RHRealityCheck.org's News & Commentary

Access to Birth Control, Under the Next President

Amanda Marcotte — Wed, 08 Oct 2008 12:00:00 +0000

It's hard to measure support for access to contraception for two reasons -- "access" and "contraception" both denote very broad categories. Contraception is everything from condoms to birth control pills to sterilization, and access points range from non-profit distribution to convenience stores to doctor's offices. Do we consider someone's access more or less limited if they can get birth control pills from Planned Parenthood but the condoms at the grocery store are locked up after 10pm, which is when they discover they need them? I can't answer that question for you, because it's the very definition of subjective, but I can point out five basic areas where access meets contraception and how the two candidates for President approach them. As far as I know, both McCain and Obama have not registered an opinion on whether or not it's completely lame of your grocery store to require you to summon a clerk to open the condom display.

So here's a rundown of five basic questions people ask of themselves when looking to access contraception, and answers Senators McCain and Obama have given through votes and campaign platforms.

Can I get a prescription from a doctor? The chance of getting a prescription from a doctor is 99% based on whether or not you can see one, and that, for most people, depends on if you have insurance that covers this. Currently, 16% of Americans don't have this basic opportunity. Both candidates claim they have plans that will get coverage to most Americans and lower costs, but these are claims that bear closer examination.

The McCain proposal is all about the free market. The campaign claims that getting people out of employer-provided health care and making them free agents on the market will lower prices. To reach this goal, they intend to tax employer-provided benefits, with the hope that this encourages people to give up that coverage. Less people using employer-provided benefits is extremely unlikely to have the results promised by McCain. We only have so many uninsured people right now because they don't have employer-provided insurance, and therefore can't use their employers' bargaining power to get coverage despite pre-existing conditions. At best, we will see people just paying more for health care under the McCain plan, but at worst we'll see the number of uninsured go up, meaning that more women will have to turn to non-profits or government programs for birth control access. Or go without.

The Obama proposal takes another tack, responding to the fact that most Americans who are uninsured are so because they don't have access to employer-provided health care. People who already have employer-provided health care don't have to change a thing or pay more for it. People who aren't able to access that kind of health care will be extended the opportunity to buy into a national health plan that will have guaranteed eligibility, so you won't need to have an employer's power backing you up so you can get insurance. For people who don't already qualify for Medicaid or SCHIP but still need assistance paying for health insurance, there will be subsidies to help them out.

By addressing the main cause of insurance gaps---lack of access to employer-provided insurance---the Obama plan will be far likelier to increase the number of Americans who have coverage.

Can I get contraceptives from non-profits or government programs? For people who go to Planned Parenthood or some other non-profits that receive government funds for their health care, this election might also influence their bottom line ability to receive care. The main thing you're wanting to look at in this department is the voting record on Title X and other family planning programs. On this issue, the two candidates strongly differ. McCain attempted to end Title X funding that pays for contraception programs, as well as other women's health care. Obama is a strong supporter of Title X funding, which causes much consternation amongst anti-choicers. If you get your contraception---prescribed or over the counter at a discount---or any kind of health care from Planned Parenthood, then this is the funding debate that pertains to you.

Obama has also sought ways to expand the ways in which the government can make it easier for you to get contraception, by co-sponsoring the Prevention First Act. This legislation would increase Title X spending, but also make it easier to get emergency contraception if you're sexually assaulted.

Can I get contraception from my pharmacy? Under Bush, as you no doubt know by now, Health and Human Services (HHS) tried to expand the right of health care workers to refuse to give you contraception by allowing individuals to decide that they just believe that contraception is abortion, facts be damned. Refusal clauses are another brain child of the religious right. They figure if they can't get the government to deny you contraception, they'll get vigilante pharmacists to do it instead. This HHS controversy is the first time the issue has really risen to the national level, and so we have a fairly cut-and-dry source to look for which Senators will fight against refusal clauses and which won't--- Hillary Clinton's letter of protest against the HHS for this abuse of power. Barack Obama was one of 28 Senators who signed this. John McCain did not.

Do I know how to use this stuff? Right now, the federal government doesn't pay for the education of adolescents in the art of not getting knocked up or catching some nasty STI, but instead backs abstinence-only "education", otherwise known as, "Maybe you'll figure it out after the first 3 unintended pregnancies or STI infections" non-education. McCain considers himself a supporter of abstinence-only programs. Barack Obama has tried to introduce comprehensive sex education in two separate ways. First was the Prevention Through Affordable Access Act, which would support comprehensive sex education programs. Then there was the Lautenberg/Menendez amendment to Child Custody Protection Act to reduce teen pregnancy through education. Obama voted for this amendment, and McCain voted against it.

Can I afford this? For a lot of women who use hormonal contraception, affordability depends on whether or not their health care plans cover contraception. For college-aged women, this often means using discounted pills through student health services, a discount that disappeared after budgetary changes to reduce the deficit in 2005. To restore access to inexpensive contraception, Barack Obama introduced the Prevention Through Affordable Access Act in 2007, which, if it passes, will rectify the problem and reduce the price of birth control pills on campus.

Women who rely on insurance co-payment to make their birth control more affordable hit a major obstacle when they have insurance companies that won't pay for it, but will pay for other drugs like Viagra. McCain voted against a bill that would require equal coverage for women, and asked about it by a reporter for the L.A. Times, tried to get out of the question. Obama, in contrast, championed the Prevention First Act, which would ensure that insurance companies treat birth control pills like they do other drugs, instead of giving them higher co-pays.

Let's Talk About Sex, Baby: The Candidates on Sex Ed, In Their Own Words

Sarah Seltzer — Wed, 08 Oct 2008 12:00:00 +0000

Recently, the troubling issues surrounding abstinence-only-until-marriage programs -- like that they don't work -- have started getting some public attention. This newfound spotlight on sex-ed (or the lack thereof) has come from discouraging sources, whether it was cries of hypocrisy spurred by Bristol Palin's pregnancy, or a recent rise in teen STIs and teen pregnancy after years of decline.

But attention is attention, and the 2008 election is a great chance to re-examine what kind of sex ed Americans want for their kids. Here are some of the different bullet-points being batted back and forth in the debate, and where the candidates stand on them in their own words.

