complications from breast augmentation — numb nipples, hard or painful breasts, and for some women chronic fatigue or other problems – make them feel physically messed up and guilty because they “made a stupid decision and now I’m paying for it.”

Myth and Reality

Where does the myth of breast augmentation as therapy come from?   Wouldn’t you think that any cosmetic surgery would make women feel better about themselves?

If you ask women (or men) who had plastic surgery how it influenced them, many will say that they feel better about themselves.  But, memory can play tricks on us.  For example, some of us have mostly wonderful memories of our childhood and others have mostly sad memories, but those memories aren’t always accurate.  The best way to find out what the impact of breast augmentation – or any cosmetic surgery – is to interview the people before the surgery and again after they have completely recovered from surgery and gotten used to the “new me.”

Study after study shows that men and women who get plastic surgery usually feel better about the body part that was “fixed” but they don’t feel better about themselves and they don’t feel better about their relationships or their lives.  How we feel about ourselves is a central part of who we are.  It doesn’t change easily. For example, a “good hair day” or a great outfit can help us feel more attractive, at least for a while, and can help us have a good day, but it doesn’t make us feel more worthwhile as people or happier in our lives in general.

Psychologists explain that this is the difference between a “state of mind” (feeling good because I’m having a good hair day) and a personality trait (how I feel about myself because of my high or low self-esteem).

Plastic surgeons like to believe that they make magic by making people feel better about themselves.  And the “beauty industry” helps convince us that if we just buy the right product (whether it is a cosmetic, an outfit, or a surgery) will make all the difference.  For example, “makeovers” – whether in magazines or on TV – work by making the women feel awful about themselves at first and then “curing” their shortcomings.

Teenagers are the most vulnerable

Teenagers are especially likely to feel bad about how they look.  But every year throughout the teen years, boys and girls tend to feel better about how they look.  By the time they are 18, they feel much better than they did at 13 or 14, for instance.  If they get plastic surgery as teens, they think that’s the reason they feel better, but the truth is that even teens who don’t get plastic surgery and don’t necessarily look better than they used to, still feel more comfortable with how they look as they get a few years  older.

One more thing to keep in mind: women who get plastic surgery once tend to want more plastic surgeries.  In other words, after fixing one perceived flaw, they find other flaws that bother them and that they want to fix.  That’s another sign that breast augmentation and plastic surgery are not the way to improve self-esteem.

Therapy vs. Plastic Surgery

Why are so many women so unhappy with how they look, and especially with their bodies?  The standards seem to be getting more unattainable.  Let’s face it: thin bodies with very large breasts don’t happen in nature very often.

I’ve talked to actresses about this and I call it the trickle down insecurity effect.  Beautiful women are more likely to become actresses or models than plain Janes, but as they struggle to make it in Hollywood or the beauty industry, they are told they are not quite beautiful enough.  They try extreme diets, personal trainers, professional make-up artists, the best hairdressers, and the most gorgeous outfits.  When even that isn’t enough, they get plastic surgery.  Then regular girls and women see them and feel inadequate as they think “Why can’t I look like that?”

Of course, even movie stars don’t always look as good as they do in magazines or movies.  In real life, there is no photoshoping, airbrushing, or flattering lighting to fix the imperfections.

But the bottom line is: if you want very large breasts, breast implants can help.  If you want to feel better about yourself, breast augmentation isn’t the answer.  Therapy might be.  And, it can also help to stop comparing yourself to women whose images aren’t real, but have instead been manufactured into unattainable ideals of beauty.

Over the past two weeks, the HBO show ‘Girls’ has focused on the mental health challenges of Hannah. We have been introduced to Hannah’s secret – her shameful struggle with anxiety characterized by obsessive tendencies, a necessity to repeat tasks 8 times, often until the point of embarrassment, injury (as we saw last week), and exhaustion.

In the past, many TV shows have attempted to portray the realities of those struggling to maintain good mental health. These portrayals are often inaccurate, used as the butt of jokes, dangerously perpetuating the stigma too often associated with mental health related struggles. As a recent example, a character on Glee ‘developed’ bulimia, as if to assume that an eating disorder is chosen and then easily eradicated. Such misinformation and lack of seriousness is dangerous – it stops those in need from seeking help from supportive others; it has been estimated that the majority of those with a mental health concern choose to conceal their struggles and avoid professional help. It keeps far too many isolated; 2 out of every 5 people experiencing a mood, anxiety, or substance use disorder will seek assistance. It reduces quality of life.

But to my surprise, ‘Girls’ nailed it. Finally! Mainstream TV discussed a mental illness and did it in the right way; it wasn’t pretty, it wasn’t cured after one session or dose of a magic pill, and discussing it wasn’t funny, or natural, or easy. Hannah struggled. Hannah was shamed. Blamed. Hindered. The mental health community was elated. Having admitted to similar struggles, Lena Dunham portrayed her own experiences with mental illness, and in rare fashion, did it in a way that urged those needing help to reach out and find it.

As someone who has been challenged by maintaining mental health (for a quick and dirty summary of my mental health history you can read a previous post) and is now involved in the mental health community in various capacities, I was excited to hear the response from the feminist community. Surely a story line involving a powerful yet empowering discussion of a ubiquitous health concern that affects nearly half of the world’s population would lead to discussion.

I waited…and it didn’t come. There have been ‘Girls’ related posts about the abortion episode, her consistent nakedness, and a general discussion of virginity. Yet, a raw and accurate portrayal of mental illness went virtually unnoticed by the feminist community. In fact, one of the only pieces I read discussing the ‘Girls’ mental health story line  joked that the writers may have considered calling one of the episodes “Crazy Eights” (poking fun at Hannah’s painstaking compulsion to repeat tasks in sets of 8), and referred to her as “mentally ill” in comparison to her “mentally chill” ex-boyfriend.

