“I would like to outlaw contraception. It is disgusting—people using each other for pleasure,” says Joseph Scheidler, national director of the Pro-Life Action League. Some people are obsessed with the “rights” of sperm to fertilize eggs, and with fertilized eggs to implant. Operation Rescue founder Randall Terry says, “I don’t think Christians should use birth control.” In fact, some in the anti-choice movement have attacked fellow activists for not opposing contraception. As University of Dallas Professor Janet Smith says, “It is foolish for pro-lifers to think they can avoid the issue of contraception and sexual irresponsibility and be successful in the fight against abortion.”1
Clearly, their logic is backward: Obviously, the way to eliminate abortion is to eliminate unwanted pregnancy. They should ardently support birth control, but they don’t. Aspiring presidential candidate Rick Santorum says he cannot support availability of the Pill. During a Senate debate intended to minimize contraceptive coverage by insurance plans several years ago, Senator Dick Durbin (D-IL) said, “I was stunned when I came to Congress many years ago to find that the people most vehemently opposed to abortion were equally opposed to contraception. How can that make sense?”2
Other than your partner, and possibly your mother, why would anyone—especially a stranger—care about whether you use a condom, keep emergency contraception (EC) on hand, or have an abortion?
It starts with a belief that the only legitimate purposes of sex are reproduction and marital intimacy. Contraception symbolizes sex for other purposes—that is, pleasure. Thus, an attack on contraception is an attack on sex-for-pleasure. And that’s what the battle over reproductive rights is all about—limiting sex for pleasure.
So forget “pro-life.” Forget “birth control pills cause cancer.” Forget “condoms don’t protect against a broken heart.” Listen to what else the anti-sex “conservatives” are saying:
These are not public health messages. They are the strategic thinking of people trying to control the amount and type of sex that everyone has.
Why everyone? After all, if you think abortion is horrible, don’t get one. If you think an IUD or diaphragm dehumanizes you, don’t use one.
While many Americans believe that whatever two adults do privately is their own private affair, many others disagree. For them, sex is either authorized or unauthorized. And sex is authorized only between legally married heterosexual couples, generally limited to penis-vagina intercourse. The only legitimate reasons for this sex are reproduction and, according to some clergy, strengthening the bond of holy matrimony.3 This means that most Americans are having unauthorized sex. Put another way, most of the sex people have in America is unauthorized, including the sex had by most religious conservatives.4
Those who war on contraception and abortion don’t just want to discourage everyone from having unauthorized sex. They want to prevent it, or at least make it as difficult as possible. They may call themselves pro-life, but they’re really anti-choice. Anti your choice.
Why do these people want all unauthorized sex to stop?
They feel it pollutes their world. Obsessed by unauthorized sex, they feel it degrades everyone, even those not participating in it. They don’t seem to have the psychological tools to ignore what others do behind closed doors.
Because they are attempting to adhere to a very rigid sexual standard, temptation appears everywhere. Understandably, they fear their own (generally rather ordinary) sexual impulses, which they project onto others. Fearing their own sexual decision-making, they mistrust others’. They even talk about “slippery slopes”—that if you think you can “get away” with, say, premarital or extramarital sex, there’s no limit to what else you’ll do.
Ultimately, they characterize sexuality as dirty, and therefore incompatible with spirituality, which they claim is what drives them—and legitimizes their attack on your rights.
American government at the national, state, and local levels has created public policy to discourage unauthorized sex and minimize contraceptive use. This itself is a breathtakingly radical development. The policy isn’t quite perfectly sealed yet: You can still buy condoms in Safeway (although astonishingly, Safeway can’t freely advertise them); most single Americans do have sex (although getting birth control pills and EC is becoming harder for them); and abortion is only legal and accessible for some people some of the time (if you aren’t a teenager, are less than 3 months pregnant, can afford to travel several times, can find and afford a provider, and can stomach the lectures or sonograms you’re forced to endure). But these current parameters aren’t the point.
