Two Reasons I Think Single-Payer HealthCare Needs to Happen

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Warning: Rant coming in 3, 2, 1

There have been times in my life when I have been so f%*king DONE with our country’s convoluted system of healthcare that I wasn’t sure whether to cry, throw myself on the floor and pound my fists until they’re black and blue or scream bloody murder from the highest peak I can find.

I know lots of folks who can relate.

Seriously. Socialized medicine, folks. I mean it.

I know it won’t make everything easy-peasy, simple and clean, but it can’t make things worse.

When I went to college, I was determined to become a pediatrician. That’s all I had wanted to be since I was in elementary school and I could see it happening. I took organic chemistry, cell physiology, medical ethics classes. I struggled with some more than others, but I loved them all. My senior year, I studied for and took the ridiculously long MCAT and spent hundreds of dollars applying to medical schools and then decided to take a year off to work in the field before deciding whether to go ahead and go.

I ended up working for several years as a surgical assistant for a small group of doctors and I learned about the other side: the business of medicine. I hung out with the business manager and discovered how to tweak our diagnosis codes and pore through the (then) printed catalogs of allowed procedures to bill things so they would get paid for. When patients came in for emergency surgery, after the OR was scrubbed of blood and every last instrument was cleaned and put in the sterilizer, we convened for a quick meeting to determine just how to position the procedure to whichever insurance company might be involved so that we could have a higher chance of being paid. This not only determined which codes we used to bill, but it often meant that the doctor had to dictate his notes in a particular way so that, in case the insurance adjuster (not a physician or a nurse in most cases) asked for them, they would fully support the billing we submitted.

During those years, I discovered that if what I truly wanted to do was build relationships with patients that impacted their lives and their health, going to medical school was not the way to do it. As the surgical assistant, I spent more time with the patients than anyone – pre and post-op – and heard about the other things going on in their lives as I changed bandages and removed stitches. The doctors, while they may have liked to have more time to spend with patients, spent the majority of their time maximizing insurance payments by dictating notes, seeing a ridiculous number of patients per day, scheduling back-to-back surgeries to maximize OR usage, and occasionally getting on the phone with an insurance company who was refusing to pay for more than two scalpels or two hours of anesthesia to defend their choices.

Needless to say, I chose not to go to medical school.  And in the next several years, I spent time fighting with insurance companies for a physical therapy business, a dermatologist, and the state mental health division, not to mention myself and my family. I learned just how insurance companies make rules that increase their profits and narrow choices for their customers. I discovered that the high-level relationships that are made between drug companies and major hospital groups and insurers almost never benefit the health or wellness of a customer unless it happens to be in alignment with the bottom line of the companies involved.

A few weeks ago I called a doctor’s office for a family member to get diagnosis and procedure codes for an anticipated surgery. I then called the insurance company armed with information to ask whether these codes were considered covered procedures. After nearly an hour on the phone I came away with a vague answer that included information about the deductible and the potential coverage depending on a number of variables over which we have no control.  If the doctor is “in network” (he is), his services are covered at X%. If the hospital is “in network” (they are), their nursing and OR services are covered at X%, as long as it is a day-surgery. Overnight stays are covered at X-Y%. If the anesthesiologist is “in network” (we have no control over that and no way of knowing until the day of the surgery who that person might be), their services are covered at X%, but if that doctor is “out of network,” services are not covered at all. Not only that, but on “out of network” providers, the amount the patient pays is not applied to the deductible or the out-of-pocket maximums for the year (presumably because we had the audacity to go rogue – even though we have no choice in the matter). There are further decisions about OR supplies (one would think that those would be considered part of the surgery facility charge, but, no, it seems they are billed separately), so if the surgeon chooses a more expensive bandage or stitches, it is likely those won’t be covered at all.  I could go on, but you get the gist.

This morning, I phoned our dentist’s office to discuss a particularly high bill we received and after another hour of talking with them and the insurance company, I was told that Lola’s emergency dental procedure last summer while we were on vacation was not only not covered (out of network), but none of the $500 we paid for it were applied to our deductible (out of network). I calmly asked the representative,

“So, this was literally an emergency. As in, the plane touched down, we stopped at the pharmacy to get pain killers for our daughter, and as soon as we hit the hotel we asked the concierge to recommend a dentist who could see her ASAP (Saturday morning in Hawaii). First of all, does your insurance company have in-network providers in Hawaii? And if so, am I expected to call all of the islands to find one who happens to practice on the weekend and is willing to see my daughter? Is that a thing I should have done?”

“No. It’s not a thing,” he says.

“Explain that to me, please.”