I was initially disappointed. Now I’m just sad.

Over the past several decades, feminists have united together with the common goal of bringing a voice to all too common gendered issues: reproductive rights, violence, and income inequality. Brave women, then and now, have made incredible ground on these complex and all too deserving societal issues.

But just as these issues which far too often inhibit the livelihood of women has required us to fight, so too does mental health.

Why? Because mental health is a gendered problem.

The prevalence of common mental illness (examples include anxiety and depression) is significantly higher among women. The World Health Organization suggests that unipolar depression is twice as common in women and is thought to become the second leading cause of worldwide disability by 2020. The culture of violence, too, has resulted in women becoming the largest group to struggle with Post Traumatic Stress Disorder (PTSD).

And even when we have the ability to seek assistance, which is a rarity, our gender creates a barrier to appropriate treatment. The paternalism of our medical system continues to negatively impact women. We are much more likely to be diagnosed with depression and prescribed medication as treatment, even when men score similarly on assessment tests. We are also nearly 3 times more likely to be diagnosed with borderline personality disorder. The over representation of women in psychological areas is heightened among women of colour and low economics.

And let’s not forget society’s depiction of postpartum depression, sordidly referred to as the ‘baby blues’, as if to infer that ‘mom is just a little sad’ and it isn’t a very real, very common, and very hazardous psychological concern.

There are significant gender inequalities within mental health. We have fought barriers in order to discuss other taboo subjects, so why aren’t we talking about this?

I know we have a lot of battles to fight, but we have to fight this one. The well-being of millions of women, around the world, are depending on it.

Photocredit:  HBO ‘Girls’ via wikimedia commons

As a reproductive justice advocate at one of the most conservative colleges in the country (that is The Catholic University of America) the last few years have been nothing short of challenging. Figuring out how to get around the no condoms policy, being slut-shamed by a doctor at my campus health center, getting my favorite professor in deep shit for allowing me to talk about my pro-choice views in class, volunteering as a clinic escort at the same clinic my some of my peers sit and pray outside of — yes, I’d say it has been a challenge.

These challenges have made me bitter. Bitter about the fact that I’m consistently denied my right to do or say anything about these issues. But bitter has made me want to speak louder, it has made me want to talk about it more, listen to people’s stories, strategize, obsess, and do something about it. And as I’ve come to obsess about this, I’ve gained a bit of a reputation. I am that girl. The girl that drives around in the bright blue car covered in liberal bumper stickers that has been dubbed by some as the “dykemobile.” The girl that always talks about that “reproductive justice” stuff. That girl that knows everything about sex. The girl you go to, and you send your friends to, for any question you may have about sex.

Becoming that girlhas been awesome, especially because I hope to one day become a real human sexuality educator. But being that girlat The Catholic University of America? It’s also terrifying. Not because I fear getting caught, but because the stories and questions my peers (and even a professor or two) have shared with me are scary. So many of these people have no clue about their sexual health; they were never taught about it, and now, as adults, they don’t know where to go or who to talk to.

Most of my friends are not on birth control. Most of them have never been tested for STD’s (in Washington, D.C., HIV is an epidemic). Most of them use condoms most of the time, but not all the time (like those drunken 3AM nights when spending your last $5 on pizza seems like a much better decision than spending it on a few condoms); and never during oral sex. Most of my friends had abstinence-only education. Most of my friends can’t ask their family members about sex and their bodies because they fear their parents’ wrath. Most of my friends can’t go to our campus health center because they refuse to offer any services that might encourage more sex.

Most of my friends are having sex, yet they feel like it’s something to be ashamed of. What would my parents think? What would my church think? They have been taught their entire lives that sex outside of marriage is bad, they have been denied their right to comprehensive sex education. Most of them are comfortable in their decision to become sexually active, but so many of them feel ashamed, embarrassed, and uncomfortable talking about it. They were never given the tools to take care of their bodies; they either don’t know where to start, or they don’t understand why they need to start.

Most of my friends have been lied to, and as they begin to navigate the world as adults, they seem to struggle in determining what is true and what isn’t. “I would be on birth control but I’m not because I just don’t have enough sex to be paying that kind of money. I go months without sex, that’s months of money spent on birth control for no reason.” And, “I’m under CUA’s insurance. You think I’m going to spend $100 a month on birth control pills? I’d rather just have sex when its safe.” (Safe, she claimed, was the first few days after her period.)

So many of my peers seem to be lost. They simply don’t understand the risks they are taking by not being safe about sex. Why would they? How are they supposed to figure it out if they don’t even know where to look? What if they don’t know why they need to to look?

It is because of this that I will be watching carefully how the new opt-out of the contraception mandate will be implemented. The devil will be in the details. The Obama administration has clarified that for non-profits who consider themselves to be religious institutions, such as my alma mater, they will not have to pay for contraception in their health plans. However coverage will be provided in a wholly separate plan provided by the insurance company. It is probably safe to assume this extra step of a separate plan will involve additional paperwork and processes to get the contraception-only coverage activated. This may sound simple to some, but for those who are navigating the healthcare world on their own for the first time (and the sexual world!) this may prove harder than it seems.

This White House has brought an unprecedented expansion of access to contraception and a whole host of other sexual and reproductive health services. I hope these rules are implemented in a way that doesn’t tarnish that record by putting barriers up for students at religious institutions. Students at my school are having sex, not talking about it, and have been continuously brushed to the side, as though we need access to contraceptives less than everyone else. Please trust me when I say, I used to live in a fraternity house, we need our contraceptives. We deserve access to contraceptives, to information, to sexual health resources. We demand it.

Callie Otto is a Catholic University Students for Choice co-founder & Choice USA intern.

The piece is cross-posted with permission from Choice USA

Photo credit: Spentpenny via Creative Common 

Do you like your body?   If there was a simple way to change it, with no risks, would you do it?