The point is that our government has decided to care about what you do sexually. Again. This time it isn’t what you do with your eyes, mouth, or imagination, it’s what you do with your genitalia. Your federal and state governments care about what you do with your genitalia way more than they care about what you do with your arms or legs. And they aren’t even honest about the reasons. So let’s examine them.
Here’s another reason some people want to limit or eliminate everyone’s access to contraception and abortion: These technologies enable women to transcend the limited role of mother. Studies from around the world show that such movement is the gateway to more financial and psychological independence.5
Reproductive knowledge and practice has always been part of female folk culture. Birth control techniques have been practiced in virtually all societies, including herbal potions, ritual infanticide, abortion, magic, withdrawal, vaginal inserts, douches, and cervical caps.
The nineteenth-century legal bans against abortion and contraception were introduced partly to eliminate midwives (seen as competition by increasingly professionalizing doctors), and partly to undermine women’s emerging reproductive control. And America’s industrialization and westward expansion led government and religious groups to desire population growth. In 1905, President Theodore Roosevelt attacked birth control and the new trend toward smaller families as decadent, a sign of moral disease—and a dangerous response to the huge influx of immigrants who were “weakening” America’s gene pool.
Fifty years later, the new contraceptive technologies of the mid- and late twentieth century were seen as particularly progressive because they could potentially sever the link between sexuality and reproduction. Shulamith Firestone emphasized this would free women from the “tyranny of reproduction,” which dictated women’s oppression.6
These technical advances were opposed by conservative and religious forces on so-called moral grounds. But their hypocrisy was exposed a few years later. Whereas abortion and contraception challenged the traditional equation of femininity and motherhood, radical new fertility technologies helped fulfill the traditional female role—and were therefore approved by most Christians. Artificial ways of enabling reproduction were OK, whereas artificial ways of preventing it were not.7
As one book put it, “The use of birth control requires a [social] morality that permits the separation of sexual intercourse from procreation, and is related to the extent to which women are valued for roles other than wife and mother.”8 But only a few years after the Pill and Roe v. Wade, it was no longer just contraception that was believed to disrupt the natural connection between mother and conception or fetus, it was the new kinds of artificially aided fertility, with human eggs and embryos moving in and out of a woman’s body, or even from one woman’s body to another. Sperm was being geographically manipulated as well.
Whether surgical, biomedical, or pharmaceutical, who will have access to any new technology, and under what circumstances?9 Some attempt to frame this as a moral or spiritual or health question, but it’s most properly seen as a political question. Perhaps this is more obvious if the question is posed as, “Who shall be allowed to access the Internet in North Korea?” “Who may have a GPS locator in China?” “Which adults shall be allowed to drive a car in Saudi Arabia?”
The war on reproductive rights is carried out in several ways at once. The strategies are:
The churches, civic groups, and government agencies that promulgate these policies and restrict our choices uniformly claim that they care primarily about the disadvantages of various contraceptive/abortion technologies and the personal consequences of their use. And these days, some believe that abortion is morally wrong.
But this is disingenuous. None of the disastrous results they say they’re trying to protect us from are actually supported by science. For example, the idea that abortion leads to depression, infertility, and breast cancer, or that premarital sex leads to depression and suicide, are simply untrue. Scary, but not true. They are as untrue as the idea that the sun revolves around the Earth.
Besides, don’t Americans deserve the chance to evaluate the costs and benefits of their own choices—and aren’t we used to doing so? For example, some people feel flying in planes is dangerous, and so they don’t, while others think its benefits make flying an acceptable risk. The same is true with driving on New Year’s Eve, smoking cigarettes, getting a facelift, and enlisting in the Marines.
Here’s how your reproductive rights are being successfully challenged.
Those who war on sex depend on a simplistic hypothesis repeatedly proven wrong throughout history: that if you increase the risks and dangers of sexual expression, people will stop having sex. This shows such a dramatic lack of insight into their fellow creatures, one could be forgiven for imagining they had never met another human. Fear of AIDS has not prevented Africans from having sex, the risk of capital punishment has not prevented Iranian gays from having sex, and the possibility of unwanted pregnancy has not prevented millions of American teens from having sex.
