healthcare

Dang It All! Halfway Through No-November. There's Still Time to Not Shave for Cancer Awareness

Photo by Flickr user Tim Ellis. Cached as a bandwidth-conserving courtesy
Photo by Flickr user Tim Ellis. Used under a Creative Commons license.

Well, turns out it's No-Shave November again, and once again I've spaced out nearly half of it.

You know all the controversies about shaving various parts of our anatomies?  Well, this month is a good month to just let go of all that.  Just put away your razors, depilitories, waxes, sugars, and tweezers, antiseptic (and analgesic) after-shaves, the works.

I've got a couple of sales calls this month so it might be a little touchy since contrary to Silicon Valley myths small business owners want their prospective web developers to be neat, tidy, and "pre-pubescent" looking.  Fortunately, at least in November, I've got a good excuse: I can say (honestly) that No-Shave November originated as a way to raise money for prostate cancer awareness.

I say honestly because a) I'm going to mention it to anyone who asks why I'm not shaving, b) because I'm going to donate money myself, and c) because I'm going to invite you to donate as well.

Here's a link to the Prostate Cancer Foundation's donation page.

Prostate Cancer Foundation  Logo. Cached as a bandwidth-conserving courtesy
Logo of the Prostate Cancer Foundation. Click the image to visit their donation page.

If prostate cancer isn't your thing you can still a) decline to shave and b) contribute to other major cancer prevention and treatment foundations

The links below are to the non-profit effectiveness rating group CharityNavigator's top-rated non-profits in their respective sectors


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Republicans Don't Get the Joke, Rebuff Virginia Democrat's Attempt to Highlight Punitive Government Intrusion in Private Lives

Jill Filopovic on the way one Virginia State senator is tackling 'wingers tendencies to use even healthcare to encourage men's sexuality and discourage women's.

To protest a bill that would require women to undergo an ultrasound before having an abortion, Virginia State Sen. Janet Howell (D-Fairfax) on Monday attached an amendment that would require men to have a rectal exam and a cardiac stress test before obtaining a prescription for erectile dysfunction medication.

“We need some gender equity here,” she told HuffPost. “The Virginia senate is about to pass a bill that will require a woman to have totally unnecessary medical procedure at their cost and inconvenience. If we’re going to do that to women, why not do that to men?”

Her amendment didn’t pass, but good on her.

Now don’t get me wrong: I don’t think that men should have to undergo rectal exams and cardiac stress tests before getting Viagra. I think that’s silly and wasteful and unnecessary and invasive. But I also think that women’s health is so routinely politicized, and is so widely accepted as something that it’s ok to politicize, that turning the tables might make men think a little bit harder about these issues. Right-wing politicians have positioned reproductive rights as about abortion and babies, not as what they really are: Fundamentally tied to the body. Laws like this force that conversation; they force politicians to explain why a procedure tied to female reproduction should included legally-mandated penetration and shame, while male reproduction gets a smile and a prescription.

Source: Feministe

And of course both Jill and Sen. Howell have been clear that they don't think either men or women should have burdensome, intrusive, and unnecessary procedures imposed on them when all they really need is routine medical care. They were joking -- the seem to believe that both men and women are entitled to ordinary sexual health and healthcare. The 'wingers, unfortunately, are dead serious about increasing the imbalance between what men and women receive.


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Amanda Marcotte on the False Equvalence Between What Everyone Believes and "What Everyone Believes"

Amanda Marcotte on the pro-choice "Mississippi miracle"... and the power of the secret ballot.

