Category: History

Medical Caduceus Symbol as Scales with backlight over Wall in dark room.

Gender-Affirming Care, Abortion, and the Politics of Science: A Response to Wuest’s ‘Born this Way’

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By Aziza Ahmed

On August 21, 2023, the 11th Circuit issued a decision that allowed a ban on transgender care to go into effect in Alabama. The Alabama ban, formally called the Alabama Vulnerable Child Compassion and Protection Act, is one of the most extreme of the many bans on gender affirming care. The law defines sex as the “biological state of being female or male, based on sex organs, chromosomes and endogenous hormone profiles…genetically encoded into a person at the moment of conception…” and targets physicians who might undermine this notion of sex with criminal prosecution. Their punishment could be up to ten years in prison.

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SACRAMENTO, CA, U.S.A. - OCTOBER 9, 2021: A mother and child march with Proud Mom and Trans Rights are Human Rights signs during the National Trans Visibility March.

Protecting Trans Children: Scientific Uncertainty and Legal Debates Over Child Custody and Access to Care

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By Marie-Amélie George

A tweet turned Luna Younger’s personal struggle into a national controversy. Using 148 characters, Texas Governor Greg Abbott announced that the Texas Attorney General’s Office and the Texas Department of Family and Protective Services would be investigating the seven-year-old’s family. Prompting his declaration was a jury’s award of custody to Luna’s mother, Anne Georgulas, a pediatrician who supported Luna’s gender transition. A year before the case made its way into court, Luna had asked her parents to call her Luna, rather than her (traditionally male) legal name, to reflect her gender identity. That same year, a therapist diagnosed Luna with gender dysphoria, which is distress from the mismatch between a person’s assigned sex at birth and their gender identity. As a result, medical professionals recommended that Luna be referred to as “she” and be allowed to wear the feminine clothing and keep the long hair that she preferred. Luna’s father, Jeffrey Younger, registered his objection to Luna’s gender identity by shaving her head, even as he allowed Luna’s twin brother to maintain his locks. Georgulas petitioned for an order prohibiting her ex-husband from “engaging in non-affirming behavior and/or taking Luna outside the home as [her birth name], or allowing others to do so.” Jeffrey Younger counterclaimed for sole legal custody.

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Washington, DC, USA - December 1, 2021: Abortion rights rally at the Supreme Court, Jackson Women's Health v. Dobbs.

Biological Determinism, Scientific Uncertainty, and Reproductive Rights

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By Mary Ziegler

As Joanna Wuest writes, the role played by science in the LGBTQ+ movement “is at once a celebratory and cautionary story.” Something similar could be said of struggles over reproductive rights in the half century since the Supreme Court decided Roe v. Wade.

Today, after decades of staying on the sidelines, physicians have once again been at the forefront of struggles over abortion, launching a ballot initiative in Ohio, bringing lawsuits, and speaking against state criminal bans. Physicians’ investment in the struggle — and the scientific arguments they bring to bear — seem like a possible turning point in future struggles over reproductive rights and justice. After all, medical professionals have both special expertise and political capital that could make a difference at a time when disapproval of abortion bans is already high.

But history suggests that arguments based on science have played a far messier role in struggles over reproductive rights. As often as scientific evidence has advanced reproductive rights, abortion foes have used claims about scientific uncertainty to justify new restrictions — and have harnessed claims of biological difference to assert that there is no connection between sex equality and abortion.

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MONTREAL, CANADA -16 AUG 2015- The annual Fierte Montreal parade took place on August 16, 2015 on Boulevard Rene Levesque in Central Montreal. It is the largest Gay Pride in the Francophone world.

“Born This Way,” LGBTQ+ Rights, and the Politics of Uncertainty

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By Joanna Wuest

“Medical uncertainty” is no straightforward matter when it comes to LGBTQ+ health and civil rights. Take for instance the 11th Circuit Court of Appeals 2020 decision striking down a pair of municipal ordinances in Florida that had banned so-called “conversion therapy” for minors (contemporary psychology’s preferred nomenclature is “sexual orientation and gender identity change efforts”). In an enormous blow to the evidence-based notion that such change efforts are harmful — they are indeed responsible for much trauma and death — two Trump-appointed judges declared that the science of sexual orientation and gender identity was much too uncertain to justify the bans. Gesturing to the American Psychiatric Association’s (APA) renowned 1973 removal of homosexuality from its list of disorders, the judges explained that “it is not uncommon for professional organizations to do an about-face in response to new evidence or new attitudes.” Ergo, because the APA had changed its mind once fifty years ago, it may just as easily reverse itself again. According to this view, we may one day wake up to find that mental health professionals have reclassified queerness as a malady to be cured rather than a sense of self to be embraced and protected by law.