If making that change meant you would put your health at risk and have multiple surgeries for the rest of your life, would you hesitate?

Most women say they don’t like their bodies, and research shows that dissatisfaction usually starts during the middle school years and may never go away.  For many of us, it eases up a little in young adulthood as we come to appreciate our attributes and accept any “flaws,” but insecurities rev up again as aging takes its toll.  It seems ironic that we long to regain the body that seemed so imperfect when we were younger.

In the U.S., there are thousands of products and procedures that feed on women’s insecurities.  Most are ineffective – the pills and products that promise to melt fat away without diet or exercise, or to make cellulite or wrinkles disappear.  But only a few are actually dangerous to our health.  Breast implants are one of those.

The FDA just approved a new kind of breast implant, which many plastic surgeons promise will be safer and better than other kinds of breast implants.  It is made of thick silicone gel (nicknamed “gummy bear implants” for its consistency), which is supposed to prevent it from breaking, leaking, or wrecking havoc with your body.

What’s the proof that this product is safer, or even safe at all?  Apparently, that’s a secret.

When breast implants were first sold in the U.S. in the 1960s, no testing was required to make sure they were safe.  For the next 30 years, more than a million women in the U.S. got breast implants, not realizing that studies on women had never been done to prove they were safe or to determine how many months or years they would last.

In 1990, I was working as an investigator in the U.S. House of Representatives when a Senate staffer called me.  She told me that her mom had gotten breast implants after a mastectomy, which had resulted in terrible problems including silicone leaking out of her nipples.  Her mom was cured of cancer but the implants had put her through hell.  I was sure that the FDA had very strict rules about safety testing, but I promised I’d look into it.

I found out that I was wrong: the FDA had never required clinical trials for breast implants.  We held a Congressional hearing, I continued my investigation, and soon my office – and the media – was full of horror stories about women whose health had been ruined by breast implants.

Thanks to Congressional and media pressure, the FDA changed their policies.  They eventually required breast implant companies to conduct studies on hundreds of women with breast implants, to find out how safe their products were.  Public meetings were held so that women could testify about their experiences, scientists could openly discuss the research, and the media could report what was said.  Some companies failed to do the newly required research and their implants were no longer allowed to be sold in the U.S.  And, although all breast implants were found to have high complication rates, the FDA, under tremendous pressure from implant companies and plastic surgeons, decided that women were capable of making an informed choice about the risks they were willing to take.

I have no doubt that women are capable of making an informed choice.  But the FDA is still not providing the full information that women need to make an informed choice, and neither are the plastic surgeons.

In a giant step backwards, some FDA officials are reverting to their old ways.  They approved “gummy bear” implants with no public meeting and they have not made the study findings public.  Instead, in a press release that the agency quietly released on February 20, they report that the new breast implants have the same kind of complications as other types of implants – such as hard, painful, or lopsided breasts and the need for additional surgery – but don’t say how often those complications occur.  They also reported a new complication: the silicone gel in these new implants can crack.  What happens to women when that happens?  The FDA isn’t saying.

Since I did my investigation in 1990, I have been one of the FDA’s strongest critics and biggest fans.  I have often been horrified by some of the decisions FDA makes to approve unsafe or inadequately tested medical products, but I also know that when the FDA does its job well, it can save millions of lives.

When I did the Congressional hearing on breast implants, I was 7 months pregnant.  My son is now a college senior.  In those 22 years, the FDA regained and is now again at risk of weakening its public health focus, as Congressional pressure on the FDA to protect patients has been replaced by Congressional pressure to get products to market as quickly as possible and thus “create jobs.”  Whether it is breast implants, riskier birth control pills, TB drugs that do more harm than good, or sleeping pills with questionable benefits, the FDA is allowing drugs to be sold that do a lot of harm.  And when the FDA fails to hold medical products to a high standard, it is women – the consumers of most medical products – who are harmed the most.

For more information about the FDA’s recent decision on Allergan breast implants, see Statement of Dr. Diana Zuckerman on FDA approval of new Silicone-Gel Breast Implant Natrelle 410 and for more information about the risks of breast implants, see www.breastimplantinfo.org

Diana Zuckerman is the president of the National Research Center for Women & Families. She received her PhD in psychology from Ohio State University and was a post-doctoral fellow in epidemiology and public health at Yale Medical School.  After serving on the faculty of Vassar and Yale and as a researcher at Harvard, Dr. Zuckerman spent a dozen years as a health policy expert in the U.S. Congress and  a senior policy adviser in the Clinton White House.  She is the author of five books, several book chapters, and dozens of articles in medical and academic journals, and in newspapers across the country.

I have had the honour of helping to facilitate groups for university women with eating disorders and eating issues for the past 4 years.

Each week, for a six-week period, we come together to discuss our stories; detailing our successes, our challenges, our joys, and our heartbreak. For a short moment in time we offer each other a small window into each others’ lives, a glimpse into our personal struggles with an all-encompassing and misunderstood illness. We offer each other more than an ear – the collective provides support, understanding, and encouragement. We unite in our common experiences.

And while facilitating such a group is, by far, one of the greatest roles and most fulfilling experiences I have ever been fortunate to have, the sixth and final session is always difficult. Sure, I’m sad to say goodbye; connecting with a group full of intelligent, articulate, and unquestionably strong women creates a quick, palpable bond. However, the reality of what the end of our group means is much more heart-rending.

We walk out of the safety of our group into a world that is not as open, not as accepting, not as kind. We enter into a society that doesn’t understand, and doesn’t seem to want to take the time to.

We may want to turn to the ones we love – the ones who are supposed to understand us the best – for support as we attempt to battle this seemingly relentless disease. We want a physician to help us make sense of it, and tell us how to fight back. We want our friends to hug us on the bad days, celebrate with us on the good days, cry with us when crying is all we can hope to do.