“Was it a medical emergency? Because if it was, you should have run it through your medical claim instead of dental, and then it might have been covered even if it were out of network. But it wasn’t, and it’s too late now. It was processed as out of network and that’s how it’s going to stay. And, no, we don’t have any in-network providers in Hawaii.”

So, ultimately, it’s my fault that I didn’t sell it as a medical emergency? Or is it the dentists’ office fault? The dentist who got up on a Saturday morning and spent three and a half hours with Lola patiently tending to her and then calling us that night to make sure she was ok.

And why wasn’t my out of pocket amount applied to the deductible? Because we went rogue. Because we didn’t follow the rules. Because, if it had been, the insurance company (Premera Blue Cross, btw) would have been on the hook for all the rest of the follow up procedures that have taken place as a result of this situation in the last nine months. But they aren’t, because it all started with us needing dental care somewhere else in a hurry.  When I pointed this out to the representative this was his response:

“Well, you just really want to have your dental emergencies when you’re at home. That’s the best way to do it.”

Duly noted.

Socialized medicine, folks. Single payer. The same rules for everyone.

Health care (even dental care). It’s a basic need.

Talking To Kids About Sex (With Visual Aids)

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This is a response to Elizabeth’s comment on the previous post about sex as a commodity, and I will preface it by saying I wish I had a definitive answer. She asked how I would educate my sons about sex and rape culture if I had sons, and I think it is a particularly salient question. I thought about it in the context of my brothers and my dad, but my teenage years were a different time. Not that there wasn’t a hearty dose of misogyny and male entitlement, but it wasn’t talked about at all, and rarely was it ever challenged.

After puzzling on it for a bit, I went to a source I trust: Lola. As a 13-year old girl who is proficient in social media, steeped in girls’ empowerment, and has a strong, vocal opinion on social justice, I was interested in her ideas about how to talk to teenage boys about rape culture.  She started out by encouraging parents to watch this YouTube video about consent with their kids. All of them, boys and girls, starting at a pretty young age. It’s a pretty powerful analogy and points out just how absurd our ideas about sexual consent are.

I love this video because it doesn’t avoid the idea that a person’s consent status can change at any point. Yes, it is possible for someone to say “yes” and then change their mind, two or five or twenty-five minutes later. And no matter when it happens, it’s valid. I’ve talked to my kids about the concept of the Least Common Denominator (don’t let your eyes glaze over – this has nothing to do with math). That means that the person who is the least comfortable gets to make the rules. The lowest threshold for sexual intimacy is the trump card. So if I really want to have full sexual intercourse but my partner just really wants to make out on the couch, we stop there. Period.

The second point Lola said was important to share with teenage boys is that, even though they may not have personally done anything to make a girl feel uncomfortable, rape culture means that in many situations, we just are.  Even I, in my mid-40s and fairly fit, am always nervous when I get into an elevator with just one other person who is male. Always. That is rape culture. Rape culture is me not feeling comfortable getting into an Uber or a Lyft by myself with a male driver. Chances are, he is a nice guy who will pick me up and take me to the destination I requested without any detours, but rape culture means that I am acutely aware at all times that I lack power – and therefore physical autonomy – until I get out of the car.  And rape culture also means that I often suffer through comments on my physical appearance and speculation about what I might be going out to do (often with lewd body language) and don’t speak up because it might anger the driver and then I’m screwed. Lola said she would want boys to know that these kind of experiences happen daily to girls and women, even if they themselves aren’t perpetuating it. She wondered if they might be willing to imagine what it would be like to be constantly on guard, wondering if the next guy who spoke to you would try to do more than speak.

We ended up having a conversation about street harassment and she cracked me up when she said, “They should know that girls and women don’t get dressed in the morning so that they can go out and get comments on their appearance from total strangers. Ever. That’s not a thing.” Even if guys think it’s totally innocent or a compliment to tell someone how they look, it ultimately makes women and girls feel unsafe simply walking down the street.  This video is a powerful one because it is a small sampling of what many women experience on a daily basis as they go about their business. And the irony is, no matter how she was dressed, if she had been accompanied by a man her age or older, none of that would have happened.  Nobody would have commented on her appearance – some out of fear of the other man, and some out of respect for him. But none of them out of respect for her. And that is rape culture.

The fact is, as I wrote in my last post, in our culture sex is often about power, and those who are born with more power are the ones who often make the rules about sex. Frankly, the most impactful thing I’ve been able to do when I’m having a conversation about sex with my girls is to listen. I like to think that I’m fairly plugged in to pop culture, but I know that there is a lot that goes on that I don’t see. And I’ve discovered that if I listen without judgment, my kids actually first love to shock me with the tales of goings-on in their world, and then feel like they can dig a little deeper and think about how all of it makes them feel.  I have also discovered that talking about sex and sexuality in lots of different ways – commenting when we’re watching a TV show together or when I hear a story on NPR with them in the car, showing them a video like the ones in this post and watching for their reactions, or slipping this letter under someone’s bedroom door – gives us opportunities to continually explore and challenge the ideas we have about sex.