It's not something I've ever seen an extensive study on, but the folk wisdom of pro-choice circles is "pro-life in the streets, pro-choice in the dark", as it were. In other words, there's an intense amount of pressure to identify as "pro-life" in conservative communities, even if you secretly disagree. To be vocally pro-choice is to be marked as a pervert and a feminist, and so it's avoided, to the point where some polling data suggests that half of people who identify as "pro-life" are actually pro-choice, at least to some extent. Certainly enough that they're not willing to see women thrown in jail for having miscarriages. Because of this intense social pressure, I suspect many people who side with pro-choicers on this law or that law won't say so to a pollster over the phone. Not only are you admitting out loud something that can get you marked as a "pervert" in your community, you may be doing so in front of friends, colleagues, or family members who overhear your conversation with the pollster. No wonder so many people say they're "undecided". But when you actually have your ballot in hand and you know that no one will ever find out how you voted, a solid percentage of voters go with common sense (and with sex!) instead of prevailing community pressures. Frankly, the way the poll numbers turned out, it appears many people who said they would vote yes on 26 instead voted no.

Source: Pandagon

That sounds about right.

I think I'm coming down with another cold, or at least I'm feeling a little muzzy-headed. So I can't remember the sociology term I'm reaching for. But it seems to me like this is another one of those cases where public sentiment is dominated by the desire of a majority not to be outed as "the only one who feels that way." When, in fact, the majority really doesn't feel that way. And where, in fact, the kind of understandable desire not to be outed when it seems like "everybody else" feels that way is kind of strong. And where, I suspect, the urgent desire not to be outed leads to sometimes increasingly zealous efforts to go the other way. Thus you have people like J. Edgar Hoover or Rev. Haggard leading the charge against homosexuality. Or people like Herman Cain or Dan Quayle spouting sometimes ridiculous affirmations about no-exceptions anti-abortion policy while totally considering it a free choice for their own family members.

I think it's a big problem with so-called "conscience clauses" for healthcare providers, the ones that allow, say, pharmacists to refuse to stock emergency contraception due to their (nominally!) "private" objections. When, in fact, they may personally only be succumbing to public expectations in their communities... expectations set, as Amanda suggests, by a majority in the community who... themselves don't think it's a problem but definitely don't want to be seen as "the only ones who feels that way."

Update: I didn't read far enough before posting this, but Amanda draws the same conclusion in her post.

When they say things like, "the only way to prevent STDs is for two virgins to marry and stay faithful" or "contraception thwarts God's intentions for human sexuality", they face a chorus of amens from people who then often turn around and demonstrate, with their behavior, that they simply don't agree.

Again, that sounds right.


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Ema of the Well-Planned Period Explains to XO Jane Editors Why Plan B is No More

Photo via Tumblr. Cached as a bandwidth-conserving courtesy
Image via Tumblr

Hormonal contraception expert Ema of The Well-Timed Period says the whiny "the stores are out of Plan B so I can't have sex" piece by the so-called Humor "Health Editor" at XO Jane has to be satire because... well... she's more generous than I'd be.

The upshot being that there's an exceedingly good reason why nobody can get Plan B anymore, in New York City or pretty much anywhere else once current supplies are gone.

Plan B isn't pining for the fjords, it's no more

Pharmacies are out of Plan B because Plan B has been discontinued by its manufacturer quite some time ago. So forget about Plan B and familiarize yourselves with the available emergency contraceptive pill (ECP) brands.

Source: The Well-Timed Period

Go read Ema's post for a nice, reassuringly long list of new and improved Emergency Contraceptives.

While there's been considerable back and forth about the "morality," sensibility, responsibility, and cost of using a $50-per-use method of contraception, Ema avoids all that and points out exactly why "morning after" type pills aren't a good idea:

ECP postcoital birth control is only to be used in an emergency for the simple reason that it's not as effective as the other available methods when used on a regular basis.

And then there's her bottom line:

Forget Plan B, remember Plan B One-Step, Nextime, Next Choice, Postinor, Postinor 1/Postinor2 Unidosis, and ella. Don't substitute ECP for regular birth control. And, last but not least, even in emergencies avoid attempts at satirical articles on birth control.

I love me that Ema-style expertise.


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Two Million Stillbirths Worth Only Two and a Half Lines to "Pro-Life" Bloggers

So a bunch of clowns at something called "ProLifeBlogs" gives a whole two and a half lines, plus a link to another website, for a new report about stillbirth.

More than 2 million babies are stillborn every year worldwide and about half could be saved if their mothers had better medical care, according to research estimates published Thursday in the medical journal Lancet. ...