But for some of us, we may feel we have no one we can turn to. We may feel the type of support we want is just not there. For others, we may be too afraid to talk.

As omnipresent as they are, affecting about 20 million of us and an additional 10 million men, and despite the fact that rates have been rising since the 1950’s, eating disorders are still an unspeakable illness.

It is this very absence of conversation that has resulted in the societal misconstructions and lack of understanding that is far too often associated with eating disorders. Sure, eating disorders are just as susceptible to the usual stigma that accompanies mental health concerns. But what sets eating disorders apart from other mental illnesses is that they are perceived by many to be the result of choice. A volition, of sorts, in human suffering.

The world around us continues to blame, shame, discriminate, doubt, and dismiss us. For some, limiting the harmful words, avoiding the endless explanations, and evading the constant judgment is all-to important. Concealing the illness may seem necessary.

But staying quiet and limiting help has terrifying consequences. Eating disorders and issues, currently divided into Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Eating Disorder Not Otherwise Specified are serious mental illnesses that can significantly impact the long-term health and well being of those who struggle. They are detrimental to all facets of life; they fracture relationships, damage families, destroy bodies, impair dreams, and steal souls. Early identification and intervention are vital to the promotion of health; concealing an eating disorder and limiting help seeking can worsen symptoms and complicate recovery.

This isn’t just a public health concern, it’s a human rights concern. Eating disorders have the highest mortality rate of all psychiatric conditions, with it being the third most common chronic illness among young women. Anorexia Nervosa will, over the course of the illness, kill one in ten women struggling with the disease. We take to the streets to speak against violence, inequality, and reproductive justice, so why not because of this? Is the marginalization these women face in our communities, because of a disease, not deserving of public action?

Eating Disorder Awareness Week is upon us; in Canada: February 3^rd – 9^th, in the United Kingdom: February 11^th – 17^th, and in the United States: February 24^th – March 2^nd. This week is about starting the conversation; promoting awareness and encouraging education. Perhaps more importantly, this week provides a voice for the millions who struggle, and the multitude who do so in silence.

Please, take this week to educate yourself, inform others, and start the conversation. Remind the silent millions that they aren’t so alone and help make it safer for them to gain their own voice.

Photo credit dreamsjung via the Creative Commons License.

I have been in therapy, off and on, for the past six years.

In hindsight, I would describe the younger Kathleen as anxious, worried, and concerned about the future. As I got older, I became a perfectionist; one of those over-achieving kids who never felt as though they were ‘getting it right’. In university I began to develop obsessive tendencies – tapping light switches five times, checking locked doors five times, pushing the fridge door closed five times. Always patterns of five.

For a long time it was controllable so I figured it was normal. Besides, we all have our quirks. Many of us check all the burners on the stove before leaving the house, or feel the need to always carry hand sanitizer. So I figured I was just like everyone else. Besides, no one really told me otherwise.

And maybe I was like everyone else; that is until my obsessive tendencies began to take over my life. I would avoid using the stove at times, needed to ask others to lock the front door for me, spent many sleepless nights worrying about mundane things like my work computer, a light switch I turned on at the office, or whether the kettle may sporadically catch on fire.

At times, I had difficulty breathing, struggled with panic attacks, and became so ‘worked up’ that I needed hours to calm down. As much as it pained me to admit it, I was no longer like everyone else. It was no longer normal and I needed help.

But, like so many others, my decision to seek professional help was a painstaking one.

When someone is diagnosed with cancer, we describe them as ‘sick’ or ‘ill’, and approach them with empathy. We would categorize a broken leg as an ‘injury’, and offer to lend a helping hand. We donate, run, wear clothing, grow and cut our hair on behalf of many deserving physical illnesses.

What do we do for those struggling with mental illness?

We describe them as crazy, disturbed, deranged, insane, lunatics, ‘nuts’, troubled… the list goes on. In fact, a 2007 study has suggested that there are 250 labels utilized to negatively characterize mental illness. We have 250 ways to ridicule, fear, delegitimize, shame, and blame those diagnosed with schizophrenia, bipolar disorder, anxiety, many other diagnosable mental illnesses, and an array of mental health concerns.

We stigmatize mental illness, and this very stigmatization causes those who struggle with mental health concerns to withdraw, disassociate, and isolate from others; all the while caught within an invisible struggle to regain ‘health’. The backlash so often associated with mental illness does not go unnoticed; many live in fear and choose instead to keep their challenges with mental illness secret from family, friends, and helping professionals. A worrisome 60% of us with mental illness may not seek out treatment resulting from concealment, lack of available treatment, or inability to pay for adequate intervention. Mental illness stigmatization is, according to the World Health Organization, “the single most important barrier to overcome in the community”.

Imagine the outcry if the majority of those diagnosed with cancer were abstaining from treatment. Rarely a word is spoken when the illness is easily concealed.

The horror of the Newtown tragedy brought to light the very stigmatization that parallels mental illness. Media outlets grappled to find any history of mental illness of those involved, and began jumping to conclusions once a ‘mental health related motive’ was rumored.  Articles were written about the ‘obvious’ state of the perpetrator, and hazardous generalizations were made between experiences when little accurate information was ever provided.

We are all looking for something to blame in order to make sense of our collective anger, sadness, and terror. However, by throwing blame in the wrong direction we cause further unintentional widespread harm.

I waited to write this blog until some of the media-hype had dissipated. The reason for doing so is because by speculating on causes drawn from the shooter’s personal history we do little to de-stigmatize mental illness or to really come to terms with the tragedy. The reality is that we, the 1 in 4 Americans and 1 in 5 Canadians who struggle with a ‘diagnosable’ mental illness, are no more capable of violence than those lacking a mental illness. In fact, we are 2.5 to 4 times more likely to be victims of violence. This is what the media needs to start reporting, not sensationalizing difference, but embracing it so that we can become a more compassionate and tolerant society.