I'll tell you when you're older: The facts when age-appropriate

Democratic candidate Barack Obama has made it clear that in his mind, comprehensive sex ed is the pragmatic approach, and should begin before kids begin experimenting sexually - even while valuing the belief that young people should hold off on sexual activity. At an appearance in the summer of 2007, ABC reported Obama as saying:

"Keep in mind: I honor and respect young people who choose to delay sexual activity. I've got two daughters, and I want them to understand that sex is not something casual. That's something that we definitely want to communicate and should be part of any curriculum. But we also know that when the statistics tell us that nearly half of 15 to 19 year olds are engaging in sexual activity, that for us to leave them in ignorance is potentially consigning them to illness, pregnancy, poverty, and in some cases, death."

Age-appropriate sex-ed means increasing kids' knowledge as they get older, starting from how to recognize inappropriate touching in grade school, and building up towards explaining puberty, relationship dynamics, and eventually, contraception and protection against STDs when those topics become pertinent to students' lives.

Obama was a supporter of age-appropriate legislation in Illinois, which made him the target of ads from his opponents' campaign. The misleading ads implied that Obama wanted to teach kindergarteners about sex, when in fact the program he sponsored stipulated age-appropriate education: that at this early age, they learn how to recognize sexual abuse.

Marched towards the altar: Promoting heterosexual marriage and gender-norms.

One of the complaints against abstinence-only education is that it doesn't allow for alternate sexualities. In June 2007, Republican candidate John McCain and other Republican legislators signed a letter addressed to the heads of the Senate Finance Committee, expressing their wholehearted backing of the Title V abstinence-only program. This program doles out funds to the states for education programs that specifically leave out information about birth control. It's a $50 million dollar juggernaut, as the legislators noted in their letter, which included the following line:

"... saving sex until marriage and remaining faithful afterwards is the best choice for health and happiness."

Of course, this leaves out those who don't fall into heterosexual partnerships and those teens who have already begun to be sexually active.

A related critique of abstinence-only programs is about their use of gender norms and "shaming" -- such as the infamous "tape/candy" exercises where women are told that once they have been sexually active, they're as desirable as chewed candy or used-up tape. Obama linked this shaming aspect with the importance of medical accuracy:

"I'm going to teach [my daughters] first of all about values and morals, but if they make a mistake, I don't want them punished with a baby. I don't want them punished with an STD at the age of 16."

While this comment garnered some heat, it showed his understanding of the gendered-double standard-and the undue burden on women to be the sexual gatekeepers that is part of the abstinence-only worldview.

Look it up: Medically accurate information

Barack Obama is one of several secondary-sponsors of a bill now up for consideration, the "Prevention First Act" which is a comprehensive family planning umbrella bill with a number of subsidiary goals, from rape victim assistance to emergency contraception (his running-mate Joe Biden is also a sponsor). The Prevention First Act states that,

"Any information concerning the use of a contraceptive provided through any federally funded sex education, family life education, abstinence education, comprehensive health education, or character education program shall be medically accurate and shall include health benefits and failure rates relating to the use of such contraceptive."

Among Prevention First's daughter bills is the REAL (Real Education About Life) Act, which includes several stipulations that those programs be truthful about the advantages and risk of each kind of contraception.

Obama also proudly notes his position on his campaign website, and uses his sponsorship of "Prevention First" as an example of what he would do to promote women's reproductive health.

On the other hand, McCain's stance on medically accurate information is unclear, since he famously hemmed and hawed over a question by a reporter that touched on the fundamental science that would be taught to students in a sex ed program. As Cristina Page and others reported, this exchange with a reporter took place on McCain's campaign bus. Here is a partial transcript:

Q: "What about grants for sex education in the United States? Should they include instructions about using contraceptives? Or should it be Bush's policy, which is just abstinence?"

Mr. McCain: (Long pause) "Ahhh. I think I support the president's policy."

Q: "So no contraception, no counseling on contraception. Just abstinence. Do you think contraceptives help stop the spread of HIV?"

Mr. McCain: (Long pause) "You've stumped me."

...

Q: "But you would agree that condoms do stop the spread of sexually transmitted diseases. Would you say: 'No, we're not going to distribute them,' knowing that?"

Mr. McCain: (Twelve-second pause) .... I've never gotten into these issues before."

Abstinence-Only on the wane

A search of McCain's campaign website for the terms "sex education" and even "sex" yielded zero results. But the Republican platform calls for a replacement of all family planning programs for teens with abstinence-only programs.

In fact, states are now trending towards rejecting federal funds for abstinence-only, due to the growing belief that those programs do not work effectively.

Sex education has become one of the reproductive health issues that is most winnable for the reproductive justice crowd, be it Democrats or pro-choice Republicans. Obama and his allies have an opening to hammer home the importance of truthful education for teens at an appropriate age, and they might actually score some points in the "culture wars."

Global Lessons from China's Tainted Milk

Marcy Bloom — Wed, 08 Oct 2008 12:00:00 +0000

The headlines just kept getting worse.

The Associated Press reported on September 20 that China's leaders were scrambling to contain public fury over widespread contamination of milk supplies, castigating local officials for negligence and cover-ups, while also moving to minimize criticism of the government's slow response. Officials promised to keep stores supplied with clean milk and set up medical hotlines and a multi-level treatment system for affected babies to help the traumatized Chinese public cope with one of the worst product safety scandals in years.

Originally focused on contaminated milk powder, the poisoned milk crisis worsened when liquid milk was also found to contain melamine, the industrial chemical that has killed four infants so far and initially caused serious illnesses in 6,200 others. By September 22, the number of sick children reported by the government jumped to an astonishing 53,000.

More than 80% of the 12,892 children hospitalized were two years old or younger, and 104 were in serious condition. Another 39,965 children received outpatient treatment and were considered recovered by the end of September, according to the Chinese Health Ministry.

