Monday, July 29, 2019

India's Transgender Bill Raises Rights Concerns

July 23, 2019 (Human Rights Watch): India's Transgender Bill Raises Rights Concerns:

India's parliament introduced a new bill meant to protect the rights of transgender people on July 19 this year. Human Rights Watch ("HRW"), though, says that the Transgender Persons (Protection of Rights) Bill does not protect certain important rights upheld by India's Supreme Court in 2014--namely, the right of transgender persons to self-identify. 

The human rights organization warns that "even though the bill says that a transgender person 'shall have a right to self-perceived gender identity,' its language could be interpreted to mean transgender people are required to have certain surgeries before legally changing their gender."

Meenakshi Ganguly, the South Asia director at HRW, emphasized that "it's crucial the the law be in line with the Supreme Court's historic ruling on transgender rights." The proposed law, instead, "appears to mandate a two-step process for legal gender recognition," requiring a trans person first to apply for an initial certificate and then to apply for a "change in gender certificate," which many perceive as requiring gender-affirmation surgery along with medical confirmation.

The bill also gives discretion to the district magistrate to determine the "correctness" of the person's application for the certificates yet is silent as to how the decision of "correctness" should be made. 

In 2014, the country's highest court ruled in NALSA v. India that transgender people are a recognized third gender, enjoy all fundamental rights, and are entitled to specific benefits in education and employment. The bill introduced this month does not address whether a trans person holding a male or female gender certificate, though, will have access to the government welfare meant for transgender persons. 

Human Rights Watch further calls out the bill for not only seemingly violating India's Supreme Court holding, but also for violating international standards for gender recognition, which require separation of legal and medical processes of gender reassignment. "Self-declared identity should form the basis for access to all social security measures, benefits, and entitlements."

Notably, the bill also includes intersex persons; HRW calls for the parliament to rename the  bill to make it clear that it includes intersex persons and establish additional explicit protections for intersex persons along with transgender persons.

Other changes parliament should make, HRW says, include: prohibiting medically unnecessary procedures on children, requiring the issuing of legal identity documents to interested persons that identify their preferred gender, and emphasizing training of teachers to "adopt inclusive methods" to ensure transgender or intersex children are not harassed, bullied, or discriminated against. 

Says Ganguly: “To enact a law that meets international standards, it’s critical that parliament fully bring transgender people into the conversation."

July 29, 2019 in International, Politics, Reproductive Health & Safety, Sexuality | Permalink | Comments (0)

Friday, July 26, 2019

Another State Could Soon Insert Anti-Abortion Propaganda Into Public Schools

July 19, 2019 (Rewire.News): Another State Could Soon Insert Anti-Abortion Propaganda Into Public Schools, by Erin Heger: 

Ohio--the only U.S. state without standardized health education--may soon require public schools to focus on the “humanity of the unborn child” in health education curriculum. 

House Bill 90, introduced by the state's GOP legislature, infuses anti-abortion language into health and science materials for students and would restrict schools from providing any abortion-related information or referrals to students facing pregnancy. The legislature aims for school programs to thoroughly detail information about fetuses and gestation, promoting carrying any pregnancy to term.

In 2016, Oklahoma also introduced similar legislation (calling it the "Humanity of the Unborn Child Act"), however it has not yet been implemented in the state due to "budget constraints."

Both HB 90 in Ohio and Oklahoma’s Humanity of the Unborn Child Act state their intended purpose is an “abortion-free society.” However, not informing young people of all their options does little to prevent abortion and instead leaves people not knowing what to do or where to turn when they do face an unintended pregnancy, said Cameron Brewer, an educator with Planned Parenthood Great Plains.

“If we are restricting the information students have access, to then we are doing them a disservice as educators,” Brewer told Rewire.News. “My goal as an educator is to make sure my students have all the information they need to make the best decisions for them.” 

July 26, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Culture, Fetal Rights, Politics, Reproductive Health & Safety, State and Local News, State Legislatures | Permalink | Comments (0)

Thursday, July 25, 2019

Telemedicine Abortion is Safe

July 23, 2019 (Rewire.News): Telemedicine Abortion is Safe, No Matter What Anti-Choice Lawmakers Claim, by Auditi Guha: 

A study released July 9 finds that outcomes for medication-driven abortion through telemedicine are comparable in-person medication abortion.

The results support the importance of telemedicine for reproductive health and safety particularly for those who cannot easily reach abortion clinics due to oppressively-restrictive anti-choice legislation. 

Medication abortion has been legal in the United States for nearly twenty years and is supported by the American College of Obstetrics and Gynecologists, National Abortion Federation, and Planned Parenthood. The procedure uses a combination of mifepristone and misoprostol pills and the telemedicine aspect helps clinicians have a wider reach in authorizing and supervising the process through remote video conferencing.

Telemedicine medication abortions have often been provided in clinics where the licensed clinicians video conference in while the patient is in clinic with nurses or other professionals, but direct-to-patient telemedicine abortion services are growing. Most patients requesting these services live in abortion-hostile states where they cannot easily reach a clinic at all.