Source: "ProLifeBlogs"

Two and a half lines? Is this the best a "pro-life" organization can do?

Their blog's search feature turns up exactly four other posts about stillbirth, only a handful about miscarriage, none more recent than 2007. None are actually relevant to the millions of unanswered stillbirths every year, the tens of millions more unanswered miscarriages and spontaneous abortions, and... just all kinds of stuff about how "pro-life" those folks imagine they are.

There's only one way to measure whether someone's interest is authentically "pro-life" or if instead they just want to control women: what they do about stillbirth, miscarriage, and spontaneous abortion. If they don't do anything about it, but still call themselves "pro-life" they're liars.

You know why the pro-choice movement calls itself "pro-choice?" Do you know why it fights against forced abortion in places like China even as it fights for the right to choose to terminate an unplanned, unwanted pregnancy in the United States? Because it's not about forced pregnancy, and it's not about forced abortion (and it's sure as heck not about the "sanctity" of forced sex!) Instead it's about *choice!*

A stillbirth stops a *wanted* beating heart. A miscarriage almost always stops a wanted beating heart too. Miscarriage, spontaneous abortion, and stillbirth are almost as prevalent worldwide as induced abortion and yet "pro-life" organizations do, what? Nothing!

You know that old quip about the pro-life movement? "Caring about children from conception to birth but not a minute after?" That's not even true is it? Because they're doing exactly what? Sure, they're willing to gun down a doctor in his church or kitchen, willing to waive banners, splash blood, "ex-communicate" honest legislators, put out vaguely racist ads, to celebrate this imposition on a clinic, that imposition on women, the other "tough minded" choice to extend a rape victims nightmare from minutes to nine months.

But a minute later they're willing to... waive bye-bye to two million stillborn babies a year with a flipping two and a half line post?  Yeah, that's "pro-life" alright.

You know what will happen to the "pro-life" movement when the Supreme Court overturns Roe V. Wade? Every last one of them (those who don't turn their attention to outlawing condoms) will pack up their bags, say "that'll teach those hoors and floozies" and never again trouble their little brains with another thought about "unborn life."

Meanwhile? Two million unanswered stillbirths will still happen every year. Between tens and hundreds of millions of unanswered miscarriages and spontaneous abortions a year will still happen every year. Every one of them an "unborn life" that not a one of them ever has, or ever will care about.

Because really? If they did care then someone, somewhere in the "pro-life" movement would have already stepped up their game.

If you follow the link in that casually tossed-off post you know who it turns out helped fund that Lancet Stillbirth study? The Bill and Melinda Gates Foundation. You know who were still pro choice last time I looked? Bill and Melinda Gates. You know why they're putting time and money into this instead of a "pro-life" organization? Because unlike "pro-life" agitators they aren't just into this to punish women. They're not into this "pro-life" business to use fetuses to smack women back into line. Unlike some people. They're into it because they believe that if you make the choice to have a baby, as most people actually do, then we should all do everything we can to support that choice. Just as we should support every reproductive choice.

Instead of la-dee-daing two million stillbirths into oblivion with a miserly two and a half lines. No surprise though. That's is about what one ever expects from a bunch of lazy, immoral, unethical, inconsiderate, and hateful liars.

Update: My mistake!  A bit more research suggests that "pro-life" organizations have been agitating to... send "birth" certificates to grieving parents after stillbirth.  Because, after a hard day of defunding prenatal-care providers and imposing capricious restrictions on women's healthcare decisions what else could one possibly do about stillbirth?


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I Gave $100 to Planned Parenthood Today

I gave $100 to Planned Parenthood today.

Even though in general when I give to reproductive-health organizations I give to smaller, local ones that have neither the visibility, the clout, or the fundraising capabilities Planned Parenthood does.

But today, these days, now, that visibility, clout, and capability is precisely what's painted the right wing target "surveyor's symbol" on Planned Parenthood's back.

To paraphrase the silly Grateful Dead bumper sticker from the 1970s, Planned Parenthood may not always be the best at what they do, but in a lot of places they're the only ones doing it.