The company at the heart of the scandal, Sanlu Group Company, apologized for the poisoned products and stated that suppliers who sold the raw milk apparently added the chemical melamine - normally used in plastics, fertilizers, and flame retardants - to make the milk seem higher in protein due to melamine's high nitrogen content. The milk suppliers, in hopes of increasing their profits, watered down their milk to increase volume and then added melamine to fraudulently boost the protein content and bypass safety testing. When ingested, melamine causes kidney stones, which are especially deadly to infants and small children and rapidly induces renal failure. That is what happened to thousands of Chinese infants and toddlers.

This deadly series of events is an embarrassing failure for China's product safety system, which purports to have attempted to institute tighter controls to restore consumer confidence after a series of product safety scares in recent years that involved poisoned medicines, seafood, toothpaste, toys, and pet food ingredients.

These latest incidents represent the second major case in recent years involving shoddy baby formula. In 2004, more than 200 Chinese infants suffered malnutrition and at least 13 died after being fed phony formula that contained no nutrients.

It appears that a well-organized cover-up had been brewing for months before the Sanlu scandal was exposed. Indeed, the problem appears to have gone undetected for months, as the first baby died in May and the second in July. Apparently, Sanlu knew of its product contamination as early as July, and likely even as early as December, but did not go public with the information until September.

So far, eighteen suppliers of melamine and tainted milk have been arrested, with more than 100 others being detained or questioned.

Local government cover-ups, lax regulations, Sanlu's criminal silence, and the failure of the Communist government to guarantee food safety forced the resignation of Li Changjang, the head of the Chinese agency that monitors food and product safety. As head of the General Administration of Quality Supervision, Inspection, and Quarantine, he had promised years ago to overhaul the food and product safety system. However, this is not the failure of one man or one department to transform a deeply corrupt system. The heart-breaking systemic inability to accomplish basic and modern safety reforms indicates that China cannot keep its population safe. Despite its masterful display at a highly complex Olympic Games, China has yet to put transparent and enforceable product safety policies in place. After all, the boss of Sanlu, now in police custody, was a senior party official, as are the leaders of most of the large corporations in China.

Why Not Breast Milk?

Richard Spencer, writing from the UK in September 24's Telegraph, blasts the Chinese government: "Tens of thousands of infants are sick after drinking tainted baby milk. But this isn't an ordinary health disaster - the authorities colluded with the companies who deliberately contaminated their products and failed to warn the public." He asks an even more critical question that is fundamental to the health of women and babies:

Some ask why babies in China drink milk at all: cow's milk is not something the Chinese have traditionally liked, so there was no particular reason for them to follow the worldwide trend towards abandoning the breast. But the question answers itself: China is modernizing, and, to many people, that means doing what the rest of the world does. In present-day industrial China, it also means building your own companies to provide what [the public] and foreigners consume--but cheaper.

Even, apparently, if the price of higher profits is the loss of human life.

As this tainted milk scandal grows and affects other countries, it has forced Chinese women to reconsider breast milk. Breast-feeding in China has declined in recent years, even after the 2004 scandal. The United Nations Development Program says exclusive breastfeeding rates in China at four months of age declined to 48% in urban areas, and 60% in rural areas in 2004, the most recent year for which national statistics are available.

In its September 25 press release, the World Alliance for Breastfeeding Action (WABA) responded to this shocking and growing tragedy, stating that China is not the only country to experience serious problems with ensuring the safety of artificial milk: "There have been 71 occasions in recent years when companies have been forced to recall batches of formula because of dangerous contamination."

Furthermore, WABA declares:

While the most stringent of measures should be taken against unscrupulous and unethical milk companies, WABA calls urgently for renewed support for early, exclusive, and continued breastfeeding, and for additional resources to make this possible.... The widespread use of commercial formula, with all of its risks and side-effects, even when not contaminated [emphasis mine], is a real danger for infants and young children all over the word, even in wealthy countries.

Powerfully true. This is a fundamental lesson from China's tragedy, which has also likely affected milk products in New Zealand, Korea, Hong Kong, Singapore, Myanmar, the Philippines, Indonesia, and throughout Asia, as well as in other parts of the world.

Optimal Young Child Feeding

Optimal infant and young child feeding is defined globally as early and exclusive breastfeeding for the first six months of a child's life, and continued breastfeeding for up to two years or longer, followed by the gradual introduction of age-appropriate, nutrient-rich complementary foods from six months. Yet recently, national and international funding for public education and the training of health workers to support breastfeeding has seriously decreased. There has been a decline in the number of hospitals implementing the WHO/UNICEF Baby-Friendly Hospital Initiative, which incorporates the critical Ten Steps for Successful Breastfeeding, and disallows the unethical promotion of breastfeeding substitutes in health facilities.

In China, for example, at one time, maternity hospitals fully supported breastfeeding and this significant initiative. However, by the high level of formula use reflected in the pandemic, this practice may no longer be in place.

Susan Siew, Co-Director of WABA, states: "A tragedy such as this should not happen again. The majority of mothers, given appropriate support, timely and accurate information, and protection from aggressive marketing of infant formulas, are able to breastfeed. For working mothers, both in the formal and informal sectors, we need to provide an enabling environment with adequate maternity entitlements including maternity leave, flexible work arrangements, and mother-baby-friendly facilities at the workplace."

Even as WABA and numerous other organizations urge all members of the international community concerned with global health to renew and increase their funding and dedication to breastfeeding, it is clear that this demand is the tip of the iceberg for women and children, as it essentially requires a transformation of virtually all societies. Women's and children's needs must truly be respected, honored, and prioritized. Part of this requires a societal milieu where breastfeeding is supported, encouraged, convenient, dignified, safe, and viable for women everywhere.

Regretfully, this is not simple to achieve because this complex dilemma pits the value and welfare of women and children against the might of state-sanctioned corporate greed and endemic governmental corruption. While we should not turn our attention away from solving China's contaminated milk pandemic at this time, it's evident that the struggle for women's and children's rights and health is global.

All of us must stay focused on correcting the institutional milieu that precipitated this tragedy in China. In the process -- as we expose the regulatory shortcomings and recognize the corruption of many governments -- we must urge that each society learns to prevent this pattern from repeating elsewhere.

It is lesson for all of us.