And yet the fear (no statistics, just fear) of your “promiscuity” is routinely cited as justification for public policy. Examples include withholding access to contraception for teens, and the cancellation of condom distribution in American prisons.
This was the idea the government and Christian conservatives trotted out in attempting to restrict your access to emergency contraception (the “morning after pill” or EC). They said they feared that the drug would lower the risks of sex, thereby encouraging you to have more sex with more partners.
Discouraging such behavior is a function of the family (and church), not the government. Besides, studies show that access to the drug does not increase contraceptive risk taking.10 Unfortunately, this fact (and very positive safety data) has not influenced the anti-sex movement’s desire to discourage access to and use of the drug (for details about the government’s campaign against EC, see “Exiling Emergency Contraception” sidebar, pp. 40–41).
The latest twist in this irrational saga is the development of a vaccine that can prevent HPV—the Right’s favorite STD, because it can lead to cervical cancer. To be effective, the vaccine must be administered before a girl becomes sexually active. Remember, the Right is always pointing to HPV/cervical cancer as a tragedy people should avoid by abstaining from unauthorized sex.11 Then it attacks this medical marvel by claiming, without any data whatsoever, that the vaccine will increase “promiscuity” by reducing the possible consequences of sex. (“That’s OK, Kevin, I’m vaccinated so I can’t get HPV, which can lead to cervical cancer. Come on inside me!”) Thus, they’re against anyone using it.12
And what’s their alternate strategy for unmarried women to avoid getting HPV when they have sex? Unmarried women shouldn’t have sex. This clearly illustrates that they are far less interested in supporting people’s health than they are in controlling our sexual behavior. Their intellectual dishonesty is spectacular.
Although reliable contraception is a modern marvel, waging war on sex requires undermining people’s motivation for using these products and procedures.
Contraceptive information is, of course, systematically withheld from sex education in most American schools—often by explicit requirement. Any young person who develops the habit of using contraception to prevent unwanted pregnancy will have to do so in spite of what he or she learns in school. (For more information, see Chapter 2.)
Anti-sex forces continue to lie about the effectiveness of condoms. After years of urging condom use to prevent HIV, the Centers for Disease Control and Prevention’s (CDC) Web site started doubting their efficacy in 2005, until a firestorm of criticism forced a resumption of scientific information. The following year, the Food and Drug Administration (FDA) proposed requiring labels on condom packages that warn that they are probably less effective against certain STDs, including herpes and HPV, than others.13 President George W. Bush had been lobbying for such condom labeling for years.14
It isn’t only the American government that is willing to lie about condoms to discourage their use. For years, James Dobson (Focus on the Family), Jan LaRue (Concerned Women for America), and many others have been talking about how condoms don’t protect people very well. The Catholic Church’s continuing stance against condoms as being somehow “immoral” extends to its opposition to using them to prevent AIDS. In 2003, the Vatican stirred international controversy with its false claim that the HIV virus can pass through condoms.15
The Right attempts to discourage women from getting legal abortions by making the process so difficult or repulsive that many women just give up. Increasingly, individual states are using techniques such as mandatory waiting periods, forced exposure to photos or ultrasounds, and mandatory, propaganda-filled lectures.16
In 2011, 80 state measures were enacted that restrict access to reproductive health care.17 Thirty-four states require that women receive scripted “counseling” before receiving an abortion, something not required prior to far more dangerous procedures such as plastic surgery or heart bypass surgery. South Dakota requires that a woman be informed that abortion “will terminate the life of a whole, separate, unique, living human being” with whom the woman has “an existing relationship.” Six states require disclosure of a false18 link between abortion and breast cancer. Three others require information on possible psychological impacts of abortion, including straightforward lies19 about suicide and depression. In 2005, three states introduced bills that would require patients to view ultrasounds of their fetus, or “unborn child,” as South Dakota wants to require.20
Twenty-four states currently require a waiting period (typically 24 hours) between counseling and abortion. This necessitates two separate trips to a clinic, an enormous burden for poor women or those responsible for children—especially in states where women have to travel hundreds of miles to get to an abortion provider. Since the passage of Mississippi’s mandatory counseling and waiting period law, abortion rates have fallen, the number of women going out of state for an abortion has risen, and the proportion of second-trimester abortions has increased.21
Mandatory counseling “ignores women’s First Amendment rights to decline to attend anti-abortion lectures,” says Wendy Kaminer at the Atlantic.22 “Think about a similar law that would require pregnant women, or women planning pregnancies, to undergo counseling about the risks of childbirth, the economic costs of raising children, and the possibility that they’ll break your heart.”