Elizabeth is right. Talking to our kids about sex is incredibly hard. Sometimes they get annoyed and don’t want to talk (or listen). Sometimes I’m not the best at explaining something or helping them understand where I’m coming from. Sometimes I’m not good at listening without judgment. But the most important thing I ever did for my girls was to let them know that I’m willing to keep trying. That they can come talk to me about hard things whenever they want to and that I will bring tough subjects up from time to time and ask them to indulge me. Because if we as parents don’t work to counter the basic themes about sex that our kids get from school and the mass media, nobody will.

Sex and Sexuality: We Can Do Better

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Jon Krakauer’s Missoula: Rape and the Justice System in a College Town
The New England Prep School rape case
Peggy Orenstein’s latest book, Girls & Sex
Sex trafficking rates skyrocketing
The advertising phrase (and perhaps its most bedrock belief) “sex sells”

I could go on, but I think you’ll get the point. I’ve written here many times about rape culture and Sex Ed and I have very, very strong opinions, both as a sex assault survivor and as the mother of two daughters. But more than that, I am concerned for the way our entire culture treats the topic of sex because I think that from a very young age we are taught that sex is, first and foremost, a commodity, and secondly (sadly, a distant second for many, many people), an act of affection and/or love between individuals.

Long before most parents even consider broaching the subject of sex and sexuality with their children, they are bombarded by slick magazine ads, television shows, movies, and books that depict sex as a commodity, as something that we all ought to want and that we can buy our way into. There are many young people who are taught by older children or adults that their sexuality is something that can “buy” affection or special favors. Parents who prostitute their children are not only profiting financially, but they are teaching their children that sex has power and if you want money – or if you have it – you need only sell yourself. Many teenagers, both girls and boys, have a deep understanding of sexual favors – there are those who purchase social capital by giving blow jobs or hand jobs to others and those already in power who cement their status by receiving those favors.

Even if these kids do get “Sex Ed” in school, it is largely mechanical in scope, outlining anatomical features and talking about how pregnancy happens and how to avoid STDs. By the time they are adults, very few of them have an understanding of sex as something that is theirs to define – that they have every right to engage in it with an expectation of pleasure as opposed to some “reward.” Our American notion of “sex” is a very transactional one that is often one-sided. By the time we have the courage to really talk to our kids about sex (if we ever do), there is so much damage to undo that it feels overwhelming. And for children who learn early on, through abuse or sex trafficking, that sex is a tool, it is possible that their fundamental understanding of this act that is supposed to make their lives more whole has been forever damaged. How do you undo the notion that the person with more (power, control, money, status) has the right to obtain sex from the one with less when that is what you are shown in so many different ways over and over, nearly from the time you were born?

When girls are raised with the idea that their power lies in their ability to grant or withhold sex (the most egregious example of this I’ve heard of recently was Spike Lee’s latest movie Chi-Raq), it is damaging to their ability to see sex as something that is more intrinsically rewarding. When they are surrounded by images of women who are sexually provocative and who are praised for it (Kim Kardashian’s nude Instagram photos, anyone?), they are taught that sex is a tool, and that it ought to only look one way or it isn’t right.

When boys are raised with the notion that the more sex they have, the more masculine they are, it is equally damaging. Because, in our culture, they are born with more power at the outset, when they are presented with the idea that sex is a commodity, it isn’t much of a mental leap to imagine taking sex when they want it, simply because they can. When we set sex up to be about power, we can expect rape to follow along shortly. When business lunches are conducted in strip clubs and sex trafficking rates rise sharply during the Super Bowl, you can be sure that we have embraced sex as a commodity.

The question is, are we willing to live with the consequences of that or can we start talking to our young people about what else sex might be, instead?

It’s All Bringing Me Down

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I’m having a hard time remembering to focus on the positive. I spend way too much time following this ridiculous presidential race and it is taking a toll on my attitude. I am like a moth to a flame, flitting around looking for warmth and illumination and banging into the bulb a few times before I remember it’s not real. A day or so later, I do it all over again.

I watched the Democratic debate last Sunday and talked back to the TV screen. The girls rolled their eyes at me and admonished, “they can’t hear you.” I know, but somehow it makes me feel better to counter one candidate’s point with my own response, especially when they don’t call each other on their bullshit.