For now, I dread tomorrow's headlines. Where and when will more babies and children die from poisoned milk?

RH Reality Check Interviews Songwriter Gretchen Peters

Scott Swenson — Tue, 07 Oct 2008 19:26:08 +0000

RH Reality Check interviewed singer/songwriter Gretchen Peters about her decision to donate royalties from her song "Independence Day," made popular by Martina McBride, to Planned Parenthood in Sarah Palin's name. Like many other American icons, country music has been, to an extent, co-opted by conservatives and misunderstood by liberals, who may dismiss the genre, not recognizing its close kinship to folk music. It is the amazing stories of country music that resonate with people, stories of real life -- the pain and sorrow, the joy and triumph, that connect us one to the other. During an election when so many Americans are making extra effort to understand differences of opinion and culture, to look at race and gender in new ways, to get past the issues that divide us, we talked with Gretchen Peters by phone this morning as the nation's focus turns to Nashville tonight for the next presidential debate. We're pleased to present this interview about an iconic American song, a powerful story-telling genre, with the woman who has touched millions with her lyrics, Gretchen Peters.

RH Reality Check: What is the story behind the song "Independence Day?"

Gretchen Peters: It's a story about a woman who is being abused, told from the point of view of her eight-year-old daughter, and she can't see any other way out than burning the house down with her husband inside it. It's up to the listener to determine if the mother is in the house or not when it burns. It's about violence against women told through this one particular woman's story.

RH: Country music tells real people's stories, with lyrics that touch us and memorable tunes; it connects in ways that other music often doesn't. It is seen as the music of the famous "Joe and Jane Six-pack." Can you talk about country music's unique ability to capture these stories?

GP: Country music has a really long history of telling everyman's story, and like its close cousin folk music, at least up until the last ten to twenty years, there were several points of view in country music. What ties country and folk music together is the narrative element - more so than in any other genre that is commercially successful. Loretta Lynn, Merle Haggard and many others told stories and sang songs that could be considered controversial. Songs like "The Pill" and "One's On The Way." These are the songs that made millions of people love Loretta, made people feel a certain connection to her music and the music of others like her, because they sang stories about real life.

RH: Do you think country music has a political party?

GP: Not inherently, no. It's sort of a chicken and egg question - people who don't know much about country music have ascribed it to conservative causes and people because of geography, or because they don't take the time to understand the long history of story-telling, or because they think it sounds dumb and the people who like it talk funny, or are ignorant. Some people have an impression that we're all of the same mindset. That mostly comes from people who are ignorant about country music. There is no doubt that the political landscape in the South and Midwest has changed and the machine that makes country music -- Music Row in Nashville -- they know their audience and they know a bread and butter line when they see one. Music Row has pandered a lot to those people who want to claim country music for one cause or party. The truth is that there are plenty of songwriters that are not interested in being involved in politics. Most creative people would rather write their stories and let the people find them, and it rankles that these assumptions are being made about us or our politics. That's why more of us are speaking out.

RH: Do you find it ironic that it is conservatives - famous for economic policies that don't really favor Mr. and Mrs. Six-pack - that most use country music to connect with voters?

GP: One of the biggest mysteries to me about the political climate of the past eight years -- and there are many -- but I don't understand how blue collar, working class people who have families and don't have much else, can feel that these policies support them. I understand that conservatives have taken advantage of the religious angle, pushes that on people, but I'm hopeful that more people see through it now. Ralph Stanley, the father of Blue Grass, just endorsed Obama, and he's speaking out to coal miners, and folks living hardworking lives. That speaks volumes about the need for change, so I do feel hopeful.

RH: Why have you decided to donate royalties for "Independence Day" to Planned Parenthood in the name of Sarah Palin?

GP: I've received a lot of email and it's been overwhelmingly positive. But it wasn't my idea, I can't take credit for it. Tamara Saviano, my publicist, was on that email some women started suggesting making small contributions to Planned Parenthood in Palin's name and copying the McCain campaign to let them know it's the issues, not just the gender, that matters. They have the legal right to play the song at rallies, but this is a worthy idea and cause and a way to make a statement. I'd been feeling like I was losing my song.

RH: Many people who love this song are pro-life and that is why they like Sarah Palin. What would you say to them about the real women's stories you sing about, real women's lives and choices about reproductive health that might give them more insight into why you write and sing these powerful stories?

GP: This song is a story about one woman. It's not a diatribe against or for anything. The most powerful way to say anything is to tell one story about one specific person. We're not all going to adhere to the same political point of view. I received an incredible letter from a guy who is pro-life, and it was a letter of support for my decision because he is able to hold two opposing thoughts in his head at the same time, and he got it, he got what I was doing and was supportive, and that's the power of a story that connects with people. My aim and intent is to tell the story in a way so that listeners feel compassion for her and her daughter. I'm not prescribing any action, not suggesting women go burn their houses down. It's a story that unfortunately happens too much though. What put me over the edge -- I mean, I knew the song has been played for political reasons for a long time -- but I felt like I was losing my song. I've heard from people who only heard it on Sean Hannity and thought it was a "rah-rah" political statement. They don't even know what the song is about. That's what started it for me, so I made some effort to get my song back.

RH: Issues of abuse against women, and especially rape are mostly about power and domination over women. Do you think "Independence Day" is so popular because it is a story too many women can relate to?

GP: One of the very few negative messages that I received was that I was co-opting my own song and that Planned Parenthood has nothing to do with the issues of abuse addressed in the song. I couldn't disagree more. All these issues are related, issues of power and sex and rape. The abuse of power within the family unit is a huge issue. I used to go to Planned Parenthood when I was a teenager; I know what they do and I know that these issues are related so it is an absolutely appropriate donation. I can also tell you that the song has had an effect on people that have not had any experience with domestic violence. But for the women, and men, family members, the police officers and others who work on domestic abuse cases, they are all so moved by it because it is all too real. Women come up to me and say the song helped them "realize they could do something" about their own situation. Sometimes I feel bad even taking credit for writing it when I hear from these people, the song came from nowhere, it came through me. It's amazing when you write something that actually changes people's lives. It shows how small actions can have big impacts.