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A Professional In Vitro Fertilisation Microscope with A Monitor in Background

Introduction to the Symposium: Reproductive Technologies and Workplace Equality

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By Victoria Hooton and Elizabeth Chloe Romanis

Decisions about whether and how to reproduce are some of the most intimate and personal choices individuals and/or couples can make. For people struggling with involuntary childlessness, attempting to become a parent can involve some particularly complex decision making about technological assistance. Inevitably, these decisions touch upon all aspects of a person’s life. Their employment is no exception. People’s working status and working conditions, set against the broader context of their social circumstances, can have a huge influence on what decisions they feel able to make. This is particularly relevant for people who, for biological, social, or psychosocial reasons, need to use assisted reproductive technologies (ARTs) to reproduce.

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Washington, DC – September 23, 2021: A person walks among the over 681,000 memorial white flags dedicated to each of the COVID Pandemic victims at the National Mall.

Running Cover for Death: Pandemic Minimizers Normalize an Inhumane Baseline

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­­By Nate Holdren

Last week, David Leonhardt took to the pages of the New York Times to celebrate the latest COVID death figures, which he claims mean the U.S. is no longer in a pandemic, because there are no more “excess deaths.”

The hunger for good news is, of course, understandable amid this ongoing nightmare. But to respond to death with “smile everyone, it could have been more deaths!” is grotesque because of the disrespect to the dead and those most affected by the deaths.

It also lets the powerful off the hook, which is Leonhardt’s primary motivation, I assume. In other words, looking for good news is a political position.

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Hands with blue protective nitride gloves holding N95 respirator.

A Patient’s Right to Masked Health Care Providers

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By Katherine A. Macfarlane

In May 2023, Mass General Brigham instructed its patients that they “cannot ask staff members to wear a mask because our policies no longer require it.”

Following patient protests, the hospital updated its policies with an imperfect fix, announcing that “patients can ask, but providers determine when and if masking in a particular situation is clinically necessary.”

This episode highlights the uneasy circumstances that people with disabilities face in the U.S. while accessing essential care: On the one hand, the law surrounding reasonable modifications in health care is well-settled. On the other, the practical reality of U.S. health care leaves little room for individualized accommodation and self-advocating patients vulnerable to retaliation.

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Los Angeles, California / USA - May 28, 2020: People in Downtown Los Angeles protest the brutal Police killing of George Floyd.

Learning from the ‘COVID War’

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By Sam Friedman

Amid an emergent international consensus that the COVID pandemic is “over,” writings about the pandemic and its meanings have burst forth like the flowers of June.

This article will focus on one such book, Lessons from the COVID War: An Investigative Report. Produced by an eminently established collection of people, The COVID Crisis Group. The book is intelligently critical of what was done during the pandemic, but at all points it remains within the confines of what is “politically respectable.” This respectability, I argue, means that their recommendations are too narrow to protect Americans, much less the populations of the Global South, from pandemics ahead (barring unexpectedly marvelous advances in vaccine breadth and rapidity of deployment).

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Fertilized human egg cells dividing.

The Irony of Pro-life Efforts to Grant Embryos Legal Personhood

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By Gerard Letterie and Dov Fox

The overruling of Roe v. Wade has emboldened pro-life lawmakers to confer legal personhood status on early-stage embryos outside of pregnancy as well, including in the context of assisted reproduction. Recognizing embryos as legal persons, it is said, promotes a “culture of life.” And yet treating embryos as persons would actually undermine a promotion of human life, in this critical sense: helping people to have the children they want and are otherwise unable to have.

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Austin, TX, USA - Oct. 2, 2021: Participants at the Women's March rally at the Capitol protest SB 8, Texas' abortion law that effectively bans abortions after six weeks of pregnancy.

The Impact of Criminal Abortion Bans on Assisted Reproduction in the Post-Dobbs Landscape

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By Yvonne Lindgren

In Dobbs v. Jackson Women’s Health, the Supreme Court overruled Roe v. Wade, the constitutional floor that had protected the abortion right for nearly fifty years, and returned the issue of regulating abortion to the states. In the post-Dobbs landscape, thirteen states have banned abortion, either through laws passed after the decision, through trigger laws, or by reviving pre-Roe era abortion bans. As a result of criminalizing abortion, the protective function of medical malpractice law is supplanted by provider and institutional decision-making driven by the imperative to avoid criminal liability and loss of licensure. This essay argues that abortion bans have made all reproductive health care less safe, and that these new pregnancy-related dangers will disproportionately impact assisted reproduction, because those who conceive through assisted reproduction often face a higher risk of complications needing medical intervention, and because women may be reluctant to act as surrogates in light of the heightened risk of pregnancy.

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