If I had $10,000 I'd have given them that instead.

If you've got something to give this year might be a good time to do that.


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Simplified Access to Contraception Cuts Abortion Rates in Half So Anti-Choicers Want to, What Else, Eliminate It

Sungold has what might help explain the right's otherwise inexplicable* intolerance of contraception.

Here’s an item from the annals of “no shit, Sherlock!” science: A UCSF study shows a stunning decrease in unintended pregnancy and abortion when women are dispensed a year’s supply of birth control pills at once. What’s stunning is not the basic trend line, but the magnitude of the study’s findings. Science Daily recaps it:

"Researchers observed a 30 percent reduction in the odds of pregnancy and a 46 percent decrease in the odds of an abortion in women given a one-year supply of birth control pills at a clinic versus women who received the standard prescriptions for one — or three-month supplies."

Can I rephrase those numbers? Pregnancy declined by nearly a third, and abortion by nearly half!

Source: Kittywampus

More contraception means fewer abortions.  Since at least the 1980s hard-core anti-abortion activists have worried (correctly in my view) that there's an abortion rate threshhold below which the "squishy middle" will lose interest.  Since the hard-core's goal is absolute elimination of abortion (or at least abortion rights), again at least in the 1980s, they made a strategic decision to oppose any and all initiatives that only reduce abortion rates.

Consequently contraception is to an anti-choicer as garlic is to a vampire: a horror to be avoided and eliminated at all cost.

Cutting abortion demand by half is the last thing those assholes want.

See also

*Until maybe the middle 1970s there were on balance probably more highly-placed Republican supporters of birth control than Democratic ones it seems particularly hard to understand.  In 1947 George W. Bush's not particularly liberal grandfather Prescott Bush was nevertheless the first nationwide capital fundraiser for Planned Parenthood!  This connection probably cost him a Senate seat in Connecticut when Democrats teamed up with Catholic churches to oppose his election.  He lost by only 1,000 votes, but he still lost.  Nor was the Bush family unusual.


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Walgreens Pharmacist Refused to Dispense Miscarriage Medication Unless Caregiver Broke HIPAA Patient/Privacy Laws

Jill Filipovic's post at Feministe is short and... well, not exactly sweet but terse enough, and important enough, to quote in full.  Emphasis mine.

Pharmacists refusing to fill prescriptions for potentially life-saving drugs

If those drugs are possibly being given to women who have had abortions. A nurse practitioner at an Idaho Planned Parenthood called a local Walgreen’s pharmacy to fill a prescription for Methergine, a medicine used to prevent or control bleeding of the uterus following childbirth or an abortion. The pharmacists refused to fill the prescription unless the nurse told her whether or not the patient had an abortion. Because of patient confidentiality laws, the nurse refused to disclose that information, and asked for a referral to another pharmacy. The pharmacist hung up.

Let’s recap: A nurse practitioner needed a medication to prevent bleeding. The pharmacist refused to fill it without knowing if the patient had an abortion because… why? If the patient had terminated a pregnancy, the pharmacist would refuse to give her medicine to stop bleeding? That is how you kill people. And if you’re a pharmacist, refusing to fill prescriptions because you don’t like the choices a patient may have made should be grounds for immediate firing.

Source: Feministe

Given that, contrary to murderous wingnut fantasies, Planned Parenthood is a full-service reproductive-health service (which is why it's called Planned Parenthood!) can you think of any third possible reason why a patient might need to prevent or control uterine bleeding?

I know, how about a miscarriage?

Let's take a quick look at the Google stats for the key phrase "Methegrine abortion"

Hmm... Google turns up "About 8,190 results (0.36 seconds) " for that combination.  Ok then.  Now let's try the same thing with the key phrase "Methegrine miscarriage"

Oh look, Google turns up "About 60,800 results (0.48 seconds)!!!"