I am a firm Sanders supporter for a whole host of reasons, and I think he did well in Sunday’s debate, but I have to caution myself that there is no one candidate with whom I will agree on everything. I fell in to that trap with Obama and found myself very disappointed from time to time. I don’t know why I found it so surprising when he made a decision that ran so counter to my beliefs – cabinet appointments and trade agreements and energy policy. I have lived in this world long enough to know that I won’t agree with anyone about everything.

I am so overwhelmed with the negative, though. The news (repeated news) from the Drumpf rallies of physical violence against protestors, both by Secret Service agents and random attendees, is so disheartening. The angry, hateful language that is inspired by all of the GOP candidates and reported with glee by media outlets is a tsunami that washes over my head every day. I heard a teacher say on the radio the other day how hard it is to talk to students about compassion and empathy for each other when the biggest bullies they see are famous for being bullies. These men who are loud and brash and don’t give a damn about anyone but themselves, who are rich and powerful and disregard the rights or feelings of anyone else, whose names show up on TV and the internet all day long every day, they are the antithesis of empathy and compassion. I am used to seeing it in comments online, the trolling, the gas lighting, but to have it showcased from a stage with lights and flags and people clapping is disconcerting to say the least.

At this point, November seems like a very, very long way away. And as I listened to an interview with the head of MSNBC yesterday, defending their decision to fire Melissa Harris-Perry and substitute election coverage for her show’s time slot, I shuddered with a premonition that I hate to even give voice to: that news outlets will get so addicted to ratings that come from covering hateful, yelling politicians that even after the election they will continue to spotlight the negative. Say it isn’t so. It feels as though it has been heading that way for a long time, even before the election really heated up, and I wonder what it might take to interrupt the cycle. I can only hope that MHP finds another forum for her show, one that is committed to entertaining diverse, productive discussions and interesting discourse rather than reality-show-themed shouting and rhetoric.

I am heartened by the voices of those who talk of peace and democracy, and I suppose that is why I am such a fan of Bernie. While he could be seen to be the personification of patriarchy – white, male, older than 50 – his words and actions belie that description. He is, to my mind, more concerned with listening than with speaking. He is not convinced that he has all of the solutions, and his record shows a careful consideration of details and implications, and a distinct lack of interest in intervening heavily in the affairs of other countries to disrupt or “solve” issues that are particular to them. I am reminded that there may be issues about which we disagree, but I think that it is his approach, his entire ethic that excites me and not necessarily the nitty-gritty details.  I am holding out hope that his message will continue to make it through the noise and that those who are willing to pay attention will end up being the ones who make the difference in the end. And, I have come to the conclusion that I have to spend a lot less time listening to the chaos of the mass media if I am to stay optimistic.

Going Down This Road Again

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In light of the most recent Congressional vote to de-fund Planned Parenthood, I would like my response to reflect the same approach I’ve had to this issue for most of my life. Some folks know that about ten years ago I embarked on a project called The Faces of Choice where I endeavored to provide a forum for women to tell their stories regarding difficult or unwanted pregnancies. I wanted to elevate the conversation to include women that chose termination as well as those who didn’t, but nonetheless struggled with the decision (because it is NEVER an easy one). I had hoped to publish these stories as a book and that didn’t work out. I then moved on to creating a website where a community could be established for women who wanted to share their stories and support each other. For a whole host of reasons, that didn’t take off, either. But the website still exists and I write here about why I was so passionate about the work. I know I’m probably preaching to the choir here, but if anyone is on the fence about whether or not it is important to fund the work that organizations like Planned Parenthood does and to stay the hell out of a woman’s private medical decisions, I encourage you to go read it.