The anti-choice movement has responded by working to restrict access to telemedicine abortion as well as in-clinic abortion services. Legal bans or restrictions currently exist in Arkansas, Idaho, Mississippi, and Utah. 

The recent study, though, "indicates that telemedicine abortion is 'a safe and effective way of ending an early pregnancy, with very rare complications' and can provide the same quality of health care patients receive at a health center," according to Dr. Julia Kohn, national director of research at Planned Parenthood Federation of America and the lead author of the study.

Kohn further says: "In many ways, this study does reaffirm what we already know: Medication abortion via telemedicine is safe and effective at ending an early pregnancy."

July 25, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Current Affairs, Medical News, Pregnancy & Childbirth, Pro-Choice Movement, Reproductive Health & Safety, Scholarship and Research, Science, State and Local News, State Legislatures, Women, General | Permalink | Comments (0)

Tuesday, July 9, 2019

Vaginal exams on unconscious, non-consenting patients are legal in 42 states

Jun. 26, 2019 (Vice): Med Students Are Doing Vaginal Exams on Unconscious, Non-Consenting Patients, by Hannah Harris Green: 

For decades, medical students around the country have been expected to perform pelvic exams on unconscious women--not for the patient's benefit but solely for the student's experience. Sometimes these exams are performed multiple times by different students on the same patient. The exams involve a student inserting "two gloved fingers into the patient’s vagina and [placing] one hand on her pelvis in order to feel the uterus and ovaries." This patient is never asked for consent prior to the procedure nor is she informed of the exam afterward.

One former student--now a pediatrician in Baltimore, Maryland--learned of these procedures during his OB/GYN rotation while studying at the University of Pennsylvania Medical School in the 1990s. He refused to participate, joining in a movement to ban the practice. Ari Silver-Isenstadt took a year out of his medical studies to study the ethical implications of this practice at Penn's School of Education. He subsequently published a study in 2003 in the American Journal of Obstetrics and Gynecology that found that over 90 percent of students at the five Pennsylvania medical schools he had focused on had performed vaginal exams on non-consenting, unconscious patients. He noted that students' initial discomfort with the procedure quickly dissipated as it became a regular part of their rotations. 

California became the first state to ban these invasive exams in 2003, the same year of Silver-Isenstadt's study. Since then, Illinois, Virginia, Oregon, Hawaii, Iowa, Utah, and Maryland have followed suit. Additional states that have introduced similar legislation this year include Connecticut, Minnesota, Missouri, Nebraska, New Hampshire, New York, Oklahoma, Washington, and Texas. No federal legislation yet addresses the issue. 

Some medical schools have also banned the practice institutionally as well--like Harvard--but others, including Duke University, consistently ask their medical students to perform pelvic exams sans consent throughout their education. 

While the procedure invades the privacy of any patient, consequences can be particularly severe for patients with a history of sexual trauma who either find out a pelvic exam was performed on them while unconscious or else wake up during the produce, as did Ashely Weitz in 2007.

Weitz said testifying about her experience in support of Utah's law in February was nerve-racking, especially because she expected there to be other women at the hearing at the state house with similar experiences, but she was the only one. Given the nature of these exams, people don’t know if it's happened to them. She said it was “a very healing practice to say 'this shouldn't happen to me, it shouldn't be happening in the way that it is happening in an institution.'” But there are still parts of the incident that she hasn’t recovered from. “It changed the way that I sought and received medical care,” she said. “I was, you know, thereafter very certain that I was never going to be sedated or unconscious in a manner that would have allowed that situation to happen again. So it was in itself very traumatizing.”

Utah's ban on unconscious pelvic exams was signed into law in March of this year. It requires both medical students and doctors to get explicit consent to perform such exams on anesthetized women. A law professor at the University of Illinois, Robin Fretwell Wilson, credited Weitz's testimony as the primary driving force behind the state legislation. 

Wilson herself advocates for requiring specific consent for any pelvic exams. While opponents to legislation requiring consent argue that general consent forms signed upon entering a teaching hospital already cover these exams, Wilson and other advocates for patient protections assert that it is ethically wrong to practice procedures that are of no benefit to the patient without direct consent.

Many advocates, including Weitz, connect the growing opposition to these vaginal exams to the rising tide of the #MeToo movement in recent years. "The #MeToo movement has helped people like Weitz better understand that the violations they endure are part of a wider cultural problem."

Wilson acknowledges that even 10 or 15 years ago, the attitude toward this practice was completely different. "At the time, medical school faculty 'were more than willing to stand their ground and say, "not only do we do it, but the patients in our hospitals have a duty to participate."' . . .  15 years ago, many schools 'did not see it as an issue.'"

Advocates of legal regulations requiring patient consent, though, still fear that enforcement of the new laws will be difficult. "In order for authorities to find out, students would need to both be aware of the law and willing to report wrongdoing by their supervisors, so [Silver-Isenstadt is] hoping the culture is what will ultimately change."

July 9, 2019 in Culture, Medical News, Miscellaneous, Scholarship and Research, State Legislatures, Women, General | Permalink | Comments (0)