RH: "Independence Day" is about strength through adversity, a story many women can relate to. America is facing a time of great adversity again, what are the strengths that you see as you look around now that give you reason to hope we'll make it through this tough time?

GP: Across the board I find my hope in people under 30, my daughter is 24 and the man I'm seeing, his son is 21. They won't have the world that we had, they are going to have it tougher, but they are so clear eyed. The generations that followed the Baby-Boomers are much more clear eyed, they are not as polarized as Boomers and older generations. That is the only way to go forward. As much good as the Boomers tried to do there was always one foot planted in the past and one foot planted in the future -- that was certainly the sense in the 1960's. The real point of hope in this election -- even though it is getting uglier by the minute -- is to empower these young people and let them lead the way. They just aren't interested in the same old fights that have divided us for too long.

Here is Gretchen Peters performing Sunday Morning (Up and Down My Street): And Martina McBride performing Independence Day:

McCain Flip-Flops on HIV Prevention

Todd Heywood — Tue, 07 Oct 2008 12:00:00 +0000

John McCain changed his stance on several key issues of concern to HIV prevention and sexual health advocates, according to an interview published this past Wednesday in the District of Columbia's gay newspaper, The Washington Blade.

McCain called for a national strategy to deal with HIV/AIDS:

I am committed to supporting the development of a National AIDS Strategy. Countries receiving PEPFAR aid are required to develop a national plan; but we don't have one in our country. It's important to settle on a national strategy - with input from state, local and federal government officials; along with the private sector, doctors, drug companies and AIDS advocates. Let's roll up our sleeves and put together a National AIDS Strategy for more effectively addressing the domestic challenges. Recent CDC statistics show that gay men continue to be strongly impacted by the disease, and the disease is disproportionately affecting people of color. Our prevention and treatment efforts must be improved to address these challenges.

Barack Obama has championed as part of his platform a national strategy to address HIV/AIDS. In contrast, McCain has never voiced support for a national strategy until this interview, let alone advocated for prevention measures that address the needs of gay youth. You can read RH Reality Check's comparison of both candidate's views on this issue of HIV/AIDS here.

In fact, McCain has supported abstinence-only education mandates as part of sex education - a strategy that many experts have faulted as aiding in the increased rates of infections among gay youth. Those programs, which focus on abstinence until marriage, ignore a significant issue: Gay youth are well aware that they can't get married in most states. Government evaluations of the abstinence-only education programs have all determined the programs are failures. Yet McCain and Palin continue to support the programs.

In the Blade interview, McCain had the following exchange with the interviewer:

Blade: How would a McCain administration approach abstinence-until-marriage sex education initiatives? What is your view regarding programs that provide safe-sex messages specific to gay youth?

McCain: I have supported including abstinence as a component of sex-education programs. Decisions regarding programs targeted specifically at gay youth should be made based on a review of the scientific data to determine what works and what doesn't, but they must encourage responsible individual behavior.

Given an opportunity to support the claim that programs addressing the issue of prevention be scientifically sound, McCain voted against the measure, according to Planned Parenthood Action Fund:

McCain opposed legislation requiring that abstinence-only programs be medically accurate and scientifically based. McCain voted NO on legislation that would help reduce the number of teen pregnancies by providing funding for programs to teach comprehensive, medically accurate sexuality education and other programs to prevent unintended teen pregnancies.

So the question is, what does John McCain actually believe when it comes to HIV/AIDS prevention?

What Would a Women's Issues Debate Look Like?

Sarah Seltzer — Tue, 07 Oct 2008 12:00:00 +0000

Grab your popcorn and get ready to bang your head against the wall. Debate season is in full swing. We know that the questions pertaining to domestic women's issues during these four televised verbal jousts will be slim to none. We can expect a "litmus test" Supreme Court nomination question, an equal pay for equal work question, and if we're lucky, a sex ed question. But the range, and depth of the questions, will leave us panting for more.

Like our colleagues at ThisIsWhatWomenWant.com and Women's eNews, we at RH Reality Check thought we'd envision the questions we wished the candidates could face before an audience of millions. Preferrably, they'd be asked by Rachel Maddow, Campbell Brown, and Gwen Ifill teaming up in a cross-network collaboration, while the usual crowd of male pundits sat on the sidelines. But regardless of who's asking them, these are the questions we want to see.

Feel free to add your own ideas for questions -- and how you'd like to see them answered -- in the comments section.

Reproductive Right

The teen birth rate increased in 2007 for the first time in years. We currently have the highest teen pregnancy rate of all developed nations. To what do you ascribe these trends, and what would you do to address the issue of teen pregnancy?
While many people disagree on the issue of abortion rights, no one can argue that abortions are almost always a result of unplanned pregnancies. What are some steps you would take to lower the number of unplanned pregnancies?
Do you believe that barrier contraception -- aka condoms -- stops the spread of HIV and other sexually transmitted infections? Is this information important, and should it be given to teens as part of federally-funded sex education?
Do you believe that scientific evidence suggests contraception is the same thing as abortion? How would you respond to groups that want government agencies to classify it as such?
The United States ranks 41st in maternal mortality. How do your health plans address improving health outcomes for American mothers given the fact that maternal mortality rates in this country have flat-lined in recent years?
One of the unfortunate side effects of recent immigration-related legislation has been to block off basic health care to many women living within our borders. What measures would you take as president, under your healthcare plan or otherwise, to secure access to reproductive health services, for immigrant women, who often face extra hurdles--including discrimination or threat of deportation--in getting the essential care they need?
(For Senator McCain): In the past, you have stated that you believe abortion should be legal in the cases of incest and rape. Your party platform and your running mate have stated they don't believe there should be such an exception. What would your position be as president on these exceptions and how would you justify it?
(For Senator Obama): Can you clarify your position on whether a health exception for a late-term abortion ban would include a mental health exception, and what that would mean?