Perhaps the perpetrator behind the Newtown tragedy did struggle with a mental illness. Maybe he was seeking psychological support, or was isolated. But perhaps he did not. The fact is we may never know. But what we do know is that to insinuate that me, or you, or someone you may know and love is to be feared, shunned, and discriminated against merely because they are battling a mental illness is dangerous. By doing so we are further perpetuating the very stigma that keeps so many from seeking help and support, choosing instead to battle significant health concerns on their own. To continue such negative speak will harm countless others and will do little to ‘add some good’ into an impossibly sad situation.

The people of Newtown have witnessed unspeakable horror and profound loss. If (and more than likely when) the children, parents, educators, first responders, health professionals, funeral assistants, and the entire community seek mental health assistance will we call them crazy? Disturbed? Troubled? Will we shame them for being weak, and blame them for their struggles?

No, we’ll call them human. We’ll tell them it’s ok to ask for help. We’ll encourage them to talk, to cry, to be angry, and to work through every other emotion that may decide to surface. We’ll support them throughout their process and hope that, though they may never come to a resolution about what happened, they will be able to position themselves within a narrative that they understand, and one that allows some ‘peace’.

And so we should do for the millions of us through North American who struggle with mental illness what we already do for those suffering from cancer, or diseases like it. As a collective, we need to call for mental health reform to ensure everyone can access affordable and adequate professional support, and improved mental health literacy to create new found awareness about what mental health is, and how we can best support others. Mental illness does not discriminate, so neither should we.

In the wise words of President Clinton, “mental illness is nothing to be ashamed of, but stigma and bias shame us all”. When I sought out help I understood that I would be stigmatized, however I was lucky enough to have the supports in place that made that stigma less palpable. In 2013, let us all work to combat the stigmatization of, and lack of attention paid to, mental illness because at the end of the day health is health, whether its physical or mental, concealed or visible.

Photo credit: davebarger via photopin cc

Nobody warned me.

When I started to “come out” as a feminist activist – not just talking with friends, but sharing articles on Facebook, writing extensively about women’s rights, and participating in advocacy movements – nobody warned me.

Nobody warned me that friends, friends of friends, acquaintances, and sometimes total strangers who’d come across my writing online, would come to me with their stories. With their problems.  With their worries.

And come they did.  First it was Susan, who had seemed in a perfectly happy and healthy relationship. Except that as it turns out, her boyfriend pressured her to have sex with him every night, and was aggressive when she refused.  She was petrified of him. Then it was Rachel, who read about the tweet chat Fem2.0 hosted a few months ago at #EndtheSilence, where survivors of domestic violence spoke out on twitter about their experiences using anonymous Twitter accounts.  Rachel wanted to learn how to use Twitter so she could share her story, too. Then it was Nick, an acquaintance who sent me a Facebook message because one of his best friends from high school never spoke about her husband, but kept showing up at the emergency room with suspicious bruises.  Another time it was Roxanne, who’d been to court twice already to get restraining orders against her former boyfriend who was by all definitions of the word, stalking her.

And then there were the rapes.  My friends will sometimes talk as openly about the second time they were raped as my male friends will about the second time they had sex.  My girlfriends post social media updates about the sexual harassment they face on a daily basis (often detailing the exact intersection where it happened so as to warn others), will caution one another about the violent and controlling tendencies of a particular guy they met online, or else ask each other about the safety of a new neighborhood – particularly for a woman living alone.

The truth is, violence against women is everywhere. And not just in India, Syria, Somalia, Sri Lanka, or Ghana.   Here in America, it is a pervasive part of our society.  Even for those of us who believe our friends, our circles, are less susceptible to such violence than are others – still, it is everywhere.  When we open our eyes, when we are exposed to what is happening around us, in even the most seemingly unlikely of corners, we realize that none of us is immune to it.  Violence against women has come to be seen as almost inherent to the female experience.

And like the rest of society, the House of Representatives chose to not provide additional help and support to female survivors of violence for one reason – they don’t recognize it as a real problem.

I know what some of you are thinking – the House Republicans were just trying to derail President Obama’s agenda.  Or else they were using women as a political football, and it was all strategy.  These things aren’t false.  But the truth is that just as the establishment of the Republican Party doesn’t believe in government spending or in education for undocumented children or in investment in clean energy alternatives, they also don’t believe that women need and therefore deserve special protection or assistance.

The Violence Against Women Act

First, some quick background.  The Violence Against Women Act has been renewed with overwhelming bipartisan support since its inception in 1994.  This bill strengthens the criminal justice system and provides support to survivors of domestic violence.  Unfortunately, it also expired in October 2011, and with the 112th Congress officially finishing at the close of 2012, the Act is officially dead, requiring the 113th Congress to start from scratch.

VAWA is, quite literally, a life-saver for millions of women.  The bill has funded the training of 500,000 law enforcement officials in relevant issues, established the National Domestic Violence Hotline which receives 22,000 calls each month, and has led to a significant increase in not just the reporting of such violence, but also in the strengthening of legal protections and services for survivors.

This year, we wanted to do more.  The Senate version of the reauthorization bill included increased protections for LGBTQ, undocumented, and Native American women, all of whom are at significantly higher risk than other demographics. The reauthorized bill would have expanded protections to 30 million more women.

But the question of equality and human rights is what is really the issue here.  Because apparently these Republican Representatives who blocked the bill from coming to a vote believe that being gay, entering the country without a visa, or else living on a Native American reservation are all crimes that prohibit you from being entitled to protection and assistance in the event that you are assaulted.  Or maybe it’s just that the crime of being a woman simply means that there’s no such thing as a gender-based crime being committed against you, because your crime in existing means that frankly, you got what was coming to you.

Republicans did not want to extend special protections or resources to these special groups of women.  But the truth is that just as not all men are created equal, neither are all women created equal.

Does “Equality” Help or Hurt Our Cause?