Morality Without Religion

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There are so many examples in my life lately of the
power of simple. The more I witness disagreements on social media, the more I
retreat inside to my own quiet authority. Everything from the Kentucky court clerk who refuses to issue same-sex
marriage licenses to arguments about immigration reform and how
we treat US immigrants; refugees desperately fleeing their homeland only to be
shunned in other countries when they reach the shore and the Pope offering absolution for Catholic women who chose
abortion tempt me to enter the fray. And when I sit and think
about why and how, I realize that countering arguments is batting at paper
tigers. 
I am increasingly horrified at the use of religious
writing to prop up acts of selfishness (often couched as “good
policy”) or terror. I am ever more disillusioned with statistics and
studies and numbers that justify treating human beings as problems to be
solved. 
I continue to know in the deepest core of my own
being that there is no external authority – religious text, political or
spiritual leader, or otherwise – that will ever lead me to act in the way that
expresses my best, highest, most human self. If a leader or book encourages me
to get very quiet and still, to look at the photos of the human beings drowning
and starving and fleeing their homes to save their children and really see,
that is something. If I am prompted to read about people who are suffering and
struggling no matter the circumstances or the choices they’ve made, and to open
my heart to them, that is something. Because when I do that, when I acknowledge
the humanity of each and every person on this planet without judgment, without
moving from my heart to my brain that wants to categorize and problem-solve and
blame, I am closer than ever to doing what is right. When I am driven by a
shared humanity as opposed to data or someone else’s interpretation, I am
certain. There are no conflicts, no pros and cons, no licking my fingertip and
flipping back and forth between pages that contain charts or someone else’s
words. The day that I can look upon another being who is suffering and only see
“the bigger picture” is the day that I will have lost myself, my own
internal sense of what is right. 
This doesn’t mean that I don’t disagree with
others, it only means that I wish others could do the same. If Donald Trump and
Jeb Bush and Kim Davis can see before them someone who needs their help and
deny it based on some external notion of what is right and just and moral, I
can’t change that. If soldiers in another part of the world are convinced that
raping and torturing women and children is justified by their religious
beliefs, I can’t change that. I can attempt to speak in the language of
scripture, find citations and passages that call for mercy or implore us to act
out of love. I could consult data and past precedent to counter a politician’s
words, but it is easy to twist words and numbers. It quickly becomes a question
of whose authority or perception is “more real,” and, ultimately, if
I am going to act from a place of certainty and clarity, the source isn’t a
book or a data set. I can only hope that in some quiet moment somewhere, each
of us is able to look within and find a connection, any small spark, that
reminds us that words and prophets are not our true authorities, that at the
end of the day, all we have is our own internal sense of what is real and right
and human, and that to not reach out and help goes against everything that we
are.

Time and time again, we hear stories of people who have had incredible
moments of insight – generally when they thought they were about to die. The
majority of them talk about suddenly realizing what is important, eschewing
external motivators and measurements of success and happiness. Instead they
strive for human connection, more time with family and friends, and a deeper
understanding of themselves. We are all born with a need to be connected to
others on a very basic level and as we move toward independence, we lose
something. I love Dr. Dan Siegel’s idea that instead of raising our children to
be independent, we raise them to be interdependent,
that is, to never forget that we are all connected and rely on each other. That
is the world I want to live in. The world where everyone sees the pictures of
the small boy drowning as he flees for his life and feels an enormous tug on
their heartstrings. A world where that pull of love, of connection, leads us to
talk and think about how to reach out, where we lead with our hearts instead of
our heads, where instead of distancing ourselves from the pain by closing our
eyes or explaining why that could never happen to us, we open further. A world
where we are not driven by numbers and statistics and policies, but where those
things become merely tools as we work to alleviate suffering and create support
instead of walls we build to keep us from listening, from seeing, from feeling.
It is in feeling where I find certainty. I don’t always know where to go from
there, but for me it is always the best place to start.

One (Ex-) Catholic’s Opinion

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I had an entirely different post in mind for today, but I can’t let this one go.

Pope Allows Priests to Forgive Abortion if Women are ‘Contrite’

Being a long-lapsed Catholic, I am not really worried about this for myself. And I admit to having watched this Pope with a significant degree of awe because I feel like he really is being true to his Jesuit roots with regard to many of the decisions he makes and the things he says. I admire his commitment to being a voice for those in poverty and his courage when speaking about climate change. But this, well, perhaps there is something lost in translation, but this makes my blood begin to boil.

“I am well aware of the pressure that has led [women] to this decision. I know that it is an existential and moral ordeal.”

I call bullshit.

With all due respect, you don’t know. You have no idea what a woman who is trying to make a decision like this goes through. And you have no right to assume that you know, especially as the head of the organization that puts many of the roadblocks in her way in the first place (what’s your church’s official position on birth control, again?)

I think that the Pope is trying to do the right thing here, and I can appreciate the sentiment. But the notion that a woman, any woman, needs a man to absolve her for making a private medical decision makes me sick to my stomach. Some folks have commented that priests have no business ‘forgiving’ anyone, that that is God’s job. Others have praised the Pope for his liberal stance on this issue. In the context of the Catholic Church, a horrifyingly patriarchal system in and of itself, I suppose this seemed like a noble thing to offer.  Indeed, devout Catholics can be forgiven for a whole host of sins if they just ask with contrition, regardless of whether they are male or female, but to ask a woman to be contrite for a choice she made that is entirely private is utterly ridiculous. What’s next, you can have birth control if every time you go to pick up your prescription you go straight to confessional afterward and ask for forgiveness?