Women's Equality

While women have made strides in the workplace in recent years, their average salary still lingers below men's. How do you intend to ensure that women have equal pay?
(For Senator McCain): You voted against the Lily Ledbetter Fair Pay Act and said you believe the key to pay advancement is more education for women. With women now graduating college at a higher rate than men, to what do you attribute the enduring pay gap?
Statistics show that women, particularly women of color, are hardest hit by poverty. With the economy in a state of near-collapse, what would you do to address the issue of poverty and help these women -- often the sole breadwinners in their families-swim against the tide?
Solving the current health care crisis is particularly crucial women, who need regular and fairly frequent reproductive care. How would your health care plan enable women to live fuller lives without worrying about health care costs?
Do you believe that insurance companies should be required to cover contraception?
As president, would you seek to expand or reduce the scope of the Family and Medical Leave Act? Why or why not?
What is your early childhood education plan, how would you fund and enact it, and how do you envision that plan affecting women's lives?
What is your plan to combat the alarming growth of HIV/AIDS in America, specifically among black women?

Cultural Issues

What is sexism in your mind and what is one instance you've noticed on the campaign trail? What role can a president play in combating cultural sexism?
Who are some of your female role models? Who are some female role models you'd like your daughters to emulate?

As we head into the debates full speed ahead, it's interesting to note that up until now, some of the toughest grilling of candidates on women's issues had come from seemingly unlikely sources. Both the infamous interview with McCain on "The View" and the interviews with both candidates in the October issue of Glamour are more informative and hard-hitting than a lot of what you'll see on mainstream networks -- particularly when it comes to women's issues. It will be interesting to see whether the debate moderators take their cue from these women's media outlets, and probe below the surface of issues that matter to American women.

Council of Europe Puts Violence Against Women on the Agenda

Anna Wilkowska-Landowska — Tue, 07 Oct 2008 12:00:00 +0000

In June 2008 in Strasbourg, the Council of Europe closed its 18 month Campaign to Combat Violence against Women. It was one of the most successful and visible campaigns of the Council of Europe, in which most of its member states took part.

Violence against women, including domestic violence, is one of the most serious forms of gender-based violations of human rights. It deprives women of their ability to enjoy fundamental freedoms and represents a serious obstacle to equality between women and men. Violence against women in its various forms is still widespread at all levels of society in all Council of Europe member states.

An overview of figures for the prevalence of violence against women suggests that one-fifth to one-quarter of all women have experienced physical violence at least once during their adult lives, and more than one-tenth have suffered sexual violence involving the use of force. Data analysis supports an estimate that about 12% to 15% of all women have been in a relationship of domestic abuse after the age of 16. Many more continue to suffer physical and sexual violence from former partners even after the break-up.

One of the primary concerns of the Council of Europe is to safeguard and to protect human rights. Violence against women, including domestic violence, undermines the core values which the Council of Europe is based on. The Council of Europe, in particular its Steering Committee for the Equality between Women and Men (CDEG), has undertaken a series of initiatives to promote the protection of women against violence. In April 2002, the Council of Europe adopted Recommendation Rec (2002)5 of the Committee of Ministers to member states on the protection of women against violence. This legal instrument was the first international instrument to propose a global strategy to prevent violence and to protect victims, covering all forms of gender-based violence. Its implementation is regularly monitored using a monitoring framework to evaluate progress. Moreover, the Task Force to Combat Violence against Women, including domestic violence was set up in 2006 to evaluate progress at the national level. It is composed of eight international experts in the field of preventing and combating violence against women.

The campaign had numerous goals: it aimed to raise awareness that violence against women is a human rights violation and to encourage every citizen to challenge it, to urge member states to demonstrate political will by providing adequate resources to deliver concrete results in eradicating violence against women, and finally to promote the implementation of effective measures for preventing and combating violence against women through legislation and national action plans to regularly monitor progress.

The campaign received widespread support from key actors in local, regional and national governments as well as parliaments and it ensured that the messages of the campaign reached a large and varied audience. The Council of Europe member states contributed significantly to the success of the campaign: more than half of all member states carried out national awareness raising campaigns, while many others reviewed their policies and legislation or implemented other measures. Many national parliaments placed the issue of domestic violence on their agenda through parliamentary debates, hearings or tabling amendments to the law.

The primary result of the campaign has been the recognition by the different actors that violence against women is a human rights violation - not a private matter. Secondly, the campaign placed violence against women at the highest level of the political agenda of member states. Thirdly, it has shown that joint public action of all national and international actors is necessary to combat violence against women. Lastly, promoting the implementation of measures contained in Recommendation Rec(2002)5 has yielded significant results.

The recent information from the monitoring framework show that a large proportion of member states have recognized domestic violence as a grave problem which has to be dealt with on a solid legal foundation. Recent changes in legislation on domestic violence seem to focus on providing physical distance between victim and perpetrator, mainly by the legal provision of non-molestation, occupation orders and police barring orders. The analysis based on monitoring the national situation in various member states revealed that there is an alarming lack of rape crisis centers or other appropriate services for rape victims in Europe.

This corresponds to the extremely low and sinking level of prosecution and conviction, although for the majority of rapes reported to the police the perpetrator is known. There should be no legal exceptions or privileges that condone or permit any kind of violence within the family or intimate relationships. Such exceptions are incompatible with basic human rights and should be removed without delay in all member states. All member states should be encouraged to develop national Plans of Action, to review them, report on the outcomes, and draw up progressive plans for further activities. An important element in all such action plans will be securing education and specialized training for professionals in all relevant fields, as well as actions to improve public awareness and media treatment of gender-based violence and all related issues.

Differences exist between the eastern and western part of Europe. The legislation on violence in most east eastern European countries is based on the criminal system and rarely has specific provisions for domestic violence. Western European member states are more likely to focus on protection provided by police and civil law. Either way is effective only if appropriate implementation measures are provided.

Supreme Court Will Not Hear Case Seeking to Limit Abortion Rights

Rachel Roth — Mon, 06 Oct 2008 16:02:48 +0000

The Supreme Court opened its new term with some good news for women: it rejected an appeal from the state of Missouri, which had hoped for one more chance to defend its unconstitutional policy banning abortions for women in the prison system.