In her 2006 book, Are Women Human?, feminist advocate and law professor Catherine MacKinnon explores the legal difficulties inherent in seeking “equality” for women. She writes:

Aristotle defined equality as treating likes alike and unlikes unalike. Treating those who are the same the same, first class equality in this approach, is termed gender neutrality for sex, colorblindness for race. Its secondary rule, accompanied by an aura of inferiority, treats diffrently those seen as different; it is typically termed “special benefits” or “special protection.”

So here we are with an understanding of the 14th Amendment, or more specifically the Equal Protection Clause, which states that the law cannot deny protection and rights to one person or group of people that is enjoyed by another person or group of people.  If you are alike, you must be treated alike.  If you are different, and you experience that difference in a way that is degrading or violent, it does not defy “equal protection” because you are experiencing that difference in a context of different.  MacKinnon explains further:

Sexual violence seems assimilated to the difference between the sexes, so a woman is not considered treated unequally when she is sexually victimized, just treated differently for her differences. Sexual assault is seen as inevitable. The fact that women are generally victimized and men generally perpetrate is not considered subject to equalization. When women are treated “differently” from men, from sexual objectification to sexual murder, the traditional equality rule is not seen as violated because the distinction made by the practice fits the empirical definition of the group. Women being defined as rapable, raping them doesn’t violate them; it merely treats them as women – unlikes unalike.

What does any of this have to do with the reauthorization of the Violence Against Women Act? Quite a lot, actually.

When the House of Representatives put forth their own version of the VAWA, the provisions and protections for these additional groups – LGTBQ, undocumented, and Native American women – had been stripped.  When asked about it on NPR, Representative Sandy Adams (R-FL) responded as follows:

Let’s not look – let’s not have a solution in search of a problem … What we have to remember is you start listing the groups. Eventually, you’re going to get to a point where you’re excluding people. 

And that’s the real problem, isn’t it? That Republicans don’t want to acknowledge that women are different – and not “good” different.  Different in the fact that we face scenarios and life style requirements that they can never understand or appreciate.  And that even within that very broad definition of “women,” there are specific demographics of women who experience violence at higher rates and in different ways.

Republicans refuse to understand this.  These legislators – almost exclusively men – who control our government and our public policy.

Why were additional protections and assistance written into the law for these demographics of women? Because these demographics of women are facing higher risk of violence and lower rates of support than other demographics of women.  This is what the evidence shows.

While the National Coalition of Anti-Violence Programs estimates that the rate of domestic violence for homosexual couples is roughly the same as heterosexual couples, the former are significantly less likely to seek or receive help, and women are the overwhelming majority of the victims when such cases end in death. Native American women suffer from violent crime at some of the highest rates in the U.S., particularly at the hands of non-Native American men, because the tribes have no authority over such men.  And as I’ve written about before, immigrant women face unique challenges in seeking aid for domestic violence cases. Immigration status is just an additional tool used by abusive spouses or partners to control their victims and exert power over their lives.  If the abuser has legal status in the United States, he can use that status to his victim’s disadvantage, often by threatening to report her to authorities or refusing to file the petitions and paperwork that would give the victim legal status in the U.S.

But Republicans don’t want to acknowledge this.  In their view, women are either the same, equal to men, or they aren’t.  But we can’t have it both ways. They don’t support affirmative action because they don’t want to acknowledge or officially recognize that racism and poverty and class do, in fact, play a role in higher education admissions or in hiring practices.  Even though we all know they do.

So what’s really going on here?  As far as I can see it, Republicans who blocked the Violence Against Women Reauthorization Act from coming to a vote simply do not see this as an urgent need.  Or as a problem at all really, it seems.

Maybe it’s because they secretly don’t really believe that women are really victims here.  Maybe, like the New Delhi police, they secretly believe that women who are the victims of rape really deserved it.  Maybe they are all like Democratic Congressman Jim Moran, who, after his son was arrested for beating up his girlfriend, released a statement calling it “an accident,” instead of a crime.

One way or another, these Republicans didn’t view the safety and lives of women as being worthy of protection or support.

The 113th Congress

Less than two weeks ago, with the 112th Congress coming rapidly to a close, the 12 Democratic women serving in the Senate sent a letter to all 25 Republican women serving in the House of Representatives.  ”We are reaching out to you to ask for your help,” they wrote.  The letter urged the House Republican women to pass the Senate version of the Violence Against Women Act, which included the increased protections and aid for the three additional groups of women. Because the truth is that despite differences, there exists a shared experience of being female in a male-dominated world.  A shared experience that women serving in government recognize.  And this extends beyond even just the officeholders – the Women’s Congressional Staff Association has over 100 members from both sides of the aisle, providing mentorship, guidance, support, and shared professional fellowship in their quest to support one another, regardless of party affiliation.

This morning, a record number of women were sworn in to serve as part of the 113th Congress: 20 in the Senate and 81 in the House of Representatives.  In fact, all kinds of gender-related records were broken in the 2012 Election cycle: women who filed for Senate races (36), women who won primaries for Senate seats (18), women who filed for House races (299), women who won primaries for House seats (166).

And, as has been documented, the women from both sides seem to have a way of coming together civilly (not, for instance, screaming the F word at one another on the floor), to actually get things done.  Women in Congress have crossed party lines – happily – to pass legislation not just on issues relating to women specifically, but also on children’s safety, national security, public health, transportation, and recommendations for Supreme Court nominations.

Senator Patty Murray, a longtime advocate for the bill, has vowed to absolutely bring up the Violence Against Women Act in the 113th Congress. Will her new female colleagues – from both sides of the hill and the aisle – aid her in its passage?  This new Congress is the most diverse Congress in history – it includes 19 new people of color, the first Hindu Representative and the first Buddhist Senator, the first openly gay Congressman of color, and the first openly bisexual Congresswoman, that our federal government has ever see.