Asking a woman to be ‘contrite’ is whitewashing the entire set of cultural pressures that Catholic women live under daily. The Pope’s slight nod to the church’s anti-birth control stance (if that is what it was) doesn’t erase the reality for many women around the globe that basically tells them their highest purpose is to get married and procreate and be subservient to their husbands. It ignores the reality that women are the main caregivers of these children and yet are powerless to determine how many of them they are willing to risk their health and life having and give up their careers to raise. It ignores the reality that the only alternative to birth control or abortion is to refuse their husbands, often at their own peril. It ignores the reality that women often have very little control over whether or not they will engage in sex, especially in areas of the world where sexual assault is used as a weapon of war, but that these women are the ones left behind to deal with the consequences of that violation. Are these women to feel ‘contrite?’ Are they to come to the church and beg a powerful male figure for forgiveness because they made a decision that that powerful man who has taken a vow of celibacy could not possibly understand or have the right to judge?

I call bullshit.

Nice try, but it’s time to move along. Perpetuating the idea that a woman’s sexuality either belongs to the church or to her husband is so last-Pope. Don’t even get me started on the fact that abortion isn’t mentioned in the Bible even once…. The bible is a religious text, not a medical one. It has no authority to tell a woman how to make a medical choice, nor to forgive her for making it.

Can We Please Stop Telling Girls and Women to be Polite?

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Sexual assault weighs heavily on my mind of late. Between the former Subway pitchman admitting to child pornography and rape of children, and the New York Times story of ISIS using rape as a strategic tactic, and the trial of a prep school graduate who is alleged to have raped a fellow student as part of a graduation ritual, the news seems saturated with it. I am reading Jon Krakauer’s book on campus rape, “Missoula: Rape and the Justice System in a College Town” at a snail’s pace because the stories give me a stomach ache, both with regard to what the students went through as they were sexually assaulted and the treatment they faced from police officers and prosecutors and school officials, not to mention the perpetrators. As the mother of two daughters, it is increasingly difficult to not see threats around every corner. As a sexual assault survivor, I know all to well the power of such violations and the trails they weave throughout a life.

This morning, I was particularly struck by the article on Jezebel (referenced above) pertaining to the testimony of the alleged victim in the prep school trial. She was quoted as saying,

“I didn’t want to come across as too offensive or rude….I didn’t want to cause conflict,”

 in response to a crude email invitation he sent to her to join him.  In other testimony, she said,

“I tried to be as polite as possible.”
“I wanted to not cause a conflict”
“I feel like I had objected as much as I felt I could at the time. And other than that I felt so powerless”

And while many people have (and will continue to) comment that this girl was stupid, that by making those choices, she clearly wasn’t really objecting to sexual contact with this man (he was over eighteen at the time and she was either 14 or 15), her words resonate with so many women and girls.

To this day, I still wrestle with telling my massage therapist or the dentist that I’m uncomfortable, to go easier, because I don’t want to be rude or tell them how to do their job. Saying it out loud sounds ludicrous, but I was brought up as a compliant Catholic girl who was to always assume that my elders knew what they were doing. I was not to question them or challenge them, but to defer to them and make them feel good. Not only was that the “Right” thing to do, but I quickly learned that it was the best way to get them to like me. It made me the perfect victim of childhood sexual abuse by an older boy. I never said a word. I’m certain that as I lie in his dank, sweat-scented, 17-year-old boy bedroom and he assaulted me multiple times over a period of months, I never cried out, fought back, said no. I know that it was decades before I ever told anyone, and every time I considered it, I saw his mother’s face in my mind and wondered what it would do to her. I saw my own mother’s face in my mind and wondered what impact it might have on her if I told – would she be seen as a horrible mother? Would she think of herself that way? It never occurred to me to ask whether or not anyone would believe me because I wasn’t going to tell – it would disrupt too many lives.  I wasn’t weighing my own life in this equation at all. I had absorbed the messages served up to me by the church and our culture too well. It was more important to be liked than it was to stand up for myself. It was more important to preserve the feelings of someone else (especially if they were older than me or male) than it was to express my own feelings.

Forgive us. And let us learn from this.

Let us teach our children that they can always apologize for being rude, but they can’t ever take back those moments where they didn’t stand up for themselves.

Let us teach our children that they matter as much as everyone else around them, that their opinions and thoughts are just as valid.

Let us teach our children to listen to their gut, to develop that spidey-sense that defies logic and is always right.

Let us teach them that they have a right to draw boundaries, whether anyone else likes it or not.