Sounds like it’s not just the pharmacist’s priorities, ethics, or “conscience” that need evaluating! Since

a) Planned Parenthood is a full service reproductive-care organization for low-income and otherwise dispossessed women and men, and not just an “abortion mill,” and
b) It appears to be fairly unusual to prescribe methegrine after an abortion, but
c) It appears to be fairly common to prescribe it after a miscarriage

then

d) whatever of her personal opinions might be the pharmacist should be assumed to be professionally unprepared to do her job competently.

Oh, and while we're at it?  Let's take a look at the legal penalties the caregiver would have been subject to if she'd complied with the pharmacist's demand and disclosed medical information about her patient.

Penalties Under HIPAA

42USC1320d-5 General penalty for failure to comply with requirements and standards

(a) General penalty
(1) In general Except as provided in subsection (b), the Secretary shall impose on any person who violates a provision of this part a penalty of not more than $100 for each such violation, except that the total amount imposed on the person for all violations of an identical requirement or prohibition during a calendar year may not exceed $25,000.

* * *

42USC1320d-6 Wrongful disclosure of individually identifiable health information

(a) Offense

A person who knowingly and in violation of this part-
(1) uses or causes to be used a unique health identifier; (2) obtains individually identifiable health information relating to an individual; or (3) discloses individually identifiable health information to another person,

shall be punished as provided in subsection (b).

(b) Penalties

A person described in subsection (a) shall-
(1) be fined not more than $50,000, imprisoned not more than 1 year, or both; (2) if the offense is committed under false pretenses, be fined not more than $100,000, imprisoned not more than 5 years, or both; and (3) if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.

Source: UC Davis Health System Compliance Program

HIPAA being federal law the penalties would be the same in Idaho.

And now for a practical question: assuming was legal for a healthcare provider to disclose patient confidentiality in the first place, and assuming it was any of the pharmacist's fucking business in the second, do you think the average woman having a miscarriage wants the news blabbed all over the greater Boise metropolitan area by some professionally incompetent snoop?  I didn't think so.


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Will Anti-Choice Activists Be as Frantic About Hormonal Contraception for Men? We Might (Finally) Find Out Soon

Speaking of emergency contraception, and the tendency to blame women for using it, and the tendency to blame women, for that matter, for just about any choice they make regarding their reproductive choices and/or opportunities, and especially for anti-choicers to blame them for all of the above because they're convinced that hormonal contraception is really a closet abortion conspiracy, Jenna of My Sex Professor brings a little potentially welcome news

Many men are disappointed with their lack of contraception options: between the barrier method and vasectomy lie few other choices. A new method (RISUG) is being tested, which entail a one-time reversible injection that prevents sperm from penetrating the egg. The procedure would take five minutes and be effective for at least ten years

Source: My Sex Professor

While for years we've heard stories about how male contraceptives are just around the corner, and are thus justified in feeling a little wary, it's worth pointing out that at least the stories are coming closer and closer together.  And this one actually sounds fairly promising!

It's great news, obviously, for at least the following reasons

1) There really aren't a lot of contraception options available for men.  Worse, of the three available -- condoms, vasectomy, and withdrawal, the most recently developed, vasectomies, were introduced nearly 200 years ago! Since then?  Nothing.  And say what you will about condoms (I say they're pretty good at preventing disease and pregnancy if they don't break and if you use them correctly) they're kind of hard to use correctly until you've really gotten the hand of it, by which point... but I digress.  What I was going to say is this sounds promising because it would be really, really nice to have something intermediate to the permanence of vasectomies and the uncertainties of condoms

2) The introduction of reliable, realistic, reversible and hard to screw up contraception for men will change the blame-women-first-and-always dynamic.  Because once solutions become available for men there won't be that sort of shoulder-shrugging "what can ya do, man" resignation men who fuck up are able to rely on from their peers.  Because, in part, the obvious answer to "what can ya do, man" would then be "what you can do, asshole, is get a shot once every ten years.  You're not getting any sympathy from us."  So that's a big deal.

3) When it comes to the situations where emergency contraception is most likely used (condom breaking, or not using a condom for first-time sex after a long drought, or when functionally incapacitated by drugs or alcohol) the odds of neither party being on some form of contraception can be way lower.