Ten states now require women be told that the fetus may feel pain during abortion, and three require anesthesia be offered directly to the fetus. In 2005, bills were introduced in Colorado and West Virginia that would require fetal anesthesia regardless of a patient’s consent or additional risk.23
Kansas now provides grants to organizations that encourage women to carry their pregnancies to term, and prohibits grants to groups that provide abortion. Minnesota has appropriated $5 million to encourage women to carry their pregnancies to term.24
The number of abortion providers in the United States fell from 2,400 in 1992 to 1,793 in 2008,25 while our population increased by 50 million. Meanwhile,
At the same time, fewer and fewer medical residents are receiving training in reproductive health services. Only 20 percent of the nation’s OB-GYN residency programs require first- and second-trimester abortion training. More than a third of chief residents in family practice receive no training to fit a cervical cap, fit a diaphragm, or insert an IUD. In Maryland, 97 percent of family practice residents and 36 percent of OB-GYN residents had no experience in elective termination of pregnancy in the first trimester. Of their family practice residents, half had never inserted an IUD, 43 percent had never inserted an implant, over a third had never prescribed emergency contraceptive pills, 30 percent had never fitted a diaphragm, 90 percent had never fitted a cervical cap, and 83 percent had no experience with tubal sterilization.
The Catholic Church continues to buy hospitals across the United States, and these Catholic hospitals are now the nation’s largest single group of non-profit medical facilities. The Catholic Church operates over 600 hospitals and 1,400 nursing homes, hospices, and clinics, and dozens of health care systems.29
These institutions provide some of America’s finest health care. Their beliefs and regulations about sexuality, however, conflict with the needs of tens of millions of patients. The National Conference of Bishops’ “Ethical and Religious Directives for Catholic Health Care Services” unambiguously forbids:
According to data collected from 597 of these Catholic-run hospitals, only 5 percent of them provided EC on request. An additional 23 percent will provide EC to rape victims, but typically with onerous conditions, which can include pregnancy testing, proving they were raped, and police intervention.30 Over half of Catholic hospitals refuse to offer EC to patients under any circumstances, including rape.31 And only half of the hospitals that don’t offer EC give ER patients a referral elsewhere for EC.32
The refusal of these hospitals to provide normal health care services is particularly onerous as Catholic hospitals buy up secular facilities across America. Of the 127 mergers involving church-run and secular facilities between 1990 and 1998, nearly half resulted in the immediate termination of some or all reproductive services. For example, a Poughkeepsie, New York, hospital ended abortion services after merging with a Catholic hospital, and a Gilroy, California, hospital ended sterilization and contraceptive services after such a merger. As fewer institutions offer reproductive health care, the elimination of a single facility can add hours or even days to the task of getting legitimate services.33
Health care at Catholic colleges is similarly compromised. Of 133 Catholic colleges responding to a 2002 survey, only 16 made contraceptives available to students.34 In 2011, the Association of Catholic Colleges and Universities fought to exempt its members from new federal health care regulations requiring the provision of contraceptive services for students and employees—many of whom are not Catholic.35
Half of the Church’s 600 hospitals are funded by taxpayers—who have a variety of religious beliefs (including 34 million who claim no religion). If Catholic hospitals can accept money from the government, they should be required to provide the standard professional services offered by American medicine. Of course, no patient who rejects sexual health care services is forced to accept them—which should make this simple. Only the politics of religious exceptionalism allows Catholic hospitals to be exempt from the normal rules regulating other government-funded hospitals.