I have done my level best to help my daughters understand these things. They have been accused of being insolent or rude by some family members for “talking back,” but I’ll take that over being walked on any day. If they ruffle some feathers by being outspoken and opinionated, by refusing to do something they don’t want to do even if it will make someone else happy, I’m okay with that. And I sincerely hope that, with enough practice, if either of them ever finds themselves in a dark room with someone who is determined to overstep their boundaries, these lessons will come back to them and they will say to themselves, “F*ck rude – I said NO!” It is not a silver bullet, but it is something.

I am officially done with the culture that encourages girls to sublimate their own wishes in order to make anyone else feel good.

I am officially done with the culture that encourages boys to find conquests and ignore the wishes of others so that they can make themselves feel good.

It begins here, with a pledge to do better. To teach our girls and boys that they are, first and foremost, human beings deserving of respect, especially by themselves.

Related writings: Campus Rape
10 Things I Want My Daughters to Know About Sex
Rape in the Military

The Culture of Bullying in Reproductive Rights Issues

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Another day, another abortion ban struck down. I am happy to see it happen, but frustrated at the vast sums of money and energy and time that are spent in the effort to keep women from having reproductive freedom in this country. I know it’s been said before, but it is so absurd to me that these resources aren’t directed toward things that would educate and support women and girls instead of punishing them.

I heard a story yesterday about a clinic in Montana that was so severely vandalized a year ago that it had to be shut down. And since the woman who has run the clinic for over thirty years can’t really afford to revive it, women in the Flathead region of that state are forced to drive 120 miles each way to receive care. Not just abortions, but any kind of reproductive health care, because the clinic provided a huge range of services to women in that rural area, like most clinics that are targeted by anti-choice lawmakers and protestors alike.

Toward the end of the story, the reporter noted that the man who destroyed the clinic was sentenced to 20 years in prison – fifteen of them deferred – and forced to pay restitution.  I won’t get into the sentence that was handed down for a variety of reasons, but the notion of restitution was what piqued my interest. So many questions flitted through my head:

  • like squeezing blood from a turnip. I wonder how much money he has, anyway, to pay restitution. Do you suppose it will ever be fully repaid? 
  • restitution to whom? To the clinic owner? To the staff that lost their jobs? To the scores of women whose lives are affected by his act? Does he have to give them gas money to get to Missoula? Does he have to pay child support for all of the babies that were born to mothers who now have no option but to raise them?
  • how do you calculate the proper amount of restitution to compensate for the trauma someone suffers when their life’s work is brutally destroyed? 
As a teenager, I worked in a small-town clinic that provided abortions two days a week. The rest of the time, we provided routine family practice services like treating infections and offering vaccines as well as contraceptives and vasectomies and OB care. Two days a week, the sidewalk was lined with protesters – many of them bused in from the big city 30 miles away. They laid spike strips across the entrance to the driveway, shoved their signs in patients’ faces, yelled and chanted, sang and cried and occasionally threatened both the staff and the patients. One day, as I left work, one of them started to follow me home and I drove around for an hour and finally parked outside the police station until he gave up and drove away.  Twice, the clinic was stink-bombed after hours and once there was a small fire set in the back of the building. The doctor and nurse practitioner wore bulletproof vests to work. My boyfriend begged me to quit. 
Decades later, I continue to be shocked at how blasé people are about these kinds of tactics. I am horrified that an organization could get away with putting together an “expose” on Planned Parenthood, alleging that they sell fetal tissue for profit, be exposed themselves for blatantly lying and creatively editing the footage to show things that never actually happened, and suffer no consequences. There is a vast difference between protected free speech and lying, bullying, in-your-face terror tactics. Make no mistake, these are terror tactics. It is terrifying to go to work and have to cross a line of angry protestors. It was surely terrifying to come to work and see your clinic burning, get death threats in the middle of the night on the phone, watch the protestors laughing and chatting in the quiet moments as they ate their lunches together as if this was just another day at the office.  
The continued legislative attacks on women’s reproductive rights – abortion bans at 20 weeks, at the first sign of a fetal heartbeat, restrictions on contraceptions, the latest bill that would allow employers to fire single women who get pregnant – these things add fuel to the fire of the protestors and the organizations that are adamant that women not be able to control their own bodies. They set up a climate in which it feels normal to tell women how to live their lives. It presents the view that a woman’s health is something to be parsed out by those in power. We will let you have fertility treatments, but not oral contraceptives. We will allow your employer’s insurance to pay for your hospital stay when you have a baby, but not if you have it at home with a midwife. We will pay for your mammogram but not your D&C.  
I have come to the conclusion that there is a culture of bullying that encompasses both right-wing legislators and protestors and everyone in-between who is determined to restrict a woman’s right to control her own body. The same groups of lawmakers continue to craft new bills restricting clinics and imposing time limits on abortion services. Even though the majority of them are ultimately overturned, the time and money that is spent by the target of this abuse is debilitating – a fact I’m sure the perpetrators of this brand of abuse are well aware of. Perhaps if the lawmakers had to pay restitution when their restrictions are deemed unconstitutional,  it would slow them down. What if we acknowledged these repeated efforts to curb reproductive freedom as frivolous and saw them for the bullying tactics that they were and forced those who push them to pay the legal fees for both sides when they lose? At this point, other than the punishments handed down by judges and juries to individuals who are caught vandalizing clinics or harming abortion providers, there is no real consequence for the organizations and politicians who continue to push women of childbearing age around. This is bullying, plain and simple, and until we figure out a way to make it hard for these kinds of laws to be written, we will continue to waste our time and money on taking them to higher courts.  