Perhaps this new diversity will bring about the change we wish to see in the world.  Perhaps this new, diverse Congress with more female members than ever before, will be able to move forward on protecting and providing for survivors in a way that the previous Congress refused to do.

Maybe we can stop saying that “gender issues have to take a back seat to other priorities… [because] there is no way we can be successful if we maintain every special interest and pet project.”  Because after all, even with the fiscal cliff negotiations, Sandy relief funding, and other issues that faced the 112th Congress in its dusk, can we really continue to claim that the health and safety – the lives – of women, aren’t worth the effort it takes to protect them?

Every two minutes, somewhere in America, someone is sexually assaulted.  Every 15 seconds, somewhere in America, a woman is battered, usually by an intimate partner.  But every day, we also have a chance to do more to support and protect women, uniquely at risk for unique types of violence.

I don’t mention here the costs associated with violence against women.  What it costs us – in billions of dollars a year, what the court costs add up to, what the lost economic productivity of battered women amounts to.  Is it important? I suppose.  But ending violence against women and prosecuting perpetrators and providing help to survivors isn’t about cost.  It’s not about capitalism and about making our country as financially robust as possible.

It’s about women being people and people being women.  It’s about women’s rights being human rights and human rights being women’s rights. It’s simply the right thing to do.  Because women shouldn’t need to be men to be considered human.  For their rights to be considered as worthwhile.

Women are different from men.  There’s no doubt about it.  But being different doesn’t mean being less human.  It doesn’t mean violations against our minds and bodies, the denial of our freedoms or our liberties, aren’t human rights violations just because they didn’t happen to men – that status quo of humanity.

The 112th Congress failed in its quest to represent the American people in its failure to pass the Violence Against Women Act.  Let’s make sure the new Congress does better.

Lives – human lives – depend on it.

Photo Credits: PolicyMic and EMILY’s List

There are 62 million women of childbearing age in the United States, 43 million of whom are “at risk” for unintended pregnancy. This costs us a minimum of $12 billion dollars a year, and that doesn’t include long-term costs. “At risk” implies an uncontrollable danger. An unavoidable event that happens to a person by accident or as the result of poor decisions. This situation is neither. We persistently withhold valuable information and technologies regarding fertility and its management. Usually, individuals and societies try to reduce risks, especially those that are recognizable and preventable. But, not us. Not this one. We’d still rather tiresomely entertain Scarlet Letter sanctimony and give mainstream voice to ill-informed, nostalgic conservative malaise than enable teenage girls and adult women to manage their own reproduction. ANYTHING but that. Actually, I take that back. The only other thing we are possibly equally loathe to do is invest seriously in developing long-acting forms of male hormonal contraception, opting instead to continue relying on the updated version of 12,000 year old sheepskin. Deliberately fettering sperm for more than 30 seconds? Can’t be done. This from a country that put human beings on the moon and can fit the entire contents of the Library of Congress on a nano chip. Male hegemony is nothing if not selectively innovative.

Women manage their fertility for an average of 30 years. Despite the fact that we just had a national referendum on this issue, we seem willing to forget that even talking about birth control in the ways that we did this year was surreal.

Preventable, unplanned, very often unwanted and unmanageable pregnancies pervasively affect us all. The consequences are personal, societal, economic and fiscal. And I’m not only thinking about the “motherhood penalty,” direct medical costs or calculable expenses related to having children. There are clear linkages to increases in other social ills: like crime, lower education levels, higher incidences of domestic abuse, increased pressure on the welfare system and more. Children who result from unplanned pregnancies are far likelier to experience developmental problems, poorer physical and mental health, to struggle in school. These steep costs exponentially exceed the cost of society’s providing easy, affordable access to birth control.

Here are 50 facts detailing those costs in case you are interested. I’ve been, for some inexplicable reason, on a 50 facts binge. If you think unplanned pregnancies are unrelated to issues like rape and domestic violence (the other 50 facts), I beg to differ. They are often interrelated and co-incidental, which only more dramatically highlights this fact: Failing to educate and make safe medical technologies available to our population when we need and want them is the effective gender-biased control of fertility. If it doesn’t strike you as ridiculous that any boy or man (none of whom can actually get pregnant) can regulate his fertility with no interference by buying a $1.34 condom and girls and women must continue to deal with overt societal regulation, including but not limited to the unnecessary intervention of doctors, nurses and pharmacists, in order to do the same commensurate with their biological needs, then I don’t know what would.

The most obvious and urgent issue is the fact that emergency contraception, Plan B, is not available without a prescription to girls under the age of 17 (and even then they are being misinformed by many pharmacists.) The longer term issue is why American women are not using long-acting forms of reversible contraception.

It’s been almost exactly a year since, in an unprecedented move, Health and Human Services (HHS) Secretary Kathleen Sebelius, in an act of what some called scientifically unethical “national malpractice,“ overruled a Food and Drug Administration recommendation and restricted access to emergency contraception long known to be safe and effective for all females of childbearing age. This was roundly condemned by reproductive health care advocates as a political act, contrary to good public policy, sound scientific reasoning and bad for women and their health.

“Emergency contraception needs to be on the pharmacy shelf between condoms and pregnancy test kits, available to women and couples without delay or hassle,” explains Kirsten Moore president and CEO of Reproductive Health Technologies Project, which has led a coalition advocating for this very action for more than 10 years. “Doctors are leading the way saying that all contraception should move over the counter and be available to women of all ages. Politicians need to follow doctors’ lead and get the politics out of women’s health care once and for all.”

Many people still do not understand how Plan B works. Plan B is safer than Tylenol, as easy to use and understand, and is not an “abortion pill.” The irony is not lost. Using birth control is pretty much the only known, predictable, reliable method of safely reducing abortions. When it’s free, it reduces the incidence of abortion by more than half.