4) Taking items 1-3, above, into account, the focus of responsibility for contraception can shift away from 100% women to more like 50/50 men and women.  (If the product Jenna mentions is as effective and non-intrusive as promised responsibility could shift further onto men.  Although, obviously, an easily used saliva- or semen-based test to quickly confirm effectiveness would be welcome as well.)

But then there's

5) The beauty of the proposed method is that by robbing sperm of the ability to merge with eggs it'll make "conception" impossible! Which ought to shut the ugly pie holes of the "contraception is really abortion" covens.

And, if I can put on my speculative psychopathology-of-the-anti-choice crowd had for a moment, it could even be that...

6) If contraception happens inside men's bodies the anti-choice crowd won't actually care.  Or at least if they do they'll have to start basically from scratch.  And while yes, as a matter of fact it would be better if the anti-choicers were really anti-choice and not just anti-women-as-autonomous-agents, as most evidence suggests. But even then...

7) If the anti-choicers did turn on men and start running the same ill-willed intrusions at least it would put men squarely on the front lines  with women, as opposed to the status quo where most men have basically been confined at best to the sidelines.


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The One and Only Way HIV, Fecal Matter, and Sperm Are... Or At Least Ought to Be... Treated Identically Under the Law

So... we're pretty agreed that it's a bad thing, and often a separate criminal offense, if an individual knowingly transmits HIV or other sexually-transmitted diseases to an unknowing sex partner.  (If we're not agreed please let me know in comments.)

And... one hopes we're even more in agreement that it's a bad thing, and hopefully always a separate criminal offense, if an individual knowingly puts fecal matter in a restaurant salad bar where patrons will unknowingly consume it.  (If we're not agreed... actually please don't let me know because I don't want to... but also please never work around a salad bar!!!)

But here's where it gets tricky.  There's evidently not agreement that it's a bad thing if an individual knowingly transmits fertile sperm to an unknowing fertile woman, let alone that it should be a separate criminal offense.

Can anyone explain why one of those things should not be like the other ones?  In each case the consequences for the recipient isn't always fatal almost always is painful, incapacitating, and costly in terms of time, health, and money.  And in each case the benefit for the deliverer is marginal: marginally less wasted washing one's hands for one example, marginally more pleasurable sex for the other two.

I'd add that there are consequences not only for the direct recipients.  When word gets out that people have been sickend by fecal mattter in a local salad bar, huge numbers of people begin avoiding that particular salad bar, sure, but almost everybody becomes more wary of salad bars in general.  Same with HIV -- indeed, exploiting that avoidance tendency is a key tactic of homophobes.  Same, for that matter, that fear of pregnancy is exploited by abstinence-only types.

So... let's say you were a big fan of salad bars -- not just for personal consumption but for general consumption.  If you're such a fan how do you feel about the benefits or liabilities of regulating fecal matter in salad bars... or even criminalizing putting fecal matter in salad bars?

Similarly, let's say your'e a big fan of casual sex -- not just for your own enjoyment but for the population at large.  If you're that kind of fan how do you feel about the benefits vs. liabilities of regulating the knowing transmission of HIV or other STIs... or even criminalizing knowing transmission thereof?

And finally, lets say you're a big fan of not just casual sex in general but casual heterosexual sex in particular.  If you're that kind of fan how do you feel about the benefits vs. liabilities of regulating knowingly transmitting sperm against the expressed preference of a fertile partner?

Can anyone explain why one of those things should be unlike the other ones?

(Note: If you say yes are you sure you want to go there?  Really sure there should never, ever be any legal consequences for knowingly transmitting sperm without the partner's consent?  Beyond maybe a stern "that's what you get for lovin' me?"  Sure the police nor courts nor laws should ever become involved?  Sure there should be no special considerations or exceptions or changes in current law on behalf of aggrieved parties? Absolutely sure?  Because just a second ago, as I was wrapping up this post, it occurred to me that the issue cuts both ways.  If you were one of the guys who was sure before reading that link are you still sure now?)


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