The case, Crawford v. Roe, originated in 2005, when a young woman refused to take no for an answer and eventually enlisted the ACLU in helping her to exercise her right to make her own reproductive decisions. "Jane Roe," as she is called in court documents, spent seven weeks trying to work with the prison system to obtain an abortion, something the prison had previously accommodated by bringing women to a clinic if they could afford to pay for an abortion with their own money. A change in the governor's office led to a change in that policy.

While many women face some kind of barrier to abortion, imprisoned women face the literal barrier of the prison itself. As the Eighth Circuit Court of Appeals put it, "certainly, no prisoner could simply elect to leave the institution at will to obtain an abortion." An imprisoned woman will therefore almost always need to be taken to a health facility where she can receive abortion care. (While jails may release someone temporarily to obtain health care on her own, prisons are not likely to do so.)

Earlier this year, the Supreme Court declined to hear an appeal in a related case from Maricopa County, Arizona. In that case, the sheriff in charge of the county jails had an unwritten policy to require women seeking abortions to obtain court orders from judges before being able to access care. That policy was struck down by the state courts, and the Supreme Court declined to intervene.

The policy in Missouri was even more burdensome and extreme - it essentially prohibited all abortions unless administrators from the prison's private medical company approved the procedure as necessary for a woman's health or life. A woman seeking an abortion for any other reason would have no recourse.

To allow such a policy to stand would be to invite attacks on the right to abortion for all women. Jane Roe had argued that the policy violated both her 8th Amendment right to adequate medical care as a person in prison, and her 14th Amendment right to reproductive decision-making. The Eighth Circuit disagreed that her rights as a person in prison to adequate medical care were violated; however, it found that her right to choose abortion as guaranteed by Roe v. Wade and Planned Parenthood v. Casey was completely eliminated - something no state may do.

The Supreme Court's decisions not to hear these cases should make it clear once and for all that women do not lose the right to have an abortion because they are imprisoned. This is the consensus reached by state and federal courts that have heard cases brought by women when jail and prison officials stood in their way. And yet things are not always that simple. More recent events from Maricopa County are instructive.

After his final loss in the case, the sheriff told a reporter for The Arizona Republic, "I'm disappointed. We fought the good fight. I still don't agree that we should take females on a voluntary basis to an abortion. I'm still against that. But we took it to the highest court, and we'll see what happens if the situation comes before me again in the jail system." When the situation did come up again, members of his jail staff refused to transport a woman for an abortion - in direct violation of the court's order. The result was a four-week delay in obtaining an abortion, and the need, once again, for legal intervention.

The sheriff's intransigence reminds us that as important as court decisions are, those decisions alone may not be enough to safeguard women's rights, especially the rights of women who are poor and politically marginalized. Rather, constant vigilance, continued intervention, advocacy, and public education, and the provision of funds to women who cannot afford to pay for an abortion are also vital to ensure that all women can carry out their decisions.

To learn more about the reproductive rights of women in prison, including the right to parent, check out the pieces below!

Rachel Roth, What Do Prisons Have To Do With Reproductive Rights?

Christy Hall, From Inside Prisons, Mothers Long for Their Children

Amie Newman, Pregnant Behind Bars: The Prison Doula Project

Nicole Summer, Powerless in Prison: Sexual Assault Against Incarcerated Women

Malika Sadaa Saar, Mothering As A Reproductive Right

Read more of Rachel Roth's reporting here. And visit the ACLU Reproductive Freedom Project web site to learn more about legal issues challenging women's access to reproductive health care in prison. To learn more about helping women who need financial assistance, visit the National Network of Abortion Funds web site.

2008-2009 Supreme Court Term Begins

Emily Douglas — Mon, 06 Oct 2008 12:00:07 +0000

Today the Supreme Court resumes hearing oral argument, ushering in the 2008-2009 term. Over the past several years, the Court's significance in the lives of women and in the progress or rolling back of reproductive rights and women's access to reproductive health care has become only more pronounced.

This winter, the Court will hear arguments in four cases with particular significance for women in the workplace. In October, the Court will consider Crawford v. Metropolitan Government of Nashville, which will ask whether employees who comply with their employers' internal sexual harassment investigations are protected from retaliation. The plaintiff in Crawford lost her job after confirming allegations of sexual harassment made by another employee.

In December, the Court will hear three more cases that deal with employees' right to challenge discrimination.

In Fitzgerald v. Barnstable, the Court will examine whether public school students can sue for sex discrimination both under Title IX, the law that bars sex discrimination in schools that receive federal funds, and as a Constitutional violation, or whether the existence of Title IX prevents public school students from challenging sex discrimination as a violation of the Constitution. An amicus brief filed by the ACLU, the National Women's Law Center, and other civil rights groups argues that, "Properly understood, Title IX was intended to supplement, not replace, the right to equal protection guaranteed by the Constitution itself." The case concerns a kindergarten girl who brought claims of sexual harassment against a male classmate, explains the National Women's Law Center's blog Womenstake. Because of the high standard for proving sexual harassment, lower courts did not let the girl's case go to trial and the Court of Appeals for the First Circuit said that "remedies under Title X [were] the only ones she could pursue, and therefore upheld dismissal of her claims under the Constitution." National Partnership for Women & Families observes that "The case may determine whether women have a wide range of legal options to challenge discrimination in education."

Whether pregnant women who worked for AT&T will be discriminated against not once but twice is at issue in AT&T v. Hulteen. Before the Pregnancy Discrimination Act was enacted, in 1978, employers could offer substantially less leave for pregnancy than for other short-term disabilities; AT&T was one such employer. Now, the discriminatory treatment of pregnancy is showing up in women's pensions. Womenstake explains, "Hulteen is one of four women who sued AT&T after they received notice of their pension benefits. They learned that those benefits were lower than they would otherwise have been because they did not get credit for most of their pregnancy leave." The 9th Circuit Court ruled in favor of Hulteen and the other women, but the Supreme Court has agreed to review the case.

And in 14 Penn Plaza LLC v. Pyett, the Court will decide whether, when a collective bargaining agreement stipulates that employees must address discrimination complaints through arbitration, employees lose the right to sue for violation of anti-discrimination statutes.