Fetal rights measures have been introduced in every state. They grant a fetus the same rights guaranteed to people in state constitutions. This is critical not only in criminalizing abortion should Roe v. Wade be overturned. It will also figure in battles over the definition of abortion. For example, some legislators, pharmacists, and religious crusaders are calling EC, which prevents pregnancy, an abortion drug. If a fetus has significant legal rights, a legislature could outlaw EC on the grounds that it may harm the fetus. Indeed, a Michigan lawmaker has introduced a bill to ban over-the-counter sales of EC in his state in case the FDA legalizes it.36
In 2004, Congress enacted the Unborn Victims of Violence Act, which calls a fetus a “child in utero” and defines it as a legal victim if he or she is injured or killed during the commission of a federal crime of violence. Thirty-eight states now have “feticide” laws, defining the killing of a pregnant woman as killing two “people.” This language was conspicuous in California’s highly publicized 2004 Scott Peterson “double murder” (Laci Peterson was pregnant) trial.37
Legal recognition of fetuses’ rights is not the same thing as criminalizing abortion—it’s worse. Nor is it the same as declaring when life begins. It’s more pervasive, with a cascade of awful, medieval effects. This is not an incremental change, it is an earth-shaking event counter to every founding document and principle in American history. In essence, law has enshrined beliefs—not facts, beliefs—into legal entities. Law has taken moral and metaphysical beliefs and made them facts.
This can’t be done without compromising the rights of women, whose bodies keep fetuses alive. Mothers are always free to not get abortions, always free to treat their fetuses as if they have legal standing—say, by leaving them money in a will. But giving a fetus legal standing diminishes the rights of the mother in whose body it’s growing. This is a radical step that places an unfair burden on any pregnant woman (and her partner and any other children she has).
As the Feminist Women’s Health Center says, “The life of a fetus cannot be separated from the life of the pregnant woman. [Doing so] is unique in medicine and law. No one can create a set of medical or legal principles giving a right to life to the fetus, because doing so inevitably limits the woman’s rights.”38
And this is no abstraction. Various states are now arresting and even jailing pregnant women for behavior deemed detrimental to their fetuses. The National Advocates for Pregnant Women had to file a federal civil rights challenge to a South Carolina hospital policy of searching pregnant women for evidence of drug use (and giving the information to police).39 Some 300 women have been arrested in South Carolina alone for fetal endangerment.40
The anti-choice movement clearly cares far more for fetuses than for babies, although babies are at least as human as fetuses, thus deserving equal protection. But controlling how people treat already-born babies doesn’t help the religious community in their project of controlling sexuality. So we should not be surprised that Mississippi has the most stringent restrictions on abortion in the country and the highest infant-mortality rate. So much for the moral, “pro-life” culture of which they are so proud.
The “personhood” movement is even more draconian than fetal rights legislation. This movement would give a fertilized egg rights before implantation—which is the way “pregnancy” has been defined for a century. These people actually claim their definition is based on scientific fact, when of course it’s just an arbitrary opinion. After all, many, many fertilized eggs don’t implant, get flushed out of the body, and no one’s the wiser. Shall we mourn each of these?
According to PersonhoodUSA, “The science of fetology in 1973 was not able to prove, as it can now, that a fully human and unique individual exists at the moment of fertilization.”41 A fertilized egg is “fully human”? What exactly does that mean?
“The key to defeating Roe v Wade is Personhood,” their Web site says. They’re right, of course.