But, beyond Plan B. Last week the American College of Obstetricians and Gynecologists (ACOG)endorsed over-the-counter birth control pills (OTC).

Allow yourselves to dream for a minute, ladies: Imagine not having to pay, with your money or time, for doctors visits to get prescriptions. Waiting for or dealing with a pharmacist, who may or may not have religious or other objections to your private decisions. Imagine being able to walk into a store and buy months worth of your contraception of choice by picking it up on a shelf and taking it to the cash register where some nice person smiles, takes your money, gives you change and puts your cute (or garish) little box in a bag before you leave.

And, men, daydream for them. There are some serious upsides that accrue for guys who are, as Sarah Silverman says, bro-choice. Not to mention just basic fairness. Unlike for your girlfriends, wives, sisters, mothers and female friends, most people, doctors and those with regulatory and medical authority over these decisions, understand through experience how your John Thomas’ work and all that that implies in reproduction. After all, almost 75 percent of doctors and more than 80 percent of legislators have them. Some make no bones, no pun intended, about lacking empathy with women’s reproductive needs. Reverse those numbers and imagine what its like. And, really, your boxes are so easy to get and even have the advantage of being thematically organized for maximal pleasure. Heck, you can even customize them.

USA Today ran pro-OTC and anti-OTC pieces. I found it super interesting that the pro-OTC piece was written by, well, an actual doctor, Dr. James T. Breeden, who happens to not only be an OBG, but the president of ACOG. The anti-OTC was written by the editorial board of the paper, otherwise known as AGCU (Amateur Gynecological Club of USAToday). Among their objections they listed “medical risks. The AGOG has weighed those and come down firmly on their being minimal and far exceeded by the benefits of deregulating the pill. In addition, there was the concern that women will forgo going to the doctor if they don’t need to get birth control pills. I have no idea why this is relevant. Women aren’t children who need ovary-based prompts to care for themselves. Lots of men need to get to the doctor as well and no one is withholding contraception involving their bodies. On the contrary. Just type “Free Viagra” into your browser. Then try “free birth control.”

Personally, given the fact that for the first time ever we have a health care law that requires FDA-approved contraceptives to be available without copays for women, I am deeply cynical about the timing of the announcement. I mean, here we are making birth control pills “free” for women for the very first time and all of a sudden we’re talking about moving them OTC where women will have to pay for them again? And where there is the risk, due to costs, that they will use them even less?

Birth control is even more reliable and effective if it is available at no cost. A landmark study released in October, involving more than 9,000 women, revealed the totally unsurprising effects of providing free birth control: far fewer unwanted pregnancies and “dramatic reductions” in abortions. This study’s findings are echoed in the terrific fact that our teen pregnancy and abortion rates, while still ridiculously high, have been going down. You would think that these findings would make even the hoariest God-fearing patriarchs giddy. But, GFPs actually believe researchers, like voting machines, are colluding with sex-crazed, irresponsible, lying harlots in order to dupe good Christian men and take away their magical powers. This is happening not because girls are opting to wait to have sex in exchange for the traditional “protections” of marriage, because they are using both hormonal and other forms of long-acting birth control more effectively. Fully 46 percent of teenagers are having sex. Scary numbers of them using no birth control, including condoms. During the heyday of federal spending on abstinence-only “sex ed” during which we committed up to $170 million a year (ironically, federal spending under a Republican administration), the unwanted birth rate for girls and women 15-24 doubled. Providing a range of birth control options isn’t going to help if if people don’t know how to use them properly.Although all states are involved in providing sex ed to kids, only 18 require that information be medically accurate. Our teenagers need respect and honesty and have a right to factual information about their health and access to ways to manage it.

The last part of reducing unplanned pregnancies is promoting the use of Long Acting Reversible Contraception (LARC), which is far more successful than the most commonly used form — birth control pills. Studies consistently show that the rate of failure of LARC methods is much lower. “The contraceptive failure rate among participants using pills, patch, or ring was 4.55 per 100 participant-years, as compared with 0.27 among participants using long-acting reversible contraception.” Consider this Contraceptive Choice Project video:

Aside from those who use deliberate breeding a as a weapon or those who chose feel it is their God-given place to protect women from themselves through legislation, most people understand why family planning and birth control are critically important parts of modern life and successful modern economies. Conservative legislators, chose to ignore that American innovation, creativity and dynamism might include women, their bodies and their full participation in the economy. They continue to pursue a systematic, state-by-state focus on reducing women’s reproductive health options and high on their list is removing family planning options. (Michigan is currently in a race to the Dark Ages with Mississippi.) This while simultaneously arguing that our declining birth rates are unpatriotic and hurting our economy. To quote Katha Politt, “Oh, honestly. What nonsense.” Birth rates in industrialized nations decline not because women are using birth control in bubble-headed, traitorous fashion, but because birth rates decline when women and families cannot find economic and workplace support for their lives, lives which include children. Consider the difference between France, Sweden and Italy.

We saw this past year exactly how fractious the debate over birth control in this country still is. A lot of conservative language focused on slutty entitlement. We really need to redefine the word “entitlement” for policy purposes. You know what the entitlement is: being a white Christian man with power, not in possession of a human uterus, historically blithely unconcerned with “women’s issues,” like babies, who benefits from laws that immortalize those those three facts. That is the entitlement. Not equitable and appropriate access to birth control for women as part of their non-penis-possessing health care. That pillow on my desk is wearing thin.

At the moment, however, the Reproductive Health Technologies Project has started a petition to urge Health and Human Services Secretary Kathleen Sebelius to get us on the right track today and put women’s interests back into the women’s health equation. It seems to be a good way to let her know how you feel about this issue. Otherwise, you might want to add these cycle beads to your wish list for the holidays.

This post is originally published at The Huffington Post.  It is cross-posted with permission. 

Photo credit Â°Florian via the Creative Commons License.