"The Fitzgerald, Crawford, and Hulteen cases are of critical importance for women's statutory and constitutional rights," Marcia Greenberger, president of the National Women's Law Center, says. In this term, "All who care about maintaining hard-fought legal rights for women will be watching next term to make sure that their right to fair pay and benefits, equal education, and protection from discrimination is not undermined."

At the close of the 2007-2008 Supreme Court session, Greenberger observed, "We squeaked by this term without major precedents being overturned. But this was not a term where the Court considered a broad array of key legal protections for women, including those affecting their health and privacy rights."

The Supreme Court's term begins just as the question of judicial nominees and court-related issues are moving up as an issue of concern for voters and, certainly, for the presidential candidates themselves. "Judges are what you refer to as a ‘last 30 days' issue, and it's hard to know how it might play," Evan Tracey, of CMAG, a company that monitors political advertising, told the New York Times. “Now is the time when you start hearing messages that connect with the single-issue core voters — guns, abortion, civil rights. And it’s all about judges.”

President Bush will deliver a speech today on his judicial philosophy, likely highlighting the difference in judicial nominations between Sen. John McCain and Sen. Barack Obama. "Both presidential campaigns are gearing up for the possibility that court-related issues will become an X factor in some swing states," writes Patrick Healy for the Times.

Population, Family Planning and Presidential Priorities

Jeffrey Locke — Mon, 06 Oct 2008 12:00:00 +0000

Over the last week, the American people and financial markets around the world watched as Congress debated an eye-popping $700 billion dollar economic rescue for the American economy. Lost amidst the media's coverage of the rescue plan was another Congressional decision - to punt to the next President and new Congress tough decisions on funding for most FY 2009 government programs, including foreign assistance.

As World Watch Institute's latest magazine issue "Population Forum" illustrates, concerted foreign assistance that emphasizes international family planning programs is going to be required to address the nexus of population issues that have emerged - environmental degradation, climate change, as well as poverty, security and the health of women and children. However, having worked in Togo, West Africa, an area of the world where hundreds of thousands of women already fail to have their family planning needs met, I'm left to wonder: if the next Administration turns away from our obligations overseas, will foreign assistance and developing world women be the first casualties of the economic downturn?

This past week I attended a presentation at the Woodrow Wilson Center for International Scholars that highlighted the launching of "Population Forum." Featuring remarks by Robert Engelman, Vice President for Programs at World Watch Institute; Thomas Prugh, editor of World Watch Institute; Sean Peoples of the Woodrow Wilson Center; and PAI's own Vice President of Research, Karen Hardee; the event provided a forum to discuss the magazine's focus on population and why issues such as population growth, age structure and youth bulges have become increasingly relevant to environmental issues.

Already prominent in discussions within national security circles (as demonstrated by PAI's own Shape of Things to Come), demographic characteristics have now become salient for how environmental organizations approach environmental degradation, and efforts to mitigate global climate change. World Watch magazine editor Thomas Prugh, in acknowledging that "the planet faces a range of grave and interlinked challenges" that harbor serious consequences for ignoring population issues, left this question to policymakers: "What should be the response by the developed world?"

Over the last four decades, one of the responses by the U.S. Congress has been to provide funding for voluntary family planning programs overseas - which have succeeded in reducing average fertility rates among developing world married women from about six children per woman to three children. This success is despite a downward trend since 1995 in funding - nearly $100 million -- a 39 percent reduction (when adjusted for inflation) that coincides with President Bush withholding nearly $200 million in funding for the United Nations Population Fund and his Administration's implementation of the Global Gag Rule in 2001.

Fortunately, this past July the U.S. House and Senate Appropriations Committees proposed historic funding increases for these crucial programs, and acknowledged the role that high rate of population growth plays in contributing to "competition for limited resources, environmental degradation, malnutrition, poverty and conflict." While Congress was unable to enact these funding increases in time for the new fiscal year on October 1, the continuing resolution passed ensures that Federal agencies and programs will continue to operate at current levels - possibly until the foreign assistance priorities of the next President are revealed - which, as my colleague Craig Lasher notes, "matters greatly."

These priorities will have a direct bearing on over 200 million women in the developing world, who already want to space or limit their childbearing but live without modern contraception. Having lived among some of these women who lack access to contraception in Togo, West Africa, a country that has lacked a steady USAID presence for years, I've seen what can happen to women in the developing world if either Presidential nominee decides to turn away from family planning programs.

I've seen scores of women seeking contraception, with their babies strapped to their backs, waiting in my village's health clinic from 6 a.m. until nightfall, only to have to return the next day or the day after that, to procure elusive contraception. I've seen girls left off the rolls of school enrollment, married off as children and twice pregnant by 15. I've seen large numbers of young males lacking opportunity - lacking an adequate education to get a job, lacking sufficient land to farm, angry at their government for change - migrating from Togo to feed their young and growing families.

The situation for women and families in Togo and in much of the developing world represents the stark choice in foreign assistance priorities for the next President: does the U.S. expand family planning programs into nations that have high rates of unmet contraceptive need, or does the U.S. scale back family planning assistance, as the U.S. has done with serious consequences in the Philippines and Kenya?

For Republican Presidential nominee John McCain, his recent debate with Senator Barack Obama highlighted his belief to cut spending and institute a "spending freeze" on programs deemed not vital - leaving only entitlement, Veterans Affairs and defense programs unfrozen. Prior to the debate however, Senator McCain stated that a McCain-Palin Administration would give priority to efforts to improve maternal and child health. As family planning is recognized in public health as a crucial element (along with health clinic access and obstetric care) in improving the health of the mother and child - would international family planning programs be spared from Senator McCain's proposed spending freeze?

At the same debate with Senator McCain, Senator Obama stated that due to the financial crisis, as President he would have to prioritize and "eliminate programs that don't work and make sure programs we do have are more efficient and cost less." Senator Obama went on to acknowledge that "there are some programs that are very important that are underfunded." Will U.S. international family planning programs qualify as a program that an Obama-Biden Administration would find additional resources for?

Despite decades of success in creating healthier families and a healthier planet, we in the SR/RH and environmental communities are now left to wait and see whether international family planning programs meet the foreign assistance and funding priorities of the next President. As my Togolese brethren would say, "On verra" - we will see.