In response to the legalization of abortion in 1973, federal and state policymakers started enacting “refusal clauses.” These laws allowed doctors to refuse to perform or assist in abortions, and hospitals to refuse to allow abortions on their premises. It was a creative and effective way to circumvent the new law.42
Since then, refusal clauses have spread to an ever-expanding group of workers and activities—always involving sex. A few years ago, for example, a Wisconsin pharmacist refused to fill, and actually confiscated, a single woman’s prescription for birth control pills. An Illinois ambulance worker refused to transport a patient suffering severe abdominal pain to a clinic for an emergency abortion. Now some hospital workers are refusing to clean surgical instruments or handle paperwork they believe are tied to abortion.43
Medical facilities in every state can now refuse to provide abortions. This creates huge obstacles for women who can’t afford (or aren’t healthy enough) to travel the hundreds of miles now sometimes necessary, not to mention the problem of follow-up care. Many states now protect any institution that refuses to mention EC to women who have been raped.
In Nebraska, The Nebraska Catholic Conference demands that all mental health professionals maintain the right to refuse to treat any client because of religious or moral convictions. Social workers are fighting to insist that the Department of Health and Human Services at least require counselors who refuse to help gay clients to refer them to professionals who will. The Nebraska Catholic Conference, in a clear statement of its lack of human empathy, is resisting.44
In 2010, when enacting health care reform legislation, Congress continued existing religious exemptions from professionalism and ethics by granting refusal rights to the newly formed exchanges—including the right to refuse to refer or give factual information. State laws continue to protect any health care employee who refuses to participate in even the most indirect administration of a procedure to which he or she objects “morally”; in states such as Mississippi, payers of health care are allowed to refuse to cover any service to which they object on moral grounds, which could include sterilization, HIV treatment, STD diagnosis or treatment, contraception, or even prenatal checkups for women who “shouldn’t” be pregnant.45
“Moral grounds.” Today, that’s code for sex. “Morality” hasn’t led pharmacists to demand the right to refuse to fill prescriptions for drugs tested on animals, or drugs whose manufacture pollutes the environment, or drugs that are too expensive for anyone but the wealthy or well-insured, or drugs with awful side effects, or drugs that make children violent or adults submissive zombies. No, “moral grounds” invariably means, “Makes sex safer or more enjoyable.”
Shockingly, most states now allow pharmacists to refuse to fill any legal prescription, and to refuse to refer patients to other pharmacies that will help them. The American Pharmacists Association wants to protect “pharmacists’ rights to not dispense drugs they are opposed to.” The Christian Legal Society’s Center for Law and Religious Freedom says it’s un-American to ask pharmacists to sacrifice their rights for their jobs. The Family Research Council wants the Workplace Religious Freedom Act passed to protect pharmacists’ rights to uphold their “morals” at work.
Pharmacists do not have this “right.” Your Aunt Mabel does—in private. Indeed, pharmacists have the same rights as your Aunt Mabel to withhold, cajole, persuade, and bully in order to shape your behavior—in private.
Pharmacists and pharmacies are licensed by the state to provide health care. As such, they must adhere to standard U.S. medical practices and serve the entire community, regardless of race, ethnicity, age, height, eye color, and shoe size. Or medication requested, or condition it’s designed to treat. That’s the responsibility pharmacists take on in exchange for the privileges of their license. Anyone is free to believe that some people should not have access to certain medications—but acting on this belief disqualifies a person from being a pharmacist.
Imagine a psychotherapist who believes that the state law prohibiting him from having sex with patients conflicts with his sincere moral beliefs. Would we give him federal protection when he sleeps with his patients?
Discrimination is discrimination, whether a pharmacist bases it on your religion or hers. Refusing to sell medication to help an unmarried woman have responsible sex is just as bad as refusing to sell a black family a house in a white neighborhood. Or should people’s religious beliefs allow them to do this, too?
The government’s job is to set standards based on science so that consumers, who can’t possibly evaluate professional competence, are safe. Consumers can then use any criteria they like, including moral values, to decide which medications and procedures to use or avoid. That’s the American promise.
The Bible, while silent on abortion, repeatedly demands humility and compassion. Pharmacists who won’t dispense EC to a woman who has only a few hours left to prevent an unwanted pregnancy need to have their Viagra prescription denied, their blood pressure medication delayed, and their eyeglass prescription confiscated. Since their religion hasn’t taught them compassion, perhaps these experiences would.