By Camila Gianella
Between August and mid-October 2023, media reports documented a string of tragedies: six Peruvian girls between the ages of 10 and 13 were raped by relatives, resulting in unwanted pregnancies. Initially, health workers denied the girls access to abortion, and ultimately one died during labor.
By Wendy E. Parmet, Elaine Marshall & Alisa K. Lincoln
Last June, in Students for Fair Admissions (SFFA), the Supreme Court ruled that universities could not consider race in admitting students. In support of that decision, the Court dismissed the relevance of data about the varied experiences of racial groups, insisting that admissions decisions must be based solely on the experiences and merits of individual applicants. The Court’s rejection of group-level data evinces a critical misunderstanding about the uses and limits of such data that, if applied more broadly, portends troubling implications for health equity and health policy.
By Maayan Sudai
Joanna Wuest’s Born This Way: Science, Citizenship, and Inequality in the American LGBTQ+ Movement describes the evolution of the “born this way” framework through pivotal moments in the history of the LGBTQI+ movement.
A central theme of the book’s analysis is the role that “certainty” and “uncertainty” play in the legitimation of science-based policy regarding sexuality and gender issues. Uncertainty of what might happen has been pitted against LGBTQI+ reforms, from when conservative researchers and practitioners argued the exposure of young children to an openly gay guardian or schoolteacher could be harmful (p.92), to present-day attempts to leverage uncertainty to block trans access to sex-segregated bathrooms, prisons, and shelters (p.181).
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.
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.
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.
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.
By Katherine Macfarlane and Irina Manta
Since fall 2021, when most colleges and universities reopened their campuses to in-person activities, it has become increasingly difficult for faculty and students with disabilities to obtain reasonable accommodations to teach or attend class remotely. Remote accommodations were granted freely during the first year of the COVID-19 pandemic, but in 2021, the in-person aspect of teaching and learning was suddenly deemed essential, and at many institutions, remote classes came to an end. Despite federal disability law’s requirement that each reasonable accommodation request be assessed individually, faculty and students alike were met with bright-line policies that remote teaching and learning were out of the question.
The language and logic used to deny these accommodations at universities across the country was suspiciously similar. We wondered to ourselves whether a memo had been circulated instructing universities about which magic words to employ to deny each accommodation request. But no matter what words are used, across-the-board policies that do not contemplate accommodation-based exceptions and fail to assess accommodation requests on an individual basis do not comply with federal disability law. A recent federal case brought by a high-risk professor against his university employer has recognized these well-settled principles and highlighted the problem with formulaic denials.
By John Tingle
The English National Health Service (NHS) was 75 years of age on 5th July 2023 and there was a lot to celebrate. We are proud of our universal health care system which provides free care at the point of delivery. The NHS is an intrinsic part of our national heritage and culture.
The King’s Fund provide some facts and figures on the NHS. It has one of the world’s largest workforces with around 1.26 million full-time equivalent staff in England, as of November 2022. In terms of patient care and treatment, the King’s Fund states that on an average day in the NHS, more than 1.2 million people attend a general practitioner (GP) appointment, and around 260,000 an outpatient appointment. The NHS faces high demand for finite health care resources. We have a growing elderly population in England presenting often with comorbidities. Staffing levels are also a problem, which is being addressed in the NHS long term workforce plan.
By Jordan Brooks and Tamar Ezer
Expanding access to midwives and doulas in the United States is a vital and often overlooked way to increase access to culturally-congruent birthing options during pregnancy and improve health outcomes for birthing individuals and their children.