Listening to Stakeholders

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It is often hard to remember that listening is the best first step to creating solutions, especially when the solutions are not for us, personally. The older I get, the more I understand that listening is truly the best first step in nearly every situation, though, whether it’s meeting someone new, planning a project, walking with a friend.

If we don’t listen, it’s easy to forget that someone else’s perspective might be incredibly valuable.  Last October, Gloria Steinem told this story to a room full of people I was lucky enough to be in.

She had traveled to Africa to attend a summit on sex trafficking with many, many organizations and governmental representatives all gathered together to come up with ways to combat this rising challenge.  During a break in the meetings, she was approached by a woman who asked her to travel with her to a small village where several women had recently been lost to this trade. Gloria was flattered and shocked, unsure of what she could do to help this small village, much less how she would manage to communicate with the villagers, but she went.

She described a scene where a feast was prepared and blankets spread out on the grass, with all of the women in a circle ready to address her.  Translating their concerns was difficult, but they found a way to get their request across – the women of the village wanted elephant fences.  Gloria was confused. What do elephant fences have to do with sex trafficking? The women explained:

The livelihood of this village was largely dependent on growing maize.  Over time, though, as elephant habitats become smaller and smaller, the elephants discovered the fields of maize and came  to the village to feed on them.  This left the village in dire straits – they had not enough maize to feed their own families, much less to sell to others.  It is because of this that three young women traveled to the nearest large city to find work to send home money to support their families. When they arrived in the city, they were kidnapped and sold as sex slaves.  The rest of the villagers reasoned that if they raised the equivalent of a few thousand dollars to erect fences that would prevent the elephants from eating their maize, they could keep their young women from having to leave the village to find work.

Gloria was stunned by this simple solution – one that nobody at her enormous conference would have come up with. She traveled back to the city and worked for several days to raise money to build the fences.   More than that, she demonstrated the power of listening. By traveling to the village to hear the ideas of the people most affected, she was enabling them to empower themselves and helping them find a way to prevent their girls from being sex-trafficked.  It is not a solution for the many, to be sure, but for this village it was monumental. And it cost mere pennies compared to the proposals being raised at this multinational conference, most of which were not preventative solutions, but punitive ones for the traffickers themselves.

I am so often struck remembering this story as I read stories in the news about government agencies or non-profit organizations who are puzzling over potential solutions to poverty, hunger, major health issues, and violence in particular countries or communities. The first question I ask myself these days is whether the folks with the leverage and money to provide help have asked the communities in question for their stories, their ideas, their solutions. Bringing American-style answers to questions that exist in non-western countries may turn out to be wasteful or overkill and it may well be that if one or two people listen to the individuals living with the struggles and ask for their perspective, they can come up with simpler, more comprehensive solutions.

It seems obvious, but it is so easy to get caught up in our own viewpoint and the belief that wanting to help is enough. I do the same thing with my kids all the time, swooping in to offer advice or put into place some new system that I think will fix a pervasive problem in our household without asking them what they think. And, especially when it comes to kids, I think adults do that a lot. I watched my daughters’ middle school revamp their dress code four times in four years, having discussions with staff and administration, parents and board members, but it wasn’t until they listened to the students that they came up with a solution that everyone feels good about. It was a student that got so frustrated she crafted a PowerPoint Presentation to illustrate the issues and potential solutions, and it took a month of student council meetings to come up with a new set of guidelines that has everyone breathing a sigh of relief. Four years (at least). Four years of meetings, research, discussion, fiddling with different ideas, and nobody was happy.

I have a photo of an elephant fence tucked inside my nightstand as a powerful reminder that listening is one of the most effective, efficient things I can do every day. Even if I see my strengths as collaboration and a strong desire to help, it turns out that the best way to do that is by asking the stakeholders what they think, no